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Chemo Chair Conversations: A Qualitative Study of How Life and Death Influence Oncology Nurses’ Well-being and Professional Care 化疗椅对话:如何生与死影响肿瘤护士的福祉和专业护理的定性研究。
IF 2.3 4区 医学 Q1 NURSING Pub Date : 2025-12-06 DOI: 10.1016/j.soncn.2025.152061
Carolyn S. Phillips , Sue E. Morris , Cara C. Young , Megan C. Thomas Hebdon , Alfonzo Robinson , Catherine Bailey , Megan Lippe , Andra Davis

Objectives

Oncology nurses provide relational care with patients and families that require high levels of skill and empathy. This emotionally demanding work can lead to compassion fatigue, burnout, and unprocessed grief. Strategies to support oncology nurses are crucial for maintaining their well-being and delivering high-quality care. The purpose of this study was to analyze stories written by oncology nurses to understand the emotional experiences of caring for people with cancer.

Methods

A secondary qualitative analysis of 35 oncology nurses’ stories was conducted using Braun and Clarke’s thematic analysis framework. The nurses were participants in two Storytelling Through Music intervention studies, which included writing stories to process work-related emotions. Themes were developed to identify patterns and shared experiences across the narratives.

Results

The meta-theme of “Seeking Emotional Balance” emerged and was interwoven throughout the six themes: emotional labor, above and beyond, connections and mutual healing, cumulative grief and loss, coping and remembrance, and finding meaning. Nurses described the challenges of maintaining emotional balance while navigating professional and personal emotional demands.

Conclusion

Oncology nurses face unique relational and emotional challenges. While some found resilience in patient connections, others experienced chronic distress and burnout.
Storytelling provides a reflective outlet to process emotions, strengthen resilience, and foster shared understanding among peers. Storytelling interventions show promise as tools for emotional regulation and professional sustainability.

Implications for Nursing

Deep nurse–patient connections foster meaning and resilience but can blur boundaries, increasing risks like countertransference. Reflective practices help safeguard nurses’ well-being and care quality. At the individual level, nurses should adopt self-care strategies and engage in reflective practices. Organizational support is vital. Institutions can provide emotional resilience training, implement bereavement overload policies, and offer group storytelling opportunities to reduce stress, enhance regulation, and build supportive peer connections.
目的:肿瘤护士为患者和家属提供关系护理,这需要高水平的技能和同理心。这种需要情感的工作可能会导致同情疲劳、倦怠和未经处理的悲伤。支持肿瘤护士的策略对于维持她们的健康和提供高质量的护理至关重要。本研究的目的是分析肿瘤护士所写的故事,以了解护理癌症患者的情感体验。方法:采用Braun和Clarke的主题分析框架对35名肿瘤科护士的故事进行二次定性分析。护士们参加了两项通过音乐讲故事的干预研究,其中包括写故事来处理与工作有关的情绪。开发主题是为了确定叙事中的模式和共享经验。结果:“寻求情绪平衡”的元主题出现并交织在六个主题中:情绪劳动、超越与超越、联系与相互治疗、累积悲伤与失落、应对与记忆、寻找意义。护士们描述了在应对专业和个人情感需求的同时保持情绪平衡的挑战。结论:肿瘤科护士面临着独特的关系和情感挑战。一些人在与病人的交往中发现了韧性,而另一些人则经历了长期的痛苦和倦怠。讲故事为处理情绪、增强韧性和促进同伴之间的共同理解提供了一个反思的出口。讲故事干预有望成为情绪调节和职业可持续性的工具。对护理的影响:深厚的护患关系可以培养意义和恢复力,但也会模糊界限,增加反移情等风险。反思性做法有助于保障护士的福祉和护理质量。在个人层面上,护士应采取自我护理策略并参与反思实践。组织的支持是至关重要的。机构可以提供情绪恢复力培训,实施丧亲超载政策,并提供小组讲故事的机会,以减轻压力,加强监管,并建立支持性的同伴关系。
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引用次数: 0
Developing and Validating a Prediction Model for the Severe Pain-Fatigue-Sleep Disturbance Symptom Cluster in Patients with Lung Cancer Following Chemotherapy: A Machine Learning Analysis 建立和验证肺癌患者化疗后严重疼痛-疲劳-睡眠障碍症状群的预测模型:机器学习分析。
IF 2.3 4区 医学 Q1 NURSING Pub Date : 2025-12-05 DOI: 10.1016/j.soncn.2025.152063
Liping Teng , Zhou Zhou , Yiting Yang , Yajun Dong , Jun Sun , Teng Wang

Objectives

Pain-fatigue-sleep disturbance symptom (PFS) cluster is the most common symptom cluster in patients with lung cancer following chemotherapy, which significantly impacts their quality of life. This study aims to develop and validate a machine learning-based prediction model for the severe PFS cluster and identify the relevant factors in patients with lung cancer following chemotherapy.

Methods

A total of 612 patients were enrolled in the study, and logistic regression, along with four machine learning algorithms, was used. The area under the curve (AUC), accuracy, sensitivity, specificity, and Brier score were utilized for model evaluation. The Shapley additive interpretation and restricted cubic splines were employed to assess the significance of feature coefficients. A web-based application was developed to facilitate the practical implementation of the best model in clinical settings.

