| ObjectivesThis study aimed to longitudinally investigate the symptom clusters and quality of life in patients with gastric cancer at three time points in the perioperative period,and explore the effect of the symptom clusters on the quality of life on the basis of the correlation between them,so as to provide a reference for clinical formulation of symptom management measures based on symptom clusters and improvement of the quality of life of gastric cancer patients.MethodsA convenient sampling method was used to select patients from January to September 2021 in the gastrointestinal surgery ward and health care general surgery ward of a grade-A tertiary hospital in Jinan City,Shandong Province.A total of 202 gastric cancer patients were selected as the study subjects.On the 1st day after admission(T1),2-4 days after surgery(T2)and 1 month after surgery(T3),the general information questionnaire was used to collect the general information of the gastric cancer patients(only at T1),MDASI-GI was used to evaluate the symptoms of the patients,and FACT-G was used to evaluate the quality of life of the patients.SPSS26.0 was used for statistical description and analysis,enumeration data were described by frequency and constituent ratio,and measurement data were described by mean and standard deviation.Exploratory factor analysis was used to extract symptom clusters.Repeated measures analysis of variance was used to explore the longitudinal trends of symptom clusters and quality of life.Pearson correlation analysis was used to explore the correlation between the symptom clusters and quality of life.ANOVA and independent sample t-test were used to explore the effect of general information on the quality of life at each time point.Multiple stepwise regression analysis was used to explore the effect of general information and symptom clusters on the quality of life at each time point.Results1.At T1,T2,and T3,gastric cancer patients had 18 symptoms at each time point.The incidence and severity of distress and sadness at T1,pain and fatigue at T2,and fatigue and sadness at T3 were relatively higher.2.There were 3 symptom clusters at T1 and T3 in gastric cancer patients,namely,the digestive tract symptom cluster,the psychological symptom cluster and the energy deficiency symptom cluster.Surgery-related symptom cluster was added at T2,with a total of 4 symptom clusters.3.There were significant differences in the severity scores of symptom clusters(except surgery-related symptom cluster)in patients with gastric cancer at three time points in the perioperative period(all P<0.001),and showed a trend from low to high and then down.There were significant differences in the total scores of quality of life(except social and family status dimension)at three time points(all P<0.001),and showed a trend from high to low and then rising.4.At T1,T2,and T3,the severity scores of each symptom cluster(except the surgery-related symptom cluster)in patients with gastric cancer negatively correlated with the total scores of quality of life(r=-0.249～-0.527,all P<0.01).5.ultiple stepwise regression analysis using the overall quality of life at different time points as the dependent variable showed that the overall quality of life was affected by general information and symptom clusters,among which the digestive tract symptom cluster had a persistent and the most significant effect.ConclusionsGastric cancer patients had a large number of symptoms and a heavy symptom burden at each time pointin in the perioperative period.The symptom clusters at each time point remained relatively stable,while the severity,composition and duration of symptom clusters changed dynamically.Symptom clusters(except surgery-related symptom cluster)negatively correlated with the corresponding overall quality of life,among which the digestive tract symptom cluster had a persistent and the most significant effect.This study suggests that the management of symptom clusters is expected to improve the quality of life of the perioperative gastric cancer patients. |
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