European Journal of Oncology Nursing最新文献

Purpose: Rural breast cancer survivors (BCS) have unique unmet psychosocial needs that affect quality of life (QOL). Expressive writing (EW) has been shown to improve QOL in cancer survivors, however, its applicability is unclear among rural individuals. This pilot study explores the feasibility and acceptability of an online expressive writing (EW) intervention among rural breast cancer survivors (BCS).

Methods: Participants (N = 34) were recruited from a cancer hospital's registry and randomly assigned to either a control group or the EW intervention group to read positive messages and to write about their cancer experience three times, once per week. Health outcomes were assessed at baseline and 1 month after the intervention. Feasibility and acceptability were also assessed.

Results: The study yielded a satisfactory response rate, adherence rate, and completion rate. The majority of the participants reported enjoying the study. Preliminary analyses also demonstrated promising efficacy of the intervention, with improvements (medium effect size) observed for QOL (d = 0.51) and fatigue (d = -0.64) in the intervention group compared to the control group at 1-month follow-up.

Conclusions: The study demonstrates feasibility and acceptability of an online EW intervention among rural BCS. Future research is warranted to examine the efficacy of the intervention in larger samples of rural cancer survivors.

Purpose: To explore how regional economic levels moderate the relationships between cancer-related financial toxicity (FT) and its associated risk factors.

Methods: A secondary analysis was conducted using data from a cross-sectional survey of 1208 adult patients with cancer, conducted in six tertiary and six secondary hospitals across three Chinese provinces from February to October 2022. The interactions between the regional economic level-categorised as high- or low-/middle-income based on the gross domestic product per capita- and 13 previously identified risk factors for FT were examined via moderation analysis using the PROCESS macro for SPSS software.

Results: Regional economic level moderated the impacts of both patients' and family carers' negative work changes due to cancer and the hospital level on FT (all p-values for interaction effect <0.05). Job changes had more severe effects on FT in high-income regions (patients: B = -2.07, standard error [SE] = 0.67, p = 0.002; carers: B = -1.58, SE = 0.66, p = 0.017), while treatment in tertiary hospitals had a stronger negative impact on FT in low-/middle-income regions (B = 1.81, SE = 0.87, p = 0.037).

Conclusions: These findings highlight the need for region-specific FT mitigation strategies. In high-income regions, more attention could be paid to managing the adverse work-related effects of cancer on patients and their families. In low-/middle-income regions, increased awareness and management of cancer-related FT in tertiary hospitals is needed. Future research should explore other risk factors associated with FT that may be moderated by regional economic levels.

Purpose: To improve patient care by describing teachers' and school leaders' experiences in teaching children diagnosed with cancer, to better understand which information would be beneficial for schools to receive from the healthcare system.

Methods: This qualitative study was based on semi-structured interviews with 15 teachers and six school leaders in primary, secondary, and high schools in Sweden (student ages 6-18). The data was analyzed with thematic analysis.

Results: Three main themes were revealed: a different diagnosis from other diagnoses, meaning that the respondents in this study perceived the information about a cancer diagnosis differently compared to other diagnoses due to the uncertain outcome of the child's condition and survival; a balancing act, including a need to balance schools' educational demands with the child's needs; and a desire for more information, especially pedagogical and school-related information.

Conclusions: The emotional impact on teachers of teaching a child with cancer is significant, and the medical information provided by consultant nurses from the hospitals was very appreciated and helpful. However, educators also highlighted their need for pedagogical information. This information would preferably come from a person specialized in special educational needs for children with cancer, for example, a teacher or a special education teacher from the hospital school or the oncological team.

Purpose: This study aimed to explore symptom clusters and the inter-relationship of symptoms in esophageal cancer (EC) patients during the first week after surgery.

Methods: A cross-sectional survey across multiple centers was carried out using the EORTCQLQ-OES18. Patients with esophageal cancer within a week post-surgery were recruited from the "Be Resilient to Cancer" project in Guangdong, Hunan, and Sichuan provinces between January and September 2024. Exploratory factor analysis with a priori algorithm was used to identify symptom clusters and network analysis was employed to recognize the relationship among core and bridge symptoms.

