Journal of Clinical Nursing最新文献

Aim: To explore the meaning of lived experiences of women with a hereditary risk of breast cancer who participate in surveillance of their breasts with magnetic resonance imaging.

Design: Hermeneutic phenomenology.

Methods: Interviews on two occasions were made with 14 women in the surveillance programme. The verbatim transcripts were analysed according to van Manen. The analysis was an insightful iterative process and provided a sensitive understanding of the meaning of lived experiences.

Results: Women's lived experiences were that surveillance was constantly present in their lives. Their experiences implied 'needing to put on a mantle', 'not wanting to go through this alone' and 'wanting to keep their breasts'. The women created an invisible mantle that they put on when necessary to protect themselves. They wished to be open about their experiences and longed to be truly listened to. The women needed confirmation that they had the ethical right to their values and the choice they had made to participate in the programme. They were aware of the consequences of their decision, but they valued their breasts as a part of their identity and wanted to keep their breasts to remain who they were.

Implications for the profession and care: The understanding of the meaning of lived experiences of women in surveillance is vital for the development of person-centred care practice. Person-centredness should be integrated in the surveillance programme guidelines.

Impact: The study provides an understanding of the meaning of surveillance from the perspective of women. The evidence that women want to keep their breasts to preserve themselves as a person questions the norm of prioritising the bio-medical perspective in women's care.

Reporting method: COREQ.

Patient or public contribution: No patient or public contribution.

Skin-to-Skin Contact or Kangaroo Mother Care is an evidence-based intervention proven to enhance breastfeeding rates, improve cardiorespiratory stability and promote neurodevelopment in neonates. While established as a standard of care for stable term infants and increasingly recognised for preterm infants, the implementation of sustained skin-to-skin contact faces significant systemic and clinical challenges, particularly within the intensive care environment. This editorial argues that the focus must shift from when skin-to-skin contact is permitted to how sustained skin-to-skin contact can be universally integrated as a non-negotiable core practice, even for extremely preterm infants. Addressing practical barriers, such as staff training, equipment design, parental support and perceived clinical instability, is essential to realise the full potential of sustained skin-to-skin contact to optimise neurodevelopmental and physiological outcomes for all neonates, closing the gap between compelling evidence and inconsistent global practice.

Background: Cough, a prevalent and debilitating symptom of lung cancer, remains poorly managed. Accumulating evidence on non-pharmacological interventions for lung cancer cough necessitates systematic evaluation to assess their efficacy.

Aim: To synthesise evidence on non-pharmacological interventions for managing cough in lung cancer patients.

Design: A systematic review and meta-analysis following the Preferred Reporting Items for Systematic reviews and Meta-Analyses reporting guideline.

Methods: Nine databases were searched from inception to December 2024 to identify randomised controlled trials. Study quality was appraised using the Revised Cochrane Risk-of-Bias Tool for Randomised Trials. Meta-analyses were performed for quantitative synthesis, with sources of heterogeneity examined using meta-regression and subgroup analyses.

Results: Thirty-eight studies representing 2995 lung cancer patients were identified. These studies investigated acupuncture therapy, moxibustion, pulmonary rehabilitation, self-management intervention, physical exercises, psychoeducation support, mindfulness, and multicomponent interventions. Non-pharmacological interventions showed positive effects on cough severity and cough-related quality of life. Additional benefits were observed for expectoration, dyspnea, and general quality of life. Pulmonary rehabilitation showed a greater effect on cough severity than other non-pharmacological interventions.

Conclusion: Non-pharmacological interventions are promising in improving cough, expectoration, dyspnea, and general quality of life among lung cancer patients. Pulmonary rehabilitation showed the most promising effect. Future research should adopt objective cough measures in addition to self-reported measures.

Implications for the profession and/or patient care: Non-pharmacological interventions demonstrated potential effects in relieving cough and additional benefits in improving expectoration, dyspnea, and general quality of life among lung cancer patients. Healthcare professionals may adopt pulmonary rehabilitation for cough and related symptoms in lung cancer patients.

Impact: As the first meta-analysis addressing non-pharmacological interventions for lung cancer cough, this study provides evidence supporting their clinical efficacy for improving cough and associated symptoms among patients with lung cancer.

Patient or public contribution: No patient or Public contribution.

Registration: PROSPERO CRD42024588729.