Sickness behavior clustering in children with cancer

Marilyn J. Hockenberry, Mary C. Hooke, Kathy McCarthy, Mary Ann Gregurich

Research output: Contribution to journalArticlepeer-review

28 Scopus citations


Despite knowing that pediatric cancer patients experience multiple concurrent symptoms, most research focuses on individual symptoms. This study is a secondary data analysis from previous research evaluating symptom clusters and carnitine plasma levels in 67 children and adolescents aged between 7 and 18 years, before and after receiving ifosfamide, doxorubicin, or cisplatin chemotherapy. In preparation for cluster analysis, fatigue, nausea and vomiting, depression, and performance status symptoms were rated in categories of none, mild, moderate, or severe. A conceptual approach was used to evaluate the identification of unique patterns of symptoms that cluster as well as what subgroup members of pediatric oncology patients assemble together. Comparison of symptoms is made with the recent literature on sickness behavior symptoms. The hierarchical agglomerative cluster analysis was used to identify and classify variables into groups based on similarities they possess. This cluster analysis increases awareness of sickness behavior symptoms, patterns, interaction, and synergy. Increasing knowledge of the complex symptom experiences of pediatric oncology patients provides the scientific basis for new directions in symptom intervention.

Original languageEnglish (US)
Pages (from-to)263-272
Number of pages10
JournalJournal of Pediatric Oncology Nursing
Issue number5
StatePublished - Sep 2011

Bibliographical note

Funding Information:
The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This research project was funded by the Alex’s Lemonade Stand Foundation.


  • adolescents
  • cancer
  • children
  • sickness behavior
  • symptom clusters


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