Network analysis of concurrent symptoms in Patients with lung Cancer during the Intermission of chemotherapy

Abstract Objective To investigate the incidence and severity of symptoms in patients with lung cancer during the intermission of chemotherapy, and to identify the core symptoms and core symptom clusters of patients with lung cancer during the intermission of chemotherapy by using the concurrent symptom network analysis method. Methods : From January 2024 to June 2025, 239 patients with lung cancer during the chemotherapy interval who were treated at Suzhou Municipal Hospital were selected by convenience sampling. The patients were investigated using the Chinese version of the Anderson Symptom Scale. Based on R software, a concurrent symptom association network was established. The characteristic indicators of the network structure were evaluated, and their stability and accuracy were tested. The centrality characteristics of the nodes were analyzed, and the predictability indicators of each node were calculated. Finally, the core symptoms were identified. Results : A total of 249 cases were finally included in this study. The most common symptom was restless sleep (95.18%), and the most serious symptom was forgetfulness (92.37%). Exploratory factor analysis showed that the cumulative variance contribution rate was 61.603%, and three symptom clusters were identified: emotion-functional symptom cluster, multiple somatic symptom cluster, and digestive tract - neurological symptom cluster. The results of symptom network analysis show that the strongest correlations within the symptom clusters are vomiting and numbness (r=0.360), restlessness and distress during sleep (r=0.341), and relationships with others and walking (r=0.317). The strongest connections among symptom clusters were drowsiness and poor appetite (r=0.262). Central index analysis: Drowsiness (EI=1.140) was the core symptom. The symptoms most affected by bridge expectations are sadness, drowsiness and poor appetite (BEI=0.807, 0.805, 0.718). Conclusions : Drowsiness is the core symptom of patients with lung cancer during the intermission of chemotherapy. Nursing staff can identify the symptoms and changes of patients with lung cancer during the intermission of chemotherapy early based on the concurrent network, accurately determine the key intervention targets, and reduce the burden of symptom management for patients with lung cancer during the intermission of chemotherapy.