Introduction:Chemotherapy-induced gastrointestinal symptom clusters in breast cancer impair quality of life and treatment adherence,yet lack effective interventions.While acupuncture mitigates isolated chemotherapy-in...Introduction:Chemotherapy-induced gastrointestinal symptom clusters in breast cancer impair quality of life and treatment adherence,yet lack effective interventions.While acupuncture mitigates isolated chemotherapy-induced symptoms,its mechanisms for multi-symptom clusters remain unclear.This study evaluates electroacupuncture's efficacy and explores its biological mechanisms in managing these clusters.Methods:This prospective,multicenter,block-randomized,double-blind,sham-controlled trial will enroll 388 patients with breast cancer undergoing neoadjuvant/adjuvant chemotherapy,to be randomly assigned(1:1)to electroacupuncture or sham electro-acupuncture groups.Both groups will receive the standard quadruple antiemetic regimen combined with electroacupuncture or sham intervention.The primary endpoint is the incidence of chemotherapy-induced gastrointestinal symptom clusters within 120 h after chemotherapy.Secondary endpoints include improvement in gastrointestinal symptom clusters post-first chemotherapy cycle,nausea-free rates during acute and delayed phases,vomiting-free rates during overall,acute,and delayed phases,complete response rate,complete protection rate,and quality of life.Adverse events will be documented throughout the study.Discussion:This study will assess the efficacy and safety of electroacupuncture in alleviating chemotherapy-induced gastro-intestinal symptom clusters in patients with breast cancer.By integrating multi-omics analyses,we aim to elucidate the biological mechanisms underlying its therapeutic effects.The findings may offer a robust clinical foundation for optimizing symptom cluster management in cancer care.Trial Registration:Clinical Trials ID:NCT06952920.Date of registration:April 16,2025.Prospectively registered.URL of Trial Registry Record:https://clinicaltrials.gov/study/NCT06952920cond=NCT06952920&rank=1.展开更多
Objectives To identify core symptoms and symptom clusters in patients with neuromyelitis optica spectrum disorder(NMOSD)by network analysis.Methods From October 10 to 30,2023,140 patients with NMOSD were selected to p...Objectives To identify core symptoms and symptom clusters in patients with neuromyelitis optica spectrum disorder(NMOSD)by network analysis.Methods From October 10 to 30,2023,140 patients with NMOSD were selected to participate in this online questionnaire survey.The survey tools included a general information questionnaire and a self-made NMOSD symptoms scale,which included the prevalence,severity,and distress of 29 symptoms.Cluster analysis was used to identify symptom clusters,and network analysis was used to analyze the symptom network and node characteristics and central indicators including strength centrality(r_(s)),closeness centrality(r_(c))and betweeness centrality(r_(b))were used to identify core symptoms and symptom clusters.Results The most common symptom was pain(65.7%),followed by paraesthesia(65.0%),fatigue(65.0%),easy awakening(63.6%).Regarding the burden level of symptoms,pain was the most burdensome symptom,followed by paraesthesia,easy awakening,fatigue,and difficulty falling asleep.Six clusters were identified:somatosensory,motor,visual,and memory symptom clusters,bladder and rectum symptom clusters,sleep symptoms clusters,and neuropsychological symptom clusters.Fatigue(r_(s)=12.39,r_(b)=68.00,r_(c)=0.02)was the most central and prominent bridge symptom,and motor symptom cluster(r_(s)=2.68,r_(c)=0.10)was the most central symptom cluster among the six clusters.Conclusions Our study demonstrated the necessity of symptom management targeting fatigue,pain,and motor symptom cluster in patients with NMOSD.展开更多
The first three months after lung transplantation are the clinical“vulnerable period”.Complications during this period often appear in the form of symptom clusters.The core includes primary graft dysfunction(PGD),in...The first three months after lung transplantation are the clinical“vulnerable period”.Complications during this period often appear in the form of symptom clusters.The core includes primary graft dysfunction(PGD),infection,inflammatory response and multiple organ dysfunction,and are interconnected to form a complex network.The symptom cluster shows a clear dynamic trajectory:the risk of PGD peaks at 24 hours after surgery,and its evolution trajectory(recovery,delay,deterioration)directly affects long-term graft function;infections show a“double peak distribution”,with bacteria/fungi dominant in the early stage(<1 month)and viruses/opportunistic infections dominant in the middle stage(1-6 months),and promote each other with PGD.Influencing factors include four dimensions:donor(smoking history,infection),recipient(weakness,immune status),perioperative period(surgical method,support strategy)and postoperative management(balance of immunosuppression).In the future,dynamic prediction models and individualized management paths need to be built to improve patient outcomes.展开更多
