Cancer Nursing最新文献

Background: Subsyndromal delirium (SSD) is a clinical manifestation between delirium and nondelirium. There is no established guideline for diagnosing SSD, with a few different tools used for diagnosis.

Objectives: To construct and verify the risk prediction model for subdelirium syndrome in patients with advanced malignant tumors and explore its application value in risk prediction.

Methods: A total of 455 patients admitted to the Oncology Department in a tertiary grade A hospital in Hengyang City were recruited from December 2020 to May 2021. They were selected as the modeling group. The model was constructed by logistic regression. A total of 195 patients with advanced malignant tumors from June 2021 to July 2021 were selected to validate the developed model.

Results: The predictors incorporated into the model were opioids (odds ratio [OR], 1.818), sleep disorders (OR, 1.783), daily living ability score (OR, 0.969), and pain (OR, 1.810). In the modeling group, the Hosmer-Lemeshow goodness-of-fit test was P = .113, the area under the receiver operating characteristic curve was 0.884, the sensitivity was 0.820, and the specificity was 0.893. In the validation group, the Hosmer-Lemeshow goodness-of-fit test P = .108, the area under the receiver operating characteristic curve was 0.843, the Yuden index was 0.670, the sensitivity was 0.804, and the specificity was 0.866.

Conclusions: This model has excellent precision in the risk prediction of subdelirium in patients with advanced malignant tumors.

Implications for practice: The model we developed has a guiding significance for specialized tumor nurses to care for patients with advanced malignant tumors and improve their quality of life.

Background: Many cancer patients require long-term self-care, both during and after treatment, and need to have self-care competence. Mindfulness and emotional regulation can enhance self-care competence among cancer patients.

Objective: To examine the effect of mindfulness and emotional regulation on self-care competence among cancer patients undergoing chemotherapy.

Methods: The data were completed by 106 cancer patients who were hospitalized at 3 long-term nursing hospitals. The instruments were the Mindfulness Scale, Korean Version of the Difficulties in Emotion Regulation Scale, and Self-As-Care Inventory Scale.

Result: Self-care competence was significantly correlated with mindfulness among cancer patients undergoing chemotherapy. Also, the relationship between mindfulness and emotional regulation was significant. However, emotional regulation did not significantly affect self-care competence.

Conclusions: It is important for cancer patients to focus on the present moment and maintain a balanced approach that keeps a distance from excessive worry. Development and application of interventions aimed at enhancing self-care competence among cancer patients should focus on a high level of mindfulness.

Implications for practice: It is necessary to support cancer patients in taking time out for mindfulness practice through meditation programs and to help them seamlessly incorporate this habit into their daily lives. Nurses can effectively assist cancer patients by being well-versed in mindfulness techniques and providing adept guidance. Offering personalized mindfulness guidance based on the patient's condition and needs is also beneficial. By developing programs that incorporate feedback from both patients and healthcare providers, nurses can help patients continuously apply mindfulness practices.

Background: Despite numerous systematic reviews on self-management interventions for cancer survivors, little is known about survivors' daily self-management practices and the influencing factors.

Objective: To identify self-management behaviors and related factors among cancer survivors.

Methods: Six databases were searched for primary quantitative, qualitative, and mixed-methods studies on self-management behaviors in cancer survivors that were published in English-language, peer-reviewed journals between 2012 and July 2022. The methodological quality of the included studies was evaluated using the Mixed Methods Appraisal Tool. The data extracted using a predetermined form were analyzed using qualitative content analysis.

Results: A total of 22 articles were included in the review; the majority were qualitative research, and half had moderate to high quality of evidence. Nine domains of self-management behaviors were identified, namely, physical activity/exercise, diet, emotional management, complementary and alternative medicine, symptom management, religiosity/spirituality, attending regular follow-ups, adjustment of other lifestyles, and medication management. Four categories of factors were associated with self-management behaviors in cancer survivors: (1) personal factors (demographic and psychological), (2) health status, (3) family factors, and (4) healthcare system. However, the relationships between self-management behaviors and these factors were mainly identified from qualitative studies or addressed in single studies.

