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Comparing online support groups with psychoeducation versus psychoeducation alone for distressed breast cancer survivors: a randomized controlled trial 比较在线支持团体与心理教育与单独心理教育对痛苦的乳腺癌幸存者:一项随机对照试验
Pub Date : 2021-07-01 DOI: 10.1097/OR9.0000000000000058
Mohamad Baydoun, M. Speca, J. Taylor-Brown, J. Stephen, K. Piedalue, Jill A. Turner, L. Carlson
Abstract Background: Online support groups are one forum that can help breast cancer survivors cope with negative mood states, but little is known about their effects compared to self-administered psycho-educational interventions. This randomized controlled trial compared the effects of synchronous, text-based professionally led online support groups (OSGs) plus a psychoeducational coping skills training program, called Nucare, versus Nucare alone in distressed survivors of breast cancer. Methods: Consented participants were randomized to an OSG (90-minute once-weekly session for 12 weeks) plus home-based Nucare or a self-directed home-based Nucare intervention alone. The primary outcome was the Profile of Mood States-Short Form – Total Mood Disturbance score (POMS-TMD). Secondary outcomes included measures of anxiety, depression, coping, illness intrusiveness, and loneliness. Outcomes were measured before and after the intervention, and 3 months post-intervention (follow-up). Results: One hundred twenty-five stage I–III breast cancer survivors enrolled with a mean age of 53 years (OSG plus Nucare [n = 68]; Nucare alone [n = 57]). There was a significant improvement in POMS-TMD scores among the entire study sample during the intervention period (Cohen's d = 0.25, P = .002), which was maintained over follow-up. The group × time interactions on POMS-TMD over the intervention and follow-up periods were not significant (all Ps > .05), indicating neither group outperformed the other. Group x time interactions on three coping domains (positive reframing, use of instrumental support, self-blame) favored Nucare alone over OSG plus Nucare during the intervention period (Cohen's d ranged from 0.40 to 0.48), while group x time interactions over the follow-up period favored OSG plus Nucare over Nucare alone on loneliness (Cohen's d = 0.34) and one coping domain (self-blame) (Cohen's d = 0.58). Anxiety, depression, and illness intrusiveness were not significantly different between groups at any time point (all Ps > .05). Conclusion: OSGs plus Nucare were not found superior to Nucare alone in improving mood disturbance. Mood improvement among the entire sample indicates that regular use of either Nucare alone or in combination with OSGs may have the potential to ameliorate negative mood states in breast cancer survivors.
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引用次数: 0
Enhancing access to sustainable cancer supportive modalities: the roles of interactive health communication and trained volunteers 增进获得可持续癌症支助方式的机会:互动式健康交流和训练有素的志愿者的作用
Pub Date : 2021-07-01 DOI: 10.1097/OR9.0000000000000060
S. Attieh, C. Loiselle
Abstract Background: Addressing the unmet needs of individuals with cancer in a timely manner is imperative for true implementation of person-centered care. Interactive health communication (ie, people's interactions with health information technologies) and more sustainable forms of support (eg, trained volunteers), are increasingly recognized as promising means to address the many barriers to accessing cancer-related support. This pilot study is timely as it tested an accessible cancer supportive approach that included e-handouts on 25 cancer distress-related topics and supportive phone calls by trained volunteers. The study objectives were to document participants’ preferences for the types of support offered, assess changes in distress pre and post, and determine the usability of the approach. Methods: Individuals with various types and stages of cancer (N = 88), diagnosed within the past 6 months were recruited from a university-affiliated cancer center in Montreal, Quebec, Canada. Participants completed the Cancer Support Community Distress measure at baseline, and they were prompted to request different types of support. Participants completed a follow-up questionnaire including the distress measure one to four weeks post support provision. Results: Of the 88 participants who filled out baseline questionnaires, 68 completed the follow up measures. Of the former, 76% (n = 67) made at least one request (e-handouts/phone calls/or both). The most frequently requested e-handout addressed pain/physical discomfort (37 requests) and phone calls were requested mostly for sleep problems (8 requests). Participants who requested both support modalities reported significantly lower distress [F (3,64) = 3.52, P = .02] at follow-up compared to those who made no requests. Ninety-two percent of participants who requested e-handouts reported that other patients would benefit from these. Participants who requested phone calls agreed or strongly agreed that volunteers were knowledgeable. The usability score was excellent (mean = 85.5/100; SD = 16.36). Conclusion: Preliminary findings indicate that this supportive approach is promising. Future work would document the differential contributions of supportive modalities that compare, for instance, professional versus lay (trained) support.
背景:及时解决癌症患者未满足的需求是真正实现以人为本的护理的必要条件。交互式健康交流(即人们与卫生信息技术的互动)和更可持续的支持形式(例如,训练有素的志愿者)日益被认为是解决获得癌症相关支持的许多障碍的有希望的手段。这项试点研究是及时的,因为它测试了一种可访问的癌症支持方法,包括25个与癌症痛苦相关的主题的电子讲义和训练有素的志愿者的支持电话。研究的目的是记录参与者对所提供的支持类型的偏好,评估痛苦前后的变化,并确定方法的可用性。方法:从加拿大魁北克省蒙特利尔市一所大学附属癌症中心招募过去6个月内确诊的不同类型和分期的癌症个体(N = 88)。参与者在基线时完成了癌症支持社区压力测量,并被提示要求不同类型的支持。参与者在提供支持后一到四周完成了一份随访问卷,包括痛苦测量。结果:在88名填写了基线问卷的参与者中,68名完成了随访措施。在前者中,76% (n = 67)至少提出了一个要求(电子讲义/电话/或两者兼而有之)。请求最多的电子讲义是关于疼痛/身体不适的(37次请求),请求最多的电话是关于睡眠问题的(8次请求)。要求两种支持方式的参与者报告的痛苦程度显著降低[F (3,64) = 3.52, P =。[02]与那些没有提出要求的人相比。要求电子讲义的参与者中有92%的人报告说,其他患者将从中受益。要求打电话的参与者同意或强烈同意志愿者知识渊博。可用性得分优秀(平均85.5/100;sd = 16.36)。结论:初步研究结果表明,这种支持方法是有希望的。未来的工作将记录支持模式的不同贡献,例如,比较专业支持与非专业(训练)支持。
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引用次数: 0
A cross-sectional study of breast pain in a diverse population of breast cancer patients. 乳腺疼痛在不同人群乳腺癌患者的横断面研究。
Pub Date : 2021-07-01 DOI: 10.1097/or9.0000000000000055
Jami Fukui, Erin Bantum, Madison Meister, Shannon Lim, Ashley Davidson Marumoto, Ian Pagano

