Evidence map›Paper›PMID 40739214›Full record

ArticleBMC gastroenterology2025

The relationships between symptom clusters and contributing factors in patients with esophageal cancer: structural equation modelling based on theory of unpleasant symptoms.

Xiuqin Ren, Aijuan Wang, Xiaowei Wei, Ying Yu, Xiancui Wu, Suping Qin

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Article in BMC gastroenterology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

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4citing papers in PubMed
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1 · What the graph read from it

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3 · Its place in the literature

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4 citing papers in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

6 authors.

Xiuqin Ren *Outpatient Department, Nanjing First Hospital, Nanjing Medical University, No. 68 Changle Road, Nanjing, Jiangsu Province, 210006, China.
Aijuan Wang *Medical Oncology, Nanjing First Hospital, Nanjing Medical University, No. 68 Changle Road, Nanjing, Jiangsu Province, 210006, China.
Xiaowei WeiMedical Oncology, Nanjing First Hospital, Nanjing Medical University, No. 68 Changle Road, Nanjing, Jiangsu Province, 210006, China.
Ying YuMedical Oncology, Nanjing First Hospital, Nanjing Medical University, No. 68 Changle Road, Nanjing, Jiangsu Province, 210006, China.
Xiancui WuMedical Oncology, Nanjing First Hospital, Nanjing Medical University, No. 68 Changle Road, Nanjing, Jiangsu Province, 210006, China. 810150136@qq.com.
Suping QinGeneral Office, Nanjing First Hospital, Nanjing Medical University, No. 68 Changle Road, Nanjing, Jiangsu Province, 210006, China. qsp1999@126.com.

Funding

Nanjing Medical Science and Technique Development Foundation YKK20105
6 · The paper itself

Abstract

backgroundThe caring behaviors of nurses play a crucial role in improving the quality of care in hospitals. This study aimed to investigate the symptom clusters of patients with esophageal cancer undergoing radiotherapy or chemoradiotherapy, as well as the relationship among symptom clusters, NLR (neutrophil to lymphocyte ratio), ALB (albumin), anxiety, depression, social support, self-care, and self-efficacy through structural equation modeling based on the theory of unpleasant symptoms (TOUS).

methodsA cross-sectional study was conducted from December 2021 to December 2023 among 310 patients with esophageal cancer at a general hospital in Jiangsu Province. Data were collected using a general information questionnaire, five scales including the esophageal cancer symptom assessment, scales of anxiety and depression, social support, self-care and self-efficacy, and NLR, ALB levels test. Collected data were analyzed by IBM SPSS v26.0 and AMOS 24.0.

resultsA total of 289 valid questionnaires for each scale (five scales) were collected. The study identified four distinct symptom clusters: reflux cough (severity score: 17.85 ± 5.74), dysphagia (severity score: 16.66 ± 4.52), adverse reaction (severity score: 10.87 ± 3.78), and energy deficiency (severity score: 15.1 ± 3.33). These symptom clusters demonstrated significant correlations with NLR, ALB, psychological states, social support, self-care, and self-efficacy (all P < 0.01). Symptom clusters exerted significant negative effects on both self-care (β = -0.194, P = 0.007) and self-efficacy (β = -0.363, P = 0.007). Furthermore, social support fully mediated the effect of symptom clusters on self-efficacy (total effect: P = 0.001), and ALB levels fully mediated the effect of symptom clusters on self-care (total effect: P = 0.001).

conclusionsSocial support alleviates symptom clusters through direct or indirect effects in esophageal cancer patients undergoing chemoradiotherapy. Similarly, ALB levels improve self-care ability by modulating symptom severity and boosting self-efficacy. Future studies should investigate the differential impacts of social support types (family, medical staff, peers) and nutritional interventions (e.g., family involvement, multidisciplinary collaboration) on specific symptom cluster-self-efficacy pathways.

Indexed as

Esophageal NeoplasmsAdultAgedAnxietyChemoradiotherapyChinaCross-Sectional StudiesDeglutition DisordersDepressionFemaleHumansLatent Class AnalysisMaleMiddle AgedSelf CareSelf EfficacySerum AlbuminEsophageal cancerSelf-careSelf-efficacySocial supportStructural equation modelingSymptom clustersTheory of unpleasant symptoms

Identifiers

PMID40739214
PMCPMC12312602

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.