Conclusions: Self-management behaviors in cancer survivors are multifaceted. There is an urgent need for quantitative exploration of factors associated with self-management in cancer survivors.

Implications for practice: This review provides nurses with a comprehensive basis for designing self-management support interventions for cancer survivors.

Background: As a protective factor, social support can influence benefit finding (BF) in patients with advanced lung cancer. However, the mechanism through which social support affects BF is controversial.

Objective: To investigate the factors influencing BF in patients with advanced lung cancer and the role of hope level in mediating the relationship between social support and BF.

Methods: This was a cross-sectional study. From September 2022 to March 2023, 286 participants completed the Social Support Rating Scale, Herth Hope Index, and Benefit Finding Scale. Data analysis included correlation analyses and multiple stepwise regression analysis; the SPSS PROCESS program was used to determine the significance of mediating effects.

Results: Social support and hope level were positively associated with BF. Monthly per-capita household income, social support and hope level entered the final regression model and explained 50.7% of BF variance. Social support's direct and indirect effects on BF were significant ( P < .05), suggesting that hope level partially mediated the relationship between social support and BF.

Conclusion: Our findings validate a positive association between social support and BF in patients with advanced lung cancer. The hope level as a mediating variable provided the impetus for their BF.

Implications for practice: Nurses should implement necessary interventions to help patients with advanced lung cancer carry out protective resources and coping strategies to facilitate their BF.

Background: Postoperative delirium (POD) is a common and serious complication after extensive surgery. Understanding the independent and potential modifiable risk factors leading to POD in patients with head and neck cancer (HNC) can provide information for future intervention trials aimed at reducing this risk.

Objective: To systematically analyze influencing factors of POD in patients with HNC and identify high-risk individuals for delirium.

Methods: PubMed, EMBASE, Scopus, OVID, and Cochrane Library were searched for publications prior to June 2023. Comparative studies in which POD risk factors were investigated were identified following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. The Newcastle-Ottawa Scale was used to evaluate the study quality. Pooled odds ratios or mean differences for individual risk factors were estimated using the Mantel-Haenszel and inverse-variance methods.

Results: This review included 17 studies with a total of 4188 patients undergoing HNC surgery. The pooled prevalence of POD was 15.44%. Based on pooled analysis, 8 significant risk factors were identified including age older than 70 years, male sex, history of smoking, history of psychiatric disorder, American Society of Anesthesiologists score, albumin level, postoperative insomnia, and fluid intake.

Conclusion: In the present study, 8 factors that correlated with POD were identified: 6 preoperative, 1 intraoperative, and 1 postoperative.

Implications for practice: The influencing factors for POD in patients with HNC were identified that can provide a reference for improving the psychological state of the patient population and further development of effective treatment interventions.

Background: Yoga can be considered supportive therapy for patients with cancer to alleviate cancer-related symptoms. However, there has been no meta-analysis examining yoga's effects among patients with cancer undergoing chemotherapy and/or radiotherapy.

Objective: To synthesize the evidence regarding the effects of yoga on improving cancer-related fatigue, psychological distress, and quality of life among patients with cancer undergoing chemotherapy and/or radiotherapy.

Methods: Ten English databases and 2 Chinese databases were searched from inception to December 2022. Two independent reviewers screened studies and extracted the data. Randomized controlled trials examining the effects of yoga on cancer-related fatigue, psychological distress, and quality of life were included. Meta-analysis was conducted, and narrative synthesis was performed when meta-analysis was not applicable.