Results

The random forest model was identified as optimal, exhibiting the best discrimination and calibration in the test set (AUC: 0.765 and Brier score: 0.159) and excellent performance in the validation set (AUC: 0.914 and Brier score: 0.124). The factors encompassed in the model construction comprised stress, C-reactive protein, depression, body mass index (BMI), anxiety, neutrophils, age, gender, pathological classification, and Eastern Cooperative Oncology Group performance status. A nonlinear relationship existed between stress, BMI, age, and the severe PFS cluster.

Conclusions

The developed web program would assist health care professionals in accurately identifying patients experiencing the severe PFS cluster in clinical practice and facilitating efficient symptom management.

Implications for Nursing Practice

Clinical nurses can use a web-based calculator developed in this study to effectively identify patients with the severe PFS cluster and provide targeted interventions.
目的:疼痛-疲劳-睡眠障碍症状(PFS)是肺癌化疗后患者最常见的症状,显著影响患者的生活质量。本研究旨在开发和验证基于机器学习的重度PFS集群预测模型,并确定肺癌化疗后患者的相关因素。方法:共纳入612例患者,采用逻辑回归和4种机器学习算法。采用曲线下面积(AUC)、准确性、敏感性、特异性和Brier评分对模型进行评价。采用Shapley加性解释和限制三次样条来评估特征系数的显著性。开发了一个基于网络的应用程序,以促进临床环境中最佳模型的实际实施。结果:随机森林模型在测试集(AUC: 0.765, Brier评分:0.159)和验证集(AUC: 0.914, Brier评分:0.124)中具有最佳的识别和校准效果。模型构建的因素包括应激、c反应蛋白、抑郁、体重指数(BMI)、焦虑、中性粒细胞、年龄、性别、病理分型、东部肿瘤合作组成绩状况。应激、BMI、年龄与严重PFS聚类之间存在非线性关系。结论:开发的网络程序可以帮助医疗保健专业人员在临床实践中准确识别严重PFS群集的患者,并促进有效的症状管理。对护理实践的启示:临床护士可以使用本研究开发的基于网络的计算器来有效识别严重PFS患者,并提供有针对性的干预措施。
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引用次数: 0
Toward Scalable Electromyography in Oncology: A Narrative Review of Normalization Challenges and Machine Learning Innovations 迈向肿瘤可扩展肌电图:标准化挑战和机器学习创新的叙述性回顾。
IF 2.3 4区 医学 Q1 NURSING Pub Date : 2025-12-05 DOI: 10.1016/j.soncn.2025.152064
Tania Karina Garcia-Vite , Achilleas Pavlou , Marios Avraamides , Christos I. Ioannou

Objectives

Electromyography (EMG) is increasingly applied in oncology to monitor neuromuscular impairment, treatment toxicities, and rehabilitation outcomes. However, reliance on maximal voluntary contraction (MVC) normalization limits scalability, as many patients cannot perform safe and reliable MVCs due to fatigue, pain, or treatment-induced impairments. This narrative review evaluates the feasibility and clinical utility of machine learning (ML)–predicted MVCs as an alternative normalization method in oncology care.

Methods

Peer-reviewed articles published between 2015 and 2025 were retrieved from PubMed, IEEE Xplore, ScienceDirect, SpringerLink, and open-access repositories. Search terms included electromyography, oncology, maximum voluntary contraction, machine learning, sarcopenia, cachexia, and rehabilitation.

Results

Thirty-eight studies were included. Findings highlight that traditional MVC-based normalization is frequently infeasible in cancer populations due to neuromuscular compromise, variability in body composition, and safety risks. ML approaches, leveraging demographic, anthropometric, and submaximal EMG data, show promise for estimating MVC indirectly. Predictive models such as artificial neural networks and ensemble learners demonstrate potential to improve accuracy, reduce patient burden, and enable broader EMG integration into rehabilitation and survivorship monitoring. Clinical applications include safer exercise prescription, individualized progress tracking, and remote continuous monitoring through wearable sensors.

Conclusions

ML-predicted MVCs may overcome longstanding barriers to EMG standardization in oncology. By reducing dependence on direct maximal efforts, these approaches can improve functional assessment accuracy, optimize rehabilitation strategies, and enhance patient-centered care.

