Objective To investigate the current status of symptom cluster burden in lung cancer patients after thoracoscopic surgery and to explore the influencing factors.

Methods  A total of 178 patients undergoing thoracoscopic surgery were selected as the research subjects. The relevant demographic data and disease information of the patients were collected. The breath-holding test was used to assess basic cardiopulmonary function. The Barthel Index was used to assess activities of daily living. The Nutritional Risk Screening Scale-2002 was used to assess nutritional risk. The Tilburg Frailty Indicator was used to assess frailty. The Perceived Social Support Scale was used to assess social support. The Cancer Self-Management Efficacy Scale was used to evaluate self-efficacy. The Chinese version of the M.D. Andersen Symptom Assessment Inventory (MDASI-C) and the revised lung cancer-specific module (MDASI-LC) were used to survey symptom cluster burden after the operation.

Results The total mean score of symptom cluster burdern in postoperative lung cancer patients was (4.28 ± 0.26), indicating a moderate level of burden. The occurrence frequency of symptoms such as fatigue, coughing and distress was relatively high, while the severity of symptoms such as sleep disturbance, pain and fatigue was relatively severe. Age, duration of chest tube placement, cardiopulmonary function, frailty, social support, and disease self-management efficacy were the main influencing factors for the symptom burden level of postoperative lung cancer patients (P ＜ 0.05), collectively explaining 61.60% of the total variance.

Conclusions Lung cancer patients after thoracoscopic surgery experience decreased physical function and a significant symptom cluster burden. Nursing staff should focus on elderly patients, those with long-term indwelling of chest tubes, poor cardiopulmonary function, frailty, low levels of social support, and low self-efficacy in disease management. By developing scientifically effective strategies for managing symptom clusters, they can reduce the disease burden and improve the level of early functional rehabilitation.