Identification of the Core Nutrition Impact Symptoms Cluster in Patients with Lung Cancer During Chemotherapy: A Symptom Network Analysis

Objectives: Lung cancer patients undergoing chemotherapy are present in multiple Nutrition Impact Symptoms (NIS). There have been no studies utilizing symptom networks to identify core NIS in lung cancer patients undergoing chemotherapy, it is necessary to identify core symptoms for effective and precise symptom management. We aimed to construct a symptom network of NIS in lung cancer patients receiving chemotherapy, and explore the core Nutrition Impact Symptoms cluster.

Methods: A cross-sectional survey was conducted among 315 patients with lung cancer. The Patient-Generated Subjective Global Assessment-Short Form was used to assess the prevalence and severity of NIS. We constructed a symptom network and identified centrality indexes using R packages.

Results: Fatigue emerged as the most prevalent and severe symptom, affecting 87% of participants, with an intensity of 3.0 ± 1.3. The network density was measured at 0.5. Strength centrality showed a stability coefficient of 0.7, with fatigue (Rs = 0.73), lack of appetite (Rs = 1.02), and nausea (Rs = 0.70) ranking as the top three symptoms. For betweenness centrality, the stability coefficient was 0.3, highlighting fatigue (Rb = 12), lack of appetite (Rb = 34), and emotional change (Rb = 18) as the primary symptoms.

Conclusions: This study identified a core symptom cluster consisting of fatigue, lack of appetite, and emotional change. These findings provide valuable insights for developing targeted symptom management strategies and interventions for this patient population in the future.

Implications for nursing practice: Nurses need to comprehensively consider the interaction of multidimensional symptoms to provide lung chemotherapy cancer with targeted symptom management strategies and intervention guidance to reduce the burden of symptoms and improve quality of life.