Asia-Pacific Journal of Oncology Nursing最新文献

Objective: Breast cancer survivors experience significant physical and psychosocial changes after mastectomy, making them vulnerable to mental health challenges such as depression, anxiety, and social dysfunction. This study identifies factors influencing the mental health of breast cancer survivors using Roy's Adaptation Model (RAM), which provides a framework for understanding adaptation processes and their impact on health outcomes.

Methods: A cross-sectional structural equation modeling (SEM) study was conducted to develop and validate a hypothetical model based on RAM. Data were collected through an online survey administered from February 1 to 28, 2023, to female breast cancer survivors who had undergone mastectomy at least one year but less than five years before the commencement of the study. A total of 346 participants from an online community of patients with breast cancer were included in the final analysis. Statistical analyses were performed using IBM SPSS 26.0 and AMOS 28.0.

Results: The goodness-of-fit indices for the structural model indicated acceptable fit (goodness-of-fit index [GFI] ​= ​0.82; RMR ​= ​0.05; comparative-fit-index [CFI] ​= ​0.85; root mean square error of approximation [RMSEA] ​= ​0.09). Seven of the eight hypothesized paths were significant. Coping and adaptation processes directly influenced symptom experience, body image, role performance, and social support and indirectly affected mental health. Body image, role performance, and social support collectively explained 88% of the variance in mental health outcomes. Multigroup SEM analysis revealed differences in the structural paths based on breast reconstruction status.

Conclusions: Effective mental health assessment and intervention for breast cancer survivors undergoing mastectomy requires an integrated approach that considers coping processes, body image, role performance, and social support. Nurses should focus on strengthening adaptive coping strategies, fostering a positive body image, managing role-related stress, and enhancing social support systems to improve survivors' overall mental well-being.

Objective: This study aimed to clarify the subtypes of electronic health literacy among patients with lung cancer surgery and explore the factors affecting profile membership.

Methods: A cross-sectional study utilizing surveys among patients who underwent lung cancer surgery (n ​= ​354). Patients completed the general demographic questionnaire, eHealth literacy scale, strategies used by people to promote health scale, perceived social support scale, and functional assessment of cancer therapy lung cancer scale. Data analyses involved latent profile analysis, variance analysis, Chi-square tests, and multivariate logistic regression.

Results: A total of 354 valid questionnaires were collected and categorized into three latent classes based on eHealth literacy levels among post-operative patients with lung cancer: "Low eHealth Literacy," "Moderate eHealth Literacy," and "High eHealth Literacy". Each profile exhibited distinct characteristics representative of the different levels of eHealth literacy among these patients. Factors such as age, educational attainment, occupation type, monthly household income, presence of chronic diseases, daily use of smart devices, frequency of health information searches, variety of eHealth information sources, self-management efficacy, and levels of social support were identified as influencing the eHealth literacy of postoperative patients with lung cancer across these categories.

Conclusions: eHealth literacy among postoperative patients with lung cancer exhibits distinct classification characteristics, with over half falling into low or moderate levels. Identifying the sociodemographic factors and influences affecting different patient groups is crucial for developing internet-based continuity of care measures tailored to the specific needs of these patients.

Objective: This study examined the relationship between dyadic coping and fear of cancer progression (FoP) in patients with hepatocellular carcinoma (HCC) and their spouses to provide insights into their interrelations and inform future couple-based practice.

Methods: This cross-sectional study included 305 HCC patients and their spousal dyads. FoP and dyadic coping were measured using the 12-item FoP Questionnaire-Short Form (FoP-Q-SF) and Dyadic Coping Inventory, respectively, and administered to both patients and spouses. The actor-partner interdependence model (APIM) was applied via structural equation modeling to evaluate the relationships between different dyadic coping and FoP dimensions.