Objective:This study aims to investigate the patterns of symptom occurrence in patients experiencing acute exacerbations of chronic obstructive pulmonary disease(AECOPD).It will explore the composition of symptom clus...Objective:This study aims to investigate the patterns of symptom occurrence in patients experiencing acute exacerbations of chronic obstructive pulmonary disease(AECOPD).It will explore the composition of symptom clusters and analyze the correlation between these clusters and health-related quality of life(HRQoL).Methods:A total of 207 patients with AE-COPD were surveyed from a tertiary grade A hospital.Data collection was conducted using three validated instruments:the Basic Information Questionnaire(BIQ),Disease Symptom Survey Questionnaire(MSAS),and Quality of Life Questionnaire(CAT).Statistical software SPSS 22.0 was used to analyze the correlation between symptom clusters and quality of life.Results:Exploratory factor analysis showed that five major symptom clusters existed in the patients,including the psycho-emotional symptom cluster,the sleep-related symptom cluster,the other side effects symptom cluster,the energy deficiency symptom cluster and the cough-loss of appetite symptom cluster,and the severity of the symptom clusters showed a significant negative correlation with the quality of life of the patients(P<0.05).Conclusion:Strengthening the comprehensive management of symptom clusters in patients with AE-COPD can help to effectively reduce the symptom burden of patients,and then significantly improve their quality of life.展开更多
Objectives To identify symptom clusters among patients with advanced heart failure （HF） and the independent relationships with their quality of life （QoL）. Methods This is the secondary data analysis of a cross-se...Objectives To identify symptom clusters among patients with advanced heart failure （HF） and the independent relationships with their quality of life （QoL）. Methods This is the secondary data analysis of a cross-sectional study which interviewed 119 patients with advanced HF in the geriatric unit of a regional hospital in Hong Kong. The symptom profile and QoL were assessed by using the Edmonton Symptom Assessment Scale （ESAS） and the McGill QoL Questionnaire. Exploratory factor analysis was used to identify the symptom clusters. Hier- archical regression analysis was used to examine the independent relationships with their QoL, after adjusting the effects of age, gender, and comorbidities. Results The patients were at an advanced age （82.9± 6.5 years）. Three distinct symptom clusters were identified： they were the distress cluster （including shortness of breath, anxiety, and depression）, the decondition cluster （fatigue, drowsiness, nausea, and reduced appetite）, and the discomfort cluster （pain, and sense of generalized discomfort）. These three symptom clusters accounted for 63.25% of variance of the patients＇ symptom experience. The small to moderate correlations between these symptom clusters indicated that they were rather independent of one another. After adjusting the age, gender and comorbidities, the distress （β = -0.635, P 〈 0.001）, the decondition （β = -0.148, P = 0.01）, and the discomfort （β = -0.258, P 〈 0.001） symptom clusters independently predicted their QoL. Conclusions This study identified the distinctive symptom clusters among patients with advanced HF. The results shed light on the need to develop palliative care interventions for optimizing the symptom control for this life-limiting disease.展开更多
Cancer survivors often experience multisymptom clusters, substantial discomfort and lower QOL (quality of life) than the general population. This article summarized the progress of the research on symptom clusters in ...Cancer survivors often experience multisymptom clusters, substantial discomfort and lower QOL (quality of life) than the general population. This article summarized the progress of the research on symptom clusters in cancer survivors, and reviewed the definitions, influencing factors, and identified approaches and interventions regarding symptom clusters. The findings allow recommendations to be made in clinical nursing to improve the QOL of cancer survivors. In future studies, longitudinal, large-sample and multicenter studies are recommended to obtain more in-depth information about the changes in symptom and symptom cluster experience perceived by groups of cancer survivors.展开更多
Objective:To use Cite Space and VOSviewer to investigate the scientific production in the field of symptom clusters in cancer research.Methods:The search was performed using the terms“symptom clusters,”“cancer,”an...Objective:To use Cite Space and VOSviewer to investigate the scientific production in the field of symptom clusters in cancer research.Methods:The search was performed using the terms“symptom clusters,”“cancer,”and“oncology”on the Web of Science Core Collection database.The retrieval time was from 2001 to 2021,which covers the last 2 decades.Based on the production theory of scientific knowledge and the data mining of citations,data pertaining to the annual publications,journals,countries,organizations,authors,and keywords that produce symptom clusters in cancer research,as well as their cooperation(collaboration network),were extracted,and then both were clarified by the software tools VOSviewer(version 1.6.16)and Cite Space(version 6.1.R2).Results:A total of 1796 publications were retrieved between 2001 and 2021,and 473 relevant publications were included after screening.The results showed an increasing trend in published articles.The United States had the largest number of publications(261/473,55.18%),followed by China and Canada.The University of California,San Francisco,was the most productive institution.Current research hotspots included the analysis of symptom clusters and symptom management in patients with breast cancer and lung cancer,as well as any advanced cancer and cancer cachexia;fatigue-related symptom clusters and depression-anxiety symptom cluster;and the impacts of symptom clusters on quality of life.The research frontiers included analysis between health-related quality of life and symptom clusters,data mining in symptom clusters,research on the mental health status of cancer patients,and study of the mechanism and biological pathways of symptom clusters.Conclusions:The study provides insight into the global research perspective for the scientific progress on cancer symptom clusters,which suggests a growing scientific interest in this field,and more studies are warranted to guide symptom management.展开更多
