European Journal of Oncology Nursing最新文献_第6页

Adaptive digital and non-digital self-management in permanent enterostomy patients: A qualitative study based on the Chronic Illness Trajectory framework. 永久性肠造口患者的适应性数字化和非数字化自我管理：基于慢性疾病轨迹框架的定性研究。

IF 2.7 3区医学 Q1 NURSING

European Journal of Oncology Nursing

Pub Date : 2024-11-15 DOI: 10.1016/j.ejon.2024.102733

Qian Li, Yu Lu, Yan Hao, Yuan Zhao, Xin-Xi Qi, Jia Qiao

Purpose: To examine the adaptive self-management strategies of enterostomy patients across different health trajectory phases and explore how patients utilize a combination of digital tools and traditional practices to manage their condition effectively within the Chronic Illness Trajectory Framework (CITF).

Methods: Participants were recruited from Qingdao Municipal Hospital's Stoma Clinic between October 2022 and August 2024. A total of 26 adults who had undergone permanent enterostomy surgery at least six months prior were selected through purposeful sampling to capture diverse experiences across different health trajectory phases. Semi-structured interviews were conducted, and data were analyzed using thematic analysis, with saturation reached when no new insights emerged.

Results: Three primary trajectory types emerged: (1) Living with a Stable Enterostomy Condition, where structured routines and preventive practices helped patients maintain health stability; (2) Experiencing Cycles of Deterioration and Recovery, characterized by proactive monitoring and recovery practices, often supported by family and telemedicine; and (3) Responding to Unstable Changes, requiring immediate actions, real-time adjustments, and crisis planning, with patients relying on both wearable monitors and established self-care routines. Across all phases, a balanced use of digital and non-digital methods enhanced adaptability and resilience.

Conclusion: The findings underscore the importance of phase-specific, adaptive self-management strategies that blend digital innovations with foundational self-care practices. CITF offers a valuable framework for clinicians to assess patients' trajectory phases and provide tailored support that aligns with their unique health needs. This approach can promote patient autonomy, improve quality of life, and inform the development of comprehensive, patient-centered care models for enterostomy and other chronic conditions.

目的：研究肠造口患者在不同健康轨迹阶段的适应性自我管理策略，并探讨患者如何在慢性疾病轨迹框架（CITF）内利用数字工具和传统实践相结合来有效地管理他们的病情。方法：参与者于2022年10月至2024年8月从青岛市市立医院口腔诊所招募。通过有目的的抽样，总共选择了26名至少六个月前接受过永久性肠造口手术的成年人，以捕捉不同健康轨迹阶段的不同经历。进行了半结构化访谈，并使用主题分析来分析数据，当没有出现新的见解时达到饱和。结果：出现了三种主要的轨迹类型：(1)生活在稳定的肠造口状态中，有组织的常规和预防性实践帮助患者保持健康稳定；(2)经历恶化和恢复周期，以主动监测和恢复实践为特征，通常由家庭和远程医疗支持；(3)应对不稳定变化，需要立即采取行动，实时调整和危机计划，患者依赖可穿戴监护仪和既定的自我护理程序。在所有阶段，平衡使用数字和非数字方法可增强适应性和复原力。结论：研究结果强调了将数字创新与基础自我保健实践相结合的阶段性适应性自我管理策略的重要性。CITF为临床医生提供了一个有价值的框架，以评估患者的轨迹阶段，并根据他们独特的健康需求提供量身定制的支持。这种方法可以促进患者的自主性，提高生活质量，并为肠造口和其他慢性疾病的全面，以患者为中心的护理模式的发展提供信息。

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引用次数: 0

A pilot randomized controlled trial of a yoga program for alleviating cancer-related fatigue and psychological distress in women with gynecological cancer 为减轻妇科癌症女性患者与癌症相关的疲劳和心理压力而开展的瑜伽项目随机对照试验。

IF 2.7 3区医学 Q1 NURSING

European Journal of Oncology Nursing

Pub Date : 2024-11-15 DOI: 10.1016/j.ejon.2024.102731

Xing Ma , Meimei Shang , Cho Lee Wong , Yishu Qi , Dorothy Ngo Sheung Chan

Purpose

Yoga can alleviate cancer-related fatigue and psychological distress while improving health-related quality of life. However, most studies focused on breast cancer. This study aimed to evaluate the feasibility and acceptability of a yoga program for women with gynecological cancer and estimate its preliminary effects on cancer-related fatigue, psychological distress, and health-related quality of life.

