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The use of immersive virtual reality for managing physical and psychological distress in children and adolescents with cancer undergoing chemotherapy via implanted vascular access device needle insertion: A systematic review 使用沉浸式虚拟现实技术管理通过植入式血管通路装置插针接受化疗的癌症儿童和青少年的生理和心理压力:系统综述
IF 2.7 3区 医学 Q1 NURSING Pub Date : 2024-09-26 DOI: 10.1016/j.ejon.2024.102695
Theologia Tsitsi , Koralia A. Michail , Frederick G. Christou , Andreas Charalambous

Purpose

Children and adolescents undergoing cancer treatment often endure distressing procedures, leading to pain and anxiety. Immersive virtual reality (VR) is a novel distraction technique for distress management, but research in pediatric oncology remains limited. This systematic review aims to assess the effectiveness of IVR intervention utilizing advanced head-mounted displays, in alleviating physical and psychological distress among Children and Adolescents diagnosed with malignancies undergoing chemotherapy treatment via Implantable Venous Access Device/Port (IVAD/P) (P) needle insertion. Additionally, the study evaluates the usability and acceptability of the IVR intervention among healthcare professionals, patients, and their parents.

Method

A thorough database search (PubMed, Medline, Embase, CINHAL, and APA Psycinfo) identified seven relevant quantitative studies published until April 2024.

Results

In five studies, VR significantly reduced physical distress, especially pain, though the other two showed positive trends without statistical significance. For psychological distress, two studies reported significantly lower levels in the VR group, while three showed promising but statistically insignificant results. Children and adolescents, as well as healthcare professionals, found VR user-friendly and expressed willingness to use it again.

Conclusions

The review suggests that immersive VR has significant potential as a distraction method for children and adolescents undergoing CMT via IVAD/P. It shows promise in reducing physical and psychological distress and is well-received by patients and healthcare professionals.
目的正在接受癌症治疗的儿童和青少年经常要忍受痛苦的治疗过程,从而导致疼痛和焦虑。沉浸式虚拟现实(VR)是一种新颖的分散注意力的方法,但在儿科肿瘤学领域的研究仍然有限。本系统性综述旨在评估利用先进的头戴式显示器进行 IVR 干预在减轻通过植入式静脉通路装置/端口(IVAD/P)(P)针插入进行化疗的恶性肿瘤儿童和青少年的生理和心理压力方面的效果。此外,该研究还评估了 IVR 干预措施在医护人员、患者及其家长中的可用性和可接受性。方法通过数据库搜索(PubMed、Medline、Embase、CINHAL 和 APA Psycinfo),找到了截至 2024 年 4 月发表的七项相关定量研究。在心理困扰方面,有两项研究报告称,虚拟现实组的心理困扰程度明显降低,另有三项研究显示了有希望的结果,但在统计学上并不显著。儿童和青少年以及医疗保健专业人员都认为 VR 对用户友好,并表示愿意再次使用。它有望减轻患者的身心痛苦,并受到患者和医护人员的欢迎。
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引用次数: 0
Nurses’ experiences of palliative end-of-life care in patients at risk of a carotid blowout syndrome: A qualitative exploration 护士对有颈动脉爆裂综合征风险的患者进行临终姑息护理的经验:定性探索
IF 2.7 3区 医学 Q1 NURSING Pub Date : 2024-09-26 DOI: 10.1016/j.ejon.2024.102694
Christien Beiboer , Richtsje Andela , Leonora Q. Schwandt , Margreet C.J.M. van der Cingel

Purpose

Hospital nurses play an important role in providing palliative end-of-life care, for example for patients with carotid blowout. In such cases, dying is a severe event in which exsanguination occurs. Little is known about nurses’ experiences regarding care to patients at risk of a carotid blowout. This study aims to explore thoughts, experiences, and opinions of nurses about what they consider to be quality end-of-life nursing care for patients and their relatives, specifically those at risk of carotid blowout syndrome and the impact of providing such care on their professional and emotional well-being.

Methods

This study employed a qualitative design using audio-recorded, semi-structured focus group interviews. Three focus groups were conducted, comprising 11 nurses who worked on a head and neck unit. Interview transcripts were analyzed using thematic analysis.

Results

Participants reported nursing priorities in end-of-life carotid blowout care, comprising patients’ wishes, emotional support, preparing patients and dying care. Participants mentioned that a carotid blowout event was rare and impactful. A comprehensive protocol and scenario-based training facilitated the provision of end-of-life care. This study identified areas for improvement, such as the opportunity for moral support and debriefing after a blowout event for involved nurses.

