A network analysis and nursing implications of core symptoms and symptom clusters in head and neck cancer patients
Objective To investigate the prevalence and severity of symptoms and to construct symptom networks in head and neck cancer patients during treatment to identify core symptoms and symptom clusters.Methods 366 patients who were hospitalized in 3 tertiary hospitals in Changsha were selected using convenience sampling from March to October 2022 and asked to complete the M.D.Anderson Symptom Inventory-Head & Neck.Exploratory factors analysis was used to extract the symptom clusters,and R packages were used to construct the symptom severity network and symptom clusters network.The centrality indexes of the networks,including strength,closeness,and betweenness,were analyzed to identify core symptoms and core symptom cluster.Results The most common symptoms in head and neck cancer patients during treatment were dry mouth(93.44%),fatigue(89.07%),loss of appetite(86.34%),and difficulty swallowing or chewing(85.79%),and the most severe symptoms were dry mouth,loss of appetite,oral or pharyngeal mucus,and difficulty swallowing or chewing.4 symptom clusters were extracted,namely oral-pharyngeal,gastrointestinal,emotional-sleep,and sickness-sensing behavioral,which could explain 67.415%of the total variance.In the symptom severity network,oral or pharyngeal mucus(rs=9.60)was a symptom with the highest strength.In the symptom clusters network,oral or pharyngeal mucus(rs=1.20),nausea(rs=1.00),fatigue(rs=1.10),and drowsiness(rs=0.97)were the symptoms with the highest strength across 4 symptom clusters.Conclusion Oral or pharyngeal mucus,nausea,fatigue,and drowsiness are the core symptoms of symptom clusters in head and neck cancer patients during treatment.Oral-pharyngeal symptom cluster is the core symptom cluster.It is recommended that clinical staff should develop interventions based on the core symptoms and symptom cluster to implement precise symptom management and improve symptom management efficiency.
Head and Neck CancerCore SymptomsSymptom ClustersNetwork AnalysisNursing Care