Methods

This pilot study used a single-blinded randomized controlled trial design. Participants in the intervention group received the yoga program and usual care, while the control group only received usual care. Feasibility was assessed using eligibility, consent, attrition, and adherence rates. Acceptability was measured using a satisfaction questionnaire. Preliminary effects were evaluated on cancer-related fatigue, psychological distress, and health-related quality of life outcomes.

Results

The yoga program demonstrated feasibility, with satisfactory rates of eligibility (62.7%), consent (64.9%), attrition (4.2%), and adherence (75%). The participants reported high satisfaction with the program. Significant intervention effects were observed on the behavioral/severity dimension of cancer-related fatigue (Hedges's g = 0.86). The intervention group demonstrated greater reductions in overall and other cancer-related fatigue subscales than the control group. Greater improvements in distress, anxiety, depression, and health-related quality of life were noted in the intervention group than in the control group, with effect sizes of 0.29, 0.77, 0.21, and 0.12, respectively.

Conclusions

The yoga program is feasible and acceptable, showing a trend in reducing cancer-related fatigue and psychological distress and improving health-related quality of life in women with gynecological cancer. A full-scale randomized controlled trial is warranted.

目的：瑜伽可以缓解与癌症有关的疲劳和心理困扰，同时提高与健康有关的生活质量。然而，大多数研究都集中在乳腺癌上。本研究旨在评估妇科癌症女性瑜伽课程的可行性和可接受性，并估计其对癌症相关疲劳、心理困扰和健康相关生活质量的初步影响：本试验研究采用单盲随机对照试验设计。干预组的参与者接受瑜伽课程和常规护理，而对照组只接受常规护理。可行性通过资格审查、同意率、流失率和坚持率进行评估。可接受性则通过满意度问卷来衡量。对癌症相关疲劳、心理困扰和健康相关生活质量结果的初步效果进行了评估：结果：瑜伽项目证明了其可行性，合格率（62.7%）、同意率（64.9%）、减员率（4.2%）和坚持率（75%）均令人满意。参与者对该计划的满意度很高。在癌症相关疲劳的行为/严重程度维度上观察到了显著的干预效果（Hedges's g = 0.86）。与对照组相比，干预组在总体和其他癌症相关疲劳分量表上的减幅更大。与对照组相比，干预组在苦恼、焦虑、抑郁和健康相关生活质量方面的改善幅度更大，效应大小分别为 0.29、0.77、0.21 和 0.12：瑜伽项目是可行的、可接受的，在减轻癌症相关疲劳和心理困扰、改善妇科癌症妇女的健康相关生活质量方面显示出趋势。有必要进行全面的随机对照试验。

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引用次数: 0

Examining the impact of cancer treatment on personhood: A participatory research investigation into the unique experiences of lesbian, gay, and bisexual individuals 研究癌症治疗对人格的影响：参与式研究调查女同性恋、男同性恋和双性恋者的独特经历。

IF 2.7 3区医学 Q1 NURSING

European Journal of Oncology Nursing

Pub Date : 2024-11-15 DOI: 10.1016/j.ejon.2024.102738

Gareth Hill , Cathy Bulley

Purpose

Cancer incidence is growing in the UK population and will affect half of all individuals in their lifetime, with most new diagnoses occurring over the age of 60 years old. Despite legal reforms and liberation of lesbian, gay, bisexual, transgender, queer, or questioning (LGBTQ) people's rights in recent years, many LGBTQ people affected by cancer will have faced significant societal discrimination in their lives. The aim of this research was to explore how cancer treatment impacts on the personhood of LGB people, and to increase understanding of social issues specific to this community.

