Asia-Pacific Journal of Oncology Nursing最新文献

Objective

This study aimed to identify latent subgroups of dyadic coping (DC) among colorectal cancer (CRC) patients and their spousal caregivers, and to explore the factors associated with these subgroups.

Methods

We conducted a cross-sectional study involving 268 pairs of CRC patients and their spousal caregivers. Participants completed the General Information Questionnaire, the Dyadic Coping Inventory, the Cancer-Related Communication Problems Scale, and the Fear of Progress Questionnaire-Short Form. Latent profile analysis (LPA) of DC among CRC couples was performed using Mplus 8.3. We compared couple illness communication, fear of cancer recurrence (FCR), and demographic characteristics between the identified subgroups and conducted ordinal logistic regression analysis to examine factors associated with these subgroups.

Results

The 268 pairs of CRC patients and their spousal caregivers were classified into four subgroups based on their coping levels: low-DC group (12.3%), low common-DC group (7.1%), moderate-DC group (52.6%), and high-DC group (28.0%). Disease stage, couple illness communication, and spouse's FCR were significantly associated with the four subgroups.

Conclusions

There is considerable variability in DC levels among CRC patients and their spousal caregivers. Patients with advanced disease stages, inadequate communication between spouses, and severe RCR exhibit lower levels of DC. These findings provide a theoretical basis for nursing personnel to develop personalized intervention strategies tailored to the characteristics of these subgroups.

Objective

To provide a comprehensive summary of evidence on prevention strategies for catheter-related infections among cancer patients with home parenteral nutrition.

Methods

A systematic literature search was conducted for identifying prevention strategies for catheter-related infections among cancer patients with home parenteral nutrition, including clinical decisions, guidelines, best practices, expert consensus, evidence summaries, and systematic reviews. The search period includes publications from January 2000 to April 2024.

Results

Seven articles were included in the review, comprising four guidelines, one expert consensus, and two systematic reviews. This resulted in the identification of five evidence themes and 33 best evidence statements, addressing safety and monitoring, team and education training, hand hygiene and aseptic techniques, catheter and exit site selection, and catheter care and protection.

Conclusions

This evidence summary identifies the prevention of catheter-related infections in home parenteral nutrition, and offers valuable resources for clinical application and guidance for preventing infections among cancer patients receiving home parenteral nutrition.

Objective

The aim of this study was to develop and validate a health action process approach (HAPA) inventory for measuring cognitive belief factors influencing home nutritional behavior among postoperative gastric cancer patients.

Methods

Item pool of the inventory was constructed based on the HAPA, literature review, and qualitative interview. Expert consultations were used for item improvement. Then postoperative gastric cancer patients (n = 404) were surveyed to conduct item analysis, reliability and validity test of the inventory. Reliability was evaluated through internal, split-half, and test–retest reliability. Validity was assessed through content and construct validity.

Results

Starting with 44 items in the item pool, the final inventory comprised 23 items. The exploratory factor analysis identified six dimensions—namely, risk perception, outcome expectancy, self-efficacy, intention, action planning, coping planning. And the cumulative variance contribution rate was 70.676%. Confirmatory factor analysis showed the model fits well (χ² = 370.794, df = 214, and χ²/df = 1.733, root mean square of approximation error = 0.054, comparative fit index = 0.943, Tucker–Lewis index = 0.933, and incremental fitting index = 0.944). The item and scale level content validity were 0.83–1.00, and 0.98, which was considered good. The reliability was acceptable (Cronbach's α = 0.922, split-half reliability = 0.781, test–retest reliability = 0.716).

Conclusions

The developed inventory was valid and reliable to assess HAPA-based cognitive belief factors of home nutritional behavior of postoperative gastric cancer patients. Future research is needed to examine the applicability of the inventory in patients across diverse cultural backgrounds and healthcare systems.

