Journal Article

Symptom clusters and network analysis of patients with intermediate and advanced liver cancer treated with targeted immunotherapy

Jin, Guangzhi, He, Yalun, Li, Shan, Chen, Mei, Qi, Zhi, Li, Rui

2024

Overview

Background This study aims to identify symptom clusters in patients with intermediate and advanced liver cancer receiving targeted immunotherapy, focusing on core and bridge symptoms to establish a foundation for precise symptom management. Methods This study used a cross-sectional survey and utilized convenience sampling from May 2023 to January 2024 at a third-class hospital in Shanghai, China. The severity of symptoms in liver cancer patients during treatment was evaluated using the Memorial Symptom Assessment Scale. Network analysis was employed to depict the interrelation of symptom clusters and identify core and bridge symptoms. Results The symptoms were classified by severity into five clusters: oral, gastrointestinal, fatigue-related, body image, and pain-sleep. Within the symptom network, the core symptoms were pain, “I don’t look like myself,” and nausea, while the critical bridge symptoms included pain, itching, and feeling bloated. The strongest connections were observed between nausea and vomiting, followed by taste changes and dry mouth, as well as weight loss and “I don’t look like myself.” Conclusion In patients receiving targeted immunotherapy for intermediate and advanced liver cancer, multiple symptoms can emerge simultaneously, forming interconnected clusters. By identifying and intervening in core and bridge symptoms, personalized management strategies can be developed to relieve other symptoms and disrupt connections between symptom clusters, thereby enhancing symptom management efficacy. This study has significant clinical and research implications, offering new insights to improve patients’ quality of life and treatment outcomes.

• Publisher: Springer Berlin Heidelberg,Springer,Springer Nature B.V
• Subject: Adult / Aged / Analysis / Body image / Cancer / Cancer patients / China / Clinical outcomes / Clinical research / Clustering / Cross-Sectional Studies / Drug therapy / Efficacy / Female / Humans / Immunotherapy / Immunotherapy - methods / Liver cancer / Liver Neoplasms - therapy / Male / Management / Medical treatment / Medicine / Medicine & Public Health / Middle Aged / Multiple symptoms / Nausea / Network analysis / Nursing / Nursing Research / Oncology / Oncology, Experimental / Oral diseases / Pain / Pain Medicine / Patients / Pruritus / Quality of Life / Rehabilitation Medicine / Sampling / Severity of Illness Index / Side effects / Strategic planning (Business) / Surveys / Surveys and Questionnaires / Symptom Assessment - methods / Symptom management / Taste disorders / Terminal illnesses / Treatment outcomes / Vomiting / Weight loss