Relationship between symptom burden and benefit finding in patients with gastrointestinal cancers undergoing...

Patients with gastrointestinal (GI) cancer undergoing chemotherapy frequently exhibit heterogeneous symptom burden, while psychological adaptation may exert differential impacts on benefit finding.

To explore the relationship between symptom burden and benefit finding in GI cancer patients, and to determine whether comprehensive needs and communication pattern play a mediating role in this relationship.

This was a cross-sectional study. The study employed a convenience sampling method to recruit 221 eligible GI cancer patients from the digestive oncology ward of a Tertiary Grade-A Hospital in Qingdao, China between September 2024 and January 2025. Assessments were conducted using the M.D. Anderson Symptom Inventory (MDASI), Comprehensive Needs Assessment Tool in cancer for patient (CNAT), Patient Communication Pattern Scale (PCPS), and the Benefit Finding Scale (BFS). The Cronbach's α coefficients of all scales are all above 0.8, and they are applicable to the Chinese population. The study variables are all continuous variables; data analysis was conducted using descriptive statistics, Pearson correlation, linear regression, and the PROCESS macro.

Pearson correlation analysis showed that in GI cancer patient, there was a significant positive correlation between symptom burden and comprehensive needs (r = 0.512, p < 0.001), a significant negative correlation with communication patterns (r =  - 0.473, p < 0.001) and benefit finding (r =  - 0.520, p < 0.001). Furthermore, the mediation analysis revealed that the total effect of symptom burden on benefit finding was - 0.351. The comprehensive needs and communication pattern served as partial mediators in the influence of symptom burden on the disease benefit. The mediating effects are 33.05% and 15.38%, respectively. The chained mediation effect was - 0.034, representing 9.69% of the total effect.

The comprehensive needs and communication pattern play a chain-mediating role in the relationship between symptom burden and benefit finding. Timely identification of patients' comprehensive needs and optimization of communication pattern undergoing chemotherapy may serve as important targets for psycho-social interventions. These findings suggest that implementing dynamic assessments to monitor evolving patient needs can facilitate the development of precision communication interventions, to mitigate the negative impact of symptom burden on benefit finding.