In the 1990s, the School of Nursing and Health Professions at the University of California, San Francisco (UCSF) began developing symptom management strategies to help individual patients cope with their symptoms and combined these symptom management strategies with behavioural strategies in group settings (Buccheri et al. 1996). Dodd et al. (2001) described symptom management as a dynamic process where management strategies are constantly modified according to factors such as outcomes, people, environment, health and illness. Dodd et al. (2001) divided symptom management into three components: symptom experience, symptom management strategies and symptom outcomes. After ‘identifying their symptoms, patients measure the severity of their symptoms and the effects of their symptoms on their daily lives to further determine whether an active response and management are required. Once they decide to manage their symptoms, patients then determine what management strategies to use and how, when, where, under what conditions and to what extent these management strategies should be employed. After treating their symptoms through these management strategies, patients finally evaluate the effectiveness of the management strategy by considering their physiological function, self-care, economic benefits, quality of life and emotional states. Fatality rates are also considered. The three components of symptom experience, symptom management strategies and symptom outcomes constantly influence each other due to the effects of factors such as people, environments, health and illness, eventually reaching a dynamic balance.