Results: The sample consisted of 501 patients with esophageal cancer, who were predominantly male (83%), married (93%) and 57% were ≥60 years. Three symptom clusters were identified: "reflux-pain", "eating", and "dysphagia-dry mouth". Acid or bile coming up (support = 40.1%, confidence = 1, lift = 2.53), eating difficulties (support = 40.1%, confidence = 0.990, lift = 2.408) and dry mouth (support = 42.9%, confidence = 0.808, lift = 1.298) were marked as sentinel symptoms for these clusters, respectively. Acid indigestion or heartburn was identified as the core symptom (EI = 1.142 without covariates and EI = 1.153 with covariates), and dry mouth served as the bridge symptoms (EI = 0.63 and EI = 0.656).

Conclusions: Addressing acid or bile coming up, eating difficulties, dry mouth are imperative to help relief symptom burden at the cluster level. Furthermore, targeting acid indigestion and heartburn are crucial to break the chains among different symptom clusters.

Purpose: This study aimed to investigate the serial mediating effects of attitudes toward digital healthcare services (ATDH) and digital health literacy (DHL) on the relationship between accessibility of digital information (ADI) and intention to use digital healthcare services (IUDH) among patients with multiple myeloma (MM).

Methods: A cross-sectional questionnaire-based survey was conducted with patients with MM under outpatient follow-up at the cancer center of a university-affiliated hospital in South Korea. Data were collected between September and December 2023 from a convenience sample of 139 patients.

Results: ADI had a significant direct effect on both ATDH (β = 0.39, p < .001) and DHL (β = 0.28, p < .001), with only DHL showing a significant direct effect on IUDH (β = 0.54, p < .001). Although ADI did not have a direct effect on IUDH (β = -0.05, p = .534), it indirectly influenced IUDH through the mediation of DHL alone (Effect = 0.06, 95%, CI = 0.02, 0.12) or in sequence with ATDH (Effect = 0.03, 95%, CI = 0.01, 0.06).

Conclusion: These findings emphasize the importance of DHL for facilitating the use of digital healthcare service (DHS) among patients with MM. To promote sustained engagement and the anticipated outcomes from DHS, it is essential to address patients' needs related to ADI, ATDH, and DHL. Healthcare providers and service developers should actively support patients in developing the competencies and resources necessary for effective use of DHS.

Purpose: Persons living with brain tumors may experience severe impairment, requiring social support (i.e., informal care). Although informal caregiving can be rewarding, it can also lead to physical or psychological burdens. The aim of this study was to explore how informal caregivers of persons living with brain tumors use resources available to them, including social support, to balance caregiving with other aspects of life.

Methods: Sixteen informal caregivers (14 partners, two adult children) of persons living with brain tumors, varied in gender (10 female, six male), age (26-79 years), and caregiving experience (1-20 years) were interviewed. Data were analyzed using conventional content analysis.

Findings: We generated nine categories representing informal caregivers' strategies grouped by resources used. Intrapersonal resources were used for: Flexibly adjusting to changing life situations; Separating the care recipient from the illness; and Reflectively renegotiating self-expectations. Interpersonal resources were used for: Coping together with the care recipient; Sharing responsibilities within the family; Seeking guidance from persons in similar situations; and Grouping social relations by function. Healthcare and community resources were used for: Active collaborations with healthcare staff and Accessing professional and community resources for mental well-being.

Conclusions: Informal caregivers used their intrapersonal, interpersonal, and healthcare and community resources in various ways for mainly emotional and instrumental support. More informational support from healthcare was desired, indicating that healthcare services, along with patient and caregiver organizations, may be able to enhance such support for informal caregivers. This could, in turn, allow more flexibility to manage caregiving alongside other life commitments.

Purpose: Cancer recurrence requires patients to make many decisions regarding treatment and daily life, possibly causing decision fatigue. This study interpreted and understood the experience of decision fatigue among patients with cancer recurrence.

Method: This research utilized a qualitative study approach with semi-structured interviews. Online interviews were conducted for 15 patients with recurrent cancer. Data were analyzed using content analysis.

Results: Four analytic themes were extracted: decision fatigue related to treatment, decision fatigue in daily life, coping with decision fatigue, and expectations for healthcare providers to reduce decision fatigue.

