Symptom clusters and core symptoms of Chinese patients with lung cancer: a cross-sectional study

<h2>Abstract</h2><h3>Background</h3> Chinese lung cancer patients experience various cancer-related symptoms during the course of disease, which usually occur as symptom clusters, leading to heavy symptom burden and low quality of life. Identifying symptom cluster and core symptom is conducive to developing symptom management interventions so as to improve health-related outcomes of patients with lung cancer. To investigate the symptom clusters and core symptom of Chinese patients with lung cancer. <h3>Methods</h3> Approved by the ethics committee, a cross-sectional study was conducted at one of the most influential general hospitals in Southwest China. The MD Anderson Symptom Inventory and the revised lung cancer-specific module were utilized to collect symptom experience of patients with lung cancer. R within the RStudio platform was used to conduct descriptive statistics, exploratory factor analysis and network analysis. <h3>Findings</h3> A total of 219 lung cancer patients were recruited. Four symptom clusters were identified as psychoneurological, respiratory, gastrointestinal and fatigue-related symptom clusters, which could explain 59% of the total variance. The results of the symptom severity network analysis revealed that short of breath (r_c= 1.35) was the symptom with the highest closeness score among all symptoms. In the symptom clusters network, short of breath (r_c= 1.35), lack of appetite (r_c= 1.27), fatigue (r_c= 1.04) and feeling drowsy (r_c= 0.82) were the symptoms with the closeness score in the four symptom clusters, respectively. <h3>Interpretation</h3> Chinese lung cancer patients experienced four symptom clusters among lung cancer patients, which highlighted the significance of addressing general symptoms and cancer-specific symptoms in cancer symptom cluster management. The identification of core symptoms offered health care professionals potential interventional targets in future clinical practice in symptom management among patients with lung cancer. Tailored interventions based on symptom clusters are needed to synergistically reduce the symptom burden, thereby improving patients' outcomes.