Latent Transition Analysis of Symptom Burden Before and After Pulmonary Rehabilitation in Postoperative Lung Cancer Patients.
- 1Department of Cardiothoracic Surgery, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, People's Republic of China.
Abstract
Aim
To identify latent classes of symptom burden in lung cancer patients before and after pulmonary rehabilitation (PR) and to examine factors associated with transitions between classes.Design
A longitudinal study.Methods
The M. D. Anderson Symptom Inventory (Chinese version) was completed by 273 postoperative lung cancer patients before (T1) and 12 weeks after PR (T2). Latent profile analysis identified symptom burden classes, and latent transition analysis estimated the probability of moving between classes. Measurement invariance was tested, and the two-class solution was retained on the basis of fit indices, entropy and interpretability. Univariate-significant variables entered a logistic regression model.Results
Two latent classes were identified at both T1 and T2 (high and low symptom burden). The two-class solution was retained because it showed the lowest AIC, BIC and aBIC, adequate entropy (0.844 at T1; 0.902 at T2) and interpretable profiles, whereas the three-class model did not improve fit and yielded small classes. Among 262 patients (95.97% valid), the low burden class was stable (0.863), and 61.07% of patients in the high burden class at T1 moved to the low burden class at T2; these probabilities denote the proportion of patients moving between classes. Age <45 years (OR = 2.345), no financial burden (OR = 2.841), satisfactory sleep (OR = 3.130) and family living (OR = 2.949) were associated with transition from the high to the low burden class, whereas age ≥60 years (OR = 0.724), unmarried (OR = 0.418) and divorced (OR = 0.405) status with lower odds of transition.Conclusion
Symptom burden in postoperative lung cancer patients is heterogeneous and follows class-specific trajectories. Younger age, better sleep and stronger family and financial resources were associated with a favourable transition. As this was a single-arm observational study, the findings indicate associations rather than causal effects of PR.
Related
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- Knowledge, Attitudes, and Practice Regarding Postoperative Rehabilitation Among Patients Who Underwent Biliary Surgery and Their Family Members: A Cross-Sectional Study.
- Latent classes and symptom network analysis of kinesiophobia in older adult patients with chronic obstructive pulmonary disease.
BibTeX
@article{wu2026latent,
title = {{Latent Transition Analysis of Symptom Burden Before and After Pulmonary Rehabilitation in Postoperative Lung Cancer Patients.}},
author = {Ying Wu and Qun Yang and Jinguo Wang and Yunyun Xu and Tingting Li},
journal = {Cancer management and research},
year = {2026},
month = oct,
doi = {10.2147/cmar.s617802},
url = {https://europepmc.org/article/MED/42947954},
note = {CC BY-NC},
}
RIS
TY - JOUR
TI - Latent Transition Analysis of Symptom Burden Before and After Pulmonary Rehabilitation in Postoperative Lung Cancer Patients.
AU - Ying Wu
AU - Qun Yang
AU - Jinguo Wang
AU - Yunyun Xu
AU - Tingting Li
PY - 2026
DA - 2026/10/22
JO - Cancer management and research
DO - 10.2147/cmar.s617802
UR - https://europepmc.org/article/MED/42947954
AB - Aim To identify latent classes of symptom burden in lung cancer patients before and after pulmonary rehabilitation (PR) and to examine factors associated with transitions between classes.Design A longitudinal study.Methods The M. D. Anderson Symptom Inventory (Chinese version) was completed by 273 postoperative lung cancer patients before (T1) and 12 weeks after PR (T2). Latent profile analysis identified symptom burden classes, and latent transition analysis estimated the probability of moving between classes. Measurement invariance was tested, and the two-class solution was retained on the basis of fit indices, entropy and interpretability. Univariate-significant variables entered a logistic regression model.Results Two latent classes were identified at both T1 and T2 (high and low symptom burden). The two-class solution was retained because it showed the lowest AIC, BIC and aBIC, adequate entropy (0.844 at T1; 0.902 at T2) and interpretable profiles, whereas the three-class model did not improve fit and yielded small classes. Among 262 patients (95.97% valid), the low burden class was stable (0.863), and 61.07% of patients in the high burden class at T1 moved to the low burden class at T2; these probabilities denote the proportion of patients moving between classes. Age <45 years (OR = 2.345), no financial burden (OR = 2.841), satisfactory sleep (OR = 3.130) and family living (OR = 2.949) were associated with transition from the high to the low burden class, whereas age ≥60 years (OR = 0.724), unmarried (OR = 0.418) and divorced (OR = 0.405) status with lower odds of transition.Conclusion Symptom burden in postoperative lung cancer patients is heterogeneous and follows class-specific trajectories. Younger age, better sleep and stronger family and financial resources were associated with a favourable transition. As this was a single-arm observational study, the findings indicate associations rather than causal effects of PR.
SN - 1179-1322
ER -