To explore the symptoms and clusters of patients with advanced non-small cell lung cancer (NSCLC) , and to discuss the correlation between their symptom clusters and quality of life.

A total of 150 patients who were diagnosed of advanced NSCLC in Nanjing Chest Hospital between January 2015 and December 2016 were selected by convenience sampling. The patients' basic information was collected, and their symptoms and quality of life were evaluated with M. D. Anderson symptom inventory (MDASI) and functional assessment of cancer therapy-lung (FACT-L) . The symptom clusters were extracted by principal component analysis, and the correlation between symptom clusters and the quality of life were then explored through correlation analysis and multivariate regression analysis.

The top 3 symptoms in terms of severity in the 150 advanced NSCLC patients were fatigue, poor appetite and shortness of breath, while the top 3 symptoms in terms of frequency were fatigue, poor appetite and distress. Totally 4 symptom clusters were extracted by principal component analysis, including the emotional symptom cluster, the fatigue cluster, the illness perception cluster and the gastrointestinal tract cluster. The 4 symptom clusters were negatively correlated with the quality of life (r=-0.359- -0.721, P<0.05) . According to the multivariate regression analysis, the gastrointestinal tract and fatigue clusters were the main factors contributing to the life quality in advanced NSCLC patients (R²=0.522, P<0.05) .

Advanced NSCLC patients were plagued with multiple symptom clusters. Therefore, nursing staff should build an efficient symptom management pattern to improve their quality of life.

Carcinoma, non-small cell lung; Quality of life; Nursing care; Symptom cluster