Exploring core symptoms and symptom clusters among patients with neuromyelitis optica spectrum disorder: A network analysis  

视神经脊髓炎谱系疾病患者症状群的网络分析及护理启示

作　　者：Hao Liang Jiehan Chen Lixin Wang Zhuyun Liu Haoyou Xu Min Zhao Xiaopei Zhang 梁好;陈捷晗;王立新;刘竹韵;许浩游;赵敏;张小培

机构地区：[1]Department of Neurology,The Second Affiliated Hospital of Guangzhou University of Chinese Medicine/Guangdong Provincial Hospital of Chinese Medicine,Guangzhou,Guangdong,China

出　　处：《International Journal of Nursing Sciences》2025年第2期152-160,共9页国际护理科学(英文)

基　　金：supported by the Specific Research Fund for Top-notch Talents of Guangdong Provincial Hospital of Chinese Medicine(No.2022KT1188).

摘　　要：Objectives To identify core symptoms and symptom clusters in patients with neuromyelitis optica spectrum disorder(NMOSD)by network analysis.Methods From October 10 to 30,2023,140 patients with NMOSD were selected to participate in this online questionnaire survey.The survey tools included a general information questionnaire and a self-made NMOSD symptoms scale,which included the prevalence,severity,and distress of 29 symptoms.Cluster analysis was used to identify symptom clusters,and network analysis was used to analyze the symptom network and node characteristics and central indicators including strength centrality(r_(s)),closeness centrality(r_(c))and betweeness centrality(r_(b))were used to identify core symptoms and symptom clusters.Results The most common symptom was pain(65.7%),followed by paraesthesia(65.0%),fatigue(65.0%),easy awakening(63.6%).Regarding the burden level of symptoms,pain was the most burdensome symptom,followed by paraesthesia,easy awakening,fatigue,and difficulty falling asleep.Six clusters were identified:somatosensory,motor,visual,and memory symptom clusters,bladder and rectum symptom clusters,sleep symptoms clusters,and neuropsychological symptom clusters.Fatigue(r_(s)=12.39,r_(b)=68.00,r_(c)=0.02)was the most central and prominent bridge symptom,and motor symptom cluster(r_(s)=2.68,r_(c)=0.10)was the most central symptom cluster among the six clusters.Conclusions Our study demonstrated the necessity of symptom management targeting fatigue,pain,and motor symptom cluster in patients with NMOSD.目的通过网络分析识别视神经脊髓炎谱系疾病(neuromyelitis optica spectrumdisorder,NMOSD)患者的核心症状及症状群。方法于2023年10月10日至30日,采用便利抽样法选取140例NMOSD患者为研究对象。采用一般资料调查表与自制NMOSD症状量表收集相关数据,自制量表包括29种症状的发生率、严重程度及对生活的困扰程度。采用聚类分析明确NMOSD患者的症状群,使用网络分析构建症状严重程度网络和症状群网络并分析中心性指标以确定核心症状及症状群,包括强度(r。)、紧密度(rc)和中介度(r)。结果NMOSD患者发生率最高的症状为疼痛(65.7%)、感觉异常(65.0%)、疲劳(65.0%)、易醒(63.6%),最严重的症状为疼痛、感觉异常、易醒、疲劳和入睡困难。NMOSD患者存在6个症状群,分别为躯体感觉、运动、视觉和记忆、膀胱和直肠、睡眠和神经心理症状群。疲劳(r_(s)=12.39,r_(b)=68.00,r_(c)=0.02)是最核心的症状,运动症状群(r_(s)=2.68,r_(c)=0.10)是最核心的症状群。结论该研究表明疲劳是NMODS患者最核心的症状,运动症状群是最核心的症状群,医护人员应基于核心症状和症状群制订干预措施,实施精准化症状管理。

关 键 词：Neuromyelitis optica spectrum disorder Network analysis SYMPTOM Symptom clusters NURSING 

分 类 号：R47[医药卫生—护理学]