(13 items) and symptom interference (6 items), revealed three symptom clusters: sickness symptoms; gastro-intestinal symptoms; and, emotional symptoms.19 Walsh and Rybicki7 also reported symptom clusters, in 922 advanced cancer patients, by using a thirty-eight symptoms assessment tool empirically derived from the traditional systems review that routinely is employed in medical history taking. Seven different clusters were identified, including one regarding: fatigue; anorexia-cachexia; neuropsychological; upper gastrointestinal; nausea-vomiting; pain; and, debility. Interestingly, the debility cluster was identified by just two symptoms: edema and confusion.
Since a symptom