Title: The relationships between symptom clusters and contributing factors in patients with
esophageal cancer: Structural equation modelling based on theory of unpleasant symptoms
Version: 3 Date: 28 May 2025
Reviewer's report:
1.Table 3 shows that four symptom groups were extracted through factor analysis.  It is
mentioned in the text that "eight symptoms were excluded due to insufficient validity".  It is
suggested to supplement and explain the specific criteria for excluding symptoms (such as factor
load <0.4 or excessive cross-load).
2.The information shown in Table 5 is incomplete.  For example, the relationship between SC
and NLR, anxiety and depression, and ALB level, social support, self-care and self-efficacy.
3.Among the research tools, except for the Social support rating scale, the other scales should
elaborate on their reliability and validity in this study.
4.In the Discussion part, Clinical implications, Limitations and future research should be
separately expounded
Title: The relationships between symptom clusters and contributing factors in patients with
esophageal cancer: Structural equation modelling based on theory of unpleasant symptoms
Version: 3 Date: 28 May 2025
Reviewer's report:
1.Table 3 shows that four symptom groups were extracted through factor analysis.  It is
mentioned in the text that "eight symptoms were excluded due to insufficient validity".  It is
suggested to supplement and explain the specific criteria for excluding symptoms (such as factor
load <0.4 or excessive cross-load).
2.The information shown in Table 5 is incomplete.  For example, the relationship between SC
and NLR, anxiety and depression, and ALB level, social support, self-care and self-efficacy.
3.Among the research tools, except for the Social support rating scale, the other scales should
elaborate on their reliability and validity in this study.
4.In the Discussion part, Clinical implications, Limitations and future research should be
separately expounded
Please review this paper.
user
Title: The relationships between symptom clusters and contributing factors in patients with
esophageal cancer: Structural equation modelling based on theory of unpleasant symptoms
Version: 3 Date: 28 May 2025
Reviewer's report:
1.Table 3 shows that four symptom groups were extracted through factor analysis.  It is
mentioned in the text that "eight symptoms were excluded due to insufficient validity".  It is
suggested to supplement and explain the specific criteria for excluding symptoms (such as factor
load <0.4 or excessive cross-load).
2.The information shown in Table 5 is incomplete.  For example, the relationship between SC
and NLR, anxiety and depression, and ALB level, social support, self-care and self-efficacy.
3.Among the research tools, except for the Social support rating scale, the other scales should
elaborate on their reliability and validity in this study.
4.In the Discussion part, Clinical implications, Limitations and future research should be
separately expounded
assistant