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.