Conclusion

Remarkable knowledge emerged about nurses’ experiences regarding end-of-life care and frequently used nursing interventions. Being prepared and having a workable protocol to deliver end-of-life care emerge as key. This exploratory study facilitates discussion of areas important to nurses providing end-of-life care in rare and impactful conditions.
目的医院护士在提供临终姑息护理方面发挥着重要作用,例如为颈动脉爆裂患者提供临终姑息护理。在这种情况下,死亡是一个严重的事件,其中会发生失血。护士对有颈动脉爆裂风险的病人的护理经验知之甚少。本研究旨在探讨护士的想法、经验和观点,了解他们认为对患者及其亲属(尤其是有颈动脉爆裂综合征风险的患者及其亲属)提供优质临终护理的意义,以及提供此类护理对其职业和情感健康的影响。共进行了三次焦点小组访谈,包括 11 名在头颈部科室工作的护士。访谈记录采用主题分析法进行分析。结果参与者报告了临终颈动脉吹脱护理中的护理重点,包括患者意愿、情感支持、患者准备和临终关怀。参与者提到,颈动脉爆裂事件非常罕见且影响巨大。全面的方案和基于情景的培训有助于提供临终护理。本研究发现了需要改进的地方,例如在发生颈动脉爆裂事件后为参与其中的护士提供精神支持和汇报的机会。做好准备和制定可行的方案是提供临终关怀的关键。这项探索性研究有助于对护士在罕见和有影响的情况下提供临终关怀的重要领域进行讨论。
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引用次数: 0
Exploring the emotional labour of paediatric oncology nurses and its impact on their well-being: An integrative review 探讨儿科肿瘤科护士的情感劳动及其对护士福祉的影响:综合综述
IF 2.7 3区 医学 Q1 NURSING Pub Date : 2024-09-24 DOI: 10.1016/j.ejon.2024.102693
Wejdan Shaqiqi , Pam Smith , Rawan Shaqiqi

Purpose

To explore emotional labour in paediatric oncology nurses along with the negative impact of emotional labour on these nurses.

Methods

The MEDLINE, CINALH, ScienceDirect, and PubMed databases were searched for relevant evidence published from 2000 to 2023. Selected studies were evaluated for quality and synthesized into themes. The Preferred Reporting Items for Systematic reviews and Meta-Analyses literature search extension was followed.

Results

Eighteen empirical studies were reviewed. Nurses acknowledged the importance of managing and displaying emotions through emotional labour to gain patients' and families' trust and provide care in a safe and comfortable environment. They described emotional labour in the forms of empathy and close relationships. The frequency and intensity of performing emotional labour vary among nurses based on different factors. Nurses reported feelings associated with burnout, compassion fatigue, secondary traumatic stress, and emotional dissonance. The three main coping behaviours were avoidance, changing practice and sharing feelings.

Conclusion

Although using emotional labour facilitates high-quality care, it may negatively influence nurses' well-being without implementing effective supportive interventions. A considerable number of paediatric oncology nurses intended to leave the unit. The proposed solutions are to address this issue at the organizational level by providing training and support services to enhance nurses' competence in performing this high-level skill and minimize its negative impacts.
目的 探讨儿科肿瘤科护士的情绪劳动以及情绪劳动对这些护士的负面影响。方法 在 MEDLINE、CINALH、ScienceDirect 和 PubMed 数据库中搜索 2000 年至 2023 年发表的相关证据。对所选研究进行了质量评估并归纳成主题。结果 对 18 项实证研究进行了综述。护士们承认通过情绪劳动来管理和展示情绪的重要性,从而赢得患者和家属的信任,并在安全舒适的环境中提供护理服务。她们以移情和亲密关系的形式描述了情感劳动。护士进行情感劳动的频率和强度因不同因素而异。护士们报告了与职业倦怠、同情疲劳、二次创伤压力和情感失调有关的感受。结论虽然情绪劳动有助于提供高质量的护理,但如果不采取有效的支持性干预措施,情绪劳动可能会对护士的身心健康产生负面影响。相当多的儿科肿瘤科护士打算离开科室。建议的解决方案是通过提供培训和支持服务,从组织层面解决这一问题,以提高护士执行这一高级技能的能力,并将其负面影响降至最低。
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引用次数: 0
“Oh when's your treatment ending?” “Never!” The unmet needs of cancer patients treated with immunological, biological and precision therapies: A qualitative interview study "哦,你的治疗什么时候结束?""永远不会!"接受免疫、生物和精准疗法治疗的癌症患者尚未满足的需求:定性访谈研究
IF 2.7 3区 医学 Q1 NURSING Pub Date : 2024-09-23 DOI: 10.1016/j.ejon.2024.102696
L. Crowe , M.C. Brown , J. Lecouturier , A. Greystoke , A. Bojke , R. Bojke , J. Richardson , M. Wells , E. Ezeala , L. Carter , L. Sharp , A. Todd

Purpose

To explore the unmet supportive care needs of patients with advanced cancer receiving immuno-, biological and precision (IBP) therapies.

Methods

We conducted semi-structured interviews with: (1) adults diagnosed with advanced cancer (lung, colorectal, ovary, breast, renal, melanoma) treated with an IBP therapy (e.g. tyrosine kinase inhibitors, monoclonal antibodies, immunotherapy), for at least one month; (2) healthcare professionals involved in providing hospital care for patients receiving IBP therapies. Interviews were audio-recorded, transcribed and analysed using the Framework Analysis approach; the framework comprised of 11 domains of unmet need: activities of daily living, autonomy, economic, healthcare, information, physical, psychological, role, sexual, social; and an “other” category (to capture data relating to unmet needs that did not fit within pre the-defined domains).

