Symptom clusters and their impact on quality of life among Chinese patients with lung cancer: A cross-sectional study

Purpose: To investigate the symptom clusters of Chinese patients with lung cancer, and explore their impact on quality of life (QoL) and each of its functioning.Method: A cross-sectional study was conducted between October 2022 and April 2023 among 219 lung cancer patients at a general hospital in Sichuan Province. Data were collected using a general information questionnaire, the MD Anderson Symptom Inventory, and the EORTC QLQ-C30. R within the RStudio platform was used to conduct descriptive statistics, exploratory factor analysis and multiple regression analysis.Results: Psychoneurological, respiratory, gastrointestinal and fatigue-related symptom clusters were identified, each of which was significantly negatively correlated with overall QoL, global health status/QoL and each functioning. The respiratory (beta = -0.60, P = 0.02) and fatigue-related symptom cluster (beta = -0.86, P = 0.02) were predictors of global health status/QoL; the fatigue-related symptom cluster predicted physical (beta = -1.68, P < 0.01), role (beta = -1.63, P < 0.01) and cognitive functioning (beta = -1.45, P < 0.01); the psychoneurological symptom cluster was a predictor of patients' emotional functioning (beta = -1.26, P < 0.01); and the psychoneurological (beta = -0.81, P < 0.01) and gastrointestinal symptom cluster (beta = -0.60, P = 0.05) predicted social functioning.Conclusions: Respiratory and fatigue-related symptom clusters were strong predictors of global health status/QoL; fatigue-related, psychoneurological and gastrointestinal symptom clusters had a negative impact on patients' functioning. Nurse practitioners should pay more attention to monitoring respiratory and fatigue-related symptom clusters to identify high-risk populations in time, and tailored interventions based on symptom clusters are needed to synergistically reduce the symptom burden, thereby improving patients' QoL.