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Identifying and responding to domestic abuse in cancer care: A mixed methods service evaluation of a training and support intervention 识别和应对癌症护理中的家庭虐待:培训和支持干预的混合方法服务评估。
IF 2.7 3区 医学 Q1 NURSING Pub Date : 2025-02-01 DOI: 10.1016/j.ejon.2024.102724
Sandi Dheensa , Ruth Hendy , Linda Finn , Marion Goodchild , Estela Capelas Barbosa

Purpose

This article reports on a service evaluation of a domestic abuse intervention for hospital-based cancer professionals in two sites. The core component was a training and monitoring process, which hospital-based domestic abuse coordinators led. This role was adapted from a generic hospital role to be cancer specific. Pre-training preparedness to identify and respond to domestic abuse, domestic abuse identifications, and changes ∼6 months post-training are presented.

Methods

We used an explanatory sequential design including a survey pre-training (Time 1), immediately post-training (Time 2) (with follow-up semi-structured interviews) and ∼6 months post-training (Time 3). Sites were asked to share domestic abuse identification numbers pre- and post-coordinator hire.

Results

Coordinators trained 1080 staff (17% of staff across two sites). Survey 1 (Time 1 & 2) response rate was 44.9% (n = 485) and survey 2 8.8% (n = 95) (Time 3). All confidence scores significantly increased from pre- (Time 1) to post-training (Time 2). Time 3 also saw significant gains. There were also highly significant decreases in the perception of most barriers to asking about and responding to domestic abuse post-training. We were unable to determine Site 2's identification rate but Site 1's increased. Qualitative findings shed light on key moderators between intervention components and outcomes, and additional components needed to change practice.

Conclusion

Our evaluation contributes further evidence of the benefit of hospital-based domestic abuse coordinator roles; contributes new evidence for the feasibility of adapting the role for a specific context; and illustrates the need for a domestic abuse response in the cancer setting.
目的:本文报告了两个地点对医院癌症专业人员家庭虐待干预的服务评估。核心组成部分是由医院家庭虐待协调员领导的培训和监测进程。这个角色从一个普通的医院角色改编为癌症特异性角色。介绍了识别和应对家庭虐待的培训前准备、家庭虐待识别和培训后约6个月的变化。方法:我们采用了解释性序列设计,包括培训前(时间1)、培训后(时间2)(随访半结构化访谈)和培训后6个月(时间3)的调查。要求网站分享协调员招聘前和招聘后的家庭暴力识别号码。结果:协调员培训了1080名员工(占两个站点员工的17%)。调查1(时间1和时间2)的回复率为44.9% (n = 485),调查2 (n = 95)(时间3)的回复率为8.8% (n = 95)。从训练前(时间1)到训练后(时间2),所有的信心得分都显著增加。培训后对询问和应对家庭暴力的大多数障碍的看法也显著减少。我们无法确定Site 2的识别率,但Site 1的识别率增加了。定性研究结果揭示了干预成分和结果之间的关键调节因素,以及改变实践所需的其他成分。结论:我们的评估进一步证明了医院家庭暴力协调员角色的好处;为使该角色适应特定环境的可行性提供新的证据;这也说明了在癌症环境下应对家庭暴力的必要性。
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引用次数: 0
Profiles of chemotherapy-induced peripheral neuropathy in breast cancer patients undergoing taxane-based chemotherapy: A latent class analysis 接受紫杉烷类化疗的乳腺癌患者化疗诱导的周围神经病变概况:一项潜在分类分析。
IF 2.7 3区 医学 Q1 NURSING Pub Date : 2025-02-01 DOI: 10.1016/j.ejon.2024.102758
Ruo-lin Li , Li-xiao Bai , Yu Liu , Ai-ling Yang , Lu Chen , Fu-yun Zhao , Ling Zhang , Jun-E Liu

Purpose

This study aimed to identify the potential subgroups of chemotherapy-induced peripheral neuropathy (CIPN) in breast cancer patients undergoing taxane-based chemotherapy and examine the association of the latent subtype with patient characteristics.

