Predictors of symptom experience in Korean patients with cancer undergoing chemotherapy

Purpose: This study aimed to investigate symptom experience and identify the predictors of symptom experience in cancer patients undergoing chemotherapy. Method: This study was a cross-sectional and descriptive design. A total of 167 participants were recruited from the outpatient department of a university hospital in South Korea. Symptom experience (symptom prevalence, severity, and interference with daily activities), physiological factors (absolute neutrophil count, hemoglobin), psychological factors (depression, fighting spirit), and a situational factor (social support), based on the Theory of Unpleasant Symptoms, were measured. Descriptive statistics and multiple regression analyses were performed. Results: Symptom prevalence ranged from 74.3% to 98.8% of patients. The five most severe symptoms were fatigue, numbness/tingling, dry mouth, sleep disturbance, and drowsiness. General activity and work were the most affected areas of daily life. Symptom experience was significantly related to hemoglobin, depression, fighting spirit, and social support. In the multiple regression analysis, higher level of depression and lung cancer accounted for 20.2% of the variance in symptom severity. Higher level of depression, lower level of fighting spirit and third or fourth-line chemotherapy accounted for 31.0% of the variance in symptom interference. Conclusions: Attention is drawn to developing a comprehensive approach which considers relevant physiological, psychological and social factors in assessment and management of concurrent symptoms in cancer patients undergoing chemotherapy. Health care professionals need to play a key role in helping patients deal with depressive mood and promote fighting spirit, particularly in patients with lung cancer or patients treated with higher-line chemotherapy, for controlling their symptom experience.