Results

Thirty-one patients and 22 healthcare professionals were interviewed. Ten domains of unmet needs (exceptions: spiritual, other) were evident in the data. Identified unmet needs related to: (1) utilising the IBP therapies (e.g. specific treatment side effects [physical domain], living long-term with uncertainty [psychological], others not understanding why they were not cured [social]; and (2) living with (advanced) cancer (e.g. retiring from work [role], loss of independence [autonomy]).

Conclusions

Patients with advanced cancer being treated with IBP therapies have a diverse range of often inter-related unmet needs. It is vital that healthcare professionals involved in the care of cancer patients using IBP therapies are alert to the unmet needs among this patient group. Interventions and services should be developed to address these needs.
目的 探讨接受免疫、生物和精准(IBP)疗法的晚期癌症患者未得到满足的支持性护理需求:(1) 被诊断为晚期癌症(肺癌、结直肠癌、卵巢癌、乳腺癌、肾癌、黑色素瘤)并接受 IBP 疗法(如酪氨酸激酶抑制剂、单克隆抗体、免疫疗法)治疗至少一个月的成人;(2) 参与为接受 IBP 疗法的患者提供医院护理的医护人员。访谈采用框架分析法进行录音、转录和分析;框架包括 11 个未满足需求领域:日常生活活动、自主性、经济、医疗保健、信息、身体、心理、角色、性、社交;以及一个 "其他 "类别(用于捕捉与未满足需求相关的数据,这些需求不属于定义的领域)。数据显示有十个未满足的需求领域(例外情况:精神、其他)。确定的未满足需求涉及(1) 使用 IBP 疗法(如特定的治疗副作用[生理领域]、长期生活在不确定性中[心理]、其他人不理解他们为何未被治愈[社会]);以及 (2) 与(晚期)癌症共存(如从工作中退休[角色]、失去独立性[自主性])。参与护理使用 IBP 疗法的癌症患者的医护人员必须对这一患者群体中尚未满足的需求保持警惕。应针对这些需求开发干预措施和服务。
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引用次数: 0
Integrating the symptom experience and coping in patients with stage I-III breast cancer in China: A qualitative study 中国I-III期乳腺癌患者的症状体验与应对相结合:定性研究
IF 2.7 3区 医学 Q1 NURSING Pub Date : 2024-09-21 DOI: 10.1016/j.ejon.2024.102692
Minyu Liang , Ying Xiong , Siying Zhu , Yishu Wang , M. Tish Knobf , Zengjie Ye

Purpose

To develop an in-depth understanding of the meaning of symptoms in the context of how women with stage I-III breast cancer in China cope with the effects of primary and adjuvant therapies for breast cancer.

Method

A qualitative descriptive approach was used. A purposive sample of women diagnosed with stage I-III breast cancer were recruited from the “Be Resilient to Breast Cancer” study between November 2023 and March 2024. Data was collected from in person interviews using a semi-structured interview guide. Interviews were audio-recorded and transcribed verbatim. The framework analysis method was used to generate codes and themes.

Results

A sample of 17 women with breast cancer agreed to participate. The average age was 50.1 years (SD = 8.45), and the majority (65%) had stage III. The overarching theme was Confronting Physical and Psychological Symptoms. The four themes explaining the experience were Changed Identity, Uncertainty, Finding Meaning and Seeking Support and Solace. Changed Identity and Uncertainty reflected the challenges of coping with multiple symptoms from the treatment. The themes of Finding Meaning and Seeking Support and Solace captured how women adapted a positive perspective to cope with the experience.

