Cancer Nursing最新文献

Background: Colorectal cancer is among the most common malignancies. With advancements in medical treatments, cancer survival rates have improved significantly. However, patients still encounter considerable unpredictable and uncontrollable life changes, which can negatively impact their subjective well-being.

Objective: To explore changes in the subjective well-being of patients newly diagnosed with colorectal cancer over time and identify the factors influencing these changes.

Interventions/methods: This study utilized an observational longitudinal design. Patients with newly diagnosed colorectal cancer (N = 117) who were scheduled for tumor resection surgery were recruited from the colon and rectal surgery department at a medical center in northern Taiwan. Data were collected using questionnaires distributed before surgery and 1 and 6 months after surgery. Demographic attributes, disease characteristics, symptom distress, disease uncertainty, coping behavior, and subjective well-being were measured.

Results: Subjective well-being declined 1 month after surgery but improved by 6 months. Patients who experienced higher symptom distress, higher disease uncertainty, less use of approach-oriented coping behavior, and more use of avoidance-oriented coping behavior demonstrated low levels of subjective well-being.

Conclusions: Patients with low symptom distress, a greater sense of control over their disease and environment, and better coping skills demonstrated higher subjective well-being.

Implications for practice: Nurses should identify sources of disease uncertainty in patients and offer clear, personalized disease information and professional support. Furthermore, guiding patients to adopt approach-oriented coping behavior and applying interventions to alleviate symptom distress may help enhance their subjective well-being.

Background: Pain interference is a significant factor affecting the emotional and psychological well-being of patients with cancer, often leading to decreased hope. Recent studies suggest that spiritual well-being may mediate this relationship, offering a potential pathway to improving patients' resilience and quality of life.

Objective: This study investigates the impact of pain intensity, pain interference, spiritual well-being, and other factors on the hope of patients with cancer. Additionally, the study examined the mediating effect of spiritual well-being on the relationship between pain interference and hope of patients with cancer.

Methods: A cross-sectional study was conducted with 288 patients with cancer receiving treatment at a chemotherapy center in Turkey. Data were collected using validated tools, including the Brief Pain Inventory, Herth Hope Index, and Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being Scale. Analytic tests included independent sample t tests, Mann-Whitney U, and Kruskal-Wallis tests and SPSS PROCESS Macro Model 4.

Results: Pain interference negatively correlated with hope (r = -0.356, P < .001), whereas spiritual well-being positively correlated with hope (r = 0.483, P < .001). Mediation analysis confirmed that spiritual well-being partially mediated the relationship between pain interference and hope, explaining 33.8% of the total effect.

Conclusions: Spiritual well-being plays a critical role in mitigating the adverse effects of pain interference on hope among patients with cancer.

Implications for practice: Integrating spiritual care into oncology practice may enhance patients' psychological resilience. Holistic interventions addressing both physical and spiritual needs should be prioritized in cancer care to foster hope and improve overall well-being.

Background: Prostate cancer is perceived as a "couple's disease"; the diagnosis and treatment impact the patient-partner relationship.

Objective: To explore the storied narratives of a partner and their relationship with their loved one who has undergone a radical prostatectomy (RP) to treat prostate cancer.

Methods: This qualitative interpretive study used narrative analysis to understand how participants construct stories and narratives from their personal experiences. This approach provides insight into the partners' experiences, relationship changes post-RP, and barriers.

Results: Two overarching themes emerged: (1) partners' experience with the cancer diagnosis and (2) partners' experience with RP treatment. Seven main themes emerged as areas of significance related to the patient-partner relationship: (1) changing the relationship, (2) intimacy (including sexual and emotional intimacy), (3) desire for support, (4) managing disruption, (5) loss of control, (6) elevating partner's needs, and (7) protecting affected partner.

Conclusions: This study suggests that the post-RP relationship between the participant and their loved one improved or stayed the same; however, the sexual intimacy was negatively impacted, whereas the emotional intimacy was deepened. This study's findings highlight the need for ongoing education, resources, and support for the partner.

Implications for practice: Support resources must be cultivated and offered to partners, and a "projected timeline" must be created to assist partners in managing the disruption and the feeling of loss of control. Incorporating relationship and caregiver counseling, sex education, and therapy can significantly impact the post-RP relationship.

Background: Fear of cancer recurrence can act as a critical variable in cancer coping, and effectively managing this fear is crucial for the treatment and recovery processes.