Sub-health,characterized by an imbalance of yin and yang within the organism.Traditional Chinese medicine(TCM)demonstrates distinct advantages and potential in the prevention and treatment of suboptimal health.This st...Sub-health,characterized by an imbalance of yin and yang within the organism.Traditional Chinese medicine(TCM)demonstrates distinct advantages and potential in the prevention and treatment of suboptimal health.This study innovatively focuses on common symptoms within five domains of the“Suboptimal Health Status Questionnaire-25”through a systematic review of relevant literature,it delves into the clinical research status and mechanistic advances of TCM interventions for suboptimal health-related symptoms.Document analysis demonstrates that TCM interventions have shown efficacy in ameliorating diverse symptoms in individuals with suboptimal health,can achieve the effect of bolstering immunity,maintaining metabolic equilibrium,and regulating the operations of internal organs to promote overall physical and mental well-being.Its mechanism of action is closely related to immune regulation,metabolic control,inflammation management,oxidative stress inhibition,hypothalamic-pituitary-adrenal axis and brain-gut axis.In summary,this paper offers a systematical review of clinical and preclinical studies on TCM interventions for sub-health symptom clusters,outlining the current research landscape and affording a more scientific and effective theoretical basis and clinical evidence for the application of TCM in the field of sub-health intervention.This is expected to promote the further application and development of TCM in the prevention and treatment of sub-health,offering new ideas and methods for addressing sub-health issues.展开更多
BACKGROUND Adolescent depression manifests through diverse,interconnected symptoms,yet the clinical profile in patients treated with repetitive transcranial magnetic stimulation(rTMS)remains inadequately characterized...BACKGROUND Adolescent depression manifests through diverse,interconnected symptoms,yet the clinical profile in patients treated with repetitive transcranial magnetic stimulation(rTMS)remains inadequately characterized.While rTMS shows therapeutic potential,its efficacy may be overestimated due to limited research and symptom heterogeneity.Identifying key symptom clusters and evaluating their predictive value for treatment response is crucial for optimizing rTMS outcomes in this population.AIM To identify adolescent depression symptom clusters and assess their differential responses to rTMS treatment.METHODS One hundred adolescent patients with first-episode major depressive disorder were randomized into control and study groups.Both groups received sertraline treatment,while the study group additionally underwent 10 sessions of adjunctive rTMS.Depressive symptoms were evaluated using the 17-item Hamilton Depression Rating Scale(HAMD-17)at baseline,week 2,and week 4.RESULTS Hierarchical clustering revealed four distinct symptom clusters:Subjective mood,impaired activity,somatic concerns,and anxiety/insomnia.The main effect of treatment visit showed significant decreases in symptom severity across all clusters.In the study group,the effect size between baseline and week 4 was largest for the subjective mood cluster(Cohen’s d=2.41)and smallest for somatic concerns(Cohen’s d=0.59).In the control group,the largest effect size was observed in the anxiety/insomnia cluster(Cohen’s d=1.20),with the smallest effect in impaired activity(Cohen’s d=0.47).CONCLUSION This study identified four distinct symptom clusters with differential responses to rTMS treatment.The findings demonstrate that rTMS shows greatest efficacy for improving subjective mood symptoms,guiding targeted therapeutic approaches.展开更多
Objective:To investigate the intervention effect of symptom management education based on the Knowledge-Attitude-Practice(KAP)theory on the symptom cluster of fatigue,pain,and sleep disturbances in lung cancer patient...Objective:To investigate the intervention effect of symptom management education based on the Knowledge-Attitude-Practice(KAP)theory on the symptom cluster of fatigue,pain,and sleep disturbances in lung cancer patients.Methods:A total of 232 lung cancer patients treated in the oncology department from October 2024 to October 2025 were included and randomly divided into an experimental group and a control group,with 116 cases in each group.The control group received routine nursing care for lung cancer,while the experimental group received additional symptom management education intervention based on the KAP theory.Fatigue,pain,and sleep conditions were quantified at the 4th and 8th weeks after the intervention.Results:After 4 and 8 weeks of intervention,the RPFS scores,VAS scores,and PSQI scores in the experimental group were lower than those in the control group at the same time points(p<0.05);moreover,the scores in the experimental group at each time point were lower than those before the intervention(p<0.05).Conclusion:Symptom management education based on the KAP theory can effectively improve the symptom cluster of fatigue,pain,and sleep disturbances in lung cancer patients,enhance their quality of life,and has clinical promotion value.展开更多