Results: Fourteen studies from 16 articles were included. The results showed that yoga reduced cancer-related fatigue (standardized mean difference [SMD], -0.75; 95% confidence interval [CI], -1.12 to -0.38; P < .001), anxiety (SMD, -0.91; 95% CI, -1.68 to -0.14; P = .02), but not depression (SMD, -0.82; 95% CI, -1.67 to 0.04; P = .06). The effects of yoga on distress and quality of life were inconclusive.

Conclusions: Yoga significantly helped reduce cancer-related fatigue and anxiety but did not reduce depression among patients with cancer undergoing chemotherapy and/or radiotherapy. Further rigorous studies are needed to identify the optimal characteristics of yoga for these patients.

Implications for practice: It is possible to recommend yoga to patients with cancer undergoing chemotherapy and/or radiotherapy for managing cancer-related fatigue and anxiety after duly considering patients' physical conditions and ensuring appropriate instructions are given.

Background: Breast cancer has become the leading cause of global cancer incidence. With the improvement of treatment methods, financial toxicity among breast cancer patients has been widely studied.

Objectives: The aims of this study were to summarize the risk factors for and outcomes of financial toxicity among breast cancer patients, to identify populations at risk for financial toxicity, to identify the consequent health impacts, and to provide evidence for subsequent intervention programs.

Methods: We searched the PubMed/MEDLINE, Web of Science, MEDLINE (Ovid), CINAHL (EBSCO), EMBASE (Ovid), ProQuest, and China National Knowledge Infrastructure databases from inception to July 21, 2022. We followed the updated framework for scoping reviews proposed by the Joanna Briggs Institute.

Results: A total of 31 studies were included. Risk factors and outcomes of financial toxicity among breast cancer patients were identified and extracted. The risk factors included socioeconomic, demographic, disease and treatment, and psychological and cognitive factors, whereas financial toxicity affected the physical, behavioral, and psychological domains of breast cancer patients, resulting in material loss, coping behaviors, and impaired health-related quality of life.

Conclusion: Financial toxicity among breast cancer patients depends on multiple factors and has profound effects. The findings will be helpful for identifying breast cancer patients at a high risk of financial toxicity and developing intervention programs to reduce financial toxicity and outcomes.

Implications for practice: More high-quality prospective, multicenter studies should be conducted in the future to better understand the trajectory of and risk factors for financial toxicity. Further studies should merge symptom management and psychosocial support into intervention programs.

Background: Surgical interventions are commonly utilized in the treatment of breast cancer; however, they can elicit adverse effects on women's perceptions of femininity, leading to stress, negative body image, diminished self-esteem, and challenges in sexual adjustment.

Objective: This study investigates the efficacy of mindfulness-based meditation and yoga in alleviating stress, enhancing self-esteem, improving body image, and facilitating sexual adjustment among women undergoing modified radical mastectomy.

Methods: Using a prospective (pretest, posttest, and second-month follow-up), 2-arm (1:1), randomized controlled experimental design, the study involved 39 women (intervention group = 19, control group = 20) undergoing modified radical mastectomy. The intervention group participated in face-to-face mindfulness-based meditation and yoga sessions lasting approximately 90 minutes each over an 8-week period.

Results: Following the intervention, significant reductions in perceived stress and the significance attributed to breasts in sexuality were observed ( P < .05), accompanied by increases in self-esteem and body perception ( P < .05). However, no significant differences were observed in sexual adjustment ( P > .05).

Conclusions: Mindfulness-based meditation and yoga interventions demonstrated efficacy in mitigating perceived stress, enhancing self-esteem, and improving body perception among women undergoing modified radical mastectomy. The findings advocate for the integration of mindfulness-based stress reduction programs, particularly during the preoperative phase, to support oncological patients, particularly those with breast cancer.

Implications for practice: Psychosocial aspects such as body image, self-esteem, and sexual adjustment following radical mastectomy are frequently overlooked in clinical care. This research highlights the potential benefits of incorporating mindfulness-based yoga and meditation techniques into nursing interventions to alleviate stress and enhance body confidence among women undergoing mastectomy.