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Longitudinal study of core symptom clusters in postoperative breast cancer patients undergoing chemotherapy based on network analysis
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Jiayi ZHANG1, Xi ZHANG2, Wanqin TIE1, Lu PAN1, Siyu CHEN1, Qiuyuan SUN1, Meina YANG1
Chinese Nursing Research | 2026, 40(6) : 906 - 915
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Chinese Nursing Research | 2026, 40(6): 906-915
• Original Articles •
Longitudinal study of core symptom clusters in postoperative breast cancer patients undergoing chemotherapy based on network analysis
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Jiayi ZHANG1, Xi ZHANG2, Wanqin TIE1, Lu PAN1, Siyu CHEN1, Qiuyuan SUN1, Meina YANG1
Affiliations
  • 1School of Nursing, Ningxia Medical University, Ningxia 750004 China
  • 2General Hospital of Ningxia Medical University
Published: 2026-03-25 doi: 10.12102/j.issn.1009-6493.2026.06.003
Outline
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Objective

To construct a network model of symptom clusters and quality of life in postoperative breast cancer patients undergoing chemotherapy.To identify the core symptom clusters and the core domains of quality of life,and to determine the predictive relationships between them,thereby providing scientific guidance for improving patients' quality of life.

Methods

A total of 260 breast cancer patients receiving chemotherapy in the oncology department of a tertiary grade A hospital in Yinchuan city were selected as the survey subjects using convenience sampling from May to December 2024.A longitudinal survey was conducted to track their symptoms and quality of life before,during,and after chemotherapy.Data were analyzed using exploratory factor analysis,partial correlation networks,and cross-lagged panel networks.

Results

Exploratory factor analysis and partial correlation network analysis revealed four stable symptom clusters in postoperative breast cancer patients undergoing chemotherapy,namely the sickness behavior symptom cluster,the psychosocial symptom cluster,the body image symptom cluster,and the gastrointestinal symptom cluster.The centrality of fatigue symptoms remained the top five across all three periods(rs1=3.02,rs2=4.21,rs3=4.10).Cross-lagged panel network analysis further indicated that the body image symptom cluster was the core symptom cluster in postoperative breast cancer patients undergoing chemotherapy,and physical well-being was the core domain of quality of life.The body image symptom cluster at the previous time point positively predicted physical well-being at the subsequent time point across the three periods(β=1.24 and β=1.49,respectively).

Conclusions

The core symptom cluster in postoperative breast cancer patients undergoing chemotherapy is the body image symptom cluster.Physical well-being is the core domain of quality of life.The body image symptom cluster positively predicts improvements in quality of life.Healthcare professionals should develop interventions based on core symptom clusters during treatment to reduce the transmission effect of the body image symptom cluster within the symptom network,indirectly promote the improvement of physical well-being,and thereby enhance quality of life.

breast cancer  /  chemotherapy  /  core symptom clusters  /  quality of life  /  network analysis  /  longitudinal study
张嘉怡, 张曦, 铁万琴, 潘璐, 陈思羽, 孙秋圆, 杨妹娜. 基于网络分析的乳腺癌术后化疗病人核心症状群的纵向研究. 护理研究, 2026 , 40 (6) : 906 -915 . DOI: 10.12102/j.issn.1009-6493.2026.06.003
Jiayi ZHANG, Xi ZHANG, Wanqin TIE, Lu PAN, Siyu CHEN, Qiuyuan SUN, Meina YANG. Longitudinal study of core symptom clusters in postoperative breast cancer patients undergoing chemotherapy based on network analysis[J]. Chinese Nursing Research, 2026 , 40 (6) : 906 -915 . DOI: 10.12102/j.issn.1009-6493.2026.06.003
Year 2026 volume 40 Issue 6
50
19
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Article Info
doi: 10.12102/j.issn.1009-6493.2026.06.003
  • Receive Date:2025-03-09
  • Online Date:2026-10-28
  • Published:2026-03-25
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History
  • Received:2025-03-09
  • Revised:2026-02-09
Affiliations
    1School of Nursing, Ningxia Medical University, Ningxia 750004 China
    2General Hospital of Ningxia Medical University

Corresponding:

ZHANG Xi, E-mail:
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表12种不同金属材料的力学参数
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Family
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Number of
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鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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