{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T10:11:35Z","timestamp":1780481495063,"version":"3.54.1"},"reference-count":22,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T00:00:00Z","timestamp":1773878400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T00:00:00Z","timestamp":1773878400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Otolaryngology"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Identify the types of symptom clusters in patients with peripheral facial paralysis during the disease, construct symptom networks, explore core symptoms, and analyze the factors affecting the symptom scores of patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design<\/jats:title>\n                    <jats:p>A cross\u2010sectional study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>From December 2024 to May 2025, 283 patients with PFP in Zhejiang Province were assessed using the Memorial Symptom Assessment Scale (MSAS). Symptom clusters were extracted via exploratory factor analysis, and multiple linear regression was employed to examine factors associated with symptom burden. A symptom network was constructed using R software to identify core symptoms based on centrality indices. Network stability and accuracy were evaluated using nonparametric bootstrapping.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Five symptom clusters were identified: psychological, neurological, fatigue\u2010related, gastrointestinal, and PFP\u2010specific. Factors associated with higher symptom scores included age\u2009\u2265\u200970\u2009years, House\u2013Brackmann grade VI, autumn onset, no corticosteroid therapy, and initiation of acupuncture 7\u201314\u2009days after onset. Centrality analysis revealed that difficulty concentrating (\n                      <jats:italic>s<\/jats:italic>\n                      \u2009=\u20091.041), feeling sad (\n                      <jats:italic>s<\/jats:italic>\n                      \u2009=\u20091.006), and worrying (\n                      <jats:italic>s<\/jats:italic>\n                      \u2009=\u20090.980) were core symptoms within the network.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Patients with PFP experience a significant symptom burden. Network analysis elucidates the complex interrelationships amongst symptoms and identifies difficulty concentrating, feeling sad, and worrying as central to the symptom experience. These findings provide a scientific basis for targeted symptom assessment and the development of personalised interventions aimed at core symptoms to improve patient quality of life.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/coa.70102","type":"journal-article","created":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T14:20:37Z","timestamp":1773930037000},"page":"555-564","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Symptom Clusters and Symptom Networks Analysis During Illness in Peripheral Facial Paralysis Patients: A Cross\u2010Sectional Study"],"prefix":"10.1111","volume":"51","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-6976-4922","authenticated-orcid":false,"given":"Luyi","family":"Huang","sequence":"first","affiliation":[{"name":"School of Nursing Zhejiang Chinese Medical University  Hangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xinrui","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Acupuncture Medicine The First Affiliated Hospital of Zhejiang Chinese Medical University  Hangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-4621-7223","authenticated-orcid":false,"given":"Yan","family":"Xu","sequence":"additional","affiliation":[{"name":"School of Nursing Zhejiang Chinese Medical University  Hangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7699-9792","authenticated-orcid":false,"given":"Min","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Acupuncture Medicine The First Affiliated Hospital of Zhejiang Chinese Medical University  Hangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,3,19]]},"reference":[{"issue":"3","key":"e_1_2_13_2_1","first-page":"1","article-title":"Clinical Practice Guideline: Bell's Palsy","volume":"149","author":"Baugh R. F.","year":"2013","journal-title":"Otolaryngology\u2010Head and Neck Surgery"},{"issue":"41","key":"e_1_2_13_3_1","first-page":"692","article-title":"The Diagnosis and Treatment of Idiopathic Facial Paresis (Bell's Palsy)","volume":"116","author":"Heckmann J. G.","year":"2019","journal-title":"Deutsches \u00c4rzteblatt International"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1080\/000164802760370736"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0b013e318254b08d"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjhp.12440"},{"issue":"2","key":"e_1_2_13_7_1","first-page":"78","article-title":"A Proposed Theory of Symptom Cluster Management","volume":"7","author":"Tabudlo J. B.","year":"2021","journal-title":"Nursing Journal"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijnurstu.2014.02.004"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/NMD.0000000000001485"},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.1146\/annurev-clinpsy-050212-185608"},{"key":"e_1_2_13_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/cam4.4904"},{"key":"e_1_2_13_12_1","doi-asserted-by":"publisher","DOI":"10.47263\/JASEM.4(2)01"},{"key":"e_1_2_13_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otc.2018.07.001"},{"key":"e_1_2_13_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-019-09282-4"},{"key":"e_1_2_13_15_1","doi-asserted-by":"publisher","DOI":"10.1126\/science.abd5926"},{"key":"e_1_2_13_16_1","doi-asserted-by":"publisher","DOI":"10.1080\/2162402X.2019.1644110"},{"key":"e_1_2_13_17_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-021-96422-4"},{"key":"e_1_2_13_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.30333"},{"key":"e_1_2_13_19_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599813506835"},{"key":"e_1_2_13_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/coa.12026"},{"key":"e_1_2_13_21_1","doi-asserted-by":"publisher","DOI":"10.1080\/00016489.2024.2302899"},{"key":"e_1_2_13_22_1","doi-asserted-by":"publisher","DOI":"10.7717\/peerj.10449"},{"key":"e_1_2_13_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.anl.2022.02.005"}],"container-title":["Clinical Otolaryngology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/coa.70102","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/coa.70102","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/coa.70102","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T09:22:47Z","timestamp":1780478567000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/coa.70102"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,19]]},"references-count":22,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2026,7]]}},"alternative-id":["10.1111\/coa.70102"],"URL":"https:\/\/doi.org\/10.1111\/coa.70102","archive":["Portico"],"relation":{"has-review":[{"id-type":"doi","id":"10.1111\/COA.70102\/v1\/decision1","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/COA.70102\/v1\/review1","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/COA.70102\/v1\/review2","asserted-by":"object"}]},"ISSN":["1749-4478","1749-4486"],"issn-type":[{"value":"1749-4478","type":"print"},{"value":"1749-4486","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,19]]},"assertion":[{"value":"2025-09-03","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-03-02","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-03-19","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}