School of Nursing, Southern Medical University, Guangzhou, Guangdong, China.
Nursing Department of Taikang Tongji (Wuhan) Hospital, Wuhan, Hubei, China.
Semin Oncol Nurs. 2024 Jun;40(3):151651. doi: 10.1016/j.soncn.2024.151651. Epub 2024 May 3.
This study aimed to identify symptom clusters in lung cancer patients undergoing chemotherapy and the central and bridge symptoms within each symptom cluster.
In this cross-sectional study, 1,255 patients with lung cancer were recruited through convenience sampling at Nanfang Hospital. Patient symptom burden was assessed using the M.D. Anderson Symptom Inventory (MDASI) and the Lung Cancer module of the MDASI (MDASI-LC). Symptom clusters were identified using the Walktrap algorithm, and central and bridge symptoms in the symptom clusters were identified by network analysis.
The patients included 818 (65.18%) males and 437 (34.82%) females with a mean age of 56.56 ± 11.78 years. Four symptom clusters were identified: fatigue, gastrointestinal, psychoneurological and respiratory. Their central symptoms were fatigue, vomiting, distress and hemoptysis, respectively, and their bridge symptoms were pain, vomiting, dry mouth and shortness of breath.
Lung cancer symptoms show certain strong correlations with each other, resulting in symptom clusters. Central symptoms may influence other symptoms within a symptom cluster, and bridge symptoms might impact the density of the symptom network. This study identified central and bridge symptoms in lung cancer patients undergoing chemotherapy. Targeting these symptoms with interventions for symptom clusters could make symptom management more precise and effective.
In clinical settings, the burden of symptom clusters may be reduced by intervening against the central symptoms of these symptom clusters. Alternatively, if the objective is to diminish the connections between different symptom clusters and holistically alleviate the overall burden, interventions focused on bridge symptoms may be employed.
本研究旨在确定正在接受化疗的肺癌患者的症状群，并确定每个症状群中的中心和桥梁症状。
在这项横断面研究中，通过方便抽样，从南方医院招募了 1255 名肺癌患者。使用 MD 安德森症状量表（MDASI）和 MDASI 肺癌模块（MDASI-LC）评估患者的症状负担。使用 Walktrap 算法确定症状群，通过网络分析确定症状群中的中心和桥梁症状。
患者包括 818 名（65.18%）男性和 437 名（34.82%）女性，平均年龄为 56.56±11.78 岁。确定了四个症状群：疲劳、胃肠道、精神神经和呼吸系统。它们的中心症状分别是疲劳、呕吐、苦恼和咯血，桥梁症状分别是疼痛、呕吐、口干和呼吸急促。
肺癌症状彼此之间存在一定的强相关性，导致症状群的出现。中心症状可能会影响症状群内的其他症状，而桥梁症状可能会影响症状网络的密度。本研究确定了正在接受化疗的肺癌患者的中心和桥梁症状。针对这些症状群中的中心症状进行干预，可能会使症状管理更加精确和有效。
在临床环境中，可以通过干预这些症状群的中心症状来减轻症状群的负担。或者，如果目标是减少不同症状群之间的联系，并全面减轻整体负担，则可以采用针对桥梁症状的干预措施。
