Only a few theoretical frameworks have addressed the clustering of symptoms. The Symptom
Management Model proposed by investigators at the University of California-- San Francisco
includes a dimension called the “symptom experience.”2 This dimension comprises the
perception, evaluation, and response to symptoms. While the plural term “symptoms” is used,
explanations and descriptions in the text refer to the singular “symptom” or “primary symptom.”
Symptom clusters are referred to as an area for development and refinement of this model. Dodd
et al .5 and Miaskowski et al.1 have further developed the concept of symptom clusters but it has
not been addressed in the context of the Symptom Management Model.