Implications for Nursing Practice

Oncology nurses and rehabilitation specialists could incorporate ML-supported EMG assessments into clinical and home-based programs, supporting adaptive, real-time interventions that promote safety, engagement, and quality of life for individuals with cancer.
目的:肌电图(EMG)在肿瘤学中越来越多地应用于监测神经肌肉损伤、治疗毒性和康复结果。然而,依赖最大自愿收缩(MVC)规范化限制了可扩展性,因为许多患者由于疲劳、疼痛或治疗引起的损伤而无法进行安全可靠的MVC。这篇叙述性综述评估了机器学习(ML)预测的MVCs作为肿瘤治疗替代规范化方法的可行性和临床应用。方法:从PubMed、IEEE explore、ScienceDirect、SpringerLink和开放获取知识库中检索2015 - 2025年间发表的同行评议文章。搜索词包括肌电图、肿瘤学、最大自主收缩、机器学习、肌肉减少症、恶病质和康复。结果:纳入38项研究。研究结果强调,由于神经肌肉损伤、身体成分的可变性和安全风险,传统的基于mvc的规范化在癌症人群中往往是不可行的。利用人口统计学、人体测量学和亚极大肌电图数据的机器学习方法显示了间接估计MVC的希望。人工神经网络和集成学习器等预测模型显示出提高准确性、减轻患者负担以及将肌电图更广泛地整合到康复和生存监测中的潜力。临床应用包括更安全的运动处方,个性化的进度跟踪,以及通过可穿戴传感器进行远程连续监测。结论:ml预测的mvc可能克服长期以来肿瘤学中肌电图标准化的障碍。通过减少对直接最大努力的依赖,这些方法可以提高功能评估的准确性,优化康复策略,并加强以患者为中心的护理。对护理实践的影响:肿瘤护士和康复专家可以将ml支持的肌电图评估纳入临床和家庭项目,支持适应性的实时干预措施,提高癌症患者的安全性、参与度和生活质量。
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引用次数: 0
Associations Between Potassium Channel Genes and the Occurrence of Palpitations in Women Prior to Breast Cancer Surgery 钾通道基因与乳腺癌手术前女性心悸发生的关系
IF 2.3 4区 医学 Q1 NURSING Pub Date : 2025-12-01 DOI: 10.1016/j.soncn.2025.152039
Ying Sheng , Matthew R. Fleming , Carolyn J. Harris , Jon D. Levine , Steven M. Paul , Janet S. Carpenter , Yvette P. Conley , Joosun Shin , Kate Oppegaard , Marilyn J. Hammer , Christine Miaskowski

Objectives

The aim of the study was to evaluate for associations between the occurrence of palpitations in women prior to breast cancer surgery and single nucleotide polymorphisms (SNPs) for potassium channel genes.

Methods

A total of 398 women were recruited prior to breast cancer surgery and provided detailed information on demographic and clinical characteristics. The occurrence of palpitations was assessed using a single item (ie, did you experience your “heart race/pounds” in the past week – yes or no). Blood samples were collected for genomic analyses and genotyping of single nucleotide polymorphisms (SNPs) was done using a custom array. Multiple logistic regression analyses were used to identify associations between the occurrence of palpitations and variations in potassium channel genes.

Results

After controlling for functional status and the occurrence of back pain, significant associations were found between the occurrence of palpitations and six SNPs among five candidate genes, including potassium voltage-gated channels (ie, potassium voltage gated channel modifier subfamily S member 1 (KCNS1) rs4499491), potassium inwardly rectifying channels (ie, potassium inwardly rectifying channel subfamily J member 3 (KCNJ3) rs717175, KCNJ subfamily J member 5 (KCNJ5) rs11221510, KCNJ subfamily J member 6 (KCNJ6) rs13049947 and KCNJ6 rs1399596), and potassium two pore domain channels (ie, potassium two pore domain channel subfamily K member 2 (KCNK2) rs12757222).

Conclusions

Variations in potassium channel genes are associated with the occurrence of palpitations in women prior to breast cancer surgery.

Implications for Nursing Practice

While direct clinical implications cannot be made, these findings provide preliminary evidence of potential therapeutic targets.
目的:本研究的目的是评估乳腺癌手术前女性心悸的发生与钾通道基因的单核苷酸多态性(snp)之间的关系。方法:在乳腺癌手术前招募了398名女性,并提供了详细的人口统计学和临床特征信息。心悸的发生是用一个单项来评估的(例如,你在过去一周是否经历过“心跳/体重”——是或否)。采集血样进行基因组分析,并使用定制阵列进行单核苷酸多态性(snp)基因分型。多重逻辑回归分析用于确定心悸的发生与钾通道基因变异之间的关联。结果:在控制了功能状态和背痛的发生后,心悸的发生与钾电压门控通道(即钾电压门控通道修饰子亚家族S成员1 (KCNS1) rs4499491)、钾向内矫正通道(即钾向内矫正通道亚家族J成员3 (KCNJ3) rs717175、钾向内矫正通道亚家族J成员5 (KCNJ5) rs11221510、KCNJ亚族J成员6 (KCNJ6) rs13049947和KCNJ6 rs1399596),以及钾二孔域通道(即钾二孔域通道亚族K成员2 (KCNK2) rs12757222)。结论:钾通道基因的变异与乳腺癌手术前女性心悸的发生有关。对护理实践的启示:虽然不能产生直接的临床意义,但这些发现为潜在的治疗靶点提供了初步证据。
{"title":"Associations Between Potassium Channel Genes and the Occurrence of Palpitations in Women Prior to Breast Cancer Surgery","authors":"Ying Sheng ,&nbsp;Matthew R. Fleming ,&nbsp;Carolyn J. Harris ,&nbsp;Jon D. Levine ,&nbsp;Steven M. Paul ,&nbsp;Janet S. Carpenter ,&nbsp;Yvette P. Conley ,&nbsp;Joosun Shin ,&nbsp;Kate Oppegaard ,&nbsp;Marilyn J. Hammer ,&nbsp;Christine Miaskowski","doi":"10.1016/j.soncn.2025.152039","DOIUrl":"10.1016/j.soncn.2025.152039","url":null,"abstract":"<div><h3>Objectives</h3><div>The aim of the study was to evaluate for associations between the occurrence of palpitations in women prior to breast cancer surgery and single nucleotide polymorphisms (SNPs) for potassium channel genes.</div></div><div><h3>Methods</h3><div>A total of 398 women were recruited prior to breast cancer surgery and provided detailed information on demographic and clinical characteristics. The occurrence of palpitations was assessed using a single item (ie, did you experience your “heart race/pounds” in the past week – yes or no). Blood samples were collected for genomic analyses and genotyping of single nucleotide polymorphisms (SNPs) was done using a custom array. Multiple logistic regression analyses were used to identify associations between the occurrence of palpitations and variations in potassium channel genes.</div></div><div><h3>Results</h3><div>After controlling for functional status and the occurrence of back pain, significant associations were found between the occurrence of palpitations and six SNPs among five candidate genes, including potassium voltage-gated channels (ie, potassium voltage gated channel modifier subfamily S member 1 (<em>KCNS1</em>) rs4499491), potassium inwardly rectifying channels (ie, potassium inwardly rectifying channel subfamily J member 3 (<em>KCNJ3</em>) rs717175, <em>KCNJ</em> subfamily J member 5 (<em>KCNJ5</em>) rs11221510, <em>KCNJ</em> subfamily J member 6 (<em>KCNJ6</em>) rs13049947 and <em>KCNJ6</em> rs1399596), and potassium two pore domain channels (ie, potassium two pore domain channel subfamily K member 2 (<em>KCNK2</em>) rs12757222).</div></div><div><h3>Conclusions</h3><div>Variations in potassium channel genes are associated with the occurrence of palpitations in women prior to breast cancer surgery.</div></div><div><h3>Implications for Nursing Practice</h3><div>While direct clinical implications cannot be made, these findings provide preliminary evidence of potential therapeutic targets.</div></div>","PeriodicalId":54253,"journal":{"name":"Seminars in Oncology Nursing","volume":"41 6","pages":"Article 152039"},"PeriodicalIF":2.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145309886","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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
Caring Under Challenges: Exploring the Experiences of Oncology Nurses in a Tertiary Hospital in Northern Iran 挑战下的护理:伊朗北部一家三级医院肿瘤护士的经验探索。
IF 2.3 4区 医学 Q1 NURSING Pub Date : 2025-12-01 DOI: 10.1016/j.soncn.2025.152044
Somayeh Shirkosh , Gholamreza Mahmoodi-Shan , Leila Jouybari

