Robyn Gallagher, Editor
One of the hallmarks of chronic diseases is the presence of multiple symptoms, the severity of which increases as the disease progresses or exacerbation occurs. In chronic disease these symptoms often occur together in a relatively predictable way, yet research persistently focusses on single entities such as breathlessness or pain for example. However, the patient experience is of a cluster of symptoms, and it is this cluster that can impact their lives profoundly. In the study by Almatury et al., the most common clusters of symptoms are identified in patients who have chronic kidney disease and the relative influence of severity, distress and frequency. They found that while some symptoms clustered around distinct aspects of the underlying disease process, such as excess fluid volume, there were other symptoms, such as fatigue, sleep disturbance and restless legs, that were present in several of the clusters. Symptoms did not occur in isolation. This means that clusters of symptoms should not only be assessed comprehensively, and that treatments should aim to by synergistic so that multiple benefits can be experienced. Finally, as patients with chronic disease, as in this study, often have concurrent conditions, treatment of symptom clusters may also benefit patients' experience of other conditions.
Almutary H, Douglas C, Bonner A (2016) Multidimensional symptom clusters: An exploratory factor analysis in advanced chronic kidney disease Journal of Advanced Nursing doi: 10.1111/jan.12997