Conclusions

This study contributed to the evidence of the integration of the symptom experience in coping with breast cancer treatment in the context of a collectivist Chinese culture. It enhanced the understanding of the physical and psychological symptom experience of curative intent breast cancer therapy and offered insight into how women from China cope in early survivorship.
目的深入了解中国I-III期乳腺癌妇女如何应对乳腺癌初治和辅助治疗的影响。在 2023 年 11 月至 2024 年 3 月期间,从 "抗击乳腺癌 "研究中招募了被确诊为 I-III 期乳腺癌的女性作为目的性样本。采用半结构化访谈指南,通过当面访谈收集数据。对访谈进行了录音和逐字转录。采用框架分析法生成代码和主题。平均年龄为 50.1 岁(SD = 8.45),大多数(65%)为 III 期。首要主题是面对生理和心理症状。解释其经历的四个主题分别是身份改变、不确定性、寻找意义以及寻求支持和慰藉。身份的改变和不确定性反映了应对治疗带来的多种症状的挑战。寻找意义和寻求支持与慰藉这两个主题反映了妇女如何从积极的角度来应对这一经历。该研究加深了人们对乳腺癌意向性治疗的生理和心理症状体验的理解,并为中国妇女如何应对早期生存提供了启示。
{"title":"Integrating the symptom experience and coping in patients with stage I-III breast cancer in China: A qualitative study","authors":"Minyu Liang ,&nbsp;Ying Xiong ,&nbsp;Siying Zhu ,&nbsp;Yishu Wang ,&nbsp;M. Tish Knobf ,&nbsp;Zengjie Ye","doi":"10.1016/j.ejon.2024.102692","DOIUrl":"10.1016/j.ejon.2024.102692","url":null,"abstract":"<div><h3>Purpose</h3><div>To develop an in-depth understanding of the meaning of symptoms in the context of how women with stage I-III breast cancer in China cope with the effects of primary and adjuvant therapies for breast cancer.</div></div><div><h3>Method</h3><div>A qualitative descriptive approach was used. A purposive sample of women diagnosed with stage I-III breast cancer were recruited from the “Be Resilient to Breast Cancer” study between November 2023 and March 2024. Data was collected from in person interviews using a semi-structured interview guide. Interviews were audio-recorded and transcribed verbatim. The framework analysis method was used to generate codes and themes.</div></div><div><h3>Results</h3><div>A sample of 17 women with breast cancer agreed to participate. The average age was 50.1 years (SD = 8.45), and the majority (65%) had stage III. The overarching theme was <em>Confronting Physical and Psychological Symptoms</em>. The four themes explaining the experience were Changed Identity, Uncertainty, Finding Meaning and Seeking Support and Solace. Changed Identity and Uncertainty reflected the challenges of coping with multiple symptoms from the treatment. The themes of Finding Meaning and Seeking Support and Solace captured how women adapted a positive perspective to cope with the experience.</div></div><div><h3>Conclusions</h3><div>This study contributed to the evidence of the integration of the symptom experience in coping with breast cancer treatment in the context of a collectivist Chinese culture. It enhanced the understanding of the physical and psychological symptom experience of curative intent breast cancer therapy and offered insight into how women from China cope in early survivorship.</div></div>","PeriodicalId":51048,"journal":{"name":"European Journal of Oncology Nursing","volume":"73 ","pages":"Article 102692"},"PeriodicalIF":2.7,"publicationDate":"2024-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142433680","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A causal model of health-related quality of life in colorectal cancer patients post-surgery 结直肠癌患者术后健康相关生活质量的因果模型
IF 2.7 3区 医学 Q1 NURSING Pub Date : 2024-09-12 DOI: 10.1016/j.ejon.2024.102691
Thi Hong Hanh Tran , Sureeporn Thanasilp , Noppamat Pudtong

Purpose

this study aims to develop and test a model examining the causal relationship between self-efficacy, social support, fatigue, pain, functional status, and health-related quality of life (HRQL).

Methods

A cross-sectional correlation study was conducted using a multi-stage sampling technique to recruit 256 individuals aged 20 to 59 with colorectal cancer (CRC) post-surgery from three hospitals in Northern Vietnam. The hypothesized model, based on Ferrans’ HRQL conceptual model and literature review, was validated using structural equation modeling (SEM) and Mplus.

Results

the model fit the data well, explaining 52% of the variance of HRQL. Self-efficacy emerged as the most influential factor directly impacting HRQL (β = .494, p < .05) and also had negative indirect effects on HRQL through fatigue and pain (β = −.271, p < .05). Social support had a positive direct (β = .406, p < .001) and negative indirect effects on HRQL via fatigue and pain (β = −.143, p < .05). Fatigue and pain had negative indirect effects on HRQL through functional status (β = −.336, p < .05 and β = −.219, p < .05, respectively). Functional status had a positive direct effect on HRQL (β = .418, p < .001).

Conclusions

The study's findings highlight the importance of improving self-efficacy, social support, and functional status, while reducing fatigue and pain to enhance HRQL among individuals with CRCpost-surgery. These insights can inform the development of targeted interventions to improve the well-being of this population.

方法 采用多阶段抽样技术,从越南北部三家医院招募了 256 名年龄在 20 至 59 岁之间的结直肠癌术后患者,开展了一项横断面相关性研究。假设模型以 Ferrans 的 HRQL 概念模型和文献综述为基础,使用结构方程建模(SEM)和 Mplus 进行了验证。自我效能是直接影响 HRQL 的最有影响力的因素(β = .494,p < .05),同时也通过疲劳和疼痛对 HRQL 产生负面的间接影响(β = -.271,p < .05)。社会支持对 HRQL 有积极的直接影响(β = .406,p < .001),并通过疲劳和疼痛对 HRQL 有消极的间接影响(β = -.143,p < .05)。疲劳和疼痛通过功能状态对 HRQL 产生负向间接影响(β = -.336, p <.05;β = -.219, p <.05)。结论该研究结果强调了改善自我效能、社会支持和功能状态的重要性,同时减轻疲劳和疼痛以提高 CRC 术后患者的 HRQL。这些见解可以为制定有针对性的干预措施提供参考,从而改善这一人群的健康状况。
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引用次数: 0
Hope and relationship dynamics among couples faced with their child's cancer: A dyadic phenomenological interpretative analysis 面对子女患癌的夫妇的希望与关系动态:二元现象学解释分析
IF 2.7 3区 医学 Q1 NURSING Pub Date : 2024-09-06 DOI: 10.1016/j.ejon.2024.102690
Laurine Milville , Sophie Lelorain , Pascal Antoine

Purpose

The onset of paediatric cancer leads to changes in the functioning of the parental couple. The interactions and interdependence between partners affect their individual and dyadic adjustments. Hope can enable parents to cope with difficulties and alleviate their distress. The aim of this study is to explore how both partners experience their relationship dynamics and hope within the couple.

