Asia-Pacific Journal of Oncology Nursing最新文献_第10页

The effect of symptom distress on medication adherence in patients with breast cancer undergoing endocrine therapy: A moderated mediation model 乳腺癌内分泌治疗患者症状困扰对药物依从性的影响：一个有调节的中介模型

IF 2.4 3区医学 Q1 NURSING

Asia-Pacific Journal of Oncology Nursing

Pub Date : 2025-04-15 DOI: 10.1016/j.apjon.2025.100701

Huanxi Li , Chunlei Liu , Sangsang Ke , Linna Cui , Mengying Sun , Ying Bian , Yanru Song , Qian Lu

Objective

Poor medication adherence is common among breast cancer patients undergoing endocrine therapy. Although previous studies have shown that symptom distress, illness perception, and fear of recurrence can have a connection with medication adherence, the underlying mechanism remains unclear. This study explored the effect of symptom distress on medication adherence, the mediating role of illness perception between symptom distress and medication adherence, and the moderating role of fear of recurrence among those factors.

Methods

Symptom distress, illness perception, fear of recurrence, and medication adherence were assessed in 405 patients. A structural equation model verified the mediating role of illness perception, and a multi-cluster analysis tested the moderating role of fear of recurrence.

Results

Illness perception had a mediating effect between symptom distress and medication adherence (effect size: −0.213), accounting for 28% of the total effect. A significant difference was observed in the path coefficient of “illness perception → medication adherence” between the low and high fear of recurrence group (CR = |-3.578| > 1.96, P < 0.05). In the high fear of recurrence group, the association between symptom distress and medication adherence was mediated by illness perception, while in the low fear of recurrence group, medication adherence was only connected by symptom distress.

Conclusions

The links of symptom distress and medication adherence were mediated by illness perception, whereas fear of recurrence moderated this relationship. To improve medication adherence, oncology nurses should alleviate symptom distress and implement interventions for patients with high fear of recurrence to reduce negative illness perception.

目的乳腺癌内分泌治疗患者药物依从性较差。尽管先前的研究表明，症状困扰、疾病感知和对复发的恐惧可能与药物依从性有关，但其潜在机制尚不清楚。本研究旨在探讨症状困扰对药物依从性的影响，疾病知觉在症状困扰与药物依从性之间的中介作用，以及复发恐惧在这些因素中的调节作用。方法对405例患者进行症状困扰、疾病感知、复发恐惧及药物依从性评估。结构方程模型验证了疾病知觉的中介作用，多聚类分析检验了复发恐惧的调节作用。结果疾病知觉在症状困扰和药物依从性之间具有中介作用（效应量为- 0.213），占总效应的28%。低恐惧复发组与高恐惧复发组的“疾病感知→服药依从性”路径系数(CR = |-3.578| >；1.96, P <；0.05)。在高恐惧复发组中，症状困扰与药物依从性之间的关联通过疾病感知介导，而在低恐惧复发组中，药物依从性仅通过症状困扰介导。结论症状困扰与药物依从性的关系受疾病知觉的调节，而复发恐惧调节了两者之间的关系。为提高依从性，肿瘤科护士应减轻患者的症状困扰，并对复发高度恐惧的患者实施干预措施，以减少对疾病的负面认知。

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引用次数: 0

Shared-care management standards of palliative care in Chinese adults: A Delphi study 中国成人姑息治疗共享医疗管理标准：德尔菲研究

IF 2.4 3区医学 Q1 NURSING

Asia-Pacific Journal of Oncology Nursing

Pub Date : 2025-04-15 DOI: 10.1016/j.apjon.2025.100702

Junchen Guo , Linghao Zeng , Yunyun Dai , Xianghua Xu , Yonghong Hu , Yongyi Chen

Objective

Shared-care management (SCM) in palliative care is a collaborative model where shared care teams work in partnership with patients' original health care providers, employing multimodal strategies including consultations and coordinated referrals to enhance quality of care for patients. The evidence regarding its implementation remains fragmented and lacks detailed explanations, which impedes its application in clinical practice. This study aimed to develop a SCM standard of palliative care in adults in mainland regions of China.

