Temporal relationship between symptom cluster and quality of life in rectal cancer patients after laparoscopic anus-preserving surgery

Abstract Although it is generally recognized that symptom clusters and quality of life are related, major ambiguity arises from the difficulty in determining their causal relationship. The present study aimed to investigate longitudinal causal relationships between symptom clusters and quality of li...

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Main Authors: Chaoxiang You, Guiqiong Xie, Shun Lin, Shuang Li, Mengying Jia, Xiufei Wu, Xiaoxuan Zhang, Yi Zhou, Hongyan Kou
Format: Article
Language:English
Published: Nature Portfolio 2024-12-01
Series:Scientific Reports
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Online Access:https://doi.org/10.1038/s41598-024-83755-z
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author Chaoxiang You
Guiqiong Xie
Shun Lin
Shuang Li
Mengying Jia
Xiufei Wu
Xiaoxuan Zhang
Yi Zhou
Hongyan Kou
author_facet Chaoxiang You
Guiqiong Xie
Shun Lin
Shuang Li
Mengying Jia
Xiufei Wu
Xiaoxuan Zhang
Yi Zhou
Hongyan Kou
author_sort Chaoxiang You
collection DOAJ
description Abstract Although it is generally recognized that symptom clusters and quality of life are related, major ambiguity arises from the difficulty in determining their causal relationship. The present study aimed to investigate longitudinal causal relationships between symptom clusters and quality of life. 128 patients with rectal cancer from Nanchong City, Sichuan Province who underwent laparoscopic anus-preserving surgery completed 4 follow-up visits, and the survey time point are 2 weeks after surgery (T1), 1 month after surgery (T2), 3 months after surgery (T3), and 6 months after surgery (T4). We used the Anderson Gastrointestinal Cancer Symptom Assessment Scale and the Colorectal Cancer Quality of Life Measurement Scale to evaluate the patient’s symptom incidence, symptom severity, and quality of life at four time points respectively. After extracting symptom clusters by symptom, we constructed A four-wave cross-lagged model analyzed the causal relationship between symptom clusters and quality of life. Our research results show that the patients with rectal cancer treated by laparoscopic anus-preserving surgery have four symptom clusters during the 6 months after surgery, which are named sickness symptom cluster, gastrointestinal symptom cluster, psychological-sleep symptom cluster and Psycho-therapy related symptom clusters. Pearson correlation analysis showed that symptom clusters and quality of life were negatively correlated. The cross-lagged path effect coefficient shows that the impact of quality of life on symptom clusters is stronger than the impact of symptom clusters on quality of life (β = − 0.164 to − 0.713, P<0.05). The four-wave cross-lagged model showed that quality of life can significantly negatively predict the sickness symptom cluster and gastrointestinal symptom cluster, but this relationship is not bidirectional. Only T3 quality of life significantly negatively predicted the psycho-sleep symptom cluster, and the reverse path was also not observed. These findings provide evidence that decreases in quality of life levels precede increases in symptom cluster severity. There is a one-way temporal correlation between symptom clusters and quality of life. The decrease in quality of life leads to an increase in the severity of symptom clusters. The improvement in overall quality of life is expected to alleviate the distress of symptom clusters.
