Identify symptom clusters and core symptoms in patients with bladder instillation based on network analysis
10.3969/j.issn.1671-8283.2025.08.003
- VernacularTitle:基于网络分析的膀胱灌注患者症状群及核心症状的识别
- Author:
Wen LI
1
;
Jun QIAO
;
Qiang WANG
;
Tingting PU
;
Mengyan JIANG
;
Liyuan WU
Author Information
1. 贵州医科大学护理学院,贵州 贵阳,550004
- Publication Type:Journal Article
- Keywords:
bladder cancer;
symptom cluster;
core symptom;
network analysis;
cross-sectional study
- From:
Modern Clinical Nursing
2025;24(8):17-22
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the types of symptom clusters in patients with bladder instillation and identify the core symptoms through symptom network analysis,and to provide evidence for symptom management of the patients.Methods Convenience sampling was used to select 226 patients with bladder instillation for bladder cancer at a Tier-IIIA hospital in Guiyang from March 2023 to July 2024.Data were collected through review of medical record,general information questionnaires and symptom assessment questionnaires specific to the patients with bladder instillation.Exploratory factor analysis was used to extract symptom clusters,and symptom relationships were analysed using R language for network layout and centrality calculations.Results A total of 223 patients with bladder cancer completed the survey.Four symptom clusters were identified,namely the urinary system symptom cluster,digestive system symptom cluster,somatic symptom cluster and psychological symptom cluster,with a cumulative variance contribution rate of 66.038%.The symptom network analysis showed strong associations between dysuria and urethral pain during catheterisation,incomplete emptying and dysuria,as well as distress and poor sleep quality.In terms of centrality indicators,the top three symptoms by strength were dysuria(rS=2.26),incomplete emptying(rS=0.99)and poor sleep quality(rS=0.90).Of the expected impacts,the top three were dysuria(rE=2.09),poor sleep quality(rE=1.34)and frequency of urinary(rE=0.55).Regarding the closeness centrality,the top three were dysuria(rC=2.23),incomplete emptying(rC=0.64)and poor sleep quality(rC=0.54).Dysuria had the highest strength,expected impact and closeness centrality,indicating the dysuria was the core symptom in the patients with bladder cancer.Conclusion For the patients with bladder instillation experience,multiple and interconnected symptoms appear at the same time and together they form a symptom clusters,of which the pain in urination is the core symptom.Medical staff should consider symptom prevalence and core symptoms and to develop the targeted and precise management strategies for targeted nursing.
