<![CDATA[Background: Well-being is an overall indicator of an individual’s health status. Psychological and somatic symptoms may negatively affect patients undergoing chemotherapy for advanced cancer. Previous studies have identified cancer-related symptoms and psychosocial factors associated with impaired well-being but have not fully explored the relationships among multiple symptoms and impaired well-being.Purpose: This study aimed to develop and test a path model of the relationships between unpleasant symptoms and impaired well-being among patients undergoing chemotherapy for advanced cancer.Methods: A cross-sectional secondary data analysis was conducted among 500 patients with advanced cancer who received treatment at a tertiary care hospital in the Lower Northern region of Thailand. Data included personal and clinical information and the Edmonton Symptom Assessment System (ESAS), which assessed pain, anxiety, nausea, shortness of breath, drowsiness, tiredness, depression, loss of appetite, and well-being. Impaired well-being was measured using the ESAS well-being item, ranging from 0 (best well-being) to 10 (worst possible well-being). Path analysis was used to examine the relationships between symptoms and impaired well-being.Results: The final path model demonstrated a good fit to the data and explained 22.1% of the variance in impaired well-being (R² = .221). Loss of appetite had the strongest total effect on impaired well-being (β = 0.72, p < .001). Loss of appetite (β = 0.71, p < .001), depression (β = 0.31, p < .001), and shortness of breath (β = 0.21, p < .001) had significant direct effects. Anxiety, nausea, shortness of breath, pain, tiredness, and loss of appetite had indirect effects on impaired well-being.Conclusion: The study provides an explanatory model of the relationships between symptoms and impaired well-being in patients undergoing chemotherapy for advanced cancer. The findings may help nurses design interventions that consider the multidimensional relationships among symptoms associated with impaired well-being and poor functional status. ]]>
