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

Katrien Moens, Richard J. Siegert, Steve Taylor, Eve Namisango, Richard Harding, Lucy Selman, Godfrey Agupio, Natalya Dinat, Julia Downing, Liz Gwyther, Thandi Mashao, Keletso Mmoledi, Tony Moll, Lydia M. Sebuyira, Barbara Ikin, Irene J. Higginson, Lieve Van Den Block, Zeger De Groote, Sarah Brearley, Augusto CaraceniJoachim Cohen, Anneke L. Francke, Stein Kaasa, Karen Linden, Guido Miccinesi, Bregje Onwuteaka-Philipsen, Koen Pardon, Roeline Pasman, Sophie Pautex, Sheila Payne, Deliens Luc

Research output: Contribution to journalArticlepeer-review

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

Original languageEnglish
Article numbere0126554
JournalPLoS One
Volume10
Issue number5
DOIs
Publication statusPublished - May 12 2015

ASJC Scopus subject areas

  • Agricultural and Biological Sciences(all)
  • Biochemistry, Genetics and Molecular Biology(all)
  • Medicine(all)

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