Longitudinal study of core symptom clusters in postoperative breast cancer patients undergoing chemotherapy based on network analysis
ZHANG Jiayi
ZHANG Xi
TIE Wanqin
PAN Lu
CHEN Siyu
SUN Qiuyuan
YANG Meina
Abstract：Objective:To construct a network model of symptom clusters and quality of life in postoperative breast cancer patients undergoing chemotherapy.To identify the core symptom clusters and the core domains of quality of life,and to determine the predictive relationships between them,thereby providing scientific guidance for improving patients'quality of life.Methods:A total of 260 breast cancer patients receiving chemotherapy in the oncology department of a tertiary grade A hospital in Yinchuan city were selected as the survey subjects using convenience sampling from May to December 2024.A longitudinal survey was conducted to track their symptoms and quality of life before,during,and after chemotherapy.Data were analyzed using exploratory factor analysis,partial correlation networks,and cross-lagged panel networks.Results:Exploratory factor analysis and partial correlation network analysis revealed four stable symptom clusters in postoperative breast cancer patients undergoing chemotherapy,namely the sickness behavior symptom cluster,the psychosocial symptom cluster,the body image symptom cluster,and the gastrointestinal symptom cluster.The centrality of fatigue symptoms remained the top five across all three periods(rs1=3.02,rs2=4.21,rs3=4.10).Cross-lagged panel network analysis further indicated that the body image symptom cluster was the core symptom cluster in postoperative breast cancer patients undergoing chemotherapy,and physical well-being was the core domain of quality of life.The body image symptom cluster at the previous time point positively predicted physical well-being at the subsequent time point across the three periods(β=1.24 and β=1.49,respectively).Conclusions:The core symptom cluster in postoperative breast cancer patients undergoing chemotherapy is the body image symptom cluster.Physical well-being is the core domain of quality of life.The body image symptom cluster positively predicts improvements in quality of life.Healthcare professionals should develop interventions based on core symptom clusters during treatment to reduce the transmission effect of the body image symptom cluster within the symptom network,indirectly promote the improvement of physical well-being,and thereby enhance quality of life.
Keywords：breast cancerchemotherapycore symptom clustersquality of lifenetwork analysislongitudinal study
Publication Date：2026-03-25
Online Publishing Date：2026-03-26(First online date of this platform, not the publication date of the document)
Pages：10( 906-915 )