Symptom clusters after chemoradiotherapy in discharged nasopharyngeal carcinoma patients

Front Oncol. 2023 Jun 14:13:920889. doi: 10.3389/fonc.2023.920889. eCollection 2023.

Abstract

Objective: To investigate the incidence of complications and types of chemoradiotherepy induces symptom clusters in patients with nasopharyngeal carcinoma (NPC) who were first diagnosed after treatment and discharged from hospital.

Methods: After their discharge home, 130 NPC patients who had been treated with chemoradiotherapy were asked to complete a modified Chinese version of the Quality of Life Questionnaire-Head and Neck Module developed by the European Organization for the Research and Treatment of Cancer in the Head and Neck. Symptom clusters in patients were identified through exploratory factor analysis.

Results: The most serious symptoms for discharged NPC patients who had received chemoradiotherapy were dental problems, a sense of obstruction while swallowing, embarrassment in physical contact with family members and friends, difficulty in speaking with others, and embarrassment in public. The six symptom clusters identified through exploratory factor analysis were (1) painful eating, (2) social difficulties, (3) psychological disorders, (4) symptomatic shame, (5) teeth/throat injuries, and (6) sensory abnormalities. The total contribution rate of variance was 65.73%.

Conclusion: NPC patients who are treated with chemoradiotherapy can experience adverse symptom clusters that continue after discharge. Nurses should evaluate the patients' symptoms before discharge and provide targeted health education services which would reduce the patients' complications and improve the quality of life at home. Besides, medical staff should evaluate the complications in a timely and comprehensive manner and provide individualized health education for the affected patients to help them manage chemoradiotherapy side effects.

Keywords: chemoradiotherapy; nasopharyngeal carcinoma; nursing; otorhinolaryngology; symptom clusters.

Grants and funding

Guangxi Key Research and Development Plan (Contract No.: Guike AB16450009, Guike AB1850010). Fund project of Guangxi Health Commission (Contract No.: Z20180753, Z20180752, Z2015686, Z2014218). National Natural Science Foundation of China (Contract No.: 81960186, 81460097). Guangxi Natural Science Foundation (Contract No.: 2017GXNSFAA198013). Guangxi Science and Technology Base and Talent Project (GuiKe-AD20297069).