Background: Breast cancer is the most common cancer in women, and postoperative breast pain has been reported to be anywhere from 25% to 60%. However, there is sparse data regarding racial/ethnic differences in breast pain among breast cancer patients.

Methods: We performed a cross-sectional anonymous survey of breast cancer patients from the Hawaii Cancer Consortium over a 6-week period between 2019 and 2020. The 237 breast cancer participants were ages 29 to 98, 74% Asian, and mainly from outpatient oncology clinics. We evaluated the prevalence of breast pain in a diverse group of breast cancer patients and characterized the pain using a modified short-form McGill pain questionnaire (sfMPQ).

Results: Eighty-fourrespondents(35.4%) reported breast pain. On univariable analysis, we found significant racial/ethnic differences in the amount of breast pain, where Chinese and Japanese participants reported significantly less pain compared to White participants on a 10-point pain scale. We found differences in breast pain according to age and endocrine therapy use as well as survey location, however, no differences were seen according to chemotherapy, radiation, or breast surgery. Based on the sfMPQ, the most common descriptors of breast pain were sensory (throbbing, shooting, and stabbing) compared to affective (tiring-exhausting, sickening, fearful, and punishing-cruel) characteristics. Although they were described as mild and intermittent, in women with breast pain, 33.4% reported the breast pain affected their sleep, 16.7% their work, and 15.4% their sexual activity.

Conclusions: Breast pain is a significant problem in our breast cancer community. This survey assessment has informed our understanding of breast pain in our diverse population. In turn, we are developing culturally appropriate pain management strategies to treat this challenging symptom common in breast cancer survivors.

