Symptom experience in patients with gynaecological cancers: the development of symptom clusters through patient narratives

The aim of the study was to explore the interplay between the physical and psychological symptom experience in patients with gynaecological cancer undergoing radiotherapy and/or chemotherapy and strategies they used to self-manage these symptoms. The study collected qualitative longitudinal data over four assessment points. Thirty nine interview data sets from ten participants were analysed. Participants had a mean age of 62.8 years, and five had ovarian cancer. A key theme was the strong inter-relationship between the physical and psychological symptoms experienced by patients. Symptoms seemed to co-occur, highlighting the presence of symptom clusters, complicating the patients’ symptom experience. Complex physical and psychological links emerged particularly in relation to fatigue, hair loss, weight gain and peripheral neuropathies. While some complementary and self-management approaches were used to manage symptoms, few options and interventions were discussed. The findings provide evidence that patients with gynaecological cancer experience complex symptoms with little formal support to manage them, which highlights the need for a more thorough patient support and has implications for the physiological, psychological, sociocultural and behavioural components of the symptom experience essential for effective symptom management.