TY - JOUR
T1 - Symptom networks in glioma patients
T2 - understanding the multidimensionality of symptoms and quality of life
AU - Röttgering, J. G.
AU - Varkevisser, T. M. C. K.
AU - Gorter, M.
AU - Belgers, V.
AU - de Witt Hamer, P. C.
AU - Reijneveld, J. C.
AU - Klein, M.
AU - Blanken, T. F.
AU - Douw, L.
N1 - Funding Information: The work was supported by the Stichting Anita Veldman Foundation CCA.2019.2–21. Data collection in this study was funded by the Dutch Epilepsy Foundation NEF 08–08, 09–09; the Dutch Research Council (NWO) Veni 016.146.086; NWO Vidi 198.015; and Branco Weiss Fellowship. Publisher Copyright: © 2023, The Author(s).
PY - 2023
Y1 - 2023
N2 - Purpose: To comprehend the complex relationship between symptoms and health-related quality of life (HRQoL) in patients with diffuse glioma, we applied symptom network analysis to identify patterns of associations between depression, cognition, brain tumor-related symptoms, and HRQoL. Additionally, we aimed to compare global strength between symptom networks to understand if symptoms are more tightly connected in different subgroups of patients. Methods: We included 256 patients and stratified the sample based on disease status (preoperative vs. postoperative), tumor grade (grade II vs. III/IV), and fatigue status (non-fatigued vs. fatigued). For each subgroup of patients, we constructed a symptom network. In these six networks, each node represented a validated subscale of a questionnaire and an edge represented a partial correlation between two nodes. We statistically compared global strength between networks. Results: Across the six networks, nodes were highly correlated: fatigue severity, depression, and social functioning in particular. We found no differences in GS between the networks based on disease characteristics. However, global strength was lower in the non-fatigued network compared to the fatigued network (5.51 vs. 7.49, p < 0.001). Conclusions: Symptoms and HRQoL are highly interrelated in patients with glioma. Interestingly, nodes in the network of fatigued patients were more tightly connected compared to non-fatigued patients. Implications for Cancer Survivors: We introduce symptom networks as a method to understand the multidimensionality of symptoms in glioma. We find a clear association between multiple symptoms and HRQoL, which underlines the need for integrative symptom management targeting fatigue in particular.
AB - Purpose: To comprehend the complex relationship between symptoms and health-related quality of life (HRQoL) in patients with diffuse glioma, we applied symptom network analysis to identify patterns of associations between depression, cognition, brain tumor-related symptoms, and HRQoL. Additionally, we aimed to compare global strength between symptom networks to understand if symptoms are more tightly connected in different subgroups of patients. Methods: We included 256 patients and stratified the sample based on disease status (preoperative vs. postoperative), tumor grade (grade II vs. III/IV), and fatigue status (non-fatigued vs. fatigued). For each subgroup of patients, we constructed a symptom network. In these six networks, each node represented a validated subscale of a questionnaire and an edge represented a partial correlation between two nodes. We statistically compared global strength between networks. Results: Across the six networks, nodes were highly correlated: fatigue severity, depression, and social functioning in particular. We found no differences in GS between the networks based on disease characteristics. However, global strength was lower in the non-fatigued network compared to the fatigued network (5.51 vs. 7.49, p < 0.001). Conclusions: Symptoms and HRQoL are highly interrelated in patients with glioma. Interestingly, nodes in the network of fatigued patients were more tightly connected compared to non-fatigued patients. Implications for Cancer Survivors: We introduce symptom networks as a method to understand the multidimensionality of symptoms in glioma. We find a clear association between multiple symptoms and HRQoL, which underlines the need for integrative symptom management targeting fatigue in particular.
KW - Brain neoplasms
KW - Fatigue
KW - Mental health
KW - Network analysis
KW - Patient-reported outcome measures
KW - Quality of life
UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85149918069&origin=inward
UR - https://www.ncbi.nlm.nih.gov/pubmed/36922442
U2 - https://doi.org/10.1007/s11764-023-01355-8
DO - https://doi.org/10.1007/s11764-023-01355-8
M3 - Article
C2 - 36922442
SN - 1932-2259
JO - Journal of cancer survivorship
JF - Journal of cancer survivorship
ER -