Longitudinal Subgrouping of Patients With Cancer Based on Symptom Experiences An Integrative Review

PROBLEM IDENTIFICATION: The purpose of this integrative review is to identify literature describing (a) subgrouping patients with cancer based on symptom experiences and their patterns of symptom changes over time and (b) methodologies of subgrouping patients with cancer based on symptom experiences. LITERATURE SEARCH: PubMed (R), CINAHL (R), and PsycINFO (R) were searched through January 2019. DATA EVALUATION: Studies were appraised for patterns of symptom change over time and methodologic approach using the QualSyst quality rating scale. SYNTHESIS: 11 studies met inclusion criteria. Clinical variables that influence symptom patterns were diverse. The most common clustering method was latent variable analysis (73%), and all studies collected symptom data prospectively using survey analysis to assess symptoms. IMPLICATIONS FOR PRACTICE: The majority of studies (91%) observed that the symptom experience within the group of patients with cancer changed over time. Identifying groups of patients with similar symptom experiences is useful to determine which patients need more intensive symptom management over the trajectory of cancer treatment, which is essential to improve symptoms and quality of life.