Annually, over 400,000 children develop cancer, with the majority living in low- and middle-income countries (LMICs). Survival rates in high-income countries (HICs; ≥ 75%–80%) significantly exceed those in LMICs (< 30%). Acute myeloid leukemia (AML) is a childhood cancer with high mortality rates in LMICs and is not included in the World Health Organization (WHO)’s ‘six common and curable types of cancer’. This case report explores two pediatric AML cases in Kenya (LMIC) and the Netherlands (HIC), highlighting differences and similarities in both patient journeys. The first case is a 15-year-old Kenyan boy who initially experienced dizziness and fatigue. After repeated blood transfusions without a definitive diagnosis, AML was confirmed via bone marrow aspiration (BMA) 63 days later, and treatment followed the SIOP PODC AML guidelines for LMICs. The second case is a 6-year-old Dutch boy with fatigue and malaise. Initially diagnosed with post-viral bone marrow failure, a BMA performed 61 days after symptom onset revealed AML, and treatment followed the NOPHO-DBH AML-2012 protocol. Both patients faced frequent febrile neutropenia, managed per local guidelines, illustrating the balance between anti-cancer treatment and supportive care. Despite challenges, both boys completed treatment and are in complete remission. This case series highlights the potential for effective AML treatment in resource-constrained settings and underscores the need to address cancers beyond the ‘six common and curable types’.

Objective

Early detection and diagnosis of lymphedema are crucial for effective treatment and prevention of its progression. Normative-based diagnostic thresholds can enhance diagnostic accuracy in the absence of preoperative measurements. This study aimed to investigate preoperative inter-arm differences and the associated factors, as well as to determine normative-based thresholds for lymphedema in Chinese breast cancer patients.

Methods

This study utilized baseline data from a large cohort of Chinese breast cancer patients. Bilateral arm circumferences were measured at the wrist and at 10 cm intervals proximally up to 40 cm. Arm volumes were calculated using the truncated cone formula. Paired t test, repeated measures analysis of variance, and regression analysis were performed.

Results

A total of 1707 breast cancer patients were included. Paired t tests showed that the dominant arm circumferences and volumes were significantly larger than those of the nondominant arm (P < 0.001). Regression analysis and repeated measures analysis of variance revealed that hand dominance was the influencing factor of inter-arm differences (P < 0.05). Normative-based thresholds determined by two standard deviations above the mean inter-arm volume ratio were 1.057 for the dominant arm and 1.079 for the nondominant arm.

Conclusions

The absolute and relative normative-based thresholds for Chinese breast cancer patients differed slightly from the commonly used diagnostic criteria and those reported in Western populations and among Chinese healthy women. The normal variability and asymmetry associated with arm dominance underscore the importance of preoperative baseline assessments. Implementing normative-based diagnostic thresholds can facilitate more accurate lymphedema diagnosis when preoperative measurements are unavailable.

Trial registration

Registration No. ChiCTR2200057083.

Objective

To explore the perspectives and needs related to fertility preservation decision-making in patients of childbearing age with breast cancer.

Methods

Semistructured face-to-face interviews were conducted in a tertiary hospital in Baoding, China from July to October 2023. Purposive sampling was used to ensure the diversity of samples. The interview guide is based on the literature review and the discussions within the research team. A traditional content analysis approach was used for data analysis.

Results

A total of 18 participants were interviewed. Three themes emerged from the data: conflicts between subjective desires and concerns, coexistence of objective benefits and challenges, and decision-making support needs. The conflicts between subjective desires and concerns included five sub-themes, the coexistence of objective benefits and challenges also included five sub-themes, and the decision-making support needs included two sub-themes.

Conclusions

Patients faced a difficult trade-off between desires and concerns, benefits, and challenges regarding fertility preservation decisions, with numerous unmet needs. Healthcare professionals should prioritize patients' fertility desires, providing timely fertility preservation information and adequate counseling after a cancer diagnosis. This approach can help alleviate unnecessary concerns, facilitate satisfactory decision-making, and improve patients' quality of life.

Objective

Despite the significance of research in nursing practice and its role in enhancing the quality of life for cancer patients, nurses report limited opportunities to engage with research. Known barriers include limited organizational support, a lack of time, resources, and knowledgeable colleagues/mentors. The study aims to determine research knowledge, attitudes, and practices among cancer nurses and understand factors influencing nurses’ involvement in research.

Methods

Registered nurses responded to a cross-sectional questionnaire. Data were collected using a modified version of the Nursing Research Knowledge, Attitudes, and Practices survey and the Barriers to Nurses’ Participation in Research Questionnaire.

