Symptom, symptom clustering and functional status of 65 years and older cancer patients receiving chemotheraphy

The aim of this descriptive study was to determine the symptoms, symptom clusters and functional status 65 years and older cancer patients undergoing chemotherapy treatment. The study was carried out in the outpatient chemotherapy unit and hematology and oncology inpatient units with 90 patients aged 65 and over who received chemotherapy treatment between September 25th, 2018 and April 30th, 2019. Data was collected with "Introductory Patient Form, Memorial Symptom Assessment Scale (MSAS), Functional Life Scale (Cancer), ECOG and Karnofsky Performans Scale", at the beginning of every cycle for 5 cycles after the 1st cycle. Patients experienced an average of 12.06±4.39 symptoms, the most common symptoms for all cycles were fatigue and dry mouth, in the 1st cycle problems with sexual activity and nausea, in the 2nd, 3rd and 4th cycle hair loss, and numbness in hand and feet in the 5th cycle. As the number of cures increased, symptom frequency, severity and distress found to be increased. Symptom clusters were found as 4 clusters, while "nausea, vomiting, pain, feeling sad, worry, bloating" were stable in each cycle. The mean score of the Karnofsky performance scale for 5 cycles of the patients was 79.1±12.4 (50-100), and the mean score of the ECOG performance scale was 1.36±0.67 (0-3). As the number of cures increased, Functional Life Scale total scores statistically significantly decreased, whereas there was no difference in social function sub-dimension. A negative and statistically significant correlation was found between symptom severity and the physical functions, psychological functions, gastro-intestinal sub-dimensions of Functional Life Scale and total score of Functional Life Scale and between MSAS total scores and Functional Life Scale total scores. For all cycles negative correlation was found between MSAS and Functional Life Scale. As the number of cycles increases the symptom frequency, severity and distress and their functional status deteriorates, close monitoring and support of older adults for symptom management is recommended.