Methods

This multi-center, cross-sectional investigation was conducted between April 2022 and March 2023. CIPN was evaluated using the Functional Assessment of Cancer Therapy/Gynecologic Oncology Group-Neurotoxicity scale. Latent class analysis was employed to identify distinct CIPN subgroups, and multinomial logistic regression was used to analyze the associations between these subgroups and patient characteristics.

Results

In total, 397 individuals were categorized into three subgroups: high symptoms with high dysfunction (Class 1; 25.4%), moderate symptoms with low dysfunction (Class 2; 39.2%), and low symptoms with low dysfunction (Class 3; 35.3%). Taxane type, chemotherapy cycles, fatigue, β-blocker use, and depression were significant predictors of the subgroups (P < .05).

Conclusion

CIPN symptoms in breast cancer patients are heterogeneous. Significant factors for the latent subgroups included taxane type, chemotherapy cycles, β-blocker use, fatigue, and depression. Identifying different subgroups of chemotherapy-induced peripheral neuropathy would help develop interventions tailored to the patients.
目的:本研究旨在确定接受紫杉烷类化疗的乳腺癌患者化疗诱导的周围神经病变(CIPN)的潜在亚群,并研究潜在亚型与患者特征的关系。方法:于2022年4月至2023年3月进行多中心横断面调查。CIPN采用肿瘤治疗功能评估/妇科肿瘤组神经毒性量表进行评估。使用潜类分析来识别不同的CIPN亚组,并使用多项逻辑回归来分析这些亚组与患者特征之间的关系。结果:共有397人被分为三个亚组:高症状和高功能障碍(1类;25.4%),中度症状伴低功能障碍(2类;39.2%),低症状伴低功能障碍(3类;35.3%)。紫杉烷类型、化疗周期、疲劳、β受体阻滞剂使用和抑郁是亚组的显著预测因子(P结论:乳腺癌患者的CIPN症状具有异质性。潜在亚组的重要因素包括紫杉烷类型、化疗周期、β受体阻滞剂的使用、疲劳和抑郁。确定化疗引起的周围神经病变的不同亚组将有助于制定针对患者的干预措施。
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引用次数: 0
Navigating specific targets of breast cancer symptoms: An innovative computer-simulated intervention analysis 导航乳腺癌症状的特定目标:一种创新的计算机模拟干预分析。
IF 2.7 3区 医学 Q1 NURSING Pub Date : 2025-02-01 DOI: 10.1016/j.ejon.2024.102708
Minyu Liang , Yichao Pan , Jingjing Cai , Ying Xiong , Yanjun Liu , Lisi Chen , Min Xu , Siying Zhu , Xiaoxiao Mei , Tong Zhong , M. Tish Knobf , Zengjie Ye

Purpose

To pinpoint optimal interventions by dissecting the complex symptom interactions, encompassing both their static and temporal dimensions.

Methods

The study incorporated a cross-sectional survey utilizing the MD Anderson Symptom Inventory. Participants with breast cancer undergoing chemotherapy were recruited from the “Be Resilient to Breast Cancer” from April 2023 to June 2024. Static symptom interrelationships were elucidated using undirected and Bayesian network models, complemented by an exploration of their dynamic counterparts through computer-simulated interventions.

Results

The study included 602 patients with breast cancer. Both undirected networks and computer-simulated interventions concurred on the symptoms of distress and fatigue as optimal alleviation targets. The Bayesian network and computer-simulated interventions both emphasized “shortness of breath” as preventive care. Notably, Distress appeared to be the most effective target for interventions, and compared to fatigue (decreasing score = 1.84–2.20, decreasing prevalence = 14.2–16.7%). Conversely, disturbed sleep, despite its high position in Bayesian network, had no propelling effects on increasing the network's overall symptom activity levels (increasing score<1).