Objective: This study aims to examine the impact of fear of cancer recurrence, perceived health status, and mindfulness on cancer coping among female patients with cancer. The focus is on the mediating effects of perceived health status and mindfulness in this relationship.

Methods: The study participants consisted of 202 women with cancer, and the data were collected through an online survey. The mediation effects were analyzed using PROCESS Macro 3.5 Model 6.

Results: The results of the direct effect analysis indicated that fear of cancer recurrence had a significant positive effect on cancer coping, whereas fear of cancer recurrence had a significant negative effect on perceived health status and mindfulness. The results of the indirect effect analysis showed that the fear of cancer recurrence significantly influenced cancer coping through both perceived health status and mindfulness. The effect size was -0.03, with a 95% confidence interval ranging from -0.05 to -0.01.

Conclusions: It is imperative in clinical practice to offer psychological support to patients experiencing high levels of fear of cancer recurrence. Moreover, ongoing education is crucial to promote a positive perception of health status and to cultivate mindfulness practices.

Implications for practice: Oncology nurses can facilitate effective coping and help to reduce fear of cancer recurrence by assisting patients in cognitively reevaluating their perceived health status and integrating mindfulness practices into daily life.

Background: Breast cancer survivors (BCSs) undergoing taxane-based chemotherapy frequently experience chemotherapy-induced peripheral neuropathy (CIPN), potentially affecting their quality of life. Early identification of high-risk survivors can help mitigate the severity of CIPN.

Objective: To construct and validate a predictive model for CIPN in BCSs receiving taxane-based chemotherapy.

Methods: In this multicenter cross-sectional study conducted across 10 hospitals in China between April 2022 and March 2023, 569 BCSs were randomly assigned to development (n = 401) or validation (n = 168) sets (ratio, 7:3). Predictive factors were identified by multiple logistic regression, and a nomogram was constructed. Model discrimination was evaluated using receiver operating characteristic curves and area under the curve values, whereas calibration was assessed with the Hosmer-Lemeshow test and calibration curves. Decision curve analysis was performed to evaluate clinical utility.

Results: CIPN was observed in 82.8% of the survivors. The nomogram included 5 factors: treatment with paclitaxel liposome, treatment with albumin-bound paclitaxel, number of chemotherapy cycles, vitamin D deficiency, and fatigue levels. The area under the curve values for the development and validation sets were 0.866 (95% confidence interval, 0.817-0.914) and 0.848 (95% confidence interval, 0.761-0.935), respectively, indicating good performance. The Hosmer-Lemeshow test and decision curve analysis confirmed good calibration and clinical utility.

Conclusions: The nomogram model demonstrates good discrimination and calibration, offering a practical and visual tool for identifying high-risk survivors for CIPN.

Implications for practice: This predictive model can assist clinicians in the early identification of BCSs at high risk for CIPN and in promptly implementing preventive measures.

Background: Children undergoing treatment for cancer may experience a range of adverse symptoms, yet there is limited information on the symptoms they experience during radiotherapy and the potential heterogeneity among these symptoms.

Objective: This study aimed to describe the symptom profiles of children during radiotherapy, identify subgroups of children with cancer experiencing similar symptom patterns, and evaluate differences in demographic and clinical characteristics across these subgroups.

Methods: A total of 154 children were assessed using the Chinese version of the Memorial Symptom Assessment Scale 10-18. Latent profile analysis was used to identify distinct subgroups of patients based on symptom occurrence profiles with a prevalence greater than 40%.

Results: Children experienced multiple adverse symptoms during radiotherapy. The best-fitting model identified 3 distinct symptom profiles: low symptom prevalence, high symptom prevalence, and high gastrointestinal symptom prevalence. Significant differences were observed among subgroups based on age, family income, demographic factors, and clinical characteristics, including treatment type, the number of patients currently receiving radiotherapy, radiotherapy site, and recent chemotherapy within the past week.

Conclusions: This study found that children experienced various adverse symptoms during radiotherapy, with notable heterogeneity in symptom profiles identified through latent profile analysis. Symptom prevalence varied according to demographic and clinical characteristics.

Implication for practice: This study highlights the need for healthcare providers to focus on different patient subgroups and provide targeted prevention and early intervention strategies for managing symptoms in children during radiotherapy.

Background: Sleep disturbances can have significant physiological consequences and are associated with several health problems, including cancer.