背景:癌症是女性最常见的癌症,据报道术后乳房疼痛在25%至60%之间。然而,关于癌症患者乳房疼痛的种族/民族差异的数据很少。方法:我们对夏威夷癌症联合会的癌症患者进行了一项横断面匿名调查,调查时间为2019年至2020年,为期6周。237名癌症参与者年龄在29至98岁之间,74%为亚洲人,主要来自肿瘤门诊。我们评估了癌症患者乳腺疼痛的患病率,并使用改良的短期McGill疼痛问卷(sfMPQ)对疼痛进行了表征。结果:84名受访者(35.4%)报告了乳腺疼痛。在单变量分析中,我们发现乳腺疼痛量存在显著的种族/民族差异,在10分疼痛量表中,中国和日本参与者报告的疼痛明显少于白人参与者。我们发现,乳腺疼痛的发生与年龄、内分泌治疗的使用以及调查地点有关,但化疗、放疗或乳腺手术没有差异。根据sfMPQ,与情感(疲惫、疲惫、恶心、恐惧和残忍)特征相比,乳房疼痛最常见的描述是感觉(悸动、射击和刺伤)特征。尽管乳房疼痛被描述为轻度和间歇性,但在患有乳房疼痛的女性中,33.4%的人表示乳房疼痛影响了她们的睡眠,16.7%的人表示工作,15.4%的人报告性活动。结论:乳腺疼痛是癌症社区的一个重要问题。这项调查评估为我们了解不同人群的乳房疼痛提供了依据。反过来,我们正在制定适合文化的疼痛管理策略,以治疗癌症幸存者常见的这种具有挑战性的症状。
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引用次数: 1
IPOS 2021 Abstracts Booklet IPOS 2021摘要小册子
Pub Date : 2021-06-01 DOI: 10.1097/or9.0000000000000054
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引用次数: 0
Adherence to standardized 8-week mindfulness-based interventions among women with breast or gynecological cancer: a scoping review 乳腺癌或妇科癌症患者坚持标准化的8周正念干预:一项范围综述
Pub Date : 2021-04-01 DOI: 10.1097/OR9.0000000000000048
J. Stanić, J. Barth, Nadia Danon, G. Bondolfi, F. Jermann, M. Eicher
: Participant adherence to standardized 8-week mindfulness-based interventions (MBIs) may be challenging, and adaptations from intervention protocols have been reported in mindfulness research. We conducted a scoping review to determine how women with breast or gynecological cancer adhered to standardized 8-week MBIs delivered in intervention studies. Searches were conducted for articles published till February 2020 in PubMed, Embase, CINAHL EBSCO, PsycINFO Ovid SP, and Cochrane Library Wiley. The following outcomes were investigated: class and silent retreat attendance, intervention completion rate (ICR), adherence to home practice, and reasons for dropping out from an MBI study. Among the 25 included MBI studies, mindfulness-based stress reduction was the most often delivered intervention and mostly women with stage I–III breast cancer were represented. The duration of classes varied from 1.5 to 3.5 hours. Planned home practice varied from 20 to 60 min/day, and silent retreat varied from 4.5 to 8 hours. Due to heterogeneity in the reporting of class attendance, the data could not be pooled. Six studies reported an average class attendance ranging from 5 to 8.2 classes. Overall, intervention completion rate (the proportion who completed all classes) varied from 26.3% to 100%; however, discontinuations were not systematically reported. Home practice time was reported in 20% of the studies and ranged from 17 to 24 min/day. The main reasons for dropping out from an MBI study were health-related problems, organizational challenges, travel distance, and lack of motivation/commitment. About 70% of the studies reported some data on participant adherence, revealing a relatively high overall frequency of class attendance. However, the monitoring and reporting of participant adherence should be improved in future studies to increase our knowledge on the required amount of participant engagement to improve health outcomes Abstract Participant adherence to standardized 8-week mindfulness-based interventions (MBIs) may be challenging, and adaptations from intervention protocols have been reported in