Symptom Clusters and Sentinel Symptoms in Newly Diagnosed Patients With Gastric Cancer: A Cross‐Sectional Study

Newly diagnosed patients with gastric cancer often experience multiple co-occurring symptoms before anticancer treatment, and clarifying these patterns may support earlier nursing assessment and supportive care. This cross-sectional study aimed to identify symptom clusters and key symptom roles, including sentinel, core, and bridge symptoms, in newly diagnosed patients with gastric cancer before treatment. A total of 439 patients completed the MD Anderson Symptom Inventory Gastrointestinal Cancer Module Chinese version within 24 h of admission. Exploratory factor analysis and network analysis were performed using R version 4.3.0 with the psych, qgraph, bootnet, and networktools packages, and association rule mining was conducted in Python using pandas and mlxtend. Two symptom clusters were identified: gastrointestinal and psychosomatic. Vomiting and fatigue emerged as core symptoms, drowsiness was the principal bridge symptom, and vomiting and difficulty remembering were the principal sentinel symptoms. These findings suggest that vomiting, fatigue, drowsiness, and difficulty remembering may be useful targets for early nursing assessment and supportive care.