Methods

Underpinned by person-centred principles and Critical Social Theory, a community-based participatory inquiry was carried out with nine LBG people who had been affected by cancer. In two subsequent sessions, participants created an identity map and then reflected on how cancer and care experiences had impacted their identity. Initially, content analysis of transcripts was informed by Mezirow's perspective transformation, followed by inductive thematic analysis within each data framework category. Participants were invited to provide feedback on the identified themes.

Results

The processes of coming out and facing a cancer diagnosis emerged as significant crises, leading to personal transformation. Factors such as past experiences of homophobia, duration of being openly out, and confidence in embracing altered identities influence interactions with healthcare providers and the level of support received.

Conclusions

This research makes a unique contribution by shedding light on the unreported support needs of LGB individuals affected by cancer, suggesting the need for additional assistance.

目的：在英国，癌症发病率在不断上升，一半的人一生中都会受到癌症的影响，而大多数新确诊的癌症患者年龄都在 60 岁以上。尽管近年来进行了法律改革并解放了女同性恋、男同性恋、双性恋、跨性别者、同性恋者或质疑者（LGBTQ）的权利，但许多受癌症影响的 LGBTQ 患者在生活中仍会面临严重的社会歧视。本研究旨在探讨癌症治疗如何影响 LGBT 群体的人格，并加深对该群体特有的社会问题的了解：在以人为本的原则和批判性社会理论的支持下，我们与九名受癌症影响的女同性恋、男同性恋、双性恋和变性者进行了社区参与式调查。在随后的两次会议中，参与者绘制了一张身份认同地图，然后反思癌症和护理经历如何影响了他们的身份认同。最初，根据 Mezirow 的视角转换法对记录誊本进行内容分析，然后在每个数据框架类别内进行归纳式主题分析。我们邀请参与者就确定的主题提供反馈意见：出柜和面对癌症诊断的过程是导致个人转变的重要危机。过去仇视同性恋的经历、公开出柜的持续时间以及接受改变身份的信心等因素影响着与医疗服务提供者的互动以及获得支持的程度：这项研究揭示了受癌症影响的女同性恋、男同性恋、双性恋和变性者未被报道的支持需求，表明他们需要额外的帮助，从而做出了独特的贡献。

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引用次数: 0

Perception and coping with self-perceived burden among colorectal cancer patients and their caregivers: A qualitative study 结直肠癌患者及其照顾者自我认知负担的感知与应对：一项定性研究

IF 2.7 3区医学 Q1 NURSING

European Journal of Oncology Nursing

Pub Date : 2024-11-15 DOI: 10.1016/j.ejon.2024.102732

Xuan Chen , Junrui Zhou , Zhiming Wang , Chunyan Lin , Jie Zhao , Qiuping Li

Purpose

Self-perceived burden can take a toll on the physical and psychological well-being of cancer couples and prevent them from achieving favorable outcomes. There is limited qualitative research synthesizing the cognition and coping with self-perceived burden among Chinese colorectal cancer patients and their caregivers. Therefore, this study examined perceptions of self-perceived burden and coping strategies from the perspectives of colorectal cancer patients, their spousal caregivers and nursing staff.

Methods

A qualitative study based on semi-structured interviews was implemented from May 15 to July 14, 2023. Data were analyzed using inductive thematic analysis.

Results

This study summarized the cognition and coping strategies regarding self-perceived burden through three themes. Life under self-perceived burden contained sub-themes of Uncomfortable role changing, The handling of interpersonal relationships and Communication attitudes. What need to cope with contained sub-themes of Physical changes and discomfort, Negative emotions, Inappropriate decision-making and Negative communication. Coping with different perspectives contained sub-themes of Improving self-care ability correctly, Maintaining emotional stability, Finding new meaning and Solid family support.

Conclusions

The presence of self-perceived burden hinders good outcomes for colorectal cancer couples. It is necessary to help colorectal cancer couples cope with self-perceived burden together. Nursing staff need to be a bridge of communication and exchange for colorectal cancer couples, providing them with effective and reliable information and support, thus helping colorectal cancer patients and their spousal caregivers achieve true inner peace and better outcomes.

