Exploring Core Symptoms and Intersymptom Interrelationships in Patients Undergoing Postoperative Chemotherapy for Colorectal Cancer: A Network Analysis.

OBJECTIVES

This study is a cross-sectional one, aimed at identifying the core and bridge symptoms and exploring the interconnections among common symptoms in postoperative colorectal cancer patients undergoing chemotherapy, using a network analysis approach.

METHODS

From July 2024 to December 2024, 288 patients who underwent postoperative chemotherapy for colorectal cancer at a tertiary care hospital in China were selected as study subjects. The Chinese version of the Anderson Symptom Assessment Scale-Gastrointestinal Module was utilized to investigate the symptomatology. Network analysis of 18 symptoms was conducted via R software. Core symptoms were identified through network centrality indicators, and the interrelationships between symptoms were delineated.

RESULTS

Network analysis indicated that distress exhibited the highest strength, closeness, and betweenness centrality within the symptom network. The pairs of symptoms nausea-vomiting, sadness-distress, and anorexia-altered taste had the strongest intersymptom correlations. Three symptom clusters were extracted: Sensory abnormalities, metabolic disorders, digestive, and neuropsychiatric.

CONCLUSIONS

"Distress" constitutes the core symptom, with digestive and neuropsychiatric symptoms forming the core symptom clusters. Nausea-vomiting exhibited the strongest correlation within the network.

IMPLICATIONS FOR NURSING PRACTICE: Healthcare professionals are advised to devise interventions that target these core symptoms and their interrelationships to facilitate precise symptom management and enhance the efficacy of clinical symptom management.