Objectives

Oncology nursing, as one of the most challenging areas of healthcare, requires special attention to nurses’ caregiving experiences. This study was conducted to explore the care challenges of oncology nurses in northern Iran.

Methods

This qualitative descriptive study, with a conventional content analysis approach, was conducted with the participation of 12 nurses working in oncology wards in northern Iran from August to December 2024. Data were collected through in-depth semi-structured interviews and analyzed using Graneheim and Lundman’s (2004) method. Sampling was purposive and continued until data saturation was reached.

Results

Data analysis revealed four main themes with twelve subthemes of oncology nurses’ care challenges: Supportive Care Paradox (conflict between the therapeutic communication standard and reality: mismatch between patient expectations and system capabilities, and patients’ informational conflicts), Educational Paradox in the Healthcare System (inadequate specialized training, lack of clinical skills, and educational system limitations), Multilayered Occupational Burnout (adverse effects of cytotoxic exposure, emotional-cultural burnout, and ethical-systemic burnout), and Organizational Incongruence in the Healthcare System (imbalanced resource distribution, imbalanced responsibility distribution, and insufficient systemic support). These findings show deep-rooted systemic and cultural barriers affecting care quality.

Conclusion

This study reveals systemic and emotional challenges of oncology nurses that impede the provision of sustainable care. The pressure to compensate for shortcomings exacerbates nurses’ burnout. The health system must strengthen the sustainable care and professional health of nurses through specialized training, human resource optimization, psychological support, and equitable allocation of resources.

