Objective To explore the incidence and severity of diverse clinical symptoms in patients with severe acute pancreatitis (SAP), construct a symptom correlation network model, accurately identify core symptoms within the network, and classify symptom clusters. MethodsA convenience sampling method was adopted. A total of 211 patients with SAP admitted to the First Affiliated Hospital with Nanjing Medical University (Jiangsu Provincial People’s Hospital) from January 2024 to December 2025 were enrolled. The memorial symptom assessment scale was used for evaluation to investigate the composition of clinical symptoms in SAP patients. Exploratory factor analysis was performed to extract symptom clusters. R 4.4.2 software was applied to construct symptom clusters network. Centrality indicators including strength, betweenness and closeness were analyzed to identify core symptoms and core symptom clusters. ResultsA total of three symptom clusters were extracted in this study, including the gastrointestinal symptom cluster (abdominal pain, abdominal distension, dyspnea, dry mouth, nausea, vomiting, diarrhea, constipation, dizziness), the fatigue symptom cluster (lack of energy, difficulty concentrating, drowsiness), and the psychological symptom cluster (anxiety, sleep disturbance, irritability, sadness, distress). Among them, anxiety [95.7% (202/211)], difficulty concentrating [94.8% (200/211)], lack of energy [92.4% (195/211)], and abdominal pain [90.0% (190/211)] were identified as core symptoms. Symptoms with high strength values included anxiety (rs=2.2), difficulty concentrating (rs=1.2), and dyspnea (rs=1.0); symptoms with high closeness centrality values included drowsiness (rc=1.8), difficulty concentrating (rc=1.7), and anxiety (rc=1.1); symptoms with high betweenness centrality values included difficulty concentrating (rb=2.3), anxiety (rb=2.0), and drowsiness (rb=1.5). ConclusionsAnxiety, difficulty concentrating, lack of energy, and abdominal pain were identified as the core symptoms within the symptom clusters of SAP patients, with the fatigue symptom cluster being the core symptom cluster. It is recommended that medical staff pay close attention to the manifestations of core symptoms in SAP patients during treatment and formulate targeted symptom management plans.
Patients with lung cancer commonly experience multiple interrelated symptoms during chemotherapy, including fatigue, pain, and sleep disturbance, which together form a core symptom cluster and substantially impair daily functioning, treatment experience, and quality of life. At present, evidence regarding the non-pharmacological management of this core symptom cluster remains fragmented, and there is a lack of standardized, comprehensible, and practical guidance tools designed for patients and their caregivers. This guideline was developed using an evidence-based methodological framework. Stakeholders’ health-related needs and concerns were identified through qualitative interviews and on-site questionnaire surveys. In accordance with predefined inclusion and exclusion criteria, systematic searches were conducted across domestic and international guideline repositories, websites of relevant professional associations, and comprehensive databases. The included literature was subjected to quality appraisal, and recommendations were extracted, synthesized, and graded to produce a summary of the best available evidence. Based on the identified health concerns and the evidence summary, preliminary recommendations for the patient guideline were formulated. These recommendations were subsequently revised through two rounds of Delphi expert consultation, during which consensus was reached on the strength of each recommendation. The final guideline comprises four major domains: screening and assessment of the core symptom cluster, daily management, intervention strategies, and indications for referral. Its core content covers nine areas: symptom-cluster screening, assessment, lifestyle modification, dietary interventions, sleep environment optimization, exercise interventions, psychological interventions, Traditional Chinese Medicine interventions, and referral criteria. The development of this patient guideline followed a rigorous process and fully incorporated patients’ needs, which demonstrates good feasibility, appropriateness, and clinical relevance, and can provide a decision-making basis for the self-management of the core symptom cluster among patients with lung cancer undergoing chemotherapy.