Study on symptom cluster and core symptoms of esophageal cancer patients discharged from hospital under accelerated rehabilitation surgery mode

Esophageal cancer is a common malignant tumor of the gastrointestinal tract worldwide, and surgery remains the main treatment modality. With the promotion of the enhanced recovery after surgery concept, length of hospital stay has been shortened significantly, but postoperative symptom burden may not be adequately identified and managed due to early discharge. At present, research on the discharge-time symptom clusters and core symptoms among enhanced recovery after surgery-managed esophageal cancer patients is scarce, which hinders the development of precise intervention measures. To investigate the symptom cluster and core symptoms of esophageal cancer patients at discharge under the accelerated rehabilitation surgery model, so as to provide a reference for the formulation of accurate and efficient symptom management scheme. A convenience sampling method was used to select 263 patients with esophageal cancer surgery for investigation. General information questionnaire and esophageal cancer perioperative symptom assessment scale were used. R language was used to construct the synchronous network layout, describe the relationship between symptoms, and calculate the central index. Postoperative esophageal cancer patients under the accelerated rehabilitation surgery model exhibited 3 symptom clusters at discharge: an eating-related symptom cluster, a pain-fatigue symptom cluster, and a somatic-psychological symptom cluster. These accounted for a total variance contribution rate of 67.84%. Weight loss was the most frequently occurring symptom. In the symptom network, fatigue (strength centrality, rs = 2.10) and globus sensation (rs = 2.06) exhibited the highest centrality strengths, indicating they are the most influential symptoms within the network. Under the accelerated rehabilitation surgery model, postoperative esophageal cancer patients face multiple symptom burdens. These symptoms interact to form 3 symptom clusters, with fatigue and globus sensation serving as core symptoms. Healthcare professionals should closely monitor changes in patients' symptoms and integrate symptom clusters with network-centrality indicators. This approach enables targeted and efficient interventions on key symptom clusters and core symptoms, ultimately improving the quality of life for esophageal cancer patients.