mindfulness research. We conducted a scoping review to determine how women with breast or gynecological cancer adhered to standardized 8-week MBIs delivered in intervention studies. Searches were conducted for articles published till February 2020 in PubMed, Embase, CINAHL EBSCO, PsycINFO Ovid SP, and Cochrane Library Wiley. The following outcomes were investigated: class and silent retreat attendance, intervention completion rate (ICR), adherence to home practice, and reasons for dropping out from an MBI study. Among the 25 included MBI studies, mindfulness-based stress reduction was the most often delivered intervention and mostly women with stage I – III breast cancer were represented. The duration of classes varied from 1.5 to 3.5hours. Planned home practice varied from 20 to 60min/day, and silent retreat varied from 4.5 to 8hours. Due to heterogeneity in the
参与者坚持标准化的8周基于正念的干预(mbi)可能具有挑战性,正念研究中已经报道了干预方案的适应性。我们进行了一项范围综述,以确定乳腺癌或妇科癌症患者在干预研究中如何坚持标准化的8周mbi。检索截至2020年2月在PubMed、Embase、CINAHL EBSCO、PsycINFO Ovid SP和Cochrane Library Wiley上发表的文章。以下结果被调查:课堂和静修出勤率,干预完成率(ICR),坚持家庭实践,以及退出MBI研究的原因。在纳入的25项MBI研究中,以正念为基础的减压是最常用的干预措施,其中大多数是患有I-III期乳腺癌的女性。课程时长从1.5至3.5小时不等。计划的家庭练习从每天20到60分钟不等,安静静修从4.5到8小时不等。由于课堂出勤报告的异质性,数据无法汇总。六项研究报告平均出勤率在5到8.2节课之间。总体而言,干预完成率(完成所有课程的比例)从26.3%到100%不等;但是,没有系统地报告中断的情况。20%的研究报告了家庭练习时间,范围从17到24分钟/天。退出MBI研究的主要原因是健康相关问题、组织挑战、旅行距离和缺乏动力/承诺。大约70%的研究报告了一些参与者坚持上课的数据,揭示了上课的总体频率相对较高。然而,在未来的研究中,参与者依从性的监测和报告应该得到改善,以增加我们对参与者参与改善健康结果所需量的了解。摘要:参与者对标准化8周基于正念的干预(mbi)的依从性可能具有挑战性,并且在正念研究中已经报道了干预方案的适应性。我们进行了一项范围综述,以确定乳腺癌或妇科癌症患者在干预研究中如何坚持标准化的8周mbi。检索截至2020年2月在PubMed、Embase、CINAHL EBSCO、PsycINFO Ovid SP和Cochrane Library Wiley上发表的文章。以下结果被调查:课堂和静修出勤率,干预完成率(ICR),坚持家庭实践,以及退出MBI研究的原因。在纳入的25项MBI研究中,以正念为基础的减压是最常用的干预措施,其中大多数是I - III期乳腺癌妇女。每堂课的课时由1.5至3.5小时不等。计划的家庭练习从每天20到60分钟不等,安静静修从4.5到8小时不等。由于课堂出勤报告的异质性,数据无法汇总。六项研究报告平均出勤率在5到8.2节课之间。总体而言,干预完成率(完成所有课程的比例)从26.3%到100%不等;但是,没有系统地报告中断的情况。20%的研究报告了家庭练习时间,范围从17到24分钟/天。退出MBI研究的主要原因是健康相关问题、组织挑战、旅行距离和缺乏动力/承诺。大约70%的研究报告了一些参与者坚持上课的数据,揭示了上课的总体频率相对较高。然而,在未来的研究中,应该改进对参与者依从性的监测和报告,以增加我们对参与者参与所需量的了解,以改善健康结果并促进在更大范围内实施有效的干预措施。
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引用次数: 6
From foundation to inspiration: implementing screening for distress (6th Vital Sign) for optimal cancer care—international leadership perspectives on program development 从基础到灵感:实施窘迫筛查(第六生命体征)以获得最佳癌症护理-国际领导对项目发展的看法
Pub Date : 2021-04-01 DOI: 10.1097/or9.0000000000000051
B. Bultz, L. Watson, Matthew Loscalzo, B. Kelly, J. Zabora
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引用次数: 5
The end-of-life trajectory in childhood cancer: Bereaved parents’ perceptions of the availability, use, and helpfulness of support services 儿童癌症的生命终结轨迹:失去亲人的父母对支持服务的可用性、使用和帮助的看法
Pub Date : 2021-04-01 DOI: 10.1097/or9.0000000000000050
S. Bedoya, H. Battles, C. Gerhardt, L. Wiener
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引用次数: 1
The experiences of caregivers of Indigenous cancer survivors in Australia, Canada, New Zealand, and the United States: a systematic review 澳大利亚、加拿大、新西兰和美国土著癌症幸存者看护人的经历:一项系统综述
Pub Date : 2020-11-17 DOI: 10.1097/or9.0000000000000040
Adam J. Masa, Helena Martinez-Bredeck, Tamara L. Butler, Kate Anderson, A. Girgis, S. Aoun, J. Cunningham, C. Wakefield, Shaouli Shahid, A. Smith, G. Garvey