OBJECTIVE: Apply spectral clustering to analyze the patterns of symptoms in patients with chronic gastritis(CG).METHODS: Based on 919 CG subjects, we applied mutual information feature selection to choose the positive...OBJECTIVE: Apply spectral clustering to analyze the patterns of symptoms in patients with chronic gastritis(CG).METHODS: Based on 919 CG subjects, we applied mutual information feature selection to choose the positively correlated symptoms with each pattern.Then, we used the Shi and Malik spectral clustering algorithm to select the top 20 correlated symptoms.RESULTS: We ascertained the results of six patterns.There were three categories for the pattern of accumulation of damp heat in the spleen-stomach(0.00332). There were six categories for the pattern of dampness obstructing the spleen-stomach(0.02466). There were two categories for the pattern of spleen-stomach Qi deficiency(0.013 89).There were three categories for the pattern of spleen-stomach deficiency cold(0.009 15). There were five categories for the pattern of liver-Qistagnation(0.01910).There were four categories for the pattern of stagnant heat in the liver-stomach(0.00585).CONCLUSION: Most of the spectral clustering results of the symptoms of CG patterns were in accordance with clinical experience and Traditional Chinese Medicine theory. Most categories suggested the nature and/or location of the disease.展开更多
This study explores the application value of Zhao Shi Lei-huo-jiu in managing common postoperative gastrointestinal symptom clusters following rectal cancer surgery,under the framework of the Enhanced Recovery After S...This study explores the application value of Zhao Shi Lei-huo-jiu in managing common postoperative gastrointestinal symptom clusters following rectal cancer surgery,under the framework of the Enhanced Recovery After Surgery(ERAS)concept.By detailing the development,core elements,and application of ERAS in colorectal surgery,combined with the historical origins,unique techniques,and mechanisms of Zhao Shi Lei-huo-jiu,this paper highlights the innovation of integrating traditional Chinese medicine treatments with modern surgical recovery principles.Through a rigorously designed research process,rectal cancer postoperative patients were selected as research subjects,and the data collection and implementation steps were explicitly outlined.The study results provide scientific evidence for the practical efficacy and advantages of Zhao Shi Lei-huo-jiu in postoperative rehabilitation for rectal cancer,offering significant practical implications for guiding clinical practice and promoting early patient recovery.展开更多
The international scientific literature presents still incipient results regarding the management of cancer symptom clusters by oncology nursing,especially in pediatric oncology.This is a promising field of investigat...The international scientific literature presents still incipient results regarding the management of cancer symptom clusters by oncology nursing,especially in pediatric oncology.This is a promising field of investigation for clinical nurses and researchers,and when it is subsidized by medium-range theories,they co-rroborate the diagnoses and interventions of nursing in oncology,enhancing the science of nursing care.This minireview article aims to discuss the utilizing the hospital clowns as a complementary therapy,to enhance quality of life and reduce stress and fatigue in pediatric cancer patients.Overall,the evidence presented so far pointed out that complementary therapy might help improve the quality of life of pediatric cancer patients,and that complementary therapy usage should be part of a health comprehensive care model,delivering therapeutic approaches that might enhance the mind-body during a pediatric cancer patients’life span.The results of scientific investigations by nurses,particularly those linked to the basic sciences,play a critical role in advancing personalized care in pediatric integrative oncology.展开更多
INTRODUCTION For a considerable time,psychiatry has grappled with how best to define its core diagnostic entities.1-3 Traditional psychiatric classification systems,predominantly the Diagnostic and Statistical Manual ...INTRODUCTION For a considerable time,psychiatry has grappled with how best to define its core diagnostic entities.1-3 Traditional psychiatric classification systems,predominantly the Diagnostic and Statistical Manual of Mental Disorders(DSM)and International Classification of Diseases(ICD),have long been the cornerstones of clinical psychiatry.These systems primarily characterise mental disorders through clusters of observable symptoms rather than underlying pathophysiological mechanisms,making few claims about aetiology or causal pathways.展开更多
OBJECTIVE:To establish a quantification model of Traditional Chinese Medicine(TCM)syndromes by sampling patients undergoing idiopathic precocious puberty(IPP)and early puberty.METHODS:A questionnaire for classifying a...OBJECTIVE:To establish a quantification model of Traditional Chinese Medicine(TCM)syndromes by sampling patients undergoing idiopathic precocious puberty(IPP)and early puberty.METHODS:A questionnaire for classifying and quantifying TCM syndromes was designed and administered.All the results were analyzed;the relationship between 3 types of syndrome and 47symptoms were summated.Meanwhile,the frequency distribution of each symptom or sign was aggregated.Fuzzy mathematics was used to develop a quantification model ofTCM syndromes.RESULTS:We found that precocious puberty had 3types of syndrome,including hyperactivity of fire due to Yin deficiency(Syndrome I),depressed liver Qi transforming into fire(Syndrome II),and end retention of damp heat(Syndrome III).In the IPP group,Syndrome I was the most common principal syndrome(100%).Forty-six patients(43.81%)werediagnosed with Syndrome I accompanied by Syndrome II and 11(10.48%)were diagnosed with Syndrome I accompanied by Syndrome III.In the early puberty group,Syndrome I was also the main syndrome(98.39%).The degrees of most symptoms were mild to moderate.Reddened tongue was the most common tongue manifestation(62.86%prevalence)in the IPP group.The most common pulse manifestations were slippery pulse,thread pulse,and taut pulse.The Asymptotic Normalization Coefficient(ANC)method was used to quantify the TCM syndromes in 167 cases.Diagnostic accuracy rate reached 91%,comparable to expert diagnosis.CONCLUSION:We find that there are 3 types of syndrome in the IPP group and in the early puberty group.Syndrome I(hyperactivity of fire due to Yin deficiency)is the main syndrome in the two groups.ANC may be an appropriate for quantification model ofTCM syndromes.展开更多