Method

This qualitative study focused on 7 couples whose child was in remission from cancer; each parent was interviewed separately. The semi-structured interviews were subjected to interpretative phenomenological analysis.

Results

Three themes were found to characterise the experiences of couples faced with their child's cancer. “Captain and first mate" emphasises the gendered and hierarchical distribution of roles based on the analogy of a crew struggling against the threat of cancer. “The emotional compass" focuses on how emotions guide each partner's attempts to meet their own need for emotional expression and that of their partner. "In the same boat, with divergent hope sails" reflects the complex and diverse ways in which hope and forms of hope are expressed, perceived as a resource which is often precious, sometimes viewed as unthinkable because it reflects the violence associated with the despair of the situation and transferred from one parent to the other.

Discussion

These findings highlight the need to focus on the organisation of role, the interaction of emotional needs and the dynamics of hope within parental dyads to optimise the management of couples faced with their child's cancer.

目的 儿童癌症的发生会导致父母夫妇的功能发生变化。伴侣之间的互动和相互依赖会影响他们个人和家庭的调整。希望可以帮助父母应对困难和减轻痛苦。本研究旨在探讨夫妻双方如何体验他们的关系动态以及夫妻间的希望。对半结构式访谈进行了解释性现象学分析。结果发现有三个主题是夫妻双方面对子女癌症的经历的特点。"船长和大副 "以船员与癌症威胁作斗争的比喻,强调了角色的性别和等级分配。"情感罗盘 "侧重于情感如何引导伴侣满足自己和伴侣的情感表达需求。"同舟共济,希望之帆各异 "反映了希望和希望形式表达的复杂性和多样性,希望往往被视为一种宝贵的资源,有时被视为不可想象的资源,因为它反映了与绝望处境相关的暴力,并从父母一方转移到另一方。 讨论这些研究结果突出表明,有必要关注父母双方的角色组织、情感需求的互动以及希望的动态变化,以优化面对子女癌症的夫妇的管理。
{"title":"Hope and relationship dynamics among couples faced with their child's cancer: A dyadic phenomenological interpretative analysis","authors":"Laurine Milville ,&nbsp;Sophie Lelorain ,&nbsp;Pascal Antoine","doi":"10.1016/j.ejon.2024.102690","DOIUrl":"10.1016/j.ejon.2024.102690","url":null,"abstract":"<div><h3>Purpose</h3><p>The onset of paediatric cancer leads to changes in the functioning of the parental couple. The interactions and interdependence between partners affect their individual and dyadic adjustments. Hope can enable parents to cope with difficulties and alleviate their distress. The aim of this study is to explore how both partners experience their relationship dynamics and hope within the couple.</p></div><div><h3>Method</h3><p>This qualitative study focused on 7 couples whose child was in remission from cancer; each parent was interviewed separately. The semi-structured interviews were subjected to interpretative phenomenological analysis.</p></div><div><h3>Results</h3><p>Three themes were found to characterise the experiences of couples faced with their child's cancer. “Captain and first mate\" emphasises the gendered and hierarchical distribution of roles based on the analogy of a crew struggling against the threat of cancer. “The emotional compass\" focuses on how emotions guide each partner's attempts to meet their own need for emotional expression and that of their partner. \"In the same boat, with divergent hope sails\" reflects the complex and diverse ways in which hope and forms of hope are expressed, perceived as a resource which is often precious, sometimes viewed as unthinkable because it reflects the violence associated with the despair of the situation and transferred from one parent to the other.</p></div><div><h3>Discussion</h3><p>These findings highlight the need to focus on the organisation of role, the interaction of emotional needs and the dynamics of hope within parental dyads to optimise the management of couples faced with their child's cancer.</p></div>","PeriodicalId":51048,"journal":{"name":"European Journal of Oncology Nursing","volume":"72 ","pages":"Article 102690"},"PeriodicalIF":2.7,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1462388924001881/pdfft?md5=af1aef63788c9e368877f67a87ab6f73&pid=1-s2.0-S1462388924001881-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142243283","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Breast cancer patients' perspectives and needs about wed-based surgical decision aid: A qualitative study 乳腺癌患者对基于婚礼的手术决策辅助工具的看法和需求:定性研究
IF 2.7 3区 医学 Q1 NURSING Pub Date : 2024-09-05 DOI: 10.1016/j.ejon.2024.102689
Chen Pan , Hongfan Yin , Jiehui Xu , Yihui Hu , Yun Li , Yan Yang

Purpose

Breast cancer diagnosis often presents patients with complex treatment decisions, particularly concerning surgical options. A patient decision aid can assist patients in making better decisions, and ultimately improving health outcomes positively. This study aims to explore the perceptions and needs of breast cancer patients regarding the utilization of wed-based surgical decision aids.