Implications for Practice

Implementing targeted educational programs and systemic reforms can enhance care quality and nurses’ well-being, providing implications for policy and practice in similar resource-limited settings.
目的:肿瘤护理作为医疗保健中最具挑战性的领域之一,需要特别关注护士的护理经验。本研究旨在探讨伊朗北部肿瘤护士的护理挑战。方法:采用传统的内容分析方法,对2024年8月至12月在伊朗北部肿瘤病房工作的12名护士进行定性描述性研究。通过深入的半结构化访谈收集数据,并使用Graneheim和Lundman(2004)的方法进行分析。采样是有目的的,并一直持续到数据饱和为止。结果:数据分析揭示了肿瘤护士护理挑战的四个主题和十二个副主题:支持性护理悖论(治疗沟通标准与现实的冲突;患者期望与系统能力不匹配、患者信息冲突)、医疗保健系统中的教育悖论(专业培训不足、缺乏临床技能和教育系统局限性)、多层职业倦怠(细胞毒性暴露的不利影响、情感-文化倦怠和伦理-系统倦怠)和医疗保健系统中的组织不一致(资源分配不平衡、医疗保健系统的组织不协调)。责任分配不平衡,系统支持不足)。这些发现表明影响护理质量的根深蒂固的体制和文化障碍。结论:本研究揭示了阻碍肿瘤护士提供可持续护理的系统和情感挑战。弥补缺陷的压力加剧了护士的倦怠。卫生系统必须通过专业培训、人力资源优化、心理支持和资源公平分配,加强护士的可持续护理和专业健康。对实践的启示:实施有针对性的教育计划和系统改革可以提高护理质量和护士的福祉,为类似资源有限的环境中的政策和实践提供启示。
{"title":"Caring Under Challenges: Exploring the Experiences of Oncology Nurses in a Tertiary Hospital in Northern Iran","authors":"Somayeh Shirkosh ,&nbsp;Gholamreza Mahmoodi-Shan ,&nbsp;Leila Jouybari","doi":"10.1016/j.soncn.2025.152044","DOIUrl":"10.1016/j.soncn.2025.152044","url":null,"abstract":"<div><h3>Objectives</h3><div>Oncology nursing, as one of the most challenging areas of healthcare, requires special attention to nurses’ caregiving experiences. This study was conducted to explore the care challenges of oncology nurses in northern Iran.</div></div><div><h3>Methods</h3><div>This qualitative descriptive study, with a conventional content analysis approach, was conducted with the participation of 12 nurses working in oncology wards in northern Iran from August to December 2024. Data were collected through in-depth semi-structured interviews and analyzed using Graneheim and Lundman’s (2004) method. Sampling was purposive and continued until data saturation was reached.</div></div><div><h3>Results</h3><div>Data analysis revealed four main themes with twelve subthemes of oncology nurses’ care challenges: Supportive Care Paradox (conflict between the therapeutic communication standard and reality: mismatch between patient expectations and system capabilities, and patients’ informational conflicts), Educational Paradox in the Healthcare System (inadequate specialized training, lack of clinical skills, and educational system limitations), Multilayered Occupational Burnout (adverse effects of cytotoxic exposure, emotional-cultural burnout, and ethical-systemic burnout), and Organizational Incongruence in the Healthcare System (imbalanced resource distribution, imbalanced responsibility distribution, and insufficient systemic support). These findings show deep-rooted systemic and cultural barriers affecting care quality.</div></div><div><h3>Conclusion</h3><div>This study reveals systemic and emotional challenges of oncology nurses that impede the provision of sustainable care. The pressure to compensate for shortcomings exacerbates nurses’ burnout. The health system must strengthen the sustainable care and professional health of nurses through specialized training, human resource optimization, psychological support, and equitable allocation of resources.</div></div><div><h3>Implications for Practice</h3><div>Implementing targeted educational programs and systemic reforms can enhance care quality and nurses’ well-being, providing implications for policy and practice in similar resource-limited settings.</div></div>","PeriodicalId":54253,"journal":{"name":"Seminars in Oncology Nursing","volume":"41 6","pages":"Article 152044"},"PeriodicalIF":2.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145330911","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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
Managing Lymphedema and Fibrosis in Head and Neck Cancer Survivors: A Data Analysis on Self-Care Behaviors 头颈癌幸存者的淋巴水肿和纤维化管理:自我护理行为的数据分析。
IF 2.3 4区 医学 Q1 NURSING Pub Date : 2025-12-01 DOI: 10.1016/j.soncn.2025.152016
Jessica Abene , Liming Huang , Barbara A. Murphy , Jie Deng

Objectives

Head and neck cancer survivors (HNCS) often face lymphedema and fibrosis (LEF) post-treatment, which require long-term self-management to minimize LEF progression and its negative impact on quality of life. This secondary data analysis aims to evaluate self-care, LEF status, and symptom burden among HNCS, and to examine the associations among self-care status, LEF status, and symptom burden in HNCS.

Methods

Descriptive statistics summarized the sample and variable distributions. Bivariate analysis assessed associations between variables. Multiple linear regression tested for associations, incorporating moderators including health literacy, self-efficacy, anxiety, and depression.

Results

Most participants (N = 59) were non-Hispanic (98.3%), White (89.8%), and males (83.1%). On average, participants had 2.68 anatomical sites affected by LEF in the head and neck region and spent 20.29 minutes daily on self-care. Participants spent more time (minutes per day) on self-care when their LEF was more severe (P < .05). Participants with worse symptom burden spent more time (minutes per day) conducting self-care activities (P < .05). Self-efficacy moderated the relationship between time spent on self-care and the number of sites involved with LEF. Furthermore, anxiety and depression moderated the relationship between time spent on self-care and symptom burden.

Conclusions

HNCS with more severe LEF and worse symptom burden spent more time on self-care. Self-efficacy, anxiety, and depression may moderate self-care behaviors. Findings highlight the importance of self-care management strategies to address self-efficacy and psychological factors to maximize engagement and LEF outcomes. Further investigation is warranted.