Heart failure （HF） had emerged as an epidemic since two decades ago and is now a major threatening public health problem affecting 23 million population worldwide,
基金Noncommunicable Chronic Diseases-National Science and Technology Major Project,Grant/Award Numbers:2024ZD0521400,2024ZD0521404Affiliated Hospital of Qinghai University。
文摘Introduction:Chemotherapy-induced gastrointestinal symptom clusters in breast cancer impair quality of life and treatment adherence,yet lack effective interventions.While acupuncture mitigates isolated chemotherapy-induced symptoms,its mechanisms for multi-symptom clusters remain unclear.This study evaluates electroacupuncture's efficacy and explores its biological mechanisms in managing these clusters.Methods:This prospective,multicenter,block-randomized,double-blind,sham-controlled trial will enroll 388 patients with breast cancer undergoing neoadjuvant/adjuvant chemotherapy,to be randomly assigned(1:1)to electroacupuncture or sham electro-acupuncture groups.Both groups will receive the standard quadruple antiemetic regimen combined with electroacupuncture or sham intervention.The primary endpoint is the incidence of chemotherapy-induced gastrointestinal symptom clusters within 120 h after chemotherapy.Secondary endpoints include improvement in gastrointestinal symptom clusters post-first chemotherapy cycle,nausea-free rates during acute and delayed phases,vomiting-free rates during overall,acute,and delayed phases,complete response rate,complete protection rate,and quality of life.Adverse events will be documented throughout the study.Discussion:This study will assess the efficacy and safety of electroacupuncture in alleviating chemotherapy-induced gastro-intestinal symptom clusters in patients with breast cancer.By integrating multi-omics analyses,we aim to elucidate the biological mechanisms underlying its therapeutic effects.The findings may offer a robust clinical foundation for optimizing symptom cluster management in cancer care.Trial Registration:Clinical Trials ID:NCT06952920.Date of registration:April 16,2025.Prospectively registered.URL of Trial Registry Record:https://clinicaltrials.gov/study/NCT06952920cond=NCT06952920&rank=1.
基金supported by the Specific Research Fund for Top-notch Talents of Guangdong Provincial Hospital of Chinese Medicine(No.2022KT1188).
文摘Objectives To identify core symptoms and symptom clusters in patients with neuromyelitis optica spectrum disorder(NMOSD)by network analysis.Methods From October 10 to 30,2023,140 patients with NMOSD were selected to participate in this online questionnaire survey.The survey tools included a general information questionnaire and a self-made NMOSD symptoms scale,which included the prevalence,severity,and distress of 29 symptoms.Cluster analysis was used to identify symptom clusters,and network analysis was used to analyze the symptom network and node characteristics and central indicators including strength centrality(r_(s)),closeness centrality(r_(c))and betweeness centrality(r_(b))were used to identify core symptoms and symptom clusters.Results The most common symptom was pain(65.7%),followed by paraesthesia(65.0%),fatigue(65.0%),easy awakening(63.6%).Regarding the burden level of symptoms,pain was the most burdensome symptom,followed by paraesthesia,easy awakening,fatigue,and difficulty falling asleep.Six clusters were identified:somatosensory,motor,visual,and memory symptom clusters,bladder and rectum symptom clusters,sleep symptoms clusters,and neuropsychological symptom clusters.Fatigue(r_(s)=12.39,r_(b)=68.00,r_(c)=0.02)was the most central and prominent bridge symptom,and motor symptom cluster(r_(s)=2.68,r_(c)=0.10)was the most central symptom cluster among the six clusters.Conclusions Our study demonstrated the necessity of symptom management targeting fatigue,pain,and motor symptom cluster in patients with NMOSD.
文摘The first three months after lung transplantation are the clinical“vulnerable period”.Complications during this period often appear in the form of symptom clusters.The core includes primary graft dysfunction(PGD),infection,inflammatory response and multiple organ dysfunction,and are interconnected to form a complex network.The symptom cluster shows a clear dynamic trajectory:the risk of PGD peaks at 24 hours after surgery,and its evolution trajectory(recovery,delay,deterioration)directly affects long-term graft function;infections show a“double peak distribution”,with bacteria/fungi dominant in the early stage(<1 month)and viruses/opportunistic infections dominant in the middle stage(1-6 months),and promote each other with PGD.Influencing factors include four dimensions:donor(smoking history,infection),recipient(weakness,immune status),perioperative period(surgical method,support strategy)and postoperative management(balance of immunosuppression).In the future,dynamic prediction models and individualized management paths need to be built to improve patient outcomes.