Results: Of the participants, 54.1% of patients and 67.2% of spouses experienced high FoP (FoP-Q-SF ​≥ ​34). Compared with patients, spouses experienced more severe FoPs. Based on the APIM, patients' and spouses' dyadic coping strategies exhibited significant actor and partner effects on FoP. Particularly, positive dimensions of dyadic coping were negatively associated with FoP, whereas negative dimensions of dyadic coping were positively associated with FoP. Patients seemed to benefit more from positive dyadic coping than from their spouses regarding FoP reduction.

Conclusions: Spouses had a higher FoP than patients with HCC. While dyadic coping lowered FoP in patients, it had a limited influence on spouses. Since negative coping emerged as a shared risk factor, clinical interventions have to focus on lowering maladaptive coping among partners.

Objective: Adolescents and young adults (AYAs) with cancer suffer from a high prevalence of psychological distress, but validated, age-appropriate screening tools remain limited in China. The study aimed to translate and validate a Chinese version of the Adolescent and Young Adult Psycho-Oncology Screening Tool (AYA-POST).

Methods: A methodological study was conducted, including forward and back translation, expert consultation, and a pilot testing. AYAs with cancer (n ​= ​301; 15-39 years at diagnosis; M _age ​= ​34.00 ± 5.99 years) across two hospitals in China from September 2024 to April 2025 were included. Measures included sociodemographic, clinical data, the AYA-POST (comprising the Distress Thermometer [DT] and AYA Needs Assessment [AYA-NA]), and the Hospital Anxiety and Depression Scale (HADS).

Results: All content validity indices were 1.0. Exploratory factor analysis yielded a four-factor solution explained 35% of the total variance, with a mean item complexity of 1.89. The DT correlated strongly with the HADS (r ​= ​0.533, P ​< ​0.001). A DT cut-off score of 4 showed optimal sensitivity (0.774; area under the curve ​= ​0.736). Cronbach's α was 0.754 for AYA-POST and ranged from 0.315 to 0.704 at domain level. The prevalence of psychological distress was 57.14% with a cut-off score of 4. The most frequent concerns were physical (83.72%), emotional (73.42%), and practical (66.78%).

Conclusions: The Chinese version of the AYA-POST demonstrated acceptable validity and reliability in AYAs with cancer. It can be a tool for stratified distress and psychosocial concerns management, with a DT cut-off score of 4 recommended for initial screening.

Objective: Readiness for return to work (RRTW) is a critical stage in the return-to-work process and deserves significant attention. Researchers have found that RRTW is related to symptom burden and fear of cancer recurrence (FCR). This study aimed to (1) describe RRTW among lung cancer patients, (2) examine the relationships among symptom burden, FCR, and RRTW, and (3) explore the mediating role of FCR between symptom burden and RRTW.

Methods: A cross-sectional survey was conducted among 208 lung cancer patients from February 2023 to May 2025 at a tertiary hospital in China. The RRTW Scale, the Fear of Progression Questionnaire-Short Form (FoP-Q-SF), M.D. Anderson Symptom Inventory-Chinese Version (MDASI-C) and the MDASI Lung Cancer-Specific Module (MDAS-LC) were used.

Results: The contemplation dimension scored highest (3.36 ​± ​1.09) in RRTW, and the actions-evaluation dimension scored lowest (2.57 ​± ​0.97). Symptom burden was significantly positively associated with the actions-behavior dimension of RRTW (r ​= ​0.183, P ​< ​0.01). FCR showed positive correlations with all four RRTW dimensions (r ​= ​0.147-0.272, P ​< ​0.05). The structural equation model showed that FCR significantly mediated the relationship between symptom burden and RRTW.

Conclusions: FCR had a significant mediating effect on symptom burden and RRTW. These findings highlight the importance of assessing symptom burden and FCR in postoperative lung cancer care and provide a basis for future research to explore strategies that may enhance RRTW.

Objective: To explore the association between social support and demoralization and how resourcefulness and resilience mediate this relationship.

