Features and Differences in Core Symptom Clusters in Home‐Based Hospice Patients With Advanced Cancer: A Network Analysis

Abstract

ABSTRACT Introduction Patients with terminal‐stage cancer frequently experience multiple symptoms simultaneously. Little is known about how core symptom clusters differ in advanced‐cancer patients with different survival expectancies receiving hospice care. To identify the core symptom clusters of hospice‐care cancer patients with different survival expectancies and compare the features of their symptom networks. Methods In this retrospective study, secondary data analysis was conducted. Records of 6946 patients with advanced cancer who received home‐based hospice care service in a hospice center from April 2001 to December 2020 were collected and analyzed using network analysis. Results This analysis included 6946 patients with advanced cancer receiving hospice care. In patients with survival expectancies of 0–6 months, loss of appetite was identified as the core symptom (rs = 4.03, rb = 5.21, rc = 2.63), and five symptom clusters were identified. Malnutrition was the core symptom in patients with survival expectancies of 6–12 months (rs = 2.83, rb = 2.43, rc = 0.93), and nine symptom clusters were identified. Wasting syndrome was the core symptom cluster in two groups. The network density of symptoms in patients with < 6 months of survival expectancy (91.99) was higher than in patients with 6–12 months (28.39). Conclusions Nutrition impact symptoms are the core symptoms for home‐hospice care cancer patients with a survival period of 1 year or below. Moreover, hospice cancer patients with short survival expectancies have greater inter‐symptom impact.

Keywords

• advanced cancer
• home‐based hospice
• network analysis
• nutrition impact symptom
• symptom cluster
• symptom network