Conclusions

Computer-simulated intervention integrating with traditional network analysis can improve intervention precision and efficacy by prioritizing individual symptom impacts, both statically and dynamically.
目的:通过剖析复杂的症状相互作用,包括其静态和时间维度,以确定最佳干预措施。方法:本研究采用MD安德森症状量表进行横断面调查。在2023年4月至2024年6月期间,接受化疗的乳腺癌患者从“抗乳腺癌”项目中招募。使用无向和贝叶斯网络模型阐明了静态症状之间的相互关系,并通过计算机模拟干预对其动态对应物进行了探索。结果:研究纳入了602例乳腺癌患者。无定向网络和计算机模拟干预都将痛苦和疲劳症状作为最佳缓解目标。贝叶斯网络和计算机模拟干预都强调“呼吸短促”是预防措施。值得注意的是,与疲劳相比,焦虑似乎是最有效的干预目标(降低得分= 1.84-2.20,降低患病率= 14.2-16.7%)。相反,睡眠障碍虽然在贝叶斯网络中地位较高,但对提高网络整体症状活动水平(得分)没有促进作用。结论:计算机模拟干预结合传统的网络分析,可以通过静态和动态地优先考虑个体症状的影响,提高干预的精度和效果。
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引用次数: 0
How symptom distress mediates the relationship between individual differences and perceived controllability among women with gynecologic cancer 症状困扰如何介导妇科癌症患者个体差异与感知可控性之间的关系。
IF 2.7 3区 医学 Q1 NURSING Pub Date : 2025-02-01 DOI: 10.1016/j.ejon.2024.102769
Fen-He Lin , Jong-Long Guo , Hsiao-Pei Hsu , Shu-Fen Chen , Hsin-Jui Lu , Chiu-Ping Chuang , Chiu-Mieh Huang

Purpose

This study aims to investigate the individual differences in perceived controllability among women with gynecologic cancer who are undergoing chemotherapy. We also examined the mediating effect of symptom distress on the relationship between individual differences and perceived controllability.

Methods

This cross-sectional study employs purposive sampling; data were collected via self-reported questionnaires. In total, 170 women completed the survey. Structural equation modeling was used to examine the proposed hypotheses of the mediating effect of symptom distress.

Results

Results revealed that individual differences in age (r = −0.20, p < .05), education (t = −2.24, p < .05), employment (t = −2.05, p < .05), cancer stage (t = 2.35, p < .05), and number of chemotherapy sessions in the past three months (r = −0.16, p < .05) were significantly associated with perceived treatment control. Physical, but not psychological, symptom distress fully mediated the relationship between individual differences and perceived controllability. Participants who perceived financial distress (β = 0.179, p < .05) and those who had undergone a higher number of chemotherapy sessions within the past three months (β = 0.216, p < .05) experienced greater physical symptom distress. Additionally, those who experienced greater physical symptom distress perceived lower personal control (β = −0.199, p < .05) and treatment control (β = −0.217, p < .05).

Conclusions

Understanding the mediating effects of symptom distress on the relationship between individual differences and perceived controllability can enhance our knowledge of the mechanisms of illness acceptance, which significantly contributes to illness adaptation among women with gynecologic cancer.
目的:本研究旨在探讨妇科癌症患者化疗过程中感知可控性的个体差异。我们也检视了症状困扰在个体差异与知觉可控性之间的中介作用。方法:采用目的抽样的横断面研究;数据通过自我报告的问卷收集。总共有170名女性完成了这项调查。采用结构方程模型对提出的症状困扰的中介作用假设进行检验。结论:了解症状困扰在个体差异与感知可控性之间的中介作用,有助于加深对疾病接受机制的认识,对妇科癌症患者的疾病适应具有重要意义。
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引用次数: 0
Attitudes and digital health literacy mediate the relationship of digital information accessibility with intention for digital healthcare service use in patients with multiple myeloma: A cross-sectional study 态度和数字健康素养中介数字信息可及性与多发性骨髓瘤患者数字医疗服务使用意向的关系:一项横断面研究。
IF 2.7 3区 医学 Q1 NURSING Pub Date : 2025-02-01 DOI: 10.1016/j.ejon.2025.102786
Ok-Hee Cho , Hyekyung Kim , Yoorin Cho