Implications for Nursing Practice

Nurses play a critical role in supporting HNCS with LEF. This study highlights the importance of assessing both the physical and psychological aspects of survivorship care. Nurses should routinely evaluate LEF severity, symptom burden, and psychological well-being (anxiety, depression, and self-efficacy) to personalize self-care guidance.
目的:头颈癌幸存者(HNCS)治疗后经常面临淋巴水肿和纤维化(LEF),这需要长期的自我管理,以尽量减少LEF的进展及其对生活质量的负面影响。本二次数据分析旨在评估非裔美国人的自我保健、LEF状况和症状负担,并探讨非裔美国人自我保健状况、LEF状况和症状负担之间的关系。方法:采用描述性统计对样本及变量分布进行汇总。双变量分析评估变量之间的关联。多元线性回归检验关联,纳入调节因子包括健康素养、自我效能、焦虑和抑郁。结果:大多数参与者(N = 59)是非西班牙裔(98.3%),白人(89.8%)和男性(83.1%)。平均而言,参与者在头颈部区域有2.68个解剖部位受到LEF的影响,每天花费20.29分钟用于自我护理。当参与者的LEF更严重时,他们花更多的时间(每天分钟)在自我护理上(P < 0.05)。症状负担较重的参与者进行自我保健活动的时间(分钟/天)较多(P < 0.05)。自我效能感调节了自我照顾时间与生活自理相关部位数量之间的关系。此外,焦虑和抑郁调节了自我照顾时间与症状负担的关系。结论:高传染性神经系统疾病患者的LEF越严重,症状负担越重,其自我护理时间越长。自我效能、焦虑和抑郁可能会调节自我照顾行为。研究结果强调了自我保健管理策略对解决自我效能感和心理因素的重要性,以最大限度地提高敬业度和LEF结果。有必要进一步调查。对护理实践的启示:护士在支持HNCS与LEF方面发挥着关键作用。这项研究强调了评估生存护理的生理和心理方面的重要性。护士应定期评估LEF的严重程度、症状负担和心理健康状况(焦虑、抑郁和自我效能),以个性化自我护理指导。
{"title":"Managing Lymphedema and Fibrosis in Head and Neck Cancer Survivors: A Data Analysis on Self-Care Behaviors","authors":"Jessica Abene ,&nbsp;Liming Huang ,&nbsp;Barbara A. Murphy ,&nbsp;Jie Deng","doi":"10.1016/j.soncn.2025.152016","DOIUrl":"10.1016/j.soncn.2025.152016","url":null,"abstract":"<div><h3>Objectives</h3><div>Head and neck cancer survivors (HNCS) often face lymphedema and fibrosis (LEF) post-treatment, which require long-term self-management to minimize LEF progression and its negative impact on quality of life. This secondary data analysis aims to evaluate self-care, LEF status, and symptom burden among HNCS, and to examine the associations among self-care status, LEF status, and symptom burden in HNCS.</div></div><div><h3>Methods</h3><div>Descriptive statistics summarized the sample and variable distributions. Bivariate analysis assessed associations between variables. Multiple linear regression tested for associations, incorporating moderators including health literacy, self-efficacy, anxiety, and depression.</div></div><div><h3>Results</h3><div>Most participants (<em>N</em> = 59) were non-Hispanic (98.3%), White (89.8%), and males (83.1%). On average, participants had 2.68 anatomical sites affected by LEF in the head and neck region and spent 20.29 minutes daily on self-care. Participants spent more time (minutes per day) on self-care when their LEF was more severe (<em>P</em> &lt; .05). Participants with worse symptom burden spent more time (minutes per day) conducting self-care activities (<em>P</em> &lt; .05). Self-efficacy moderated the relationship between time spent on self-care and the number of sites involved with LEF. Furthermore, anxiety and depression moderated the relationship between time spent on self-care and symptom burden.</div></div><div><h3>Conclusions</h3><div>HNCS with more severe LEF and worse symptom burden spent more time on self-care. Self-efficacy, anxiety, and depression may moderate self-care behaviors. Findings highlight the importance of self-care management strategies to address self-efficacy and psychological factors to maximize engagement and LEF outcomes. Further investigation is warranted.</div></div><div><h3>Implications for Nursing Practice</h3><div>Nurses play a critical role in supporting HNCS with LEF. This study highlights the importance of assessing both the physical and psychological aspects of survivorship care. Nurses should routinely evaluate LEF severity, symptom burden, and psychological well-being (anxiety, depression, and self-efficacy) to personalize self-care guidance.</div></div>","PeriodicalId":54253,"journal":{"name":"Seminars in Oncology Nursing","volume":"41 6","pages":"Article 152016"},"PeriodicalIF":2.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145139430","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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
The Role of General Practitioners Across the Cancer Continuum Using the Caring Life-Course Theory 全科医生在使用关怀生命历程理论的癌症连续体中的作用。
IF 2.3 4区 医学 Q1 NURSING Pub Date : 2025-12-01 DOI: 10.1016/j.soncn.2025.152022
Carolyn Ee , Betty Kandagor , Catherine Paterson , Kylie Vuong

Purpose

General Practitioners (GPs) play a crucial role across the cancer continuum, from prevention and early detection to end-of-life care. GPs provide comprehensive care that addresses a broad spectrum of health issues rather than a specific disease. Elements such as person-centeredness, continuity of care and whole-person care define the specialty of general practice. Other characteristics, such as expertise in managing uncertainty, undifferentiated illness and complexity, care coordination and teamwork, facilitate its evolution as a specialty.

Procedures

This paper uses the Caring Life-Course Theory as a theoretical framework to discuss the role of GPs in cancer care. We explore the barriers and enablers of providing optimal care in general practice for people diagnosed with cancer on an micro-, meso- and macro-level using the Caring Life-Course Theory.

Findings

The fundamentals of care framework aligns with the key characteristics of general practice namely first contact care, comprehensive care, continuity of care, person-centeredness and whole-person care. General practice is underpinned by a long-term therapeutic partnership with the patient, the ability to meet a range of care needs simultaneously, and an understanding of the context in which care is taking place. GPs provide care across the life course, facilitate self-care, care from others and care for others, assess care needs at transitions during the cancer continuum, and maintain a detailed care biography of the patient.

