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Identification of Core Symptom Cluster in Patients With Digestive Cancer: A Network Analysis
Ke Wang1, Min Diao, Zhaoxia Yang
1Author Affiliations: Department of Nursing, The Second Affiliated Hospital of Shandong First Medical University (Dr Wang, and Mss Diao and Yang), Tai'an City, China; Nursing Education Department, College of Nursing, Imam Abdulrahman Bin Faisal University (Dr Salvador), Dammam, Saudi Arabia; and College of Nursing, Shandong First Medical University (Ms Zhang), Tai'an City, China.
Background:
A lack of identified core symptom clusters in digestive cancer patients hinders achieving precision symptom intervention. There are few studies on identifying digestive cancer symptom clusters based on network analysis.
Objectives:
The aims of this study were to construct the symptom network of digestive cancer patients and identify the core symptom cluster.
Methods:
A cross-sectional study was conducted among 202 digestive cancer patients. The Chinese version of the MD Anderson Symptom Inventory for gastrointestinal cancer scale was used to assess the symptoms by convenience sampling. R software was used to construct a symptom network and identify core symptom clusters. Edge weight and centrality difference tests were used to test the accuracy of core symptom cluster identification.
Results:
The most common symptoms were distress, poor appetite, and sadness. The most serious symptoms were poor appetite, disturbed sleep, and fatigue. The core symptom cluster of the psychoemotional symptom group was distress, sadness, and numbness. The centrality index showed that the top 3 in strength were distress (Rs = 1.11), fatigue (Rs = 1.09), and sadness (Rs = 1.04). The edge weight difference test showed that the psychoemotional symptom group had high stability.
Conclusions:
The psychoemotional symptoms of digestive cancer patients should be given priority for intervention. Network analysis must be extended to the symptom research of cancer patients as soon as possible to provide a scientific basis for symptom management.
Implications For Practice:
Nurses must perform comprehensive psychological and emotional assessments, initiate referrals for psychoemotional symptom management and psychological services, and administer pharmacologic and nonpharmacologic interventions to improve appetite loss in digestive cancer patients.
Insights
Digestive cancer patients
Area of Science:
- Oncology
- Psychosomatic Medicine
- Network Analysis in Healthcare
Background:
- Precision symptom intervention for digestive cancer is limited by a lack of identified core symptom clusters.
- Few studies utilize network analysis to identify symptom clusters in digestive cancer patients.
Purpose of the Study:
- To construct a symptom network for digestive cancer patients.
- To identify the core symptom cluster within this network.
Main Methods:
- Cross-sectional study with 202 digestive cancer patients.
- Utilized the Chinese version of the MD Anderson Symptom Inventory for gastrointestinal cancer scale.
- Employed R software for network construction and core cluster identification, with edge weight and centrality difference tests for accuracy.
Main Results:
- Common symptoms included distress, poor appetite, and sadness; serious symptoms were poor appetite, disturbed sleep, and fatigue.
- The core psychoemotional symptom cluster comprised distress, sadness, and numbness.
- Distress, fatigue, and sadness were the strongest central symptoms, with high stability in the psychoemotional group.
Conclusions:
- Prioritize intervention for psychoemotional symptoms in digestive cancer patients.
- Advocates for extending network analysis to cancer symptom research for evidence-based management.
- Nurses should conduct thorough psychoemotional assessments and interventions, including referrals and pharmacologic/non-pharmacologic treatments for appetite loss.
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