Methods

A descriptive qualitative study was conducted using semi-structured interviews with purposive sampling that were audio recorded and transcribed verbatim. A thematic analysis was conducted using NVivo 12 software. Participants were recruited from a tertiary general hospital in Shanghai, China. Inclusion criteria were being diagnosed with breast cancer, age over 18 years old, considering breast cancer surgery as a treatment option and able/willing to give informed consent.

Results

From March to May 2023, 16 patients consented to participate and completed the interviews. Three major themes were revealed, with corresponding sub-themes: (1) informative and useful content (need to know as much information as possible, easy to understand and presented in multiple ways and highly credible from reliable resource); (2) user-friendly on design (easy to operate, simple function and man-machine interaction); and (3) suggested timing of use.

Conclusions

Patients' perspectives and needs about wed-based surgical decision aids are numerous and diverse. In designing wed-based surgical decision aids for breast cancer patients, content, design and timing are all factors that need to be taken into consideration to encourage informed surgical decisions. Further work will focus on developing a feasible and acceptable web-based surgical patient decision aid (PtDA), and test its usability in a clinical setting to understand if the PtDA can meet the decisional needs of breast cancer patients, thus to improve quality of decision-making.

目的 乳腺癌诊断通常会给患者带来复杂的治疗决定,尤其是手术方案。患者决策辅助工具可以帮助患者做出更好的决定,并最终积极改善健康状况。本研究旨在探讨乳腺癌患者对使用基于婚礼的手术决策辅助工具的看法和需求。方法本研究采用半结构式访谈法进行描述性定性研究,访谈采用目的性取样,并进行录音和逐字转录。使用 NVivo 12 软件进行了主题分析。参与者来自中国上海的一家三级综合医院。纳入标准为确诊为乳腺癌、年龄在 18 岁以上、考虑将乳腺癌手术作为一种治疗方案、能够/愿意做出知情同意。结果2023 年 3 月至 5 月,16 名患者同意参与并完成了访谈。访谈揭示了三大主题及相应的次主题:(1) 信息丰富且有用的内容(需要了解尽可能多的信息、易于理解且以多种方式呈现、来自可靠资源的可信度高);(2) 用户友好的设计(易于操作、功能简单且人机交互);(3) 建议的使用时机。在为乳腺癌患者设计基于 wed 的手术决策辅助工具时,内容、设计和时机都是需要考虑的因素,以鼓励患者在知情的情况下做出手术决策。今后的工作重点是开发一种可行且可接受的基于网络的手术患者决策辅助工具(PtDA),并在临床环境中测试其可用性,以了解 PtDA 能否满足乳腺癌患者的决策需求,从而提高决策质量。
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引用次数: 0
The care pathway experienced by cutaneous melanoma survivors: A qualitative longitudinal study 皮肤黑色素瘤幸存者的护理途径:定性纵向研究
IF 2.7 3区 医学 Q1 NURSING Pub Date : 2024-08-22 DOI: 10.1016/j.ejon.2024.102688
Margherita Raucci , Matías Eduardo Díaz Crescitelli , Elisa Benati , Stefania Borsari , Michela Lai , Mara Lombardi , Marica Mirra , Valentina Giorgi , Simone Stoppazzoni , Cristina Pedroni , Silvia Di Leo , Luca Ghirotto , Caterina Longo

Background

The optimal management of cutaneous melanoma is based on implementing a multidisciplinary tumour board. No studies report cutaneous melanoma patients’ perspective along the whole care pathway, taking us through their care experience longitudinally.

Aims

To explore the patients' perspective on the cutaneous melanoma care journey in a skin cancers’ tertiary referral centre.

Methods

A longitudinal qualitative study was designed, using semi-structured interviews. Cutaneous melanoma patients were interviewed three times (T0, after diagnosis; T1, after the first postoperative visit; and T2, at the follow-up). Data were analysed using the inductive framework method.

Results

Fifteen patients agreed to participate, and 8 completed all three interviews. We generated three themes describing how patients experienced the care pathway: (i) the evolving need for support during the care pathway, (ii) the development of emotions and expectations for the journey's end, (iii) the changing perceptions of hospital services, the care pathway itself, and the Skin Cancer Unit. We have emphasised the shifts in the experience of receiving assistance from the diagnosis to the follow-up stage. The more the care process progressed, the stronger the need for a relationship with healthcare professionals. The emotional impact of becoming a cancer survivor exacerbated the experience and reflected on patients' perceptions of the care pathway.

