Symptom Cluster Trajectories Among Patients With Hepatocellular Carcinoma After Partial Hepatectomy: A Longitudinal Study

AIMS: To investigate types of symptom clusters in patients with hepatocellular carcinoma after partial hepatectomy and explore symptom cluster trajectories over time. DESIGN: A longitudinal observational study was conducted. METHODS: Symptoms of patients with hepatocellular carcinoma were assessed on the second day, seventh day, third week, fourth week and twelfth week post-operation using the MD Anderson Symptom Assessment Inventory and the Symptom Module for Primary Liver Cancer. Symptom clusters were extracted using exploratory factor analysis, and symptom cluster trajectories were analysed using a latent class growth model. RESULTS: Two hundred and thirty patients with hepatocellular carcinoma completed the five-point investigation after partial hepatectomy. Three symptom clusters were identified: general somatic, psychological and liver impairment. Each symptom cluster was further categorised into three groups: severe, moderate and low. The severity of the three symptom clusters and subgroups decreased over time. CONCLUSION: Three symptom clusters were identified in patients who underwent partial hepatectomy for hepatocellular carcinoma, and symptom cluster trajectories decreased over time during the 12-week postoperative period. These findings will assist healthcare professionals in providing prompt symptom management and improve patient quality of life. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: Healthcare professionals should evaluate symptom clusters and their trajectories in patients with hepatocellular carcinoma after partial hepatectomy. REPORTING METHOD: This report was prepared in accordance with the Guidelines for Reporting Cohort Research. PATIENT OR PUBLIC CONTRIBUTION: Hepatobiliary surgery nurses worked closely with the research team to ensure the questionnaires were fully assessed before being sent to patients. The active participation of patients provided valuable information for the study. TRIAL REGISTRATION: Chinese Clinical Trial Registry (ChiCTR2400084232).