目的：自我感知的负担会对癌症夫妇的身体和心理健康造成损害，并阻止他们取得良好的结果。中国结直肠癌患者及其照顾者对自我感知负担的认知和应对的定性研究有限。因此，本研究从结直肠癌患者、其配偶照顾者和护理人员的角度考察了自我感知负担的认知和应对策略。方法于2023年5月15日至7月14日采用半结构化访谈法进行定性研究。数据分析采用归纳专题分析。结果本研究通过三个主题总结了自我感知负担的认知和应对策略。自我认知负担下的生活包含不舒服的角色转换、人际关系处理和沟通态度三个子主题。需要应对的问题包含身体变化和不适、消极情绪、不适当的决策和消极的沟通等子主题。应对不同视角包含正确提高自我照顾能力、保持情绪稳定、寻找新意义和坚实的家庭支持等子主题。结论自我认知负担的存在阻碍结直肠癌夫妇获得良好的预后。有必要帮助结直肠癌夫妇共同应对自我认知的负担。护理人员需要成为大肠癌夫妇沟通和交流的桥梁，为他们提供有效可靠的信息和支持，帮助大肠癌患者及其配偶看护人获得真正的内心平静和更好的结局。

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引用次数: 0

Anticipatory grief - A neglected phenomenon among relatives of patients with incurable cancer: A qualitative study 预期悲伤--不治癌症患者亲属中被忽视的现象：定性研究

IF 2.7 3区医学 Q1 NURSING

European Journal of Oncology Nursing

Pub Date : 2024-11-14 DOI: 10.1016/j.ejon.2024.102730

Bethina Thulstrup Paulsen , Mathilde Laura Kærgaard Johansen , Sarah Kjærsgaard Lund , Helle Enggaard , Lone Jørgensen

Purpose

To explore the experience of being a relative to a patient with incurable cancer and the relatives’ perceived need for support.

Method

A qualitative design with a critical hermeneutics approach was applied. In total, 15 semi-structured individual interviews with relatives of patients with incurable cancer were conducted and analysed through a Paul Ricœur-inspired analysis.

Findings

Three themes emerged: (1) being in a paradoxical waiting position, (2) the complex need for a respite during the illness and (3) the importance of person-centred information and continuity. The themes highlight how relatives are in a vulnerable position experiencing anticipatory grief while waiting for the patient's death. They have ambivalent feelings because of the tension between the need to be supportive and the need for a respite from the illness. However, they do not want to centre their needs and remove the attention from the patient. Their needs change over time and increase the longer the cancer has lasted. In addition, the relatives need person-centred information and continuity among healthcare professionals.

Conclusion

Relatives of patients with incurable cancer are in a vulnerable position, with a range of complex and varied needs for support. This underscores the importance of healthcare professionals being aware of anticipatory grief and the management of relatives’ needs to avoid complicated grief and its consequences.

目的：探讨作为不治癌症患者亲属的体验以及亲属对支持的感知需求：采用批判诠释学的定性设计方法。共进行了 15 次半结构化个人访谈，访谈对象为无法治愈的癌症患者的亲属，并通过保罗-里歇尔启发的分析方法对访谈结果进行了分析：出现了三个主题：(1) 处于矛盾的等待状态，(2) 在患病期间对喘息的复杂需求，(3) 以人为本的信息和连续性的重要性。这些主题强调了亲属在等待病人死亡的过程中是如何处于一种经历预期悲伤的脆弱境地的。由于需要给予支持和需要从疾病中得到喘息，他们的心情十分矛盾。然而，他们又不想把自己的需求放在中心位置，而把注意力从病人身上移开。他们的需求会随着时间的推移而变化，癌症病程越长，他们的需求就越大。此外，亲属还需要以人为本的信息和医护人员的连续性：结论：无法治愈的癌症患者的亲属处于弱势地位，需要一系列复杂多样的支持。这强调了医护人员意识到预期悲伤和管理亲属需求以避免复杂悲伤及其后果的重要性。

