Psychoneurological Symptom Clusters in Patients with Cancer: A Concept Analysis.

OBJECTIVES: To clarify the concept of psychoneurological (PN) symptom clusters in patients with cancer. METHODS: Walker and Avant's concept analysis method was applied. A comprehensive search of PubMed, Embase, CINAHL, and PsycINFO using PN symptom cluster and other symptom- and cancer-related terms identified 51 records for synthesis. Data on defining attributes, antecedents, empirical referents, and consequences were extracted from each record and analyzed for recurrent themes. RESULTS: The defining attributes of PN symptom clusters in cancer are the co-occurrence of two or more interrelated symptoms spanning at least two of three core domains-affective, somatic, and cognitive-reflecting a multidimensional PN symptom experience. Identified antecedents included biological, psychological, and contextual factors that shape the symptom experience. Consequences included reduced functional and global health-related quality of life. Empirical referents were primarily symptom scores derived from patient-reported outcome measures and used in cluster modeling. CONCLUSIONS: This conceptualization of PN symptom clusters may promote more consistent use of the term across clinical and research settings. IMPLICATIONS FOR NURSING PRACTICE: This analysis underscores the importance of routine screening for co-occurring symptoms across affective, somatic, and cognitive domains throughout cancer treatment and survivorship.