Background: Caregivers of Indigenous cancer survivors provide critical unpaid support to survivors, yet they rarely receive information or training for this role and may themselves bene fi t from support services. Little is documented about the experiences of caregivers of Indigenous cancer survivors. The aim of this systematic review was to identify and aggregate qualitative research describing the experiences of caregivers of Indigenous cancer survivors in Australia, New Zealand, Canada and the United States. Methods: We systematically searched PsycINFO, PubMed, CINAHL, Embase, Scopus and Web of Science using keywords relating to Indigenous populations; caregivers; and cancer. Data were extracted from original qualitative research articles published up to March 2020. Results: From 24 full-text articles, 14 articles from 13 studies were analyzed using meta-aggregation. This highlighted key caregiver experiences relating to: the need for information about cancer and services; providing and receiving support; communication challenges and responsibilities; balancing caregiver roles and emotions; and culturally unsafe health systems and settings. Caregivers of Indigenous cancer survivors often act as mediator between Western biomedical approaches to cancer care and Indigenous peoples ’ holistic and family-focused views of health and wellbeing, aiming to ensure that both health professionals and the cancer survivors understand each other ’ s perspectives and preferences for care. Caregivers expressed preferences for family-focussed rather than patient-focussed care. Culturally unsafe health care systems created barriers to optimal care. Conclusions: The fi ndings reveal caregivers ’ unique experiences of caring for an Indigenous cancer survivor, and identi fi es several unmet needs which should be appropriately and systematically addressed. Caregivers should be regarded as co-clients with their own needs as well as co-workers with health professionals providing cancer care. Ultimately supporting caregivers will contribute to improving health outcomes for Indigenous cancer survivors.
背景:土著癌症幸存者的照顾者为幸存者提供重要的无偿支持,但他们很少接受这一角色的信息或培训,他们自己也可能从支持服务中受益。关于土著癌症幸存者看护人的经历,文献记载甚少。本系统综述的目的是确定并汇总描述澳大利亚、新西兰、加拿大和美国土著癌症幸存者护理人员经历的定性研究。方法:系统地检索PsycINFO、PubMed、CINAHL、Embase、Scopus和Web of Science等与土著人群相关的关键词;护理人员;和癌症。数据提取自截至2020年3月发表的原始定性研究文章。结果:从24篇全文文章中,对13项研究的14篇文章进行meta-aggregation分析。这突出了与以下相关的关键护理人员经验:对癌症和服务信息的需求;提供和接受支持的;沟通挑战与责任;平衡照顾者的角色和情绪;以及文化上不安全的卫生系统和环境。土著癌症幸存者的照顾者经常充当西方生物医学癌症护理方法与土著人民整体和以家庭为中心的健康和福祉观之间的调解人,旨在确保卫生专业人员和癌症幸存者了解彼此对护理的观点和偏好。护理人员表示更倾向于以家庭为中心而不是以病人为中心的护理。文化上不安全的卫生保健系统为最佳护理创造了障碍。结论:研究结果揭示了照顾者照顾土著癌症幸存者的独特经历,并确定了几个未满足的需求,这些需求应该得到适当和系统的解决。护理人员应被视为具有自身需求的共同客户,以及提供癌症护理的卫生专业人员的同事。最终,支持护理人员将有助于改善土著癌症幸存者的健康结果。
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引用次数: 2
Psychological reactions and interventions to help Cancer patients cope during the COVID-19 pandemic in China. 帮助中国癌症患者应对新冠肺炎疫情的心理反应和干预措施。
Pub Date : 2020-09-18 eCollection Date: 2020-10-01 DOI: 10.1097/OR9.0000000000000035
Xiaohong Liu, Feng Liu, Fei Tong, Wanglian Peng, Minni Wen, Ran Zou, Lemeng Zhang, Ling Jiang, Hui Yang, Lili Yi, Xufen Huang