Methods: A convenience sampling method was used. A cross-sectional study was conducted among 343 gynecological cancer patients in three hospitals in Hunan Province, China, from October 2024 to March 2025. The Social Support Scale, Demoralization Scale, Resourcefulness Scale, and Resilience Scale were used to collect data. Data analysis was conducted via descriptive statistical analysis, Spearman correlation analysis, and regression analysis to estimate direct and indirect effects via bootstrap analysis.

Results: Social support was positively correlated with resourcefulness (r ​= ​0.395, P ​< ​0.001) and resilience (r ​= ​-0.372, P ​< ​0.001). Additionally, social support was significantly negatively correlated with demoralization (r ​= ​-0.325, P ​< ​0.001). Social support indirectly affected demoralization through three mediating pathways: resourcefulness (effect ​= ​-0.020; standard error ​= ​0.022; 95% confidence interval [CI] [-0.064, -0.024]), resilience (effect ​= ​-0.037; standard error ​= ​0.015; 95% CI [-0.072, -0.013]), and the resourcefulness-resilience pathway (effect ​= ​-0.038; standard error ​= ​0.013; 95% CI [-0.070, -0.018]). The indirect effect accounted for 18.35% of the total effect.

Conclusions: We proved that resourcefulness and resilience mediated some of the effects of social support on demoralization. The findings of this study have implications for interventions to promote the social support of gynecological cancer patients and, in particular, to enhance resourcefulness and resilience.

Objective: This study aimed to identify latent characteristics of eating-related distress (ERD) in patients with advanced cancer receiving chemotherapy, explore influencing factors, and examine associations between ERD profiles and spiritual well-being (SWB).

Methods: A cross-sectional study was conducted between February and June 2025 in three tertiary hospitals in Southwest China, involving 345 patients with advanced cancer receiving chemotherapy. Data were collected using the Demographic Information Questionnaire, the Questionnaire for ERD among Patients with Advanced Cancer, the Functional Assessment of Chronic Illness Therapy Spiritual Well-being Scale, the Hospital Anxiety and Depression Scale, and the Functional Assessment of Anorexia/Cachexia Therapy Anorexia/Cachexia Subscale. Descriptive statistics, latent profile analysis, univariate analysis, and multivariate logistic regression were used to identify ERD characteristics and influencing factors. Multiple linear regression assessed associations between ERD profiles and SWB.

Results: ERD classified into three latent profiles: "Low ERD Group" (32.7%), "Moderate ERD Group" (20.3%), and "High ERD Group" (47.0%). Significant differences were observed among groups in terms of gender, education level, religious belief, tumor metastasis, disease duration, anxiety and depression, and cancer-related anorexia (P ​< ​0.05). Multiple linear regression analysis revealed ERD profiles were significantly associated with SWB, explaining 37.1% of the variance (R ² ​= ​0.371, F ​= ​12.272, P ​< ​0.001), indicating strong explanatory power and robustness.

Conclusions: Patients with advanced cancer receiving chemotherapy exhibit heterogeneity in ERD, influenced by sociodemographic, clinical, and psychological factors. SWB varied significantly across ERD profiles. Tailored nutritional, psychological, and spiritual interventions are needed to improve well-being and quality of life.

Objective: This study aimed to translate the Escala de Impactos da Mucosite Oral em Pacientes Oncológicos (EIMOPO) into Chinese and to assess the psychometric properties of the cross-culturally adapted version, thereby ensuring its reliability and validity.

Methods: A total of 473 patients with cancer who developed oral mucositis following radiotherapy/chemotherapy were recruited from two Grade A tertiary hospitals in Shandong Province between December 2024 and April 2025 using convenience sampling, with the sample size determined based on Kendall's estimation method. The original EIMOPO scale was translated and culturally adapted following Brislin' s guidelines. Validity was evaluated through item analysis and structural validity, while reliability was assessed using internal consistency test, test-retest reliability analysis and the split-half reliability. Data analyses were performed with SPSS and AMOS.