Conclusion: Cancer patients with recurrence experience decision fatigue, especially regarding treatment options and choices about exercise and nutrition. Managing this psychosocial burden is needed to empower patients for treatment and recovery. Healthcare providers must provide sufficient information with constant empathy during the care process.

Purpose: To evaluate the current status of discharge readiness among postoperative oral cancer patients and identify the primary associated factors.

Methods: Information from 713 oral cancer patients was collected using questionnaire surveys. One-way ANOVA or t-tests were employed to compare differences in discharge readiness across various demographic characteristics. Correlation analyses were conducted to examine the relationships between discharge readiness and discharge teaching quality, as well as social support. Multiple stepwise regression analysis was utilized to identify independent factors associated with discharge readiness.

Results: The mean discharge readiness score of postoperative oral cancer patients was 89.52 ± 8.63. Seven variables, such as age, marital status, and income, were identified as significant associated factors. Furthermore, both the quality of discharge teaching and social support exhibited a significant positive correlation with discharge readiness.

Conclusion: Postoperative oral cancer patients had moderate levels of discharge readiness and social support but low levels of discharge teaching quality. Discharge readiness among these patients is linked to various factors.

Purpose: The research aimed to investigate the prevalence of PTSD in newly diagnosed Chinese women with breast cancer and to distinguish a munber of sociodemographic, disease-related and psychosocial factors connected with the severity of PTSD symptom.

Methods: This cross-sectional study recruited 674 newly diagnosed Chinese women with breast cancer at three tertiary level a general hospitals in Chengdu, China between August 2022 and May 2023. And questionnaires about general information, locus of control, social support, coping styles, emotional regulation and PTSD were filled out. Multiple linear regression analysis was applied to probe factors related to PTSD.

Results: The prevalence of PTSD was 13.95%. Significant differences were in PTSD among participants of different ethnicities (t = -2.474,p = 0.017), education levels (F = 8.532,p < 0.001), per capita monthly household income (F = 6.027,p < 0.001), stages of the disease (F = 12.972,p < 0.001). Pearson correlation analysis showed that locus of control, social support, coping style, emotional regulation, and PTSD were significantly correlated. The multiple regression model showed that ethnicity, internality of locus of control, subjective support, negative coping, cognitive reappraisal and expression inhibition can interpret 36% of the variation in PTSD.

Conclusions: The research was one of the early attempts in assessing PTSD symptom in newly diagnosed Chinese women with breast cancer and confirmed some important, possible changeable factors (internality, subjective support, negative coping, cognitive reappraisal and expression inhibition) were related to PTSD, supplying an significant guidance for formulating valid psychosocial interventions for such female population.

Purpose: To conduct a formative evaluation of ChatEx to increase and maintain exercise among older cancer survivors.

Methods: ChatEx is a blended intervention involving 12 weeks of theory-based instant messages and two in-person training sessions. This pilot study comprises three phases: (1)intervention development: developing a message library reviewed by experts; (2)message library pretesting: exploring the views of older cancer survivors toward the message library and making modifications (n = 20); and (3)intervention pilot testing: piloting the ChatEx using a non-randomized quasi-experimental design using quantitative and qualitative methods among cancer survivors aged 65+ who do not meet current exercise guidelines and have completed treatment (n = 40). Feasibility, Acceptability, aerobic and resistance exercise, exercise capacity, grip strength, frailty, quality of life, exercise self-efficacy were assessed as the main outcomes.

Results: ChatEx had a retention rate of 80%, with most participants having moderate/high levels of engagement with messaging, and 100% attendance at in-person sessions. Compared to wait-list control, the intervention group significantly increased the time spent in aerobic exercise at 24 weeks, as well as resistance exercise at both 12 weeks and 24 weeks. The intervention group also had significantly greater improvement in exercise capacity and exercise self-efficacy than control at 24 weeks. Participant interviews revealed five major themes: positive feedback, facilitators of exercise adherence, barriers to exercise adherence, negative feedback, and suggestions for improvement.

Conclusion: The findings support the feasibility, acceptability, and potential efficacy of ChatEx in increasing exercise behaviour among older cancer survivors. A full-scale trial with a larger and more diverse sample is now warranted.