Conclusions

Adequate funding of longer consultations to facilitate the delivery of complex care, and expansion of multidisciplinary primary care teams, is required to sustain the delivery of quality cancer care in general practice.

Implications for Nursing Practice

There is significant opportunity to enhance the role of primary care nursing in delivery of cancer care in general practice, but this must be supported by enablers across all levels of care delivery.
目的:全科医生(全科医生)在整个癌症连续体中发挥着至关重要的作用,从预防和早期发现到临终关怀。全科医生提供全面的护理,解决广泛的健康问题,而不是特定的疾病。以人为本、护理的连续性和全人护理等要素定义了全科医生的专业。其他特点,如管理不确定性的专业知识、无差别疾病和复杂性、护理协调和团队合作,促进了它作为一门专业的发展。程序:本文以关怀生命历程理论为理论框架,探讨全科医生在癌症护理中的作用。我们探讨障碍和使能者提供最佳护理的一般做法的人诊断癌症在微观,中观和宏观水平上使用护理生命过程理论。研究发现:护理框架的基本原则与全科实践的关键特征一致,即首次接触护理、综合护理、护理连续性、以人为本和全人护理。全科实践的基础是与患者的长期治疗伙伴关系,同时满足一系列护理需求的能力,以及对正在进行护理的背景的理解。全科医生在整个生命过程中提供护理,促进自我护理,他人护理和他人护理,评估癌症连续体过渡期间的护理需求,并保持患者的详细护理传记。结论:需要为长期会诊提供足够的资金,以促进复杂护理的提供,并扩大多学科初级保健团队,以维持高质量癌症护理的提供。对护理实践的影响:在一般实践中,加强初级保健护理在提供癌症护理中的作用是很有机会的,但这必须得到各级护理提供的推动者的支持。
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引用次数: 0
Self-Care Bra Considerations after Breast Cancer: Consumer-Led International Advocacy 乳腺癌后的自我护理胸罩考虑:消费者主导的国际倡导。
IF 2.3 4区 医学 Q1 NURSING Pub Date : 2025-12-01 DOI: 10.1016/j.soncn.2025.152038
Gillian Horton , Catherine Paterson
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引用次数: 0
Consumer-Led Design and Implementation of the Care Connect Notebook 以消费者为主导的关怀连接笔记本的设计与实现
IF 2.3 4区 医学 Q1 NURSING Pub Date : 2025-12-01 DOI: 10.1016/j.soncn.2025.152023
Thomas Binns , Tereena Cocks , Morgan Atkinson , Catherine Paterson
<div><h3>Objectives</h3><div>A “consumer” is a person, receiving or having received targeted health care, who provides a consumer perspective, contributes consumer experiences, and can advocate for the interests of current and potential health service users. Developing meaningful partnerships with Cancer Consumers has never been so important as evidence continues to underscore significant unmet supportive care needs despite routine clinical follow-up with healthcare professionals. This consumer-led project used the theoretical underpinnings of the care biographies of the Caring Life Course Theory to develop a comprehensive <em>Care Connect Notebook</em> (a care biography) created by consumers for consumers (across the lifespan of age) in partnership with the multidisciplinary cancer team to use as a support resource to consumers in preparing for medical, nursing, and allied health cancer appointments across the entire cancer care continuum.</div></div><div><h3>Methods</h3><div>A codesign-thinking approach was used to provide a person-centered approach to the development and implementation of the <em>Care Connect Notebook</em>, which was conducted in two phases: (1) discover and define, and (2) develop and deliver. A series of workshops, consumer engagement with Cancer Safety and Quality Meetings, corridor conversations, and electronic surveys were used among consumers affected by cancer and multidisciplinary cancer healthcare professionals. Consumers also led the clinical staff training on how to use the <em>Care Connect Notebook</em> with people with cancer. Data were analyzed using descriptive statistics and content analysis.</div></div><div><h3>Results</h3><div>The consumer-led and initiated project, through conceptualization and ongoing advocacy, led to the development of the first Cancer Care Biography, the <em>Care Connect Notebook</em>. The results from the real-world evaluation, led by consumers for consumers, identified that this bespoke resource formed a living document that people with cancer used before, during, and after their appointments with their cancer healthcare professionals (nursing, allied health, medicine, including General Practitioners). Consumers reported that the <em>Care Connect Notebook</em> empowered them to develop more trusting relationships with their healthcare professional team, to identify what matters most to them to actively engage and receive care according to their own idiosyncratic (needs, preferences, goals, values, cultural and social cultural contexts), and captured their “shared-care plan” while having their care network contacts available to them, all in one place.</div></div><div><h3>Conclusions</h3><div>The development of the <em>Care Connect Notebook</em> has provided valuable insights into the perspectives of consumer representatives in an Australian context and how they proactively partnered with their healthcare professionals in cancer services.</div></div><div><h3>Implications for Nursing Pract
目的“消费者”是指正在接受或已经接受有针对性的卫生保健的人,他们提供消费者的观点,贡献消费者的经验,并能倡导当前和潜在的卫生服务使用者的利益。与癌症消费者建立有意义的伙伴关系从未如此重要,因为尽管与医疗保健专业人员进行了常规临床随访,但证据继续强调显著未满足的支持性护理需求。这个以消费者为主导的项目利用护理生命历程理论的护理传记的理论基础,与多学科癌症团队合作,为消费者(跨越年龄)创建了一个全面的护理连接笔记本(护理传记),作为消费者在整个癌症护理连续体中准备医疗、护理和联合健康癌症预约时的支持资源。方法采用协同设计思维方法,以人为本,分两个阶段(1)发现与定义,(2)开发与交付进行关怀连接笔记本的开发与实施。在受癌症影响的消费者和多学科癌症医疗保健专业人员中,采用了一系列研讨会、消费者参与癌症安全和质量会议、走廊对话和电子调查。消费者还带领临床工作人员培训如何与癌症患者使用关怀连接笔记本。数据分析采用描述性统计和内容分析。结果消费者主导和发起的项目,通过概念化和持续的宣传,导致了第一本癌症护理传记,护理连接笔记本的发展。由消费者对消费者主导的真实世界评估的结果表明,这种定制资源形成了癌症患者在与癌症医疗保健专业人员(护理、联合健康、医学,包括全科医生)预约之前、期间和之后使用的活文档。消费者报告说,护理连接笔记本使他们能够与医疗保健专业团队建立更加信任的关系,根据自己的特质(需求、偏好、目标、价值观、文化和社会文化背景)确定对他们最重要的是什么,以积极参与和接受护理,并捕捉他们的“共享护理计划”,同时让他们可以使用他们的护理网络联系人,所有这些都在一个地方。护理连接笔记本的开发提供了有价值的见解,了解澳大利亚背景下消费者代表的观点,以及他们如何主动与医疗保健专业人员合作开展癌症服务。对护理实践的启示通过了解他们在现实世界中的个人经历,我们开发了一个定制的消费者癌症资源,以克服他们面临的挑战,并促进他们与癌症护士和其他医疗保健专业人员真实地参与他们的护理和治疗。
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引用次数: 0
Integrating the Caring Life Course Theory and Artificial Intelligence Applications to Enhance Cancer Care Across the Continuum 整合生命历程关怀理论与人工智能应用,提升癌症全生命周期照护。
IF 2.3 4区 医学 Q1 NURSING Pub Date : 2025-12-01 DOI: 10.1016/j.soncn.2025.152040
Juliana Christina , Kelly Ford , Bradly Menz , Michael Sorich , Ashley Hopkins , Imogen Ramsey , Maree Duddle , Alison Kitson , Catherine Paterson