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引用次数: 0

Associations between sexuality, body image and health-related quality of life in patients treated for diffuse large B-cell lymphoma: A cross-sectional study 弥漫大 B 细胞淋巴瘤患者的性行为、身体形象与健康相关生活质量之间的关系：一项横断面研究。

IF 2.7 3区医学 Q1 NURSING

European Journal of Oncology Nursing

Pub Date : 2024-11-08 DOI: 10.1016/j.ejon.2024.102729

Cecilia Olsson , Maria Larsson , Anna Josse Eklund , Anders Ringnér

Purpose

Sexuality and body image are closely related to health-related quality of life (HRQoL), but these factors are less investigated in patients treated for lymphoma.

Therefore, the aim of this study was to describe and explore the associations between sexuality, body image, comorbidities and HRQoL in patients treated for diffuse large B-cell lymphoma.

Methods

A cross-sectional study with 257 patients (25% response rate) was conducted in 2019 using measures for sexuality, HRQoL and body image and data from the Swedish National Quality Registry for Leukemia–Subregistry for Lymphoma.

Results

The participants had a mean HRQoL of 69.75 on a 1 to 100 scale, and the functional scales ranged from 68.50 for Role to 80.82 for Social functioning. The symptoms ranged from 5.56 for nausea and vomiting to 37.73 for fatigue. Regarding body image, the participants scored a total of 14.47 (reference values 10–40). The total score for Sexual adjustment was 3.02 (fair), and for the subscales Sexual Interest 2.63 (low), Sexual Relation 2.72 (low), Sexual Function 3.62 (high) and Sexual Satisfaction 3.50 (high). HRQoL was positively associated with Sexual Relation; however, negative body image and comorbidities showed negative associations. The model explains 39.6% of the variation in HRQoL.

Conclusion

The positive impact of sexual relationships on HRQoL was highlighted, which emphasised the unfavourable effect of negative body image and comorbidities on HRQoL for lymphoma patients. Cancer nurses should address these topics with patients to improve their long-term well-being.

目的：性行为和身体形象与健康相关生活质量（HRQoL）密切相关，但这些因素在淋巴瘤患者中的调查较少。因此，本研究旨在描述和探讨弥漫大 B 细胞淋巴瘤患者的性行为、身体形象、合并症和 HRQoL 之间的关系：2019年对257名患者（回复率为25%）进行了一项横断面研究，采用了性生活、HRQoL和身体形象测量方法以及瑞典国家白血病质量登记处-淋巴瘤子登记处的数据：参与者的平均 HRQoL 为 69.75（1 至 100 分），功能量表从 68.50（作用）到 80.82（社会功能）不等。症状从恶心呕吐的 5.56 分到疲劳的 37.73 分不等。在身体形象方面，参与者的总得分为 14.47 分（参考值为 10-40）。性适应总分为 3.02（尚可），性兴趣、性关系、性功能和性满足各分量表的得分分别为 2.63（低）、2.72（低）、3.62（高）和 3.50（高）。HRQoL 与性关系呈正相关；然而，负面身体形象和合并症呈负相关。该模型解释了 HRQoL 变异的 39.6%：结论：性关系对 HRQoL 的积极影响得到了强调，这突出了负面身体形象和合并症对淋巴瘤患者 HRQoL 的不利影响。癌症护士应与患者共同探讨这些话题，以改善他们的长期健康状况。

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引用次数: 0

Psychological and biological stress pathways as common mechanisms underlying a psycho-neurological symptom cluster in cancer patients: Perceived stress, cortisol, and ACTH 心理和生物压力途径是癌症患者心理-神经症状群的共同机制：感知压力、皮质醇和促肾上腺皮质激素。

IF 2.7 3区医学 Q1 NURSING

European Journal of Oncology Nursing

Pub Date : 2024-11-07 DOI: 10.1016/j.ejon.2024.102728

Hee-Ju Kim , Kyung Mi Chae , Sun-Ok Jung , Su Wol Chung , Tenko Raykov

Purpose

This study aimed to examine (a) whether psychological stress is associated with experiencing multiple psycho-neurological symptoms (depression, cognitive impairment, fatigue, sleep disturbance, and pain) as a cluster and (b) whether stress hormones (adrenocorticotropic hormone [ACTH] and cortisol) are associated with psychological stress and symptom cluster experience.

