Symptom clusters and their impact on quality of life among Chinese patients with lung cancer: A cross-sectional study

Purpose: To investigate the symptom clusters of Chinese patients with lung cancer, and explore their impact on quality of life (QoL) and each of its functioning.Method: A cross-sectional study was conducted between October 2022 and April 2023 among 219 lung cancer patients at a general hospital in Sichuan Province. Data were collected using a general information questionnaire, the MD Anderson Symptom Inventory, and the EORTC QLQ-C30. R within the RStudio platform was used to conduct descriptive statistics, exploratory factor analysis and multiple regression analysis.Results: Psychoneurological, respiratory, gastrointestinal and fatigue-related symptom clusters were identified, each of which was significantly negatively correlated with overall QoL, global health status/QoL and each functioning. The respiratory (beta = -0.60, P = 0.02) and fatigue-related symptom cluster (beta = -0.86, P = 0.02) were predictors of global health status/QoL; the fatigue-related symptom cluster predicted physical (beta = -1.68, P < 0.01), role (beta = -1.63, P < 0.01) and cognitive functioning (beta = -1.45, P < 0.01); the psychoneurological symptom cluster was a predictor of patients' emotional functioning (beta = -1.26, P < 0.01); and the psychoneurological (beta = -0.81, P < 0.01) and gastrointestinal symptom cluster (beta = -0.60, P = 0.05) predicted social functioning.Conclusions: Respiratory and fatigue-related symptom clusters were strong predictors of global health status/QoL; fatigue-related, psychoneurological and gastrointestinal symptom clusters had a negative impact on patients' functioning. Nurse practitioners should pay more attention to monitoring respiratory and fatigue-related symptom clusters to identify high-risk populations in time, and tailored interventions based on symptom clusters are needed to synergistically reduce the symptom burden, thereby improving patients' QoL.

Automated summary

This study aimed to investigate the symptom clusters of Chinese lung cancer patients and their impact on quality of life and functioning. The study identified psychoneurological, respiratory, gastrointestinal, and fatigue-related symptom clusters that were significantly negatively correlated with overall quality of life and functioning. The respiratory and fatigue-related symptom clusters were strong predictors of overall health status/quality of life, while the fatigue-related, psychoneurological, and gastrointestinal symptom clusters had a negative impact on patients' functioning. Nurse practitioners should closely monitor the respiratory and fatigue-related symptom clusters and implement tailored interventions to reduce the symptom burden and improve patients' quality of life.