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.
目的:本研究旨在探讨数字医疗服务态度(ATDH)和数字健康素养(DHL)对多发性骨髓瘤(MM)患者数字信息可及性(ADI)和数字医疗服务使用意愿(IUDH)之间关系的系列中介作用。方法:对韩国某大学附属医院肿瘤中心门诊随访的MM患者进行横断面问卷调查。数据收集于2023年9月至12月,来自139名患者的方便样本。结果:ADI对ATDH有显著的直接影响(β = 0.39, p)。结论:这些发现强调了DHL对于促进MM患者使用数字医疗服务(DHS)的重要性。为了促进持续的参与和DHS的预期结果,解决患者对ADI、ATDH和DHL的需求至关重要。医疗保健提供者和服务开发人员应积极支持患者开发有效使用DHS所需的能力和资源。
{"title":"Attitudes and digital health literacy mediate the relationship of digital information accessibility with intention for digital healthcare service use in patients with multiple myeloma: A cross-sectional study","authors":"Ok-Hee Cho ,&nbsp;Hyekyung Kim ,&nbsp;Yoorin Cho","doi":"10.1016/j.ejon.2025.102786","DOIUrl":"10.1016/j.ejon.2025.102786","url":null,"abstract":"<div><h3>Purpose</h3><div>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).</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>ADI had a significant direct effect on both ATDH (β = 0.39, <em>p</em> &lt; .001) and DHL (β = 0.28, <em>p</em> &lt; .001), with only DHL showing a significant direct effect on IUDH (β = 0.54, <em>p</em> &lt; .001). Although ADI did not have a direct effect on IUDH (β = -0.05, <em>p</em> = .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).</div></div><div><h3>Conclusion</h3><div>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.</div></div>","PeriodicalId":51048,"journal":{"name":"European Journal of Oncology Nursing","volume":"74 ","pages":"Article 102786"},"PeriodicalIF":2.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143015511","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
Comparative impact of exercise variants on depressive symptoms in cancer patients: A systematic review and network meta-analysis 运动变体对癌症患者抑郁症状的比较影响:系统综述和网络荟萃分析
IF 2.7 3区 医学 Q1 NURSING Pub Date : 2025-02-01 DOI: 10.1016/j.ejon.2024.102773
Hao Zhang , Zeyong Hu , Jiao Tong , Jianhong Hu , Xinchao Wang , Bingnan Wang

Purpose

The aim of this study was to conduct a network meta-analysis to assess the effectiveness of various forms of exercise as an intervention for post-cancer depression and to provide a guiding program based on evidence-based medicine for subsequent clinical practice.

Methods

This review was registered on the PROSPERO website with ID CRD42023485407. Pubmed, Embase, Cochrane Library, and Web of Science were comprehensively searched to obtain published articles from the establishment of the database until October 7, 2023. Bayesian network meta-analysis was conducted. Statistical analysis was conducted using R4.3.2 and Stata 15.1.

Results

This study ultimately included 51 articles and 4956 samples. Aerobic exercise (SMD = −0.33, 95%CI: 0.58, −0.08), combined exercise (SMD = −0.48, 95%CI: 0.71, −0.26), and mind-body exercise (SMD = −0.35, 95%CI: 0.6, −0.09) significantly improved depression compared with usual care (UC). According to the SUCRA value and cumulative probability, the rank of depression improvement effect of various sports interventions is as follows: combined exercise (90.71%), mind-body exercise (69.64%), aerobic exercise (65.81%), resistance training (35.86%).