During COVID-19 pandemic, how can cancer patients adjust their psychological status? In this article, some questions and suggestions are given to share. I listed some of negative emotions could happen on cancer patients and showed their harm and gave suggestions accordingly, especially in how to keep cancer patients in a healthy attitude during the difficult time.

COVID-19大流行期间,癌症患者如何调整心理状态?本文提出了一些问题和建议,与大家分享。我列出了一些可能发生在癌症患者身上的负面情绪,并指出了它们的危害,并给出了相应的建议,特别是如何在困难时期让癌症患者保持健康的态度。
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引用次数: 8
Single cases from multiple perspectives: a qualitative study comparing the experiences of patients, patients' caregivers, surgeons, and nurses when bad news is delivered about cancer. 从多个角度看单个病例:一项定性研究,比较患者、患者护理人员、外科医生和护士在得知有关癌症的坏消息时的经历。
Pub Date : 2020-09-18 eCollection Date: 2020-10-01 DOI: 10.1097/OR9.0000000000000032
Tamyra Matthews, Donald Baken, Kirsty Ross

Background: Qualitative literature on the experiences of those delivering and receiving bad news about cancer has revealed what these parties consider important during the process across many different patient cases. The current study aims to add to this understanding by employing a "linked case" study design to directly compare the perspectives of patients, their caregivers, and health care professionals (HCPs) involved in a series of single-patient cases of breaking bad news.

Method: Semistructured interviews were conducted with 13 participants (5 patients, 4 caregivers, 2 surgeons, and 2 nurses) who formed 5 linked cases. Interviews were analyzed using interpretative phenomenological analysis and directly compared within each linked case.

Results: Analyses identified 2 main superordinate themes. The first labeled "accurately perceiving and responding to needs," included HCPs recognizing and responding to patients' and caregivers' individual emotional and informational needs. The second labeled "carers fulfilling necessary roles," identified the various roles HCPs and patients' caregivers took to satisfactorily meet patients' needs.

Conclusions: The findings suggest the importance of HCPs accurately perceiving and responding to patients' and caregivers' various needs and caregivers ability and willingness to fulfilling support roles in a way that aligns with their own resources and patients' needs. This highlights the value of HCPs developing and applying interpersonal skills within bad news encounters, working as a team, and exploring caregivers' resources for patient support.

背景:关于那些传递和接受癌症坏消息的人的经历的定性文献揭示了这些当事人在许多不同病例的过程中认为重要的是什么。当前的研究旨在通过采用“关联病例”研究设计来增加这种理解,直接比较涉及一系列突发坏消息的单个患者病例的患者,其护理人员和卫生保健专业人员(HCPs)的观点。方法:采用半结构化访谈法,对13名参与者(5名患者、4名护理人员、2名外科医生和2名护士)进行访谈,形成5例关联病例。访谈采用解释性现象学分析进行分析,并在每个相关案例中进行直接比较。结果:分析确定了2个主要的上级主题。第一个标签是“准确感知和响应需求”,包括HCPs识别和响应患者和护理人员的个人情感和信息需求。第二个标签是“护理人员履行必要的角色”,确定了医护人员和患者的护理人员在满足患者需求方面所扮演的各种角色。结论:研究结果表明,医护人员准确感知和响应患者和护理人员的各种需求,以及护理人员以符合自身资源和患者需求的方式履行支持角色的能力和意愿的重要性。这突出了医护人员在遇到坏消息时发展和应用人际交往技巧、团队合作以及探索护理人员资源以支持患者的价值。
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引用次数: 5
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Journal of psychosocial oncology research and practice
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