Associations between interoceptive awareness and symptom clusters in patients with lung cancer undergoing chemotherapy: A joint network analysis
Year: 2026
Type: article
Study design: Observational Study
Abstract: Objective: To identify symptom clusters among patients with lung cancer undergoing chemotherapy and examine associations and directional dependencies between multidimensional interoceptive awareness and these clusters. Methods: A cross-sectional study was conducted at two campuses of a tertiary hospital in China. Interoceptive awareness and symptom burden were assessed using the Multidimensional Assessment of Interoceptive Awareness-2 and the M.D. Anderson Symptom Inventory-Lung Cancer Module. Symptom clusters were identified via exploratory factor analysis. Gaussian graphical network analysis examined associations and bridge centrality, while Bayesian network analysis explored directional probabilistic dependencies. Results: Among 514 patients, 56.4% were aged ≥ 65 years, and 89.5% had stage III-IV disease. Four symptom clusters emerged: psychological, gastrointestinal, respiratory, and neurocognitive. Network analysis showed the psychological and respiratory clusters were most strongly associated with the Not-Worrying (weight = -0.407) and Trusting (weight = -0.430) dimensions, respectively. Not-Worrying, Trusting, and drowsiness showed the highest bridge strengths in the psychological, respiratory, and neurocognitive symptom-level networks, respectively. Bayesian analysis identified connections between interoceptive awareness dimensions and symptoms in the psychological, respiratory, and neurocognitive networks, but no cross-community connections in the gastrointestinal network. At the symptom level, Not-Worrying was linked to pain and sadness within the psychological cluster; respiratory symptoms were linked to Trusting within the respiratory cluster; and multiple interoceptive dimensions were linked to drowsiness within the neurocognitive cluster. Conclusions: The Not-Worrying and Trusting dimensions emerged as key bridging dimensions for the psychological and respiratory clusters, respectively, while drowsiness was the key bridge symptom within the neurocognitive cluster. These findings highlight dimension-specific patterns linking interoceptive awareness to symptom clusters, offering hypotheses for future longitudinal and intervention research.
Institutions: Jiangnan University, Wuxi Fourth People's Hospital
Language: English
Topic: Cancer survivorship and care
Subfield: Oncology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $1,980
OpenAlex ID: W7214215584