Results: The Chinese version of the 21-item scale exhibited strong psychometric properties. Exploratory factor analysis identified a four-factor structure, accounting for 66.883% of the total variance. Confirmatory factor analysis further supported the model, demonstrating excellent fit: χ ² /df ​= ​1.298, RMSEA ​= ​0.035, SRMR ​= ​0.042, GFI ​= ​0.914, CFI ​= ​0.982, IFI ​= ​0.982, and TLI ​= ​0.979. Reliability measures were also robust, with an overall Cronbach's α coefficient of 0.923, the test-retest reliability ranged from 0.783 to 0.916, and the split-half reliability coefficient was 0.815.

Conclusions: The Chinese version of the EIMOPO exhibits robust psychometric properties, establishing it as a reliable and appropriate instrument for assessing quality of life related with radiotherapy/chemotherapy-induced oral mucositis in patients with cancer within the Chinese cultural context.

Objective: This study aimed to characterize symptom profiles and identify symptom clusters based on the dimensions of occurrence, severity, and distress in postoperative patients with pancreatic cancer undergoing adjuvant chemotherapy.

Methods: This cross-sectional study recruited postoperative patients with pancreatic cancer undergoing adjuvant chemotherapy at a tertiary hospital in Jiangsu Province, China, between January and March 2025. Baseline demographic and clinical data were collected one day before the chemotherapy initiation. Nutritional status was assessed using the Nutritional Risk Screening 2002 (NRS-2002). On Day 7 after the chemotherapy initiation, symptom burden and functional status were assessed using the Memorial Symptom Assessment Scale (MSAS) and the Karnofsky Performance Status (KPS) scale, respectively. Symptom clusters were identified through exploratory factor analysis (EFA), and performed separately for each dimension (occurrence, severity, and distress).

Results: A total of 194 patients with a mean of 15.01 ​± ​4.50 symptoms were included in the final analysis. The most prevalent symptom was "Feeling drowsy" (85.8%), while "Feeling nervous" exhibited the highest severity (2.10 ​± ​1.54) and distress (2.10 ​± ​1.56) scores. Five symptom clusters were consistently identified among the three assessment dimensions (occurrence, severity, and distress): gastrointestinal, psychological, neuromuscular, physiological fatigue depletion, and body image disturbance. The inter-dimensional consistency rates for these clusters were 86%, 80%, 75%, 60%, and 67%, respectively.

Conclusions: This study demonstrates that postoperative patients with pancreatic cancer undergoing adjuvant chemotherapy experience a significant multidimensional symptom burden. Three symptom clusters (gastrointestinal, psychological, neuromuscular) showed high inter-dimensional consistency (≥ 75%), warranting prioritized intervention. Lower-consistency clusters (physiological energy depletion, body image disturbance) require multidimensional assessment for precise management. Three-dimensional assessment can improve personalized care and optimizes patient outcomes.

Objective: This study aimed to analyze the relationships among cancer-related communication, family resilience, and demoralization among patients with gynecological cancer and their spouses.

Methods: A total of 600 pairs of patients with gynecological cancer and their spouses were selected from four tertiary hospitals in Anhui Province between March 2023 and October 2024. Cancer-Related Communication Problems Scale, Family Hardiness Index, and Demoralization Scale II were used for the questionnaire survey. An actor-partner interdependence mediation model was employed to analyze the relationships among cancer-related communication, family resilience, and demoralization.

Results: Cancer-related communication directly and positively predicted demoralization in both patients and their spouses. It also indirectly affected demoralization through family resilience. A significant partner-actor effect was observed in patients, suggesting that cancer-related communication from spouses positively influenced demoralization in their partners, mediated by family resilience (B ​= ​0.074, P ​< ​0.001). A significant partner-actor effect was observed in spouses (B ​= ​0.070, P ​< ​0.001), where cancer-related communication from patients positively affected demoralization in spouses, mediated by their family resilience.

Conclusions: This study highlights that cancer-related communication, and family resilience of patients and their caregivers are key factors that can be considered for improving demoralization. It also partially confirmed the interdependence of patients with gynecological cancer and their caregivers.