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Features and Differences in Core Symptom Clusters in Home-Based Hospice Patients With Advanced Cancer: A Network
Yitao Wei1, Wan Cheng1, Yuanfeng Lu1
1School of Nursing, Fujian Medical University, Fuzhou, China.
Introduction:
Patients with terminal-stage cancer frequently experience multiple symptoms simultaneously. Little is known about how core symptom clusters differ in advanced-cancer patients with different survival expectancies receiving hospice care. To identify the core symptom clusters of hospice-care cancer patients with different survival expectancies and compare the features of their symptom networks.
Methods:
In this retrospective study, secondary data analysis was conducted. Records of 6946 patients with advanced cancer who received home-based hospice care service in a hospice center from April 2001 to December 2020 were collected and analyzed using network analysis.
Results:
This analysis included 6946 patients with advanced cancer receiving hospice care. In patients with survival expectancies of 0-6 months, loss of appetite was identified as the core symptom (rs = 4.03, rb = 5.21, rc = 2.63), and five symptom clusters were identified. Malnutrition was the core symptom in patients with survival expectancies of 6-12 months (rs = 2.83, rb = 2.43, rc = 0.93), and nine symptom clusters were identified. Wasting syndrome was the core symptom cluster in two groups. The network density of symptoms in patients with < 6 months of survival expectancy (91.99) was higher than in patients with 6-12 months (28.39).
Conclusions:
Nutrition impact symptoms are the core symptoms for home-hospice care cancer patients with a survival period of 1 year or below. Moreover, hospice cancer patients with short survival expectancies have greater inter-symptom impact.
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