Application of symptom network analysis among patients with gastric cancer: A scoping review
- 1School of Nursing, Yunnan University of Chinese Medicine, Kunming, Yunnan, China
- 2Department of Nursing, The First People’s Hospital of Yunnan Province, Kunming, Yunnan, China
Abstract
Objective: To map evidence on symptom network analysis in patients with gastric cancer by summarizing study characteristics, commonly used assessment tools, central and bridge symptoms, temporal symptom relationships, and associated factors, and to provide a basis for precision symptom management. Methods: This scoping review was guided by the Arksey and O’Malley framework and reported in accordance with the PRISMA extension for Scoping Reviews (PRISMA-ScR). PubMed, Web of Science, CINAHL, Cochrane Library, Embase, CNKI, Wanfang Data, VIP, and CBM were systematically searched from database inception to April 1, 2026. Original studies published in Chinese or English that applied symptom network analysis to gastric cancer populations, including eligible mixed cancer populations with gastric cancer patients, during the perioperative period or chemotherapy were included. Literature screening, data extraction, and narrative synthesis were performed. Results: A total of 9 studies were included. Six symptom assessment tools were identified, with the Chinese version of the MD Anderson Symptom Inventory–Gastrointestinal Cancer Module (MDASI-GI-C) being the most frequently used tool (reported in 7 studies). Nine core symptoms were identified across the included studies, with fatigue being the most frequently reported core symptom (identified in 5 studies). Ten bridge symptoms were identified; however, considerable variation was observed in the identification of bridge symptoms across studies. Longitudinal analyses suggested that phlegm-dampness constitution was associated with subsequent changes in taste, while changes in taste were associated with subsequent appetite loss. Conclusions: The symptom profiles of patients with gastric cancer are characterized by complexity, dynamic changes across treatment stages, and population heterogeneity. Symptom management strategies may benefit from individualized and stage-specific approaches targeting core symptoms, bridge symptoms, and key symptom pathways. Future research should focus on standardizing symptom assessment tools and assessment time points, conducting multicenter longitudinal studies, and supporting the development and evaluation of interventions for clinical practice. Trial registration: OSF Registration DOI: https://doi.org/10.17605/OSF.IO/MJAZ3
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BibTeX
@article{zhu2026application,
title = {{Application of symptom network analysis among patients with gastric cancer: A scoping review}},
author = {Qiu Zhu and Zijing Duan and Yi Dai and Junting Chi and Wangao Guan and Lixuan Dong and Qingjiao Lin and Yingying Fu},
journal = {PLOS One},
year = {2026},
month = sep,
doi = {10.1371/journal.pone.0358940},
url = {https://doi.org/10.1371/journal.pone.0358940},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Application of symptom network analysis among patients with gastric cancer: A scoping review
AU - Qiu Zhu
AU - Zijing Duan
AU - Yi Dai
AU - Junting Chi
AU - Wangao Guan
AU - Lixuan Dong
AU - Qingjiao Lin
AU - Yingying Fu
PY - 2026
DA - 2026/09/21
JO - PLOS One
DO - 10.1371/journal.pone.0358940
UR - https://doi.org/10.1371/journal.pone.0358940
AB - Objective: To map evidence on symptom network analysis in patients with gastric cancer by summarizing study characteristics, commonly used assessment tools, central and bridge symptoms, temporal symptom relationships, and associated factors, and to provide a basis for precision symptom management. Methods: This scoping review was guided by the Arksey and O’Malley framework and reported in accordance with the PRISMA extension for Scoping Reviews (PRISMA-ScR). PubMed, Web of Science, CINAHL, Cochrane Library, Embase, CNKI, Wanfang Data, VIP, and CBM were systematically searched from database inception to April 1, 2026. Original studies published in Chinese or English that applied symptom network analysis to gastric cancer populations, including eligible mixed cancer populations with gastric cancer patients, during the perioperative period or chemotherapy were included. Literature screening, data extraction, and narrative synthesis were performed. Results: A total of 9 studies were included. Six symptom assessment tools were identified, with the Chinese version of the MD Anderson Symptom Inventory–Gastrointestinal Cancer Module (MDASI-GI-C) being the most frequently used tool (reported in 7 studies). Nine core symptoms were identified across the included studies, with fatigue being the most frequently reported core symptom (identified in 5 studies). Ten bridge symptoms were identified; however, considerable variation was observed in the identification of bridge symptoms across studies. Longitudinal analyses suggested that phlegm-dampness constitution was associated with subsequent changes in taste, while changes in taste were associated with subsequent appetite loss. Conclusions: The symptom profiles of patients with gastric cancer are characterized by complexity, dynamic changes across treatment stages, and population heterogeneity. Symptom management strategies may benefit from individualized and stage-specific approaches targeting core symptoms, bridge symptoms, and key symptom pathways. Future research should focus on standardizing symptom assessment tools and assessment time points, conducting multicenter longitudinal studies, and supporting the development and evaluation of interventions for clinical practice. Trial registration: OSF Registration DOI: https://doi.org/10.17605/OSF.IO/MJAZ3
SN - 1932-6203
ER -