Methods

Initial standard framework identification was achieved via literature evidence summary. From April to August 2024, two rounds of Delphi method was conducted with the purposes of modifying the standard. To establish consensus, items with a mean importance score > 3.50 and the coefficient of variation of item scores < 0.25 were retained.

Results

The first round involved 35 experts, with a follow-up participation of 33 in the second round. The Kendall concordance coefficients of the two rounds of experts consultation were 0.128 and 0.134, respectively (all P < 0.001), indicating consensus among the experts. At the end of the second round, the average importance score of each item was 4.73–5.00. A total of 8 modules including SCM team, applicable population, process of SCM, contents of SCM, start time, precautions, effectiveness evaluation and quality control, and the corresponding 22 items were finally identified in this standard.

Conclusions

The establishment of the standard in this study provides a critical framework that can be adopted by health care institutions to ensure that SCM services are delivered uniformly and effectively in mainland regions of China.

目的姑息治疗中的共享医疗管理（SCM）是一种协作模式，共享医疗团队与患者原来的医疗服务提供者合作，采用包括会诊和协调转诊在内的多模式策略来提高患者的护理质量。关于其实施的证据仍然支离破碎，缺乏详细的解释，这阻碍了其在临床实践中的应用。本研究旨在建立中国大陆地区成人姑息治疗的SCM标准。方法通过文献证据总结，初步确定标准框架。从2024年4月到8月，进行了两轮德尔菲法，目的是修改标准。为了建立共识，具有平均重要性得分的项目>；3.50和项目得分变异系数<；保留0.25个。结果第一轮有35名专家参与，第二轮有33名专家参与。两轮专家咨询的肯德尔一致性系数分别为0.128和0.134(均P <；0.001)，表明专家之间的共识。在第二轮结束时，每个项目的平均重要性得分为4.73-5.00。本标准最终确定了SCM团队、适用人群、SCM过程、SCM内容、启动时间、注意事项、有效性评价和质量控制等8个模块，共22个项目。结论本研究标准的建立为医疗机构提供了一个重要的框架，以确保供应链管理服务在中国大陆地区的统一和有效提供。

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引用次数: 0

Patterns and associated factors of online health information seeking behaviors among young women diagnosed with breast cancer in China 中国年轻乳腺癌女性在线健康信息寻求行为模式及相关因素

IF 2.4 3区医学 Q1 NURSING

Asia-Pacific Journal of Oncology Nursing

Pub Date : 2025-04-15 DOI: 10.1016/j.apjon.2025.100700

Jialin Chen , Yang Yang , Haozhi Xia , Yiwen Duan , Chaojin Da , Tingting Cai , Changrong Yuan

Objective

This study aimed to identify latent classes of online health information seeking (OHIS) behaviors among young women diagnosed with breast cancer in China and examine associated personal characteristics to support tailored health education strategies.

Methods

Young women diagnosed with breast cancer were recruited from a cancer center in China between April and September 2024. Participants completed questionnaires on demographic and clinical characteristics, OHIS behaviors, psychosocial and cognitive factors, trust, social norms, communication, and information seeking experience. Latent class analysis (LCA) identified OHIS patterns, and multivariate logistic regression explored associated characteristics.

Results

Among the 398 patients, the median number of topics sought was 5 (4–7). The most frequently sought topics related to breast cancer included basic knowledge (89.7%), treatment plans (77.6%), and lifestyle (75.4%). Nearly half sought information only a few times a month or less. Social media (82.7%) and official accounts/websites (71.1%) were the most frequently used sources. LCA revealed three OHIS behavior classes: Class 1 “information explorers” (26.4%), Class 2 “occasional seekers” (49.2%), and Class 3 “information experts” (24.4%). Patients in adjuvant or other treatment phases were more likely to belong to Class 2 than Class 1. Those with a longer time since diagnosis were also more likely to be classified into Class 2 or Class 3. Conversely, stage I patients and those who trusted online health information were more likely to belong to Class 1, while higher eHealth literacy was associated with Class 3 membership.