Conclusion

Exercise intervention can significantly improve post-cancer depression, but there is no significant difference in the effectiveness of various forms of exercise in improving post-cancer depression.
目的:本研究的目的是通过网络荟萃分析来评估各种形式的运动对癌症后抑郁的干预效果,并为后续临床实践提供基于循证医学的指导方案。方法:本综述在PROSPERO网站注册,ID为CRD42023485407。全面检索Pubmed、Embase、Cochrane Library和Web of Science,获取数据库建立至2023年10月7日的已发表文章。进行贝叶斯网络元分析。采用R4.3.2和Stata 15.1进行统计分析。结果:本研究最终纳入51篇文章,4956份样本。有氧运动(SMD = -0.33, 95%CI: 0.58, -0.08)、联合运动(SMD = -0.48, 95%CI: 0.71, -0.26)和身心运动(SMD = -0.35, 95%CI: 0.6, -0.09)与常规护理(UC)相比,显著改善了抑郁症。根据SUCRA值和累积概率,各运动干预对抑郁改善效果的排序为:联合运动(90.71%)、心体运动(69.64%)、有氧运动(65.81%)、抗阻训练(35.86%)。结论:运动干预可以显著改善癌症后抑郁,但不同形式的运动对改善癌症后抑郁的效果无显著差异。
{"title":"Comparative impact of exercise variants on depressive symptoms in cancer patients: A systematic review and network meta-analysis","authors":"Hao Zhang ,&nbsp;Zeyong Hu ,&nbsp;Jiao Tong ,&nbsp;Jianhong Hu ,&nbsp;Xinchao Wang ,&nbsp;Bingnan Wang","doi":"10.1016/j.ejon.2024.102773","DOIUrl":"10.1016/j.ejon.2024.102773","url":null,"abstract":"<div><h3>Purpose</h3><div>The aim of this study was to conduct a network meta-analysis to assess the effectiveness of various forms of exercise as an intervention for post-cancer depression and to provide a guiding program based on evidence-based medicine for subsequent clinical practice.</div></div><div><h3>Methods</h3><div>This review was registered on the PROSPERO website with ID CRD42023485407. Pubmed, Embase, Cochrane Library, and Web of Science were comprehensively searched to obtain published articles from the establishment of the database until October 7, 2023. Bayesian network meta-analysis was conducted. Statistical analysis was conducted using R4.3.2 and Stata 15.1.</div></div><div><h3>Results</h3><div>This study ultimately included 51 articles and 4956 samples. Aerobic exercise (SMD = −0.33, 95%CI: 0.58, −0.08), combined exercise (SMD = −0.48, 95%CI: 0.71, −0.26), and mind-body exercise (SMD = −0.35, 95%CI: 0.6, −0.09) significantly improved depression compared with usual care (UC). According to the SUCRA value and cumulative probability, the rank of depression improvement effect of various sports interventions is as follows: combined exercise (90.71%), mind-body exercise (69.64%), aerobic exercise (65.81%), resistance training (35.86%).</div></div><div><h3>Conclusion</h3><div>Exercise intervention can significantly improve post-cancer depression, but there is no significant difference in the effectiveness of various forms of exercise in improving post-cancer depression.</div></div>","PeriodicalId":51048,"journal":{"name":"European Journal of Oncology Nursing","volume":"74 ","pages":"Article 102773"},"PeriodicalIF":2.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142967276","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 cross-sectional analysis to characterise treatment decision making for advanced cancer at a tertiary treatment centre: Where can we improve the process? 三级治疗中心晚期癌症治疗决策特征的横断面分析:我们在哪里可以改进这一过程?
IF 2.7 3区 医学 Q1 NURSING Pub Date : 2025-02-01 DOI: 10.1016/j.ejon.2024.102762
Grant Punnett , Melissa Perry , Charlotte Eastwood , Laura Green , Florian Walter , Janelle Yorke

Purpose

In decisions relating to cancer treatment, the risks and benefits of treatment and the patient's preferences must be considered to ensure concordance with goals of care. Shared decision making (SDM) can facilitate these discussions and is associated with reduced decision conflict. This study aimed to characterise decision making for advanced cancer patients at a UK tertiary cancer centre and identify who may be at risk of suboptimal SDM and increased decision conflict.