Objectives

With the escalating global burden of cancer, there is an increasing imperative to adopt holistic, person-centered approaches that address the complex and evolving care needs of individuals across the cancer continuum. Integrating advanced technologies such as artificial intelligence (AI) into conventional cancer care models offers significant potential to enhance the responsiveness, inclusivity, and sustainability of cancer care delivery. This paper aimed to explore how the Caring Life Course Theory (CLCT), a comprehensive multidisciplinary framework of care, can inform and enhance the integration of AI into cancer care delivery.

Methods

A conceptual synthesis and narrative synthesis were employed to explore and understand how CLCT constructs can inform AI applications across different levels of cancer care (individual, relational/network and structural).

Results

AI technologies are being used to support personalized care planning, real-time symptom monitoring, survivorship management, and coordinated service delivery. Guided by the CLCT, these technologies offer a structured and contextually grounded approach to delivering longitudinal, life-course-informed care. Nonetheless, significant challenges remain, including ethical concerns, algorithmic bias, and implementation barriers.

Conclusions

Aligning AI technologies with the CLCT framework can promote more personalized, equitable, and relationally responsive cancer care. Future research must prioritize ethical co-design, accountability, and sustained implementation.

Implications for Nursing Practice

: The integration of CLCT and AI can support nurses in identifying care needs, facilitating remote monitoring, and coordinating personalized care. However, the integration of AI must be approached with critical attention to ethics, equity, and the preservation of fundamental nursing values.
随着全球癌症负担的不断增加,越来越有必要采用整体的、以人为本的方法来解决癌症连续体中个体复杂和不断变化的护理需求。将人工智能(AI)等先进技术整合到传统的癌症护理模式中,为提高癌症护理服务的响应性、包容性和可持续性提供了巨大的潜力。本文旨在探讨关怀生命历程理论(CLCT),一个综合性的多学科护理框架,如何告知和加强人工智能与癌症护理服务的整合。方法:采用概念综合和叙事综合来探索和理解CLCT结构如何在不同水平的癌症治疗(个体、关系/网络和结构)中为人工智能应用提供信息。结果:人工智能技术被用于支持个性化护理计划、实时症状监测、生存管理和协调服务提供。在CLCT的指导下,这些技术提供了一种结构化的、基于情境的方法来提供纵向的、生命过程知情的护理。尽管如此,重大挑战依然存在,包括伦理问题、算法偏见和实施障碍。结论:将人工智能技术与CLCT框架相结合,可以促进更加个性化、公平和相对响应性的癌症治疗。未来的研究必须优先考虑伦理协同设计、问责制和持续实施。对护理实践的影响:CLCT和人工智能的整合可以支持护士识别护理需求,促进远程监控和协调个性化护理。然而,人工智能的整合必须高度重视伦理、公平和维护基本护理价值观。
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引用次数: 0
期刊
Seminars in Oncology Nursing
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