Conclusions

Young women diagnosed with breast cancer display diverse OHIS patterns influenced by demographic and clinical factors. Recognizing these differences is vital for delivering tailored online health information services.

目的本研究旨在确定中国年轻乳腺癌女性在线健康信息寻求（OHIS）行为的潜在类别，并研究相关的个人特征，以支持量身定制的健康教育策略。方法2024年4月至9月从中国一家癌症中心招募确诊为乳腺癌的年轻女性。参与者完成了关于人口统计学和临床特征、OHIS行为、社会心理和认知因素、信任、社会规范、沟通和信息寻求经验的问卷调查。潜类分析（LCA）确定了OHIS模式，多变量逻辑回归探索了相关特征。结果在398例患者中，寻求主题的中位数为5（4-7）。与乳腺癌相关的最常见话题包括基本知识（89.7%）、治疗方案（77.6%）和生活方式（75.4%）。近一半的人一个月只搜索几次信息，甚至更少。社交媒体（82.7%）和官方账号/网站（71.1%）是最常用的来源。LCA揭示了三个OHIS行为类别：1类“信息探索者”（26.4%）、2类“偶尔寻求者”（49.2%）和3类“信息专家”（24.4%）。在辅助或其他治疗阶段的患者更可能属于2类而不是1类。那些诊断后时间较长的人也更有可能被归类为2类或3类。相反，I期患者和那些信任在线健康信息的人更有可能属于1级，而更高的电子健康素养与3级会员相关。结论受人口统计学和临床因素的影响，年轻乳腺癌患者OHIS表现多样。认识到这些差异对于提供量身定制的在线卫生信息服务至关重要。

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引用次数: 0

The impact of fear of cancer recurrence on anxiety and depression in women with cancer: The chain mediating roles of financial toxicity and psychological distress — A multicenter investigative study 癌症复发恐惧对女性癌症患者焦虑和抑郁的影响：经济毒性和心理困扰的连锁中介作用——一项多中心调查研究

IF 2.4 3区医学 Q1 NURSING

Asia-Pacific Journal of Oncology Nursing

Pub Date : 2025-04-14 DOI: 10.1016/j.apjon.2025.100699

Lu Liu , Man Liu , Yang Liu , Hang Yi , Zhuoheng Lyu , ShuJun Xing , Yan Liu

Objective

This study aimed to explore the impact of fear of cancer recurrence on anxiety and depression in female cancer patients, and to examine the chain mediating roles of financial toxicity and psychological distress in this relationship.

Methods

Between February and July 2024, a total of 417 female cancer patients from top-tier cancer hospitals across 13 regions in China were recruited. Participants completed the Fear of Progression Questionnaire-Short Form (FoP-Q-SF), the Hospital Anxiety and Depression Scale (HADS), the Comprehensive Score for Financial Toxicity (COST), and the Distress Thermometer (DT).

Results

(1) Fear of recurrence, financial toxicity, psychological distress, anxiety, and depression were significantly correlated. (2) Two mediating pathways were identified: a direct path where fear of recurrence increased psychological distress, leading to heightened anxiety and depression; and an indirect chain mediation path wherein fear of recurrence elevated financial toxicity, which in turn intensified psychological distress, ultimately contributing to anxiety and depression.

Conclusions

Health care providers should be aware of the psychological and financial burdens associated with fear of recurrence in women with cancer. Addressing these issues may enhance the effectiveness of psychological interventions, reduce emotional distress, and ultimately improve patients' quality of life.