Methods

Participants completed the SDM-Q-9, decision conflict and decision self-efficacy scale following a consultation where an advanced cancer treatment decision was made. Pearson's chi-square test identified patient characteristics associated with SDM-Q-9, decision self-efficacy and decision conflict score categories; odds ratios were calculated to determine which patients were at increased probability of experiencing suboptimal SDM, low decision self-efficacy or high decision conflict.

Results

Participant's (n = 211) scores indicated predominantly high SDM, high decision self-efficacy and low decision conflict. Patient gender and the presence of an informal caregiver in consultation were significantly associated with SDM-Q-9 score category (p > 0.05). Female patients (OR = 2.466, 95% CI: 1.223–4.974) and those attending consultations alone (OR = 0.440, 95% CI: 0.222–0.874) had greater odds of reporting lower SDM scores.

Conclusion

High SDM scores indicate either effective SDM behaviours or satisfaction with care biasing responses. Greater support to engage with SDM is required for female patients and those who attend alone in advanced cancer treatment decision consultations.
目的:在与癌症治疗有关的决策中,必须考虑治疗的风险和益处以及患者的偏好,以确保与护理目标一致。共享决策制定(SDM)可以促进这些讨论,并与减少决策冲突有关。本研究旨在描述英国三级癌症中心晚期癌症患者的决策特征,并确定哪些患者可能面临次优SDM风险和决策冲突增加的风险。方法:参与者在会诊后完成SDM-Q-9、决策冲突和决策自我效能量表,并做出晚期癌症治疗决策。皮尔逊卡方检验确定了与SDM-Q-9、决策自我效能和决策冲突评分类别相关的患者特征;计算比值比以确定哪些患者经历次优SDM、低决策自我效能或高决策冲突的可能性增加。结果:被试(n = 211)得分以高SDM、高决策自我效能和低决策冲突为主。患者性别和就诊时是否有非正式照护者与SDM-Q-9评分类别显著相关(p < 0.05)。女性患者(OR = 2.466, 95% CI: 1.223-4.974)和单独参加会诊的患者(OR = 0.440, 95% CI: 0.222-0.874)报告SDM评分较低的几率更大。结论:高SDM分数表明有效的SDM行为或对护理偏向反应的满意度。女性患者和那些单独参加晚期癌症治疗决策咨询的患者需要更多的支持参与SDM。
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引用次数: 0
A multi-center study of symptoms in patients with esophageal cancer postoperatively: A networking analysis 食管癌术后患者症状的多中心研究:网络分析
IF 2.7 3区 医学 Q1 NURSING Pub Date : 2025-02-01 DOI: 10.1016/j.ejon.2025.102784
Furong Chen , Zhenrong Shen , Ying Xiong , Yingting Jiang , Dan Zhou , Junchen Guo , Hui Huang , M. Tish Knobf , Zengjie Ye

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.
目的:探讨食管癌(EC)患者术后1周的症状群及症状间的相互关系。方法:采用EORTCQLQ-OES18进行跨中心横断面调查。2024年1月至9月,从广东、湖南和四川三省的“抗癌”项目中招募了术后一周内的食管癌患者。采用探索性因子分析和先验算法识别症状聚类,采用网络分析识别核心症状和桥梁症状之间的关系。结果:本组501例食管癌患者,男性占83%,已婚占93%,年龄≥60岁占57%。确定了三种症状群:“反流-疼痛”、“进食”和“吞咽困难-口干”。酸或胆汁分泌(支持度= 40.1%,置信度= 1,lift = 2.53)、进食困难(支持度= 40.1%,置信度= 0.990,lift = 2.408)和口干(支持度= 42.9%,置信度= 0.808,lift = 1.298)分别被标记为这些群集的前哨症状。确定胃酸消化不良或胃灼热为核心症状(无协变量EI = 1.142,有协变量EI = 1.153),口干为桥症状(EI = 0.63, 0.656)。结论:解决胃酸或胆汁分泌、进食困难、口干等问题是缓解患者症状负担的必要措施。此外,针对胃酸消化不良和胃灼热是打破不同症状群之间链的关键。
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引用次数: 0
Two sides of the same coin-sexuality from the perspective of women diagnosed with breast cancer and their partners: A qualitative study 同一枚硬币的两面——从诊断为乳腺癌的女性及其伴侣的角度看性行为:一项定性研究。
IF 2.7 3区 医学 Q1 NURSING Pub Date : 2025-02-01 DOI: 10.1016/j.ejon.2025.102783
Merve Işık , Sultan Özkan Şat , Bengüsu Tümer