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spelling doaj-art-06e1a5213f0c4e93856000e77d2bd4672025-01-05T12:23:40ZengNature PortfolioScientific Reports2045-23222024-12-0114111010.1038/s41598-024-83755-zTemporal relationship between symptom cluster and quality of life in rectal cancer patients after laparoscopic anus-preserving surgeryChaoxiang You0Guiqiong Xie1Shun Lin2Shuang Li3Mengying Jia4Xiufei Wu5Xiaoxuan Zhang6Yi Zhou7Hongyan Kou8Department of Gastroenterology, Deyang People’s HospitalDepartment of Gastroenterology, Deyang People’s HospitalDepartmen of Pediatrics, The Second People’s Hospital of DeyangDepartment of Gastrointestinal Surgery, Affiliated Hospital of North Sichuan Medical CollegeDepartment of Gastrointestinal Surgery, Affiliated Hospital of North Sichuan Medical CollegeDepartment of Gastrointestinal Surgery, Affiliated Hospital of North Sichuan Medical CollegeDepartment of Gastrointestinal Surgery, Affiliated Hospital of North Sichuan Medical CollegeDepartment of Gastrointestinal Surgery, Affiliated Hospital of North Sichuan Medical CollegeDepartment of Gastrointestinal Surgery, Affiliated Hospital of North Sichuan Medical CollegeAbstract Although it is generally recognized that symptom clusters and quality of life are related, major ambiguity arises from the difficulty in determining their causal relationship. The present study aimed to investigate longitudinal causal relationships between symptom clusters and quality of life. 128 patients with rectal cancer from Nanchong City, Sichuan Province who underwent laparoscopic anus-preserving surgery completed 4 follow-up visits, and the survey time point are 2 weeks after surgery (T1), 1 month after surgery (T2), 3 months after surgery (T3), and 6 months after surgery (T4). We used the Anderson Gastrointestinal Cancer Symptom Assessment Scale and the Colorectal Cancer Quality of Life Measurement Scale to evaluate the patient’s symptom incidence, symptom severity, and quality of life at four time points respectively. After extracting symptom clusters by symptom, we constructed A four-wave cross-lagged model analyzed the causal relationship between symptom clusters and quality of life. Our research results show that the patients with rectal cancer treated by laparoscopic anus-preserving surgery have four symptom clusters during the 6 months after surgery, which are named sickness symptom cluster, gastrointestinal symptom cluster, psychological-sleep symptom cluster and Psycho-therapy related symptom clusters. Pearson correlation analysis showed that symptom clusters and quality of life were negatively correlated. The cross-lagged path effect coefficient shows that the impact of quality of life on symptom clusters is stronger than the impact of symptom clusters on quality of life (β = − 0.164 to − 0.713, P<0.05). The four-wave cross-lagged model showed that quality of life can significantly negatively predict the sickness symptom cluster and gastrointestinal symptom cluster, but this relationship is not bidirectional. Only T3 quality of life significantly negatively predicted the psycho-sleep symptom cluster, and the reverse path was also not observed. These findings provide evidence that decreases in quality of life levels precede increases in symptom cluster severity. There is a one-way temporal correlation between symptom clusters and quality of life. The decrease in quality of life leads to an increase in the severity of symptom clusters. The improvement in overall quality of life is expected to alleviate the distress of symptom clusters.https://doi.org/10.1038/s41598-024-83755-zRectal neoplasmSymptom clusterQuality of lifeBidirectional relationship
spellingShingle Chaoxiang You
Guiqiong Xie
Shun Lin
Shuang Li
Mengying Jia
Xiufei Wu
Xiaoxuan Zhang
Yi Zhou
Hongyan Kou
Temporal relationship between symptom cluster and quality of life in rectal cancer patients after laparoscopic anus-preserving surgery
Scientific Reports
Rectal neoplasm
Symptom cluster
Quality of life
Bidirectional relationship
title Temporal relationship between symptom cluster and quality of life in rectal cancer patients after laparoscopic anus-preserving surgery
title_full Temporal relationship between symptom cluster and quality of life in rectal cancer patients after laparoscopic anus-preserving surgery
title_fullStr Temporal relationship between symptom cluster and quality of life in rectal cancer patients after laparoscopic anus-preserving surgery
title_full_unstemmed Temporal relationship between symptom cluster and quality of life in rectal cancer patients after laparoscopic anus-preserving surgery
title_short Temporal relationship between symptom cluster and quality of life in rectal cancer patients after laparoscopic anus-preserving surgery
title_sort temporal relationship between symptom cluster and quality of life in rectal cancer patients after laparoscopic anus preserving surgery
topic Rectal neoplasm
Symptom cluster
Quality of life
Bidirectional relationship
url https://doi.org/10.1038/s41598-024-83755-z
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