Methods

This cross-sectional study analyzed data from 133 patients with hematologic cancer awaiting chemotherapy. Enzyme-linked immunosorbent assays analyzed the morning stress hormone levels (ACTH and cortisol). Latent profile analyses identified the group experiencing a psycho-neurological symptom cluster. Factors influencing the experience of the psycho-neurological symptom cluster were included as covariates and analyzed using multinomial logistic regression.

Results

Thirty-three percent (n = 44) experienced all five psycho-neurological symptoms as a cluster and experienced each symptom in a higher severity than those who did not experience the symptom cluster (ps < 0.05). Thereby, this group legitimately experienced the psycho-neurological symptom cluster. The major determinant of this group was the perceived psychological stress (OR = 8.05, 95% CI = 3.08; 20.99). Further, each symptom demonstrated a positive association with stress levels (correlation r ranged from 0.22 to 0. 56, all ps < 0.05). Participants with higher stress were more likely to experience the symptom cluster. Stress hormones levels (ACTH and cortisol) were neither associated with the symptom cluster experience nor with psychological stress levels.

Conclusions

Psychological stress, rather than biological stress response, is involved in experiencing the psycho-neurological symptom cluster. Managing stress levels would help alleviate this symptom cluster.

目的：本研究旨在探讨(a)心理压力是否与多种精神神经症状（抑郁、认知障碍、疲劳、睡眠障碍和疼痛）集群体验相关；(b)应激激素（促肾上腺皮质激素[ACTH]和皮质醇）是否与心理压力和症状集群体验相关：这项横断面研究分析了133名等待化疗的血液肿瘤患者的数据。酶联免疫吸附试验分析了早晨的应激激素水平（促肾上腺皮质激素和皮质醇）。潜伏特征分析确定了出现精神神经症状群的群体。影响精神神经症状群的因素被列为协变量，并使用多项式逻辑回归进行分析：结果：33%（n = 44）的人经历了全部五种精神神经症状群，并且每种症状的严重程度都高于未经历症状群的人（ps 结论：心理压力而非生物应激反应是影响精神神经症状群的主要因素：出现精神神经症状群的原因是心理压力，而不是生物压力反应。控制压力水平有助于缓解这种症状群。

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引用次数: 0

The relationship between psychological resilience, coping strategies and fear of cancer recurrence in patients with breast cancer undergoing surgery: A descriptive, cross-sectional study 接受手术的乳腺癌患者的心理复原力、应对策略和对癌症复发的恐惧之间的关系：一项描述性横断面研究。

IF 2.7 3区医学 Q1 NURSING

European Journal of Oncology Nursing

Pub Date : 2024-11-05 DOI: 10.1016/j.ejon.2024.102719

Pinar Yilmaz Eker , Kubra Erturhan Turk , Selma Sabanciogullari

Purpose

This study aims to determine the relationship between psychological resilience, coping strategies and the fear of cancer recurrence in women who have undergone surgical procedures due to breast cancer.

Methods

The study was conducted using a descriptive, cross-sectional, and correlational research design. The sample of the study consisted of 252 women. Data were collected with The Patient Information Form, The Psychological Resilience Scale for Adults, The Ways of Coping Questionnaire and The Fear of Cancer Recurrence Inventory.

Results

The mean scores of Psychological Resilience Scale for Adults, Fear of Cancer Recurrence Inventory, and the optimistic and self-confident subscales of the Ways of Coping Questionnaire among participants were found to be above average. The mean scores of the seeking social support and submissive subscales were at a moderate level, while the mean scores of the hopelessness approach subscale were below the moderate level. A moderate positive significant relationship was found between the total mean score of the Psychological Resilience Scale for Adults and the mean scores of the optimistic approach, self-confident approach, submissive approach, and seeking social support subscales of the Ways of Coping Questionnaire.