目的探讨癌症复发恐惧对女性癌症患者焦虑和抑郁的影响，并探讨经济毒性和心理困扰在这一关系中的连锁中介作用。方法在2024年2月至7月期间，从中国13个地区的顶级肿瘤医院共招募417名女性癌症患者。参与者完成了进展恐惧简短问卷（FoP-Q-SF）、医院焦虑抑郁量表（HADS）、财务毒性综合评分（COST）和困扰温度计（DT）。结果(1)复发恐惧、财务毒性、心理困扰、焦虑和抑郁呈显著相关。(2)发现了两种中介通路：一种是直接通路，即对复发的恐惧增加了心理困扰，导致焦虑和抑郁加剧；在间接的连锁调解路径中，对复发的恐惧增加了财务毒性，这反过来又加剧了心理困扰，最终导致焦虑和抑郁。结论卫生保健人员应了解与癌症复发恐惧相关的心理和经济负担。解决这些问题可以提高心理干预的有效性，减少情绪困扰，并最终改善患者的生活质量。

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引用次数: 0

Advancing PICC excellence in cancer care: Integrating evidence-based practice with patient-centered outcomes 推进PICC卓越的癌症治疗：将循证实践与以患者为中心的结果相结合

IF 2.4 3区医学 Q1 NURSING

Asia-Pacific Journal of Oncology Nursing

Pub Date : 2025-04-11 DOI: 10.1016/j.apjon.2025.100698

Baudolino Mussa, Barbara Defrancisco

引用次数: 0

Development and validation of the “cancer pain assessment difficulties in older patients with cognitive decline” (CPAD-CD) scale: A psychometric evaluation “老年认知衰退患者癌症疼痛评估困难”（CPAD-CD）量表的开发与验证：一种心理测量学评估

IF 2.4 3区医学 Q1 NURSING

Asia-Pacific Journal of Oncology Nursing

Pub Date : 2025-04-10 DOI: 10.1016/j.apjon.2025.100696

Nami Sakuraba , Hisao Imai , Kunihiko Kobayashi

Objective

This study aimed to develop and validate the Cancer Pain Assessment Difficulties in Older Patients with Cognitive Decline (CPAD-CD) scale, designed to assess the challenges nurses face in managing cancer pain for older patients with cognitive decline.

Methods

A three-phase process was used for scale development: (1) item generation through literature review and expert input, (2) content validation via expert review and a pilot study, and (3) psychometric evaluation, including exploratory factor analysis, confirmatory factor analysis, and reliability testing. The scale was administered to 199 nurses working in oncology and palliative care settings in Japan. Internal consistency was assessed using Cronbach's alpha, and test-retest reliability was determined using intraclass correlation coefficients (ICCs). Known-groups validity was tested based on nurses' confidence levels and years of cancer nursing experience.

Results

The final CPAD-CD scale comprised 32 items across five factors, and the internal consistency coefficients were ≥ 0.80, indicating strong internal consistency. Factor loadings ranged from 0.430 to 0.859. The test-retest reliability ICC was 0.797, demonstrating moderate reliability. Known-groups validity analyses showed significant differences in total scale and factor scores based on nurses’ confidence and experience levels (P < 0.05).

Conclusions

The CPAD-CD scale is a valid and reliable instrument for assessing difficulties in cancer pain management among nurses caring for older patients with cognitive decline. It can serve as a valuable tool for evaluating training needs and guiding interventions to enhance nursing competency in pain management. Further validation in diverse cultural and clinical contexts is recommended.