Purpose

After the diagnosis of breast cancer, women's sexuality becomes complex, and the sexual lives of couples are strongly affected by the treatment process of the disease. The aim of this study is to determine the perceptions, experiences, expectations, and needs related to sexuality from the perspective of women diagnosed with breast cancer and their partners.

Method

In this study, a descriptive qualitative design based on a thematic analysis approach was used. The data were collected through individual semi-structured interviews with women diagnosed with breast cancer (n = 22) and their partners (n = 14). The thematic analysis approach was used to analyse the data.

Results

The main themes of this study that came out from both the patients' and partners' perspectives were ‘suspension (postponement) of sexual life’ and ‘unmet need for care related to sexuality’. The main themes consist of four sub-themes: ‘changes in sexual dynamics’, ‘unsatisfied sexuality’, ‘barriers to accessing information and support’, and ‘demand for individualised and tailored comprehensive counselling’.

Conclusion

Women with breast cancer and their partners were found to have difficulty in asking for help about sexuality and to postpone their sexual lives. Findings of the present study suggest that sexual counselling is of critical importance at every stage of the breast cancer treatment process, and the patients and their partners need a culturally sensitive, individualised care thereof and expect a continuous support.
目的:乳腺癌确诊后,女性的性行为变得复杂,夫妻的性生活受到疾病治疗过程的强烈影响。本研究的目的是从被诊断为乳腺癌的女性及其伴侣的角度确定与性有关的观念、经历、期望和需求。方法:在本研究中,采用基于主题分析方法的描述性定性设计。数据是通过对22名乳腺癌患者及其伴侣(14名)的半结构化访谈收集的。采用专题分析法对数据进行分析。结果:从患者和伴侣的角度来看,本研究的主题是“暂停(推迟)性生活”和“未满足的与性有关的护理需求”。主题包括四个子主题:“性动力的变化”,“不满意的性行为”,“获取信息和支持的障碍”,以及“对个性化和量身定制的综合咨询的需求”。结论:乳腺癌患者及其伴侣在寻求性方面的帮助和推迟性生活方面存在困难。本研究的结果表明,性咨询在乳腺癌治疗过程的每个阶段都至关重要,患者及其伴侣需要对文化敏感的个性化护理,并期望得到持续的支持。
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引用次数: 0
Symptoms among patients with breast cancer undergoing endocrine therapy: Application of latent profile analysis and network analysis 乳腺癌内分泌治疗患者的症状:潜在剖面分析和网络分析的应用
IF 2.7 3区 医学 Q1 NURSING Pub Date : 2025-02-01 DOI: 10.1016/j.ejon.2025.102797
Xiaoge He , Chunlei Liu , Huanxi Li , Wei Wang , Mengying Sun , Yanjuan Lu , Yanru Song , Qian Lu

Purpose

To identify the subgroups and symptom networks associated with endocrine therapy in patients with breast cancer.

Methods

This study was a cross-sectional design using convenience sampling to select patients from a tertiary hospital in China. A total of 406 patients were invited to complete demographic and clinical questionnaires and the Chinese Breast Cancer Prevention Trial Symptom Scale was used to assess their symptoms. Latent profile analysis was used to classify the symptom subgroups of patients with breast cancer undergoing endocrine therapy. Univariate and binary multivariate logistic regression analyses were used to analyze the influence of these factors on different subgroups. Network analysis was used to identify the core symptoms of different subgroups.