Conclusions

Adopting a relational approach to reassuring melanoma patients is essential. Our participants expressed needing a medical reference figure as a favourable element. When this is unfeasible, inter-professional training is desirable to help professionals cooperate in a multidisciplinary group and make this collaboration visible to patients.

背景皮肤黑色素瘤的最佳治疗基于多学科肿瘤委员会的实施。目前还没有任何研究报告了皮肤黑色素瘤患者在整个治疗过程中的视角,让我们纵向了解他们的治疗经历。目的 在一家皮肤癌三级转诊中心探索患者在皮肤黑色素瘤治疗过程中的视角。方法 采用半结构式访谈设计了一项纵向定性研究。皮肤黑色素瘤患者接受了三次访谈(T0,确诊后;T1,术后首次就诊后;T2,随访时)。我们采用归纳框架法对数据进行了分析。我们提出了三个主题来描述患者是如何经历护理路径的:(i) 在护理路径中不断变化的对支持的需求,(ii) 情感的发展和对旅程结束的期望,(iii) 对医院服务、护理路径本身和皮肤癌科的看法的变化。我们强调了从诊断到后续阶段接受援助的经历的变化。护理过程越深入,就越需要与医护人员建立联系。成为癌症幸存者的情绪影响加剧了这种体验,并反映在患者对护理路径的看法上。我们的参与者表示,需要一个医学参考人物是一个有利因素。如果无法做到这一点,最好进行跨专业培训,以帮助专业人员在多学科小组中开展合作,并让患者看到这种合作。
{"title":"The care pathway experienced by cutaneous melanoma survivors: A qualitative longitudinal study","authors":"Margherita Raucci ,&nbsp;Matías Eduardo Díaz Crescitelli ,&nbsp;Elisa Benati ,&nbsp;Stefania Borsari ,&nbsp;Michela Lai ,&nbsp;Mara Lombardi ,&nbsp;Marica Mirra ,&nbsp;Valentina Giorgi ,&nbsp;Simone Stoppazzoni ,&nbsp;Cristina Pedroni ,&nbsp;Silvia Di Leo ,&nbsp;Luca Ghirotto ,&nbsp;Caterina Longo","doi":"10.1016/j.ejon.2024.102688","DOIUrl":"10.1016/j.ejon.2024.102688","url":null,"abstract":"<div><h3>Background</h3><p>The optimal management of cutaneous melanoma is based on implementing a multidisciplinary tumour board. No studies report cutaneous melanoma patients’ perspective along the whole care pathway, taking us through their care experience longitudinally.</p></div><div><h3>Aims</h3><p>To explore the patients' perspective on the cutaneous melanoma care journey in a skin cancers’ tertiary referral centre.</p></div><div><h3>Methods</h3><p>A longitudinal qualitative study was designed, using semi-structured interviews. Cutaneous melanoma patients were interviewed three times (T0, after diagnosis; T1, after the first postoperative visit; and T2, at the follow-up). Data were analysed using the inductive framework method.</p></div><div><h3>Results</h3><p>Fifteen patients agreed to participate, and 8 completed all three interviews. We generated three themes describing how patients experienced the care pathway: (i) the evolving need for support during the care pathway, (ii) the development of emotions and expectations for the journey's end, (iii) the changing perceptions of hospital services, the care pathway itself, and the Skin Cancer Unit. We have emphasised the shifts in the experience of receiving assistance from the diagnosis to the follow-up stage. The more the care process progressed, the stronger the need for a relationship with healthcare professionals. The emotional impact of becoming a cancer survivor exacerbated the experience and reflected on patients' perceptions of the care pathway.</p></div><div><h3>Conclusions</h3><p>Adopting a relational approach to reassuring melanoma patients is essential. Our participants expressed needing a medical reference figure as a favourable element. When this is unfeasible, inter-professional training is desirable to help professionals cooperate in a multidisciplinary group and make this collaboration visible to patients.</p></div>","PeriodicalId":51048,"journal":{"name":"European Journal of Oncology Nursing","volume":"72 ","pages":"Article 102688"},"PeriodicalIF":2.7,"publicationDate":"2024-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1462388924001868/pdfft?md5=9768279c2e43515419cd99bdcdf85219&pid=1-s2.0-S1462388924001868-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142274267","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Symptoms, distress, finances, social support, resource utilization, and unmet care needs of patients with gynecological cancer 妇科癌症患者的症状、痛苦、经济状况、社会支持、资源利用和未满足的护理需求
IF 2.7 3区 医学 Q1 NURSING Pub Date : 2024-08-22 DOI: 10.1016/j.ejon.2024.102686
Chia-Li Siao , Wen-Chun Chang , Chi-Hau Chen , Yun-Hsiang Lee , Yeur-Hur Lai

Purpose

This study explored the unmet care needs of gynecological cancer patients, including overall and subdomain needs (i.e., physical and daily living needs, psychological and emotional needs, care and support needs, and health-system and information needs), and related factors.

