ArticleAsia-Pacific journal of oncology nursing2026
Bridging symptoms linking postoperative symptom clusters seven days after esophagectomy: A multicenter network analysis of 418 patients with esophageal cancer.
Article in Asia-Pacific journal of oncology nursing, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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1 citing paper in PubMed.
- Network analysis of distress, symptom burden, social support, and digital health literacy in older postoperative patients with gastric cancer.Frontiers in psychiatry · 2026Article
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5 authors.
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Abstract
Objective: To identify symptom clusters and key bridging symptoms among patients with esophageal cancer on postoperative day 7 after esophagectomy, and to examine sociodemographic correlates of these bridging symptoms. Methods: This multicenter, cross-sectional study was conducted in three tertiary hospitals in Hefei, Anhui Province, China, between January 2024 and January 2025. A total of 418 patients with esophageal cancer completed the 28-item Convalescent Symptom Assessment Scale for Esophagectomy Patients (CSAS-EC) on postoperative day 7. Exploratory factor analysis (EFA) was used to identify symptom clusters. Symptom networks were estimated using the EBICglasso model (qgraph/bootnet), and bridge centrality indices (bridge strength and bridge expected influence) were calculated using the networktools package to identify bridging symptoms. Network stability was assessed using 1000 bootstrap samples. Independent-samples t-tests and one-way ANOVA were applied to explore associations between bridging symptom severity and sociodemographic characteristics. Results: Four distinct symptom clusters were identified: psychological, surgery-related, life-disturbance, and local symptoms. Network analysis revealed that disturbed sleep (bridge strength = 0.690), incisional pain (0.587), and limited mobility (0.537) were the top three bridging symptoms linking different clusters. The stability of bridge centrality indices was robust (CS-cor = 0.672 for both bridge strength and bridge expected influence). The severity of these key symptoms differed significantly according to age, sex, place of residence, and caregiver status (all Conclusions: Disturbed sleep, incisional pain and limited mobility act as key bridging symptoms linking distinct symptom clusters in patients with Esophageal cancer seven days after esophagectomy. Prioritizing interventions that address these symptoms may interrupt inter-cluster symptom propagation and improve efficiency of postoperative symptom management.
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