本研究旨在开发和验证老年认知衰退患者癌症疼痛评估困难（cad - cd）量表，旨在评估护士在管理老年认知衰退患者癌症疼痛时面临的挑战。方法量表的编制采用三个阶段的流程：(1)通过文献查阅和专家输入生成项目；(2)通过专家评审和试点研究进行内容验证；(3)进行心理测量评估，包括探索性因子分析、验证性因子分析和信度检验。该量表对199名在日本肿瘤和姑息治疗机构工作的护士进行了调查。使用Cronbach's alpha评估内部一致性，使用类内相关系数（ICCs）确定重测信度。已知组效度测试基于护士的信心水平和多年的癌症护理经验。结果最终的CPAD-CD量表包含5个因素共32个条目，内部一致性系数≥0.80，表明内部一致性较强。因子负荷范围为0.430 ~ 0.859。重测信度ICC为0.797，信度中等。已知组效度分析显示，基于护士信心和经验水平的总量表和因子得分存在显著差异(P <；0.05)。结论CPAD-CD量表是评估老年认知衰退患者护理人员癌症疼痛管理困难程度的有效、可靠的工具。它可以作为评估培训需求和指导干预措施的有价值的工具，以提高疼痛管理的护理能力。建议在不同的文化和临床背景下进一步验证。

{"title":"Development and validation of the “cancer pain assessment difficulties in older patients with cognitive decline” (CPAD-CD) scale: A psychometric evaluation","authors":"Nami Sakuraba , Hisao Imai , Kunihiko Kobayashi","doi":"10.1016/j.apjon.2025.100696","DOIUrl":"10.1016/j.apjon.2025.100696","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to develop and validate the Cancer Pain Assessment Difficulties in Older Patients with Cognitive Decline (CPAD-CD) scale, designed to assess the challenges nurses face in managing cancer pain for older patients with cognitive decline.</div></div><div><h3>Methods</h3><div>A three-phase process was used for scale development: (1) item generation through literature review and expert input, (2) content validation via expert review and a pilot study, and (3) psychometric evaluation, including exploratory factor analysis, confirmatory factor analysis, and reliability testing. The scale was administered to 199 nurses working in oncology and palliative care settings in Japan. Internal consistency was assessed using Cronbach's alpha, and test-retest reliability was determined using intraclass correlation coefficients (ICCs). Known-groups validity was tested based on nurses' confidence levels and years of cancer nursing experience.</div></div><div><h3>Results</h3><div>The final CPAD-CD scale comprised 32 items across five factors, and the internal consistency coefficients were ≥ 0.80, indicating strong internal consistency. Factor loadings ranged from 0.430 to 0.859. The test-retest reliability ICC was 0.797, demonstrating moderate reliability. Known-groups validity analyses showed significant differences in total scale and factor scores based on nurses’ confidence and experience levels (<em>P</em> < 0.05).</div></div><div><h3>Conclusions</h3><div>The CPAD-CD scale is a valid and reliable instrument for assessing difficulties in cancer pain management among nurses caring for older patients with cognitive decline. It can serve as a valuable tool for evaluating training needs and guiding interventions to enhance nursing competency in pain management. Further validation in diverse cultural and clinical contexts is recommended.</div></div>","PeriodicalId":8569,"journal":{"name":"Asia-Pacific Journal of Oncology Nursing","volume":"12 ","pages":"Article 100696"},"PeriodicalIF":2.4,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143878647","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

Death preparedness interventions for patients with advanced cancer: A systematic review 晚期癌症患者的死亡准备干预：一项系统综述

IF 2.4 3区医学 Q1 NURSING

Asia-Pacific Journal of Oncology Nursing

Pub Date : 2025-04-10 DOI: 10.1016/j.apjon.2025.100697

Xi Zhang , Meizhen Zhao , Tieying Zeng , Xiaoli Wei

Objective

This study aims to synthesize and critically evaluate the current evidence on interventions aimed at enhancing death preparedness among patients with advanced cancer.

Methods

A comprehensive search of PubMed, Embase, Cochrane Library, CINAHL, ProQuest, and Web of Science was conducted to identify relevant studies. The review followed Systematic Review and Meta-Analysis Preferred Reporting Items (PRISMA) guidelines, with a structured assessment of study quality and intervention outcomes.