Methods

In this cross-sectional study, gynecological cancer patients treated at a medical center in northern Taiwan were recruited. Data on demographics, symptoms, distress, finances, social support, resource utilization, and care needs were collected. Spearman's correlation and the Mann–Whitney U test were used for analysis.

Results

This study of 118 cancer patients found that 73% had unmet psychological and emotional needs, followed by 54% with unmet health system and information needs. The most common physical symptoms were insomnia, fatigue, and pain, with 51.7% experiencing moderate or high levels of distress. Overall, the patients received considerable social support, both instrumental and emotional, primarily through medical information booklets (39.0%), cancer information websites (28.8%), and rehabilitative resources (20.3%). Factors associated with unmet care needs included younger age, non-ovarian cancer, symptoms (pain, fatigue, appetite loss, insomnia, dyspnea, nausea, and vomiting), distress, finances, social support, and the use of cancer information websites.

Conclusion

Psychological and emotional unmet needs is prevalent among patients with gynecological cancer; psychological support is crucial. Younger patients and those with non-ovarian cancer had more unmet care needs. These needs are linked to severe symptoms, distress, financial difficulties, limited social support, and low use of cancer information websites. Enhancing support for this population through targeted interventions is necessary.
目的 本研究探讨了妇科癌症患者未得到满足的护理需求,包括总体需求和子领域需求(即身体和日常生活需求、心理和情感需求、护理和支持需求、医疗系统和信息需求)以及相关因素。方法 在这项横断面研究中,研究人员招募了在台湾北部一家医疗中心接受治疗的妇科癌症患者。收集了有关人口统计学、症状、痛苦、经济、社会支持、资源利用和护理需求的数据。结果这项针对 118 名癌症患者的研究发现,73% 的患者的心理和情感需求未得到满足,其次是 54% 的患者的医疗系统和信息需求未得到满足。最常见的身体症状是失眠、疲劳和疼痛,51.7%的患者有中度或高度痛苦。总体而言,患者获得了大量的社会支持,包括工具性支持和情感支持,主要是通过医疗信息手册(39.0%)、癌症信息网站(28.8%)和康复资源(20.3%)。与未满足护理需求相关的因素包括年龄较小、非卵巢癌、症状(疼痛、疲劳、食欲不振、失眠、呼吸困难、恶心和呕吐)、痛苦、经济状况、社会支持以及癌症信息网站的使用。年轻患者和非卵巢癌患者有更多的护理需求未得到满足。这些需求与严重的症状、痛苦、经济困难、有限的社会支持以及癌症信息网站使用率低有关。有必要通过有针对性的干预措施加强对这一人群的支持。
{"title":"Symptoms, distress, finances, social support, resource utilization, and unmet care needs of patients with gynecological cancer","authors":"Chia-Li Siao ,&nbsp;Wen-Chun Chang ,&nbsp;Chi-Hau Chen ,&nbsp;Yun-Hsiang Lee ,&nbsp;Yeur-Hur Lai","doi":"10.1016/j.ejon.2024.102686","DOIUrl":"10.1016/j.ejon.2024.102686","url":null,"abstract":"<div><h3>Purpose</h3><div>This study explored the unmet care needs of gynecological cancer patients, including overall and subdomain needs (i.e., physical and daily living needs, psychological and emotional needs, care and support needs, and health-system and information needs), and related factors.</div></div><div><h3>Methods</h3><div>In this cross-sectional study, gynecological cancer patients treated at a medical center in northern Taiwan were recruited. Data on demographics, symptoms, distress, finances, social support, resource utilization, and care needs were collected. Spearman's correlation and the Mann–Whitney <em>U</em> test were used for analysis.</div></div><div><h3>Results</h3><div>This study of 118 cancer patients found that 73% had unmet psychological and emotional needs, followed by 54% with unmet health system and information needs. The most common physical symptoms were insomnia, fatigue, and pain, with 51.7% experiencing moderate or high levels of distress. Overall, the patients received considerable social support, both instrumental and emotional, primarily through medical information booklets (39.0%), cancer information websites (28.8%), and rehabilitative resources (20.3%). Factors associated with unmet care needs included younger age, non-ovarian cancer, symptoms (pain, fatigue, appetite loss, insomnia, dyspnea, nausea, and vomiting), distress, finances, social support, and the use of cancer information websites.</div></div><div><h3>Conclusion</h3><div>Psychological and emotional unmet needs is prevalent among patients with gynecological cancer; psychological support is crucial. Younger patients and those with non-ovarian cancer had more unmet care needs. These needs are linked to severe symptoms, distress, financial difficulties, limited social support, and low use of cancer information websites. Enhancing support for this population through targeted interventions is necessary.</div></div>","PeriodicalId":51048,"journal":{"name":"European Journal of Oncology Nursing","volume":"72 ","pages":"Article 102686"},"PeriodicalIF":2.7,"publicationDate":"2024-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1462388924001844/pdfft?md5=0284179834fbf95303cbefe26c02eb31&pid=1-s2.0-S1462388924001844-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142312684","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
期刊
European Journal of Oncology Nursing
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