World J Oncol

World Journal of Oncology, ISSN 1920-4531 print, 1920-454X online, Open Access

Article copyright, the authors; Journal compilation copyright, World J Oncol and Elmer Press Inc

Journal website http://www.wjon.org

Original Article

Volume 2, Number 6, December 2011, pages 281-288

Symptom Clusters in Cancer Patients With Bone Metastases: Subanalysis of Patients Reporting Exclusively Non-zero ESAS Scores

Figure 1. PROC TREE procedure generated dendrogram displaying three cluster solution and cluster hierarchy in 518 patients. Possible one cluster, two cluster and three cluster solutions explained 43.6%, 55.2% and 63.7% of the total variation, respectively.

Figure 2. PROC TREE procedure generated dendrogram displaying two cluster solution and cluster hierarchy in 129 patients with non-zero record at baseline. Possible one and two cluster solutions explained 44.8% and 57.3% of the total variation, respectively.

**Table 1.** Baseline Symptom Clusters in the Total Patient Sample (T) and Non-zero Subgroup (NZ)
Symptom	PCA	EFA	HCA
PCA: Principal Component Analysis; EFA: Exploratory Factor Analysis; HCA: Hierarchical Cluster Analysis.
Symptoms with corresponding symbols indicate they were in the same cluster.
Dash indicates the symptom was not present in any clusters.
Depression	Δ	Δ	Δ	Δ	Δ	Δ
Anxiety	Δ	Δ	Δ	Δ	Δ	Δ
Fatigue	Ο	Ο	Ο	O	Ο	Ο
Drowsiness	Ο	Ο	Ο	O	Ο	Ο
Pain	O	—	Ο	O	O	—
Nausea	X	Δ	Ο	Δ	X	Δ
Poor appetite	X	Δ	Ο	O	X	O
Dyspnea	X	Ο	Ο	O	X	Ο
Poor well-being	O	O	Ο	O	O	O

Table 1. Baseline Symptom Clusters in the Total Patient Sample (T) and Non-zero Subgroup (NZ)

Symptom

PCA

EFA

HCA

PCA: Principal Component Analysis; EFA: Exploratory Factor Analysis; HCA: Hierarchical Cluster Analysis.

Symptoms with corresponding symbols indicate they were in the same cluster.

Dash indicates the symptom was not present in any clusters.

Depression

Anxiety

Fatigue

Drowsiness

Pain

—

Nausea

Poor appetite

Dyspnea

Poor well-being

**Table 2.** Factor Loadings and Final Communality From the Principal Component Analysis of ESAS Symptoms in Non-zero Subgroup at Baseline (n = 129)
Symptom	Component 1	Component 2	Component 3	Final communality
Symptoms with bolded factor loadings were in the same cluster.
Depression	0.84	0.21	0.20	0.79
Nausea	0.75	0.23	-0.12	0.63
Anxiety	0.75	0.26	0.31	0.73
Poor appetite	0.54	0.40	-0.21	0.50
Drowsiness	0.12	0.89	0.06	0.80
Fatigue	0.32	0.73	0.31	0.72
Shortness of breath	0.36	0.63	-0.10	0.54
Sense of well-being	0.50	0.56	0.11	0.58
Pain	0.06	0.07	0.91	0.84
% of variance	47	12	10
Cronbach’s alpha	0.79	0.80	—
Eigenvalue	4.22	1.07	—

Table 2. Factor Loadings and Final Communality From the Principal Component Analysis of ESAS Symptoms in Non-zero Subgroup at Baseline (n = 129)

Symptom

Component 1

Component 2

Component 3

Final communality

Symptoms with bolded factor loadings were in the same cluster.

Depression

0.84

0.21

0.20

0.79

Nausea

0.75

0.23

-0.12

0.63

Anxiety

0.75

0.26

0.31

0.73

Poor appetite

0.54

0.40

-0.21

0.50

Drowsiness

0.12

0.89

0.06

0.80

Fatigue

0.32

0.73

0.31

0.72

Shortness of breath

0.36

0.63

-0.10

0.54

Sense of well-being

0.50

0.56

0.11

0.58

Pain

0.06

0.07

0.91

0.84

% of variance

Cronbach’s alpha

0.79

0.80

—

Eigenvalue

4.22

1.07

—

**Table 3.** Factor Loadings and Final Communality Determined Using Exploratory Factor Analysis in Total Patient Sample at Baseline (n = 518)
	Factor 1	Factor 2	Final communality
Symptoms with bolded factor loadings were in the same cluster.
Drowsiness	0.67	0.20	0.49
Fatigue	0.66	0.23	0.49
Sense of Well-being	0.65	0.36	0.55
Poor Appetite	0.63	0.20	0.44
Pain	0.51	0.14	0.28
Nausea	0.49	0.26	0.31
Shortness of Breath	0.44	0.13	0.21
Depression	0.29	0.89	0.87
Anxiety	0.23	0.69	0.53
% of variance	82.5	17.5
Cronbach’s alpha	0.82	0.81
Eigenvalue	10.73	2.27

Table 3. Factor Loadings and Final Communality Determined Using Exploratory Factor Analysis in Total Patient Sample at Baseline (n = 518)

Factor 1

Factor 2

Final communality

Symptoms with bolded factor loadings were in the same cluster.

Drowsiness

0.67

0.20

0.49

Fatigue

0.66

0.23

0.49

Sense of Well-being

0.65

0.36

0.55

Poor Appetite

0.63

0.20

0.44

Pain

0.51

0.14

0.28

Nausea

0.49

0.26

0.31

Shortness of Breath

0.44

0.13

0.21

Depression

0.29

0.89

0.87

Anxiety

0.23

0.69

0.53

% of variance

82.5

17.5

Cronbach’s alpha

0.82

0.81

Eigenvalue

10.73

2.27

**Table 4.** Factors (Clusters) Determined Using Exploratory Factor Analysis in Non-zero Subgroup at Baseline (n = 129)
	Factor 1	Factor 2	Final communality
Symptoms with bolded factor loadings were in the same cluster.
Drowsiness	0.76	0.18	0.61
Fatigue	0.72	0.34	0.64
Sense of Well-being	0.54	0.43	0.48
Shortness of Breath	0.53	0.30	0.37
Poor Appetite	0.43	0.31	0.28
Pain	0.16	0.14	0.04
Depression	0.25	0.91	0.89
Anxiety	0.36	0.72	0.64
Nausea	0.37	0.48	0.37
% of variance	85.8	14.2
Cronbach’s alpha	0.76	0.80
Eigenvalue	13.86	2.30

Table 4. Factors (Clusters) Determined Using Exploratory Factor Analysis in Non-zero Subgroup at Baseline (n = 129)

Factor 1

Factor 2

Final communality

Symptoms with bolded factor loadings were in the same cluster.

Drowsiness

0.76

0.18

0.61

Fatigue

0.72

0.34

0.64

Sense of Well-being

0.54

0.43

0.48

Shortness of Breath

0.53

0.30

0.37

Poor Appetite

0.43

0.31

0.28

Pain

0.16

0.14

0.04

Depression

0.25

0.91

0.89

Anxiety

0.36

0.72

0.64

Nausea

0.37

0.48

0.37

% of variance

85.8

14.2

Cronbach’s alpha

0.76

0.80

Eigenvalue

13.86

2.30