文摘Objective:This study aims to investigate the patterns of symptom occurrence in patients experiencing acute exacerbations of chronic obstructive pulmonary disease(AECOPD).It will explore the composition of symptom clusters and analyze the correlation between these clusters and health-related quality of life(HRQoL).Methods:A total of 207 patients with AE-COPD were surveyed from a tertiary grade A hospital.Data collection was conducted using three validated instruments:the Basic Information Questionnaire(BIQ),Disease Symptom Survey Questionnaire(MSAS),and Quality of Life Questionnaire(CAT).Statistical software SPSS 22.0 was used to analyze the correlation between symptom clusters and quality of life.Results:Exploratory factor analysis showed that five major symptom clusters existed in the patients,including the psycho-emotional symptom cluster,the sleep-related symptom cluster,the other side effects symptom cluster,the energy deficiency symptom cluster and the cough-loss of appetite symptom cluster,and the severity of the symptom clusters showed a significant negative correlation with the quality of life of the patients(P<0.05).Conclusion:Strengthening the comprehensive management of symptom clusters in patients with AE-COPD can help to effectively reduce the symptom burden of patients,and then significantly improve their quality of life.
文摘Objectives To identify symptom clusters among patients with advanced heart failure （HF） and the independent relationships with their quality of life （QoL）. Methods This is the secondary data analysis of a cross-sectional study which interviewed 119 patients with advanced HF in the geriatric unit of a regional hospital in Hong Kong. The symptom profile and QoL were assessed by using the Edmonton Symptom Assessment Scale （ESAS） and the McGill QoL Questionnaire. Exploratory factor analysis was used to identify the symptom clusters. Hier- archical regression analysis was used to examine the independent relationships with their QoL, after adjusting the effects of age, gender, and comorbidities. Results The patients were at an advanced age （82.9± 6.5 years）. Three distinct symptom clusters were identified： they were the distress cluster （including shortness of breath, anxiety, and depression）, the decondition cluster （fatigue, drowsiness, nausea, and reduced appetite）, and the discomfort cluster （pain, and sense of generalized discomfort）. These three symptom clusters accounted for 63.25% of variance of the patients＇ symptom experience. The small to moderate correlations between these symptom clusters indicated that they were rather independent of one another. After adjusting the age, gender and comorbidities, the distress （β = -0.635, P 〈 0.001）, the decondition （β = -0.148, P = 0.01）, and the discomfort （β = -0.258, P 〈 0.001） symptom clusters independently predicted their QoL. Conclusions This study identified the distinctive symptom clusters among patients with advanced HF. The results shed light on the need to develop palliative care interventions for optimizing the symptom control for this life-limiting disease.
文摘Cancer survivors often experience multisymptom clusters, substantial discomfort and lower QOL (quality of life) than the general population. This article summarized the progress of the research on symptom clusters in cancer survivors, and reviewed the definitions, influencing factors, and identified approaches and interventions regarding symptom clusters. The findings allow recommendations to be made in clinical nursing to improve the QOL of cancer survivors. In future studies, longitudinal, large-sample and multicenter studies are recommended to obtain more in-depth information about the changes in symptom and symptom cluster experience perceived by groups of cancer survivors.
文摘Objective:To use Cite Space and VOSviewer to investigate the scientific production in the field of symptom clusters in cancer research.Methods:The search was performed using the terms“symptom clusters,”“cancer,”and“oncology”on the Web of Science Core Collection database.The retrieval time was from 2001 to 2021,which covers the last 2 decades.Based on the production theory of scientific knowledge and the data mining of citations,data pertaining to the annual publications,journals,countries,organizations,authors,and keywords that produce symptom clusters in cancer research,as well as their cooperation(collaboration network),were extracted,and then both were clarified by the software tools VOSviewer(version 1.6.16)and Cite Space(version 6.1.R2).Results:A total of 1796 publications were retrieved between 2001 and 2021,and 473 relevant publications were included after screening.The results showed an increasing trend in published articles.The United States had the largest number of publications(261/473,55.18%),followed by China and Canada.The University of California,San Francisco,was the most productive institution.Current research hotspots included the analysis of symptom clusters and symptom management in patients with breast cancer and lung cancer,as well as any advanced cancer and cancer cachexia;fatigue-related symptom clusters and depression-anxiety symptom cluster;and the impacts of symptom clusters on quality of life.The research frontiers included analysis between health-related quality of life and symptom clusters,data mining in symptom clusters,research on the mental health status of cancer patients,and study of the mechanism and biological pathways of symptom clusters.Conclusions:The study provides insight into the global research perspective for the scientific progress on cancer symptom clusters,which suggests a growing scientific interest in this field,and more studies are warranted to guide symptom management.
基金supported by the Innovation Team Project of the Clinical Basic Discipline of Traditional Chinese Medicine in the Science and Technology Innovation Project of the Chinese Academy of Chinese Medical Sciences(CI2021B003)the commissioned project of the China Association of Chinese Medicine“Review and Prospect of the 20-year Research on Sub-health Conditions”(202451-003)the scientific research project on integrated traditional Chinese and Western medicine of the Tianjin Municipal Health Commission(2023147).