Results

Nine studies involving a total of 876 patients with advanced cancer met the inclusion criteria. Interventions demonstrated significant improvements in overall death preparedness, with additional benefits observed in psychological well-being and functional status. Most interventions incorporated death education, psychological support, and meaning-centered psychotherapy.

Conclusions

Interventions appear to be effective in enhancing death preparedness among patients with advanced cancer. Future research should focus on refining intervention components, clearly defining outcome measures, and aligning strategies with individualized patient needs and goals.

Systematic review registration

PROSPERO CRD420250652562.

目的本研究旨在综合和批判性地评价旨在提高晚期癌症患者死亡准备的干预措施的现有证据。方法综合检索PubMed、Embase、Cochrane Library、CINAHL、ProQuest、Web of Science等相关文献。该综述遵循系统评价和meta分析首选报告项目（PRISMA）指南，对研究质量和干预结果进行了结构化评估。结果共纳入876例晚期癌症患者的9项研究符合纳入标准。干预措施显示在总体死亡准备方面有显著改善，在心理健康和功能状态方面观察到额外的益处。大多数干预措施包括死亡教育、心理支持和以意义为中心的心理治疗。结论干预措施对提高晚期癌症患者的死亡准备是有效的。未来的研究应侧重于改进干预成分，明确定义结果测量，并根据患者的个性化需求和目标调整策略。系统评价注册号prospero CRD420250652562。

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引用次数: 0

Legacy-making interventions in pediatric palliative care: A mixed methods systematic review 儿童姑息治疗的传统干预：一项混合方法的系统综述

IF 2.4 3区医学 Q1 NURSING

Asia-Pacific Journal of Oncology Nursing

Pub Date : 2025-03-28 DOI: 10.1016/j.apjon.2025.100694

Chanjuan Deng , Ruishuang Zheng , Jennifer Hong , Qiaohong Guo

Objective

To identify existing legacy-making interventions for children in the context of palliative care, to evaluate the reported outcomes of these interventions, and to explore the perceptions and experiences of children, family members, and healthcare professionals regarding these interventions.

Methods

A mixed-methods systematic review was conducted. Six English databases, including PubMed, the Cochrane Library, Embase, CINAHL via EBSCO, ProQuest Nursing & Allied Health Database, and PsycINFO via EBSCO, and three Chinese databases, including CNKI, Wanfang, and Weipu, were systematically searched from inception to July 21, 2024. Articles reporting the results of qualitative, quantitative, or mixed-methods studies related to legacy-making interventions for children receiving palliative care were selected. A meta-synthesis and a quantitative narrative synthesis were conducted, and the findings were integrated using a convergent segregated approach.

Results

Twenty-one articles were included. Existing legacy-making interventions were categorized into tangible legacy items and living legacy projects. These interventions were found to have numerous benefits, such as improving children's quality of life, preserving dignity, fostering adaptive coping mechanisms for illness-specific stressors for both children and their parents, enhancing parent-child communication, and promoting psychosocial well-being. They also contributed to reducing compassion fatigue and burnout among healthcare professionals. The majority of children's and parents' experiences with legacy-making interventions were positive, with high acceptability of these interventions. Suggestions from family members and healthcare professionals for enhancing these interventions were also reported.

Conclusions

Legacy-making interventions could benefit children, their families, and healthcare professionals. More rigorous clinical trials should be conducted to confirm the effects of these interventions in the future.

Systematic review registration

This systematic review has been registered on PROSPERO (Registration No. CRD42024490925).

