Core symptoms of prostate cancer patients with androgen deprivation therapy and nursing implications: a contemporaneous network analysis
10.3760/cma.j.cn211501-20250322-00878
- VernacularTitle:前列腺癌雄激素剥夺治疗患者核心症状及护理对策:一项同期网络分析
- Author:
Hanxue LIU
1
;
Zhenqi LU
;
Xiaofeng GU
;
Xiaodan ZHU
Author Information
1. 复旦大学附属肿瘤医院护理部 复旦大学上海医学院肿瘤学系,上海 200032
- Publication Type:Journal Article
- Keywords:
Prostatic neoplasms;
Androgen deprivation therapy;
Symptom network;
Core symptoms
- From:
Chinese Journal of Practical Nursing
2025;41(32):2508-2515
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To identify the core symptoms of prostate cancer patients with endocrine therapy by constructed the symptom network, and provide a basis for precise intervention of symptoms management.Methods:In a cross-sectional study, we conveniently sampled patients receiving endocrine therapy for prostate cancer at Fudan University Shanghai Cancer Center between March and August 2018. The Expanded Prostate cancer Index Composite 26-item version (EPIC-26) and the Hospital Anxiety and Depression Scale (HADS) were used to assess symptoms.Symptom networks were constructed, and network indexes and the accuracy and stability of core symptoms were computed based on various packages of R4.3.1. Subgroup network comparison tests were conducted by Prostate-specific antigen (PSA) level, stratifying patients into PSA>0.2 ng/ml and PSA≤0.2 ng/ml groups.Results:A total of 270 questionnaires were distributed, and 261 valid questionnaires were returned, yielding a valid response rate of 96.7%. The included patients were aged 43 - 87(67.81 ± 8.14) years. Symptom network analysis revealed that the core symptom in patients undergoing endocrine therapy for prostate cancer was endocrine disorder ( rs = 1.86, rc = 0.048). However, in the population with PSA ≤ 0.2 ng/ml, depression ( rs = 1.80, rc = 0.028) occupied a more central position. There was no statistically significant difference in the network structure among patients with different PSA levels ( M = 0.294, P = 0.100). But the difference in network strength was statistically significant ( S = 1.15, P<0.05). The strongest associations were observed between depression and anxiety, as well as between endocrine disorder anddepression.The network demonstrated good stability and accuracy,indicating a reliable network model. Conclusions:Endocrine disorder is the core symptom in patients undergoing endocrine therapy for prostate cancer, serving as a critical target for intervention. Special attention should be given to the interconnected effects between endocrine disorder and depression. For the population with PSA ≤ 0.2 ng/ml, negative emotions such as depression still require ongoing focus. In the future, comprehensive interventions centered on psychological support and endocrine symptom management should be implemented for prostate cancer patients receiving endocrine therapy.