Conclusion

A direct relationship was found between psychological resilience and coping strategies. However, this relationship could not be found with fear of cancer recurrence. It was concluded that the level of psychological resilience and coping strategies among breast cancer survivors can be positively influenced through the implementation of professional interventions aimed at fostering growth, addressing the initial cancer diagnosis, and promoting healthy adaptation.

目的：本研究旨在确定因乳腺癌接受外科手术的妇女的心理复原力、应对策略和对癌症复发的恐惧之间的关系：研究采用描述性、横断面和相关性研究设计。研究样本包括 252 名妇女。通过患者信息表、成人心理弹性量表、应对方式问卷和癌症复发恐惧量表收集数据：结果发现，参与者的成人心理复原量表、癌症复发恐惧量表以及应对方式问卷中的乐观和自信分量表的平均得分均高于平均水平。寻求社会支持分量表和顺从分量表的平均得分处于中等水平，而绝望方式分量表的平均得分低于中等水平。成人心理复原力量表的总平均分与应对方式问卷的乐观方式、自信方式、顺从方式和寻求社会支持分量表的平均分之间存在中等程度的正相关关系：结论：心理复原力与应对策略之间存在直接关系。结论：心理复原力与应对策略之间存在直接关系，但这种关系与癌症复发恐惧之间并不存在。结论：通过实施旨在促进成长、解决最初的癌症诊断和促进健康适应的专业干预措施，可对乳腺癌幸存者的心理复原力和应对策略水平产生积极影响。

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引用次数: 0

Supporting cancer-related fatigue self-management: A conversation analytic study of nurse counsellor and cancer survivor consultations 支持癌症相关疲劳的自我管理：对护士顾问和癌症幸存者咨询的对话分析研究。

IF 2.7 3区医学 Q1 NURSING

European Journal of Oncology Nursing

Pub Date : 2024-11-02 DOI: 10.1016/j.ejon.2024.102726

Oluwaseyifunmi Andi Agbejule , Stuart Ekberg , Nicolas H. Hart , Raymond J. Chan

Purpose

Cancer-related fatigue (CRF) is a prevalent and distressing symptom experienced by people affected by cancer. A breakdown of the clinician-patient partnership and suboptimal clinician communication has been identified as a significant barrier to implementing into clinical practice effective self-management strategies for CRF. This study examined the use and impact of communication practices employed by trained cancer nurse counsellors when providing CRF self-management support to cancer survivors.

Methods

Interactions from 41 telehealth consultations between three nurse counsellors and 23 cancer survivors in a CRF self-management support clinic in Queensland, Australia were recorded and analysed using conversation analysis methods.

Results

Analysis found that in instances where nurses established the agenda of a consultation from the outset of a session (e.g., focusing on fatigue self-management support), cancer survivors displayed clearer understandings of their self-management role, the tasks, and goals of a session; and displayed less difficulty engaging in supportive care discussions. Furthermore, clinicians used formulation practices, such as summarising dialogue, to sustain focus on fatigue during consultations, and to close discussion matters not ostensibly pertinent to fatigue self-management planning supporting the goals of the CRF SMS clinic consultations.

Conclusion

For supportive care sessions targeting fatigue management, clinicians should ideally focus discussion on CRF support early, by clearly introducing the agenda at the outset of the consultation while also asking for client agreement. Periodically summarising patient's talk allows clinicians to maintain a focus on matters relevant for self-management fatigue planning and provide support within the typically constrained timeframes allocated for addressing CRF.

