Emotional Distress Symptom Networks in Patients with Gynecological Malignancies: A Cross-Sectional Study

Background: Emotional distress (ED) is common among patients with gynecological malignancies and is associated with reduced quality of life and suboptimal health outcomes. Total-score approaches may overlook the complex interrelationships among individual emotional symptoms. Objective: This study provides a theory-informed contextual application and empirical boundary test of symptom network analysis, organized by the Stress Process Model (SPM), to examine not only how ED symptoms cluster and co