Results

Three hundred and sixty-six nurses responded, of whom 15% had previously been involved in research. Nurses reported moderate to high research knowledge ($\mu =$ 1.72), attitudes ($\mu =$ 1.92), and practice ($\mu =$ 1.79) scores. The most common barriers to engagement with research included a lack of time (78.0%), lack of incentive or reward (61.4%), lack of knowledge or skills (54.2%), lack of training opportunities (51.4%), and lack of experienced nursing research mentors (44.8%). Holding a specialist, advanced practice, or administrative role, and a postgraduate qualification were associated with higher scores on the knowledge, attitudes and practice subscales. Previous experience of conducting research was associated with higher knowledge and attitudes scores. Previous experience of authoring a paper and submitting a grant were associated with higher knowledge scores.

Conclusions

The study reveals a moderate–to-high level of knowledge, attitudes, and practice regarding research among nurses, but low engagement. Barriers include lack of time, incentive, knowledge, training, and mentorship. Nevertheless, attitude scores, reflecting nurses’ willingness to engage in research were high on average. The findings highlight the potentially modifiable nature of barriers to research engagement. Increasing capacity for nursing research may be achieved through investment in research support and training to overcome barriers to research, which may discourage nurses engagement.

Objective

To explore symptom experiences and self-management strategies from the haematological malignancy patient's perspective.

Methods

A qualitative descriptive approach was used to provide a direct and comprehensive understanding of the symptoms experienced and self-management strategies during treatment among patients with haematological malignancy. Fourteen patients with haematologic malignancies who received chemotherapy at a Chinese tertiary hospital were selected using purposeful sampling. Data were collected via semi-structured interviews and one-on-one patient sessions. The collected data were analysed using the content analysis methods. Reporting adhered to the COnsolidated criteria for REporting Qualitative research (COREQ) guidelines.

Results

The data from this study were categorized into four themes and eight subthemes: (1) the dynamics and complexity of symptom experience (nonlinear, and overloaded symptom burden); (2) strategies for coping with symptomatic change (actively responding to challenges, and facing symptoms negatively); (3) symptom affects interaction (symptoms affect family interactions, and symptoms affect social interactions); and (4) benefit from symptom management (promoting family relationships, and regaining a new role in society).

Conclusions

Patients with haematological malignancy undergoing chemotherapy still face complex and variable symptoms, and there are still considerable challenges in symptom management. The findings underscore that health care providers should provide the necessary symptom assessment to enhance the well-being of patients based on the characteristics of the patient's symptom experience and symptom management needs at different stages of the disease.

Objective

Up to now there is a lack of research to summarize the relevant evidence for radiation dermatitis (RD) management in patients with breast cancer. Therefore, this study aimed to summarize the best evidence for the prevention and management of RD in patients with breast cancer.

Methods

According to the “6S” evidence pyramid model, all major databases were searched from January 2018 to February 2024: UpToDate, BMJ Best Practice, National Guideline Clearinghouse, Guidelines International Network, MedSci, Yi Maitong Guidelines, National Comprehensive Cancer Network, Oncology Nursing Society, Radiology Assistant database, Society and College of Radiographers, Australian JBI Evidence-Based Health Care Center database, Cochrane Library, PubMed, CINAHL, Embase, Web of Science, China National Knowledge Infrastructure, Wangfang Data, Chinese Science and Technology Journal Database, Chinese Biology Medicine, etc.

Results

A total of 22 articles which met the inclusion criteria were included in the study, comprising six guidelines, nine systematic reviews, four evidence summaries, one clinical decision, one expert consensus, and one randomized controlled trial. We summarized 35 pieces of evidence across four aspects: influence factor, evaluation and monitoring, prevention and treatment, care and health education.

Conclusions

This study provides a comprehensive summary of the best evidence for the prevention and management of RD in patients with breast cancer. It is recommended that subsequent evidence transformation should be conducted based on specific clinical circumstances to standardize the process of clinical prevention and management of RD.

Systematic review registration

This study was registered at the Fudan University Center for Evidence-Based Nursing (Registration No. ES20244311).