Results

The analysis revealed two distinct subgroups: low symptom distress (74%; Class 1) and high symptom distress (26%; Class 2). Patients who were older, had a lower monthly family income per capita, and had not received radiotherapy were more likely to belong to Class 2. Furthermore, the network analysis results revealed that “difficulty concentrating” was a core symptom of the entire sample. The core symptom for Class 1 was “lack of energy,” and the core symptom for Class 2 was “joint pain.”

Conclusion

The symptoms of patients with breast cancer undergoing endocrine therapy were heterogeneous. Different subgroups exhibited different core symptoms. Therefore, targeted interventions should be provided according to the characteristics of the different symptom subgroups and their core symptoms to achieve precise and effective symptom management.
目的:确定乳腺癌患者内分泌治疗相关的亚群和症状网络。方法:本研究采用横断面设计,采用方便抽样的方法,选取中国某三级医院的患者。共邀请406例患者填写人口学和临床问卷,并采用中国乳腺癌预防试验症状量表对其进行症状评估。采用潜伏剖面分析对接受内分泌治疗的乳腺癌患者的症状亚组进行分类。采用单因素和二元多因素logistic回归分析分析这些因素对不同亚组的影响。网络分析用于识别不同亚组的核心症状。结果:分析显示了两个不同的亚组:低症状困扰(74%);1类)和高症状困扰(26%;2类)。年龄较大、家庭人均月收入较低、未接受过放疗的患者更可能属于2类。此外,网络分析结果显示,“注意力难以集中”是整个样本的核心症状。第一类的核心症状是“精力不足”,第二类的核心症状是“关节疼痛”。结论:乳腺癌内分泌治疗患者的症状具有异质性。不同亚组表现出不同的核心症状。因此,应根据不同症状亚群的特点及其核心症状,有针对性地进行干预,实现精准有效的症状管理。
{"title":"Symptoms among patients with breast cancer undergoing endocrine therapy: Application of latent profile analysis and network analysis","authors":"Xiaoge He ,&nbsp;Chunlei Liu ,&nbsp;Huanxi Li ,&nbsp;Wei Wang ,&nbsp;Mengying Sun ,&nbsp;Yanjuan Lu ,&nbsp;Yanru Song ,&nbsp;Qian Lu","doi":"10.1016/j.ejon.2025.102797","DOIUrl":"10.1016/j.ejon.2025.102797","url":null,"abstract":"<div><h3>Purpose</h3><div>To identify the subgroups and symptom networks associated with endocrine therapy in patients with breast cancer.</div></div><div><h3>Methods</h3><div>This study was a cross-sectional design using convenience sampling to select patients from a tertiary hospital in China. A total of 406 patients were invited to complete demographic and clinical questionnaires and the Chinese Breast Cancer Prevention Trial Symptom Scale was used to assess their symptoms. Latent profile analysis was used to classify the symptom subgroups of patients with breast cancer undergoing endocrine therapy. Univariate and binary multivariate logistic regression analyses were used to analyze the influence of these factors on different subgroups. Network analysis was used to identify the core symptoms of different subgroups.</div></div><div><h3>Results</h3><div>The analysis revealed two distinct subgroups: low symptom distress (74%; Class 1) and high symptom distress (26%; Class 2). Patients who were older, had a lower monthly family income per capita, and had not received radiotherapy were more likely to belong to Class 2. Furthermore, the network analysis results revealed that “difficulty concentrating” was a core symptom of the entire sample. The core symptom for Class 1 was “lack of energy,” and the core symptom for Class 2 was “joint pain.”</div></div><div><h3>Conclusion</h3><div>The symptoms of patients with breast cancer undergoing endocrine therapy were heterogeneous. Different subgroups exhibited different core symptoms. Therefore, targeted interventions should be provided according to the characteristics of the different symptom subgroups and their core symptoms to achieve precise and effective symptom management.</div></div>","PeriodicalId":51048,"journal":{"name":"European Journal of Oncology Nursing","volume":"74 ","pages":"Article 102797"},"PeriodicalIF":2.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143015640","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
期刊
European Journal of Oncology Nursing
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