Symptom Clusters and Their Impact on Spiritual Well-Being Among Women with Breast Cancer

Figures & data

Table 1 Demographic and Clinical Characteristics of the Sample (N, 142)

Characteristics	Mean (SD)	Range
Age (years)	48.30 (10.07)	26–74
Symptom occurrence	11.46 (7.68)	0–27
FACIT-Sp^a Total	37.52 (7.54)	16–48
FACIT-Sp^a meaning and peace subscale	22.54 (6.66)	3–32
FACIT-Sp^a faith subscale	14.98 (1.74)	8–16
	Categories	n (%)
Marital status	Married	108 (76.1%)
	Non-Married	34 (23.9%)
Education	Primary/Secondary	84 (59.1%)
	College/university	58 (40.9%)
Employment status	Employed	18 (12.7%)
	Not employed	123 (86.6%)
Disease progress	Newly diagnosed	9 (6.3%)
	Treatment phase	80 (56.3%)
	Remission phase	38 (26.8%)
	Hospice phase	15 (10.6%)
Breast cancer stages	0–2	53 (37.3%)
	3–4	48 (33.8%)
Treatment type	Surgery	1 (0.7%)
	Chemotherapy	84 (59.2%)
	Radiation therapy	6 (4.2%)
	I am not receiving treatment	41 (28.9%)
	Other	9 (6.3%)
Complementary therapy	Yes	40 (28.2%)
	No	102 (71.8%)
Received spiritual support during hospitalization	Yes	8 (5.6%)
	No	134 (94.4%)
Received psychological support during hospitalization	Yes	17 (12%)
	No	125 (88%)

Abbreviation: FACIT-Sp^a, Functional Assessment of Chronic Illness-Spiritual Well-being.

Table 2 Most Frequently Reported Symptoms with Associated Levels of Reported Severity

Symptom	Occurrence n (%)	Severity Mean ± SD
Concentration	59 (41.5%)	2.54 ± 0.79
Tension	80 (56.3%)	2.79 ± 0.80
Sadness	65 (45.8%)	2.80 ± 0.94
Anxiety	86 (60.6%)	2.85 ± 0.80
Body image “I don’t look like myself.”	36 (25.4%)	2.94 ± 0.79
Fatigue	92 (64.8%)	3.12 ± 0.86
Numbness	63 (44.4%)	2.75 ± 0.80
Vertigo	60 (42.3%)	2.41 ± 0.72
Pain	77 (54.2%)	2.65 ± 0.85
Insomnia	59 (41.5%)	2.75 ± 0.84
Xerostomia	65 (45.8%)	2.64 ± 0.82
Nausea	48 (33.8%)	2.55 ± 0.79
Dysgeusia	56 (39.4%)	2.68 ± 0.83
Loss of appetite	59 (41.5%)	2.56 ± 0.74
Weight loss	36 (25.4%)	2.27 ± 0.83
Peripheral edema	31 (21.8%)	2.39 ± 0.84
Sweat	39 (27.5%)	2.74 ± 0.91
Itching	40 (28.2%)	2.53 ± 0.84
Oral ulcer	29 (20.4%)	2.45 ± 0.91
Hair loss	52 (36.6%)	2.25 ± 0.76
Skin color change	37 (26.1%)	2.51 ± 0.87
Bloating	35 (24.6%)	2.49 ± 0.81
Constipation	41 (28.9%)	2.46 ± 0.71
Muscle weakness	63 (44.4%)	2.82 ± 0.87
Hot flashes	58 (40.8%)	2.71 ± 0.83
Forgetfulness	52 (36.6%)	2.67 ± 0.81

Note: Only symptoms with the occurrence of 20% and above were included.

Table 3 Symptom Clusters Present in Women with Breast Cancer

Symptoms	Pattern Coefficients				Structure Coefficients
	Factor 1 Treatment-related SC	Factor 2 Gastrointestinal SC	Factor 3 Psychological SC	Factor 4	Treatment-Related SC	Gastrointestinal SC	Psychological SC	Factor 4
Muscle weakness	0.817				0.766
Fatigue	0.727				0.763
Bloating	0.665				0.618
Change in color of skin	0.628				0.658
Hot flashes	0.524				0.522
Forgetfulness	0.494				0.673
Numbness	0.468				0.575
Peripheral edema	0.424				0.514
Oral ulcers		0.801				0.687
Dysgeusia		0.716				0.733
Xerostomia		0.646				0.769
Constipation		0.581				0.598
Nausea		0.579				0.551
Loss of appetite		0.418				0.556
Weight loss		0.398				0.425
Anxiety			0.789				0.672
Tension			0.749				0.754
Sadness			0.720				0.759
Concentration			0.496				0.608
Insomnia			0.409				0.558
Sweat				0.528				0.583
Hair loss				0.469				0.265
Body image				0.433				0.515
Pain				0.377				0.551
Cronbach’s Alpha	0.846	0.806	0.802	0.438
Variance explained (%)	30.20	8.43	6.62	5.92

Abbreviation: SC, Symptom Cluster.

Table 4 Predictors of Spiritual Well-Being Using Multiple Linear Regression (N, 142)

Predictors	Spiritual Well-Being
	b	Beta	t
Severity of treatment-related SC	0.031	0.032	0.294
Severity of Gastrointestinal SC	0.024	0.020	0.194
Severity of psychological SC	−0.403	−0.296	−3.049**
Age	0.014	0.019	0.224
Education (school vs college or university)	1.010	0.066	0.788
Marital status (married vs single)	−1.943	−0.110	−1.333
Disease progress	0.499	0.051	0.602
Use of complementary therapy	3.278	0.196	2.363*

Notes: *p < 0.05, **p < 0.01. Dependent Variable: FACIT-Sp total score (R, 0.393; R2, 0.155; F, 3.020; p < 0.01).

Abbreviation: FACIT-Sp, Functional Assessment of Chronic Illness-Spiritual Well-being.