乳腺癌内分泌治疗患者症状群及核心症状的 网络分析

Network Analysis of Symptom Clusters and Core Symptoms in Breast Cancer Patients Receiving Endocrine Therapy

摘要: 目的：本研究通过调查乳腺癌内分泌治疗患者的症状困扰现状，识别其症状群并构建症状网络，以明确核心症状及其交互关系，为提高该人群的症状管理效率提供依据。方法：采用便利抽样法，选取2025年6月至2025年12月就诊的693例乳腺癌内分泌治疗患者为研究对象。使用乳腺癌内分泌治疗患者症状评估量表进行调查，通过探索性因子分析提取症状群，并利用R软件构建症状网络。结果：28个症状发生率≥20%，患者症状负担较重。探索性因子分析提取出肌肉骨骼、生殖系统、皮肤代谢、血管舒缩、心血管躯体不适、睡眠心理及心理–社会功能共7个症状群。症状网络分析显示，潮热在强度、紧密及中介中心性指标上均表现突出，是该症状网络的核心症状。结论：乳腺癌内分泌治疗患者症状相互交织，核心症状是潮热。护理人员应重点针对核心症状进行干预，以提升症状管理的效率。

Abstract: Objective: This study aimed to investigate the current status of symptom distress in patients undergoing endocrine therapy for breast cancer, identify symptom clusters, and construct a symptom network to clarify core symptoms and their interrelationships, thereby providing a basis for improving the efficiency of symptom management in this population. Methods: A convenience sampling method was used to select 693 patients undergoing endocrine therapy for breast cancer who visited the hospital from June 2025 to December 2025 as the research subjects. The Symptom Assessment Scale for Breast Cancer Endocrine Therapy Patients was used for the survey. Exploratory factor analysis was conducted to extract symptom clusters, and the symptom network was constructed using R software. Results: The incidence rate of 28 symptoms was ≥ 20%, indicating a heavy symptom burden for the patients. Exploratory factor analysis identified seven symptom clusters: musculoskeletal, reproductive system, skin metabolism, vasomotor, cardiovascular somatic discomfort, sleep and psychological, and psychosocial function. Symptom network analysis revealed that hot flashes stood out in terms of intensity, closeness, and betweenness centrality, making it the core symptom of this symptom network. Conclusion: Symptoms in patients undergoing endocrine therapy for breast cancer are interwoven, with hot flashes being the core symptom. Nursing staff should focus on intervening in core symptoms to enhance the efficiency of symptom management.