Objective: To assess the prevalence and self-reported determinants of sleep disturbances in patients hospitalized with oncohematological disease.

Methods: This was a cross-sectional study in 2 specialized oncohematology units of the Catalan Public Health System (Spain). A stratified probability sampling strategy was implemented. Data were collected using a questionnaire that was previously developed and tested, based on the Richards-Campbell Sleep Questionnaire and the Pittsburgh Sleep Quality Questionnaire.

Results: The study included 621 oncohematological patients. The self-reported prevalence of sleep disturbance was 61.5% (n = 375). More than 90% of the patients woke up during the night, with an average of 3.1 (SD, 2.0) interruptions. The mean self-reported quality of sleep score was 6.5/10 (SD, 2.2) points. There was a statistically significant but low-magnitude inverse relationship between the presence of disturbances and self-reported sleep quality. The most influential factors were the number of times patients woke up, professional conversations in the corridor, professional interruptions, room light, pain/discomfort, and roommates ( P < .001).

Conclusions: Inpatients with oncohematological disease report very frequent sleep disruptions. The main causes are environmental discomfort, pain and anxiety, and noise caused by clinical devices and professionals. Numerous factors in the hospital environment that result in rest disturbance can be modified or controlled.

Implications for practice: Professionals must lead strategies to change the dynamics of care and environment to improve the patient's rest. Current models of care should be reviewed with the aim of promoting better sleep environments.

Background: While head and neck cancer (HNC) patients often experience many concurrent symptoms, most research has focused on the assessment and management of individual, isolated symptoms.

Objective: The aim of this study was to investigate the longitudinal trajectories of symptom clusters in patients with HNC and analyze the predictive factors of each trajectory subgroup.

Methods: An exploratory factor analysis was conducted to analyze symptom clusters using the M. D. Anderson Symptom Inventory-Head and Neck in 218 HNC patients at 3 time points: during hospitalization, 1 month after discharge, and 3 months after discharge. The latent growth mixture modeling was used to identify the trajectory subgroups, and multinomial logistic regression was used to analyze the predictive factors of trajectory changes.

Results: The 4 symptom clusters were referred to as the mouth and throat symptom cluster, gastrointestinal symptom cluster, psychotherapeutic symptom cluster, and energy deficit symptom cluster. Three to 4 trajectory subgroups were identified in the symptom cluster using the latent growth mixture modeling. High-risk trajectory subgroups were influenced by female patients, low family per-capita monthly income, laryngeal cancer, high clinical staging, and age ( P < .05).

Conclusions: Mouth and throat symptom cluster is unique to HNC. The high-risk trajectory categories are influenced by gender, family per-capita monthly income, tumor site, TNM clinical staging, and age.

Implications for practice: Identifying high-risk trajectories and influencing factors of symptom clusters can help cancer caregivers in implementing individualized and tailored interventions.

Background: Physical activity and daylight exposure predict rest-activity circadian rhythm (RACR) in patients with cancer. However, whether daylight exposure mediates the relationship between physical activity and RACR and the optimal amounts of physical activity and daylight that benefit RACR remain unclear.

Objectives: This study investigated the mediating role of daylight exposure and determined the dose-response relationship among daylight exposure, physical activity, and RACR in patients with cancer.

Methods: This cross-sectional exploratory study recruited 319 patients with esophageal and gastric cancer from 2 surgery outpatient departments in Taiwan. Daylight exposure (>500 lux), physical activity (up activity mean), and RACR (midline estimating statistic of rhythm) were measured through actigraphy. Regression was performed, and the receiver operating characteristic curve was plotted.

Results: Daylight exposure (>500 lux) partially mediated the relationship between physical activity (up activity mean) and RACR (midline estimating statistic of rhythm). The optimal cutoffs for discriminating between satisfactory and poor RACR were 187.43 counts/min for physical activity (sensitivity, 90.3%; specificity, 84.4%) and 35.71 min/d for daylight exposure (sensitivity, 55.9%; specificity, 78.2%).

Conclusions: Participants who engaged in physical activity were more likely to receive daylight exposure and experience improved RACR. The optimal level of daylight exposure and frequency of physical activity that can improve RACR in patients with esophageal and gastric cancer are 36 min/d and 187 counts/min, respectively.

Implications for practice: Healthcare professionals should encourage patients to engage in exercise or physical activity during the daytime to improve their circadian rhythm.