目的确定姑息治疗背景下现有的儿童遗产干预措施，评估这些干预措施的报告结果，并探讨儿童、家庭成员和医疗保健专业人员对这些干预措施的看法和经验。方法采用混合方法进行系统评价。6个英文数据库，包括PubMed， Cochrane Library, Embase, CINAHL via EBSCO, ProQuest Nursing &；系统检索了联合健康数据库（Allied Health Database）、PsycINFO（通过EBSCO）和三个中文数据库，包括CNKI、万方和weiipu，检索时间从成立到2024年7月21日。文章报道了与接受姑息治疗的儿童的遗传干预相关的定性、定量或混合方法的研究结果。进行了元综合和定量叙事综合，并使用趋同隔离方法对研究结果进行了整合。结果共纳入21篇文献。现有的遗产制作干预被分类为有形的遗产项目和活的遗产项目。研究发现，这些干预措施有许多好处，如改善儿童的生活质量、维护尊严、为儿童及其父母培养针对特定疾病压力源的适应性应对机制、加强亲子沟通以及促进社会心理健康。它们还有助于减少医疗保健专业人员的同情疲劳和倦怠。大多数儿童和父母对遗产制作干预的经验是积极的，这些干预的可接受性很高。还报告了来自家庭成员和保健专业人员的建议，以加强这些干预措施。结论遗赠干预可使儿童、其家庭和卫生保健专业人员受益。将来应该进行更严格的临床试验来确认这些干预措施的效果。系统综述注册本系统综述已在PROSPERO上注册(注册号：CRD42024490925)。

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引用次数: 0

Evidence summary on pain management in thoracoscopic lung cancer surgery 胸腔镜下肺癌手术疼痛处理的证据总结

IF 2.4 3区医学 Q1 NURSING

Asia-Pacific Journal of Oncology Nursing

Pub Date : 2025-03-24 DOI: 10.1016/j.apjon.2025.100693

Dongdong Wu , Jianjuan Dai , Yifan Sheng , Yin Lin , Hong Ye , Donglin Wang , Lina Lu , Boer Yan

Objective

The study aimed to systematically retrieve, evaluate and summarize evidence on perioperative pain management in adults undergoing thoracoscopic lung cancer surgery, to assist oncology nurses in improving pain assessment and management.

Methods

The research question was established using PIPOST model and a systematic search was conducted in English and Chinese databases, professional society websites and guideline platforms for literature published between January 2017 and December 2024. Included literature types comprised guidelines, systematic reviews, evidence summaries, expert consensus, and standards. After literature searching and screening in January 2025, the remaining guidelines were evaluated by four investigators, while other literature was assessed by two investigators. Evidence was then extracted and graded.

Results

Eighteen articles were included, comprising 5 systematic reviews, 3 guidelines, 2 clinical decisions, 4 evidence summaries, 3 expert consensus, and 1 standard. Twenty-five pieces of evidence across six topics were summarized, covering organizational management, high-risk patient assessment and preoperative education, pain assessment, intraoperative analgesia, multimodal pharmacological strategies, and non-pharmacological interventions.

Conclusions

This evidence summary highlights effective strategies for perioperative pain management in thoracoscopic lung cancer surgery, which could support oncology nurses in implementing comprehensive pain assessment, identifying high-risk patients, and applying diversified analgesic interventions.

目的系统检索、评价和总结成人胸腔镜肺癌手术围手术期疼痛管理的相关证据，以帮助肿瘤科护士改进疼痛评估和管理。方法采用PIPOST模型构建研究问题，系统检索2017年1月至2024年12月间发表的中英文数据库、专业学会网站和指南平台文献。纳入的文献类型包括指南、系统综述、证据摘要、专家共识和标准。2025年1月进行文献检索和筛选后，剩余指南由4位研究者评价，其他文献由2位研究者评价。然后提取证据并进行分级。结果共纳入文献18篇，其中系统综述5篇，指南3篇，临床决策2篇，证据摘要4篇，专家共识3篇，标准1篇。总结了六个主题的25个证据，涵盖组织管理，高危患者评估和术前教育，疼痛评估，术中镇痛，多模式药物策略和非药物干预。结论总结了胸腔镜肺癌手术围手术期疼痛管理的有效策略，可支持肿瘤科护士实施全面的疼痛评估，识别高危患者，并采用多样化的镇痛干预措施。