目的：癌症相关疲劳（CRF）是癌症患者普遍存在的一种痛苦症状。临床医生与患者之间的合作关系破裂以及临床医生沟通不畅被认为是在临床实践中实施有效的 CRF 自我管理策略的重大障碍。本研究考察了训练有素的癌症护士顾问在为癌症幸存者提供 CRF 自我管理支持时采用的沟通方法及其影响：方法：在澳大利亚昆士兰州的一家 CRF 自我管理支持诊所，记录了 3 名护士顾问与 23 名癌症幸存者之间的 41 次远程咨询互动，并使用对话分析方法对其进行了分析：分析发现，如果护士在会话一开始就确定了咨询议程（例如，重点关注疲劳自我管理支持），癌症幸存者对其自我管理角色、任务和会话目标的理解就会更加清晰，参与支持性护理讨论的难度也会降低。此外，临床医生在咨询过程中使用了总结对话等表述方法，以保持对疲劳的关注，并结束表面上与疲劳自我管理规划无关的讨论，从而支持 CRF SMS 诊所咨询的目标：结论：对于以疲劳管理为目标的支持性护理会诊，临床医生最好能在会诊开始时明确介绍会诊议程，并征得患者同意，从而尽早将讨论重点放在 CRF 支持上。定期总结患者的谈话内容可使临床医生继续关注与自我管理疲劳计划相关的事项，并在通常分配给解决 CRF 问题的有限时间内提供支持。

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引用次数: 0

Expectations for gynaecological cancer nursing guidance development: A qualitative exploration: Part 1 – Creating foundational support 对妇科癌症护理指南发展的期望：定性探索：第一部分 - 创建基础支持。

IF 2.7 3区医学 Q1 NURSING

European Journal of Oncology Nursing

Pub Date : 2024-11-02 DOI: 10.1016/j.ejon.2024.102727

Natalie Williams , Georgia Halkett , Tracey Moroney , Sharon MacLean , Olivia Cook

Purpose

Nurses are acknowledged as essential in the delivery of best practice gynaecological cancer care however previous studies have identified challenges in these nursing roles. Recommendations include the development of nursing guidance focused on supporting people with a gynaecological cancer. This study aimed to explore perceptions and expectations for the development of a gynaecological cancer nursing guidance resource in Australia and investigate preferred design and content inclusion. This paper presents the findings on expectations for the resource purpose.

Methods

Utilising an exploratory qualitative descriptive design, 20 nurses and seven people with lived experience of gynaecological cancer participated in focus groups or interviews following a semi-structured interview guide. Transcripts underwent inductive content analysis.

Results

All 27 participants identified as female, lived in one of 5 Australian states, included representation from regional locations (n=9, 33%), and mostly identified as Australian or mixed Australian ethnicity (n=25, 93%). The major theme, “Foundational support resource for nurses”, described how participants require a resource to support the delivery of gynaecological cancer nursing care. Participants articulated their goals for the resource through four subthemes: reducing variation in care; acknowledging diversity in nursing roles; addressing barriers; supporting development.

Conclusion

The development of a guidance resource for gynaecological cancer nursing is supported by Australian gynaecological cancer nurses and people with cancer lived experience. It is expected its implementation will assist to improve cancer outcomes, equitable access to quality care and support the development and sustainability of the gynaecological cancer nursing workforce.

目的：护士被认为是提供最佳妇科癌症护理的关键，但以往的研究发现了这些护理角色所面临的挑战。建议包括制定以支持妇科癌症患者为重点的护理指南。本研究旨在探讨澳大利亚对开发妇科癌症护理指导资源的看法和期望，并调查首选设计和内容纳入情况。本文介绍了对资源目的期望的调查结果：采用探索性定性描述设计，20 名护士和 7 名妇科癌症患者按照半结构化访谈指南参加了焦点小组或访谈。对访谈记录进行了归纳内容分析：所有 27 名参与者均为女性，居住在澳大利亚 5 个州中的一个州，其中包括来自地区的代表（9 人，占 33%），大多数人被认定为澳大利亚人或澳大利亚混血儿（25 人，占 93%）。主要专题 "护士的基础支持资源 "描述了参与者如何需要一种资源来支持妇科癌症护理工作的开展。参与者通过四个次主题阐述了他们对资源的目标：减少护理中的差异；承认护理角色的多样性；解决障碍；支持发展：结论：妇科癌症护理指导资源的开发得到了澳大利亚妇科癌症护士和癌症患者的支持。预计该指导资源的实施将有助于改善癌症治疗效果，使人们能够公平地获得优质护理服务，并支持妇科癌症护理人员队伍的发展和可持续性。

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引用次数: 0