文摘Sub-health,characterized by an imbalance of yin and yang within the organism.Traditional Chinese medicine(TCM)demonstrates distinct advantages and potential in the prevention and treatment of suboptimal health.This study innovatively focuses on common symptoms within five domains of the“Suboptimal Health Status Questionnaire-25”through a systematic review of relevant literature,it delves into the clinical research status and mechanistic advances of TCM interventions for suboptimal health-related symptoms.Document analysis demonstrates that TCM interventions have shown efficacy in ameliorating diverse symptoms in individuals with suboptimal health,can achieve the effect of bolstering immunity,maintaining metabolic equilibrium,and regulating the operations of internal organs to promote overall physical and mental well-being.Its mechanism of action is closely related to immune regulation,metabolic control,inflammation management,oxidative stress inhibition,hypothalamic-pituitary-adrenal axis and brain-gut axis.In summary,this paper offers a systematical review of clinical and preclinical studies on TCM interventions for sub-health symptom clusters,outlining the current research landscape and affording a more scientific and effective theoretical basis and clinical evidence for the application of TCM in the field of sub-health intervention.This is expected to promote the further application and development of TCM in the prevention and treatment of sub-health,offering new ideas and methods for addressing sub-health issues.
基金Supported by the Hangzhou Medical and Health Science and Technology General Project,No.A20240472 and No.A20210156the Plan Projects of Zhejiang Provincial Department of Science and Technology,No.2025C01103the Major projects of Hangzhou Municipal Health Commission,No.Z20250275.
文摘BACKGROUND Adolescent depression manifests through diverse,interconnected symptoms,yet the clinical profile in patients treated with repetitive transcranial magnetic stimulation(rTMS)remains inadequately characterized.While rTMS shows therapeutic potential,its efficacy may be overestimated due to limited research and symptom heterogeneity.Identifying key symptom clusters and evaluating their predictive value for treatment response is crucial for optimizing rTMS outcomes in this population.AIM To identify adolescent depression symptom clusters and assess their differential responses to rTMS treatment.METHODS One hundred adolescent patients with first-episode major depressive disorder were randomized into control and study groups.Both groups received sertraline treatment,while the study group additionally underwent 10 sessions of adjunctive rTMS.Depressive symptoms were evaluated using the 17-item Hamilton Depression Rating Scale(HAMD-17)at baseline,week 2,and week 4.RESULTS Hierarchical clustering revealed four distinct symptom clusters:Subjective mood,impaired activity,somatic concerns,and anxiety/insomnia.The main effect of treatment visit showed significant decreases in symptom severity across all clusters.In the study group,the effect size between baseline and week 4 was largest for the subjective mood cluster(Cohen’s d=2.41)and smallest for somatic concerns(Cohen’s d=0.59).In the control group,the largest effect size was observed in the anxiety/insomnia cluster(Cohen’s d=1.20),with the smallest effect in impaired activity(Cohen’s d=0.47).CONCLUSION This study identified four distinct symptom clusters with differential responses to rTMS treatment.The findings demonstrate that rTMS shows greatest efficacy for improving subjective mood symptoms,guiding targeted therapeutic approaches.
文摘Objective:To investigate the intervention effect of symptom management education based on the Knowledge-Attitude-Practice(KAP)theory on the symptom cluster of fatigue,pain,and sleep disturbances in lung cancer patients.Methods:A total of 232 lung cancer patients treated in the oncology department from October 2024 to October 2025 were included and randomly divided into an experimental group and a control group,with 116 cases in each group.The control group received routine nursing care for lung cancer,while the experimental group received additional symptom management education intervention based on the KAP theory.Fatigue,pain,and sleep conditions were quantified at the 4th and 8th weeks after the intervention.Results:After 4 and 8 weeks of intervention,the RPFS scores,VAS scores,and PSQI scores in the experimental group were lower than those in the control group at the same time points(p<0.05);moreover,the scores in the experimental group at each time point were lower than those before the intervention(p<0.05).Conclusion:Symptom management education based on the KAP theory can effectively improve the symptom cluster of fatigue,pain,and sleep disturbances in lung cancer patients,enhance their quality of life,and has clinical promotion value.
基金Supported by the National Natural Science Foundation of China[the Patterns Differentiation Mode of Main TCM Clinical Symptoms Based on Complex System Method(No.81270050)Information Extraction From TCM Inquiry and the Deducting Method of Patterns Differentiation Based on Feature Selection(No.30901897)+2 种基金Common Syndrome Diagnosis of Traditional Chinese Medicine Based on The Integration of Four Diagnosis Methods(No.81173199)]College Students' Scientific Innovation Foundation of Shanghai University of TCM[SHUTCMCXHDZ(2011)03]the Foundation for Training Talents of National Basic Scientific Research(No.J1103607)
文摘OBJECTIVE: Apply spectral clustering to analyze the patterns of symptoms in patients with chronic gastritis(CG).METHODS: Based on 919 CG subjects, we applied mutual information feature selection to choose the positively correlated symptoms with each pattern.Then, we used the Shi and Malik spectral clustering algorithm to select the top 20 correlated symptoms.RESULTS: We ascertained the results of six patterns.There were three categories for the pattern of accumulation of damp heat in the spleen-stomach(0.00332). There were six categories for the pattern of dampness obstructing the spleen-stomach(0.02466). There were two categories for the pattern of spleen-stomach Qi deficiency(0.013 89).There were three categories for the pattern of spleen-stomach deficiency cold(0.009 15). There were five categories for the pattern of liver-Qistagnation(0.01910).There were four categories for the pattern of stagnant heat in the liver-stomach(0.00585).CONCLUSION: Most of the spectral clustering results of the symptoms of CG patterns were in accordance with clinical experience and Traditional Chinese Medicine theory. Most categories suggested the nature and/or location of the disease.