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引用次数: 0

Development, validation, and clinical utility of risk prediction models for cancer-associated venous thromboembolism: A retrospective and prospective cohort study 癌症相关静脉血栓栓塞风险预测模型的发展、验证和临床应用：一项回顾性和前瞻性队列研究

IF 2.4 3区医学 Q1 NURSING

Asia-Pacific Journal of Oncology Nursing

Pub Date : 2025-03-22 DOI: 10.1016/j.apjon.2025.100691

Shuai Jin , Dan Qin , Chong Wang , Baosheng Liang , Lichuan Zhang , Weiyin Gao , Xiao Wang , Bo Jiang , Benqiang Rao , Hanping Shi , Lihui Liu , Qian Lu

Objectives

This study aims to develop cancer-associated venous thromboembolism (CA-VTE) risk prediction models using survival machine learning (ML) algorithms.

Methods

This study employed a double-cohort study design (retrospective and prospective). The retrospective cohort (n = 1036) was used as training set (70.0%, n = 725) and internal validation set (30.0%, n = 311); while the prospective cohort (n = 321) was used as external validation set. Seven survival ML algorithms, including COX regression, classification, regression and survival tree, random survival forest, gradient boosting survival machine tree, extreme gradient boosting survival tree, survival support vector analysis, and survival artificial neural network, were applied to train CA-VTE models.

Results

Univariate analysis and LASSO-COX regression both selected five predictors: age, previous VTE history, ICU/CCU, CCI, and D-dimer. The seven survival ML models (C-index: 0.709–0.760; Brier Score: 0.212–0.243) all outperformed Khorana Score (C-index: 0.632; Brier Score: 0.260) in external validation set. Among all models, the COX_DD model (COX regression + D-dimer) performed best. However, ML models and Khorana Score predicted CA-VTE risk on

\geq

7 days of hospitalization with an increase in Brier Score

\geq

0.25, showing poor calibration.

Conclusions

In this study, the CA-VTE risk prediction models developed in seven survival ML algorithms outperformed Khorana Score. Combining with D-dimer can improve model performance. Applying the nomogram based on the optimal COX_DD model allows oncology nurse to reassess CA-VTE risk once a week. The prediction models developed using survival ML algorithms in this study may contribute to the dynamic and accurate risk assessment of CA-VTE for cancer survivors.

本研究旨在利用生存机器学习（ML）算法建立癌症相关静脉血栓栓塞（CA-VTE）风险预测模型。方法采用双队列研究设计（回顾性和前瞻性）。采用回顾性队列（n = 1036）作为训练集（70.0%,n = 725）和内部验证集（30.0%,n = 311）；采用前瞻性队列（n = 321）作为外部验证集。采用COX回归、分类、回归与生存树、随机生存森林、梯度增强生存机树、极端梯度增强生存树、生存支持向量分析、生存人工神经网络等7种生存ML算法对CA-VTE模型进行训练。结果单因素分析和LASSO-COX回归均选择了年龄、静脉血栓栓塞史、ICU/CCU、CCI和d -二聚体5个预测因素。7种生存期ML模型(C-index: 0.709-0.760；Brier Score: 0.212-0.243)均优于Khorana Score (C-index: 0.632；外部验证集Brier评分：0.260)。在所有模型中，COX_DD模型（COX回归+ d -二聚体）表现最好。然而，ML模型和Khorana评分预测住院≥7天CA-VTE风险，Brier评分升高≥0.25，显示校准不良。结论在本研究中，7种生存ML算法建立的CA-VTE风险预测模型优于Khorana评分。与d -二聚体结合可提高模型性能。应用基于最佳COX_DD模型的nomogram允许肿瘤科护士每周重新评估一次CA-VTE风险。本研究中使用生存ML算法建立的预测模型可能有助于对癌症幸存者的CA-VTE进行动态和准确的风险评估。

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