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Shared decision-making for early-stage breast cancer treatment: An evolutionary concept analysis 早期乳腺癌治疗的共同决策:一个进化概念分析。
IF 2.8 3区 医学 Q1 NURSING Pub Date : 2025-12-01 Epub Date: 2025-08-19 DOI: 10.1016/j.apjon.2025.100775
Heemin Chae , Hee-Ju Ji , Hyunjung Moon , Yeongeun Lee , Youn-Jung Son

Objective

The lack of a clear and unified definition of shared decision-making (SDM) may hinder its effective application in oncology care. This study aims to clarify the concept of SDM specifically in the context of early-stage breast cancer treatment through an evolutionary concept analysis.

Methods

A systematic search was conducted across PubMed, CINAHL, PsycINFO, Cochrane, and EMBASE databases for articles published from January 2015 to December 2024. Using keywords “shared decision-making” and “breast cancer,” relevant studies were identified, and key attributes of SDM were extracted and synthesized. Sixteen studies met the inclusion criteria.

Results

SDM for early-stage breast cancer treatment was characterized by 10 attributes spanning three levels: 1) Patient perspective: involvement in decision-making, values and preferences regarding treatment options, and deliberative thinking to achieve choice certainty; 2) Healthcare professional perspective: provision of individualized information, psychological support, consultation focused on patients’ best interests, collaborative partnerships with patients, coordinated care delivery, and promotion of person-centered, informed choices; 3) Healthcare system level: fostering a patient-centered healthcare culture.

Conclusions

These findings provide a comprehensive conceptual framework to guide the development of detailed SDM guidelines tailored for early-stage breast cancer patients. Enhanced understanding of SDM can support nurses and healthcare professionals in facilitating collaborative and optimal decision-making processes within oncology care. Furthermore, this study lays the groundwork for developing measurement tools and disease-specific interventions to advance SDM implementation in early-stage breast cancer treatment.

Systematic review registration

PROSPERO (CRD42024587218)
目的:共享决策(shared decision-making, SDM)缺乏清晰统一的定义,可能会阻碍其在肿瘤护理中的有效应用。本研究旨在通过进化概念分析,明确SDM在早期乳腺癌治疗背景下的具体概念。方法:系统检索PubMed、CINAHL、PsycINFO、Cochrane和EMBASE数据库,检索2015年1月至2024年12月发表的文章。以“共享决策”和“乳腺癌”为关键词,识别相关研究,提取合成SDM的关键属性。16项研究符合纳入标准。结果:早期乳腺癌治疗的SDM具有3个层次的10个属性特征:1)患者视角:参与决策、对治疗方案的价值观和偏好、慎重思考以实现选择确定性;2)医疗专业视角:提供个性化信息、心理支持、以患者最佳利益为中心的咨询、与患者的合作伙伴关系、协调的护理服务,以及促进以人为本的知情选择;3)医疗体系层面:培育以患者为中心的医疗文化。结论:这些发现为指导制定针对早期乳腺癌患者的详细SDM指南提供了一个全面的概念框架。加强对SDM的理解可以支持护士和医疗保健专业人员促进肿瘤护理中的协作和最佳决策过程。此外,本研究为开发测量工具和疾病特异性干预措施奠定了基础,以推进SDM在早期乳腺癌治疗中的实施。系统评价注册:PROSPERO (CRD42024587218)。
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引用次数: 0
Best evidence for rehabilitation management of urinary incontinence in patients with bladder cancer following orthotopic neobladder reconstruction 原位新膀胱重建术后膀胱癌患者尿失禁康复管理的最佳证据。
IF 2.4 3区 医学 Q1 NURSING Pub Date : 2025-12-01 Epub Date: 2024-12-26 DOI: 10.1016/j.apjon.2024.100647
Man Xu , Shuhong Chen , Xiyuan Liu , Yuyi Luo , Di Wang , Huiming Lu , Mengxiao Jiang , Xiaoping Chen

Objective

This study aims to establish the best evidence for the rehabilitation management of urinary incontinence (UI) in patients with orthotopic neobladder (ONB) following radical cystectomy (RC) for bladder cancer, providing a theoretical foundation for clinical practice.

Methods

A systematic search was conducted across evidence-based databases, guideline networks, and professional association websites to identify relevant literature on rehabilitation management for patients with ONB after bladder cancer surgery. Studies published in both English and Chinese, up to May 8, 2024, were included. Trained researchers assessed the quality of the literature and summarized the evidence.

Results

Fourteen documents were included, consisting of eight guidelines, two clinical decision documents, and four expert consensus reports. A total of 43 pieces of evidence were identified, covering seven key areas: preoperative UI assessment and counseling, preventive measures, UI assessment and diagnosis, conservative treatments, selection and use of nursing equipment, evaluation of effectiveness, and follow-up care.

Conclusions

The best evidence for UI rehabilitation management after ONB for bladder cancer can help standardize patient care and clinical practices. Healthcare providers should adapt this evidence to their local healthcare settings, cultural contexts, barriers, and patient preferences.

Systematic review registration

This study was conducted following the evidence summary reporting specifications of the Fudan University Center for Evidence-Based Nursing (Registration No. ES20244165).
目的:本研究旨在为膀胱癌根治