Dimensions of symptom distress in women with advanced lung cancer: A factor analysis

OBJECTIVE: To explore the structure of symptom distress in women with advanced lung cancer. DESIGN: Descriptive. SETTING: Oncology clinics and private offices. SUBJECTS: Sixty women with advanced lung cancer (71% non-small-cell); the majority received palliative treatment (88%). OUTCOME MEASURES: Symptom Distress Scale and Karnofsky Performance Status Scale. METHOD: Factor analytic techniques (principal components, varimax rotation) to investigate combinations of all symptoms in the Symptom Distress Scale and combinations of serious symptoms. RESULTS: Fatigue, disruptions in outlook, frequent pain, and difficulties in sleeping were rated the most distressing and were the most prevalent serious disruptions. A four-factor solution for the symptom distress ratings explained 63.3% of the variance and revealed groups of items representing emotional and physical suffering, gastrointestinal distress, respiratory distress, and malaise. Symptoms with a rating of serious distress were represented by five factors with emotional and physical suffering as separate factors. Symptoms were significantly related to Karnofsky Performance Status. CONCLUSIONS: Multiple symptoms formed distinct congregations of distress. Symptom control requires consideration as a multivariate approach.