Symptom clusters in people living with HIV attending five palliative care facilities in two sub-Saharan African countries:A hierarchical cluster analysis

Moens, Katrien and Siegert, Richard J. and Taylor, Steve and Namisango, Eve and Harding, Richard and Selman, Lucy and Agupio, Godfrey and Dinat, Natalya and Downing, Julia and Gwyther, Liz and Mashao, Thandi and Mmoledi, Keletso and Moll, Tony and Sebuyira, Lydia M. and Ikin, Barbara and Higginson, Irene J. and Van Den Block, Lieve and De Groote, Zeger and Brearley, Sarah and Caraceni, Augusto and Cohen, Joachim and Francke, Anneke L. and Kaasa, Stein and Linden, Karen and Miccinesi, Guido and Onwuteaka-Philipsen, Bregje and Pardon, Koen and Pasman, Roeline and Pautex, Sophie and Payne, Sheila and Luc, Deliens (2015) Symptom clusters in people living with HIV attending five palliative care facilities in two sub-Saharan African countries:A hierarchical cluster analysis. PLoS ONE, 10 (5). ISSN 1932-6203

Full text not available from this repository.

Abstract

Background: Symptom research across conditions has historically focused on single symptoms, and the burden of multiple symptoms and their interactions has been relatively neglected especially in people living with HIV. Symptom cluster studies are required to set priorities in treatment planning, and to lessen the total symptom burden. This study aimed to identify and compare symptom clusters among people living with HIV attending five palliative care facilities in two sub-Saharan African countries. Methods: Data from cross-sectional self-report of seven-day symptom prevalence on the 32-item Memorial Symptom Assessment Scale-Short Form were used. A hierarchical cluster analysis was conducted using Ward's method applying squared Euclidean Distance as the similarity measure to determine the clusters. Contingency tables, X2 tests and ANOVA were used to compare the clusters by patient specific characteristics and distress scores. Results: Among the sample (N=217) the mean age was 36.5 (SD 9.0), 73.2% were female, and 49.1% were on antiretroviral therapy (ART). The cluster analysis produced five symptom clusters identified as: 1) dermatological; 2) generalised anxiety and elimination; 3) social and image; 4) persistently present; and 5) a gastrointestinal-related symptom cluster. The patients in the first three symptom clusters reported the highest physical and psychological distress scores. Patient characteristics varied significantly across the five clusters by functional status (worst functional physical status in cluster one, p<0.001); being on ART (highest proportions for clusters two and three, p=0.012); global distress (F=26.8, p<0.001), physical distress (F=36.3, p<0.001) and psychological distress subscale (F=21.8, p<0.001) (all subscales worst for cluster one, best for cluster four). Conclusions: The greatest burden is associated with cluster one, and should be prioritised in clinical management. Further symptom cluster research in people living with HIV with longitudinally collected symptom data to test cluster stability and identify common symptom trajectories is recommended.

Item Type: Journal Article
Journal or Publication Title: PLoS ONE
Uncontrolled Keywords: /dk/atira/pure/subjectarea/asjc/2700
Subjects:
Departments: Faculty of Health and Medicine
Faculty of Health and Medicine > Health Research
ID Code: 129733
Deposited By: ep_importer_pure
Deposited On: 22 Jun 2019 08:52
Refereed?: Yes
Published?: Published
Last Modified: 03 Oct 2019 09:58
URI: https://eprints.lancs.ac.uk/id/eprint/129733

Actions (login required)

View Item View Item