文摘This study explores the application value of Zhao Shi Lei-huo-jiu in managing common postoperative gastrointestinal symptom clusters following rectal cancer surgery,under the framework of the Enhanced Recovery After Surgery(ERAS)concept.By detailing the development,core elements,and application of ERAS in colorectal surgery,combined with the historical origins,unique techniques,and mechanisms of Zhao Shi Lei-huo-jiu,this paper highlights the innovation of integrating traditional Chinese medicine treatments with modern surgical recovery principles.Through a rigorously designed research process,rectal cancer postoperative patients were selected as research subjects,and the data collection and implementation steps were explicitly outlined.The study results provide scientific evidence for the practical efficacy and advantages of Zhao Shi Lei-huo-jiu in postoperative rehabilitation for rectal cancer,offering significant practical implications for guiding clinical practice and promoting early patient recovery.
基金Supported by the Coordination of Improvement of Higher Education Personnel(CAPES)and National Council for Scientific and Technological Development(CNPq),No.311427/2023-5.
文摘The international scientific literature presents still incipient results regarding the management of cancer symptom clusters by oncology nursing,especially in pediatric oncology.This is a promising field of investigation for clinical nurses and researchers,and when it is subsidized by medium-range theories,they co-rroborate the diagnoses and interventions of nursing in oncology,enhancing the science of nursing care.This minireview article aims to discuss the utilizing the hospital clowns as a complementary therapy,to enhance quality of life and reduce stress and fatigue in pediatric cancer patients.Overall,the evidence presented so far pointed out that complementary therapy might help improve the quality of life of pediatric cancer patients,and that complementary therapy usage should be part of a health comprehensive care model,delivering therapeutic approaches that might enhance the mind-body during a pediatric cancer patients’life span.The results of scientific investigations by nurses,particularly those linked to the basic sciences,play a critical role in advancing personalized care in pediatric integrative oncology.
文摘INTRODUCTION For a considerable time,psychiatry has grappled with how best to define its core diagnostic entities.1-3 Traditional psychiatric classification systems,predominantly the Diagnostic and Statistical Manual of Mental Disorders(DSM)and International Classification of Diseases(ICD),have long been the cornerstones of clinical psychiatry.These systems primarily characterise mental disorders through clusters of observable symptoms rather than underlying pathophysiological mechanisms,making few claims about aetiology or causal pathways.
基金Supported by the National Natural Science Foundation of China(No.81072841)the Shanghai Science and Technology Research Grant Program(No.09dZ1971600)State Key Clinical Department of TCM pediatrics
文摘OBJECTIVE:To establish a quantification model of Traditional Chinese Medicine(TCM)syndromes by sampling patients undergoing idiopathic precocious puberty(IPP)and early puberty.METHODS:A questionnaire for classifying and quantifying TCM syndromes was designed and administered.All the results were analyzed;the relationship between 3 types of syndrome and 47symptoms were summated.Meanwhile,the frequency distribution of each symptom or sign was aggregated.Fuzzy mathematics was used to develop a quantification model ofTCM syndromes.RESULTS:We found that precocious puberty had 3types of syndrome,including hyperactivity of fire due to Yin deficiency(Syndrome I),depressed liver Qi transforming into fire(Syndrome II),and end retention of damp heat(Syndrome III).In the IPP group,Syndrome I was the most common principal syndrome(100%).Forty-six patients(43.81%)werediagnosed with Syndrome I accompanied by Syndrome II and 11(10.48%)were diagnosed with Syndrome I accompanied by Syndrome III.In the early puberty group,Syndrome I was also the main syndrome(98.39%).The degrees of most symptoms were mild to moderate.Reddened tongue was the most common tongue manifestation(62.86%prevalence)in the IPP group.The most common pulse manifestations were slippery pulse,thread pulse,and taut pulse.The Asymptotic Normalization Coefficient(ANC)method was used to quantify the TCM syndromes in 167 cases.Diagnostic accuracy rate reached 91%,comparable to expert diagnosis.CONCLUSION:We find that there are 3 types of syndrome in the IPP group and in the early puberty group.Syndrome I(hyperactivity of fire due to Yin deficiency)is the main syndrome in the two groups.ANC may be an appropriate for quantification model ofTCM syndromes.
文摘Heart failure （HF） had emerged as an epidemic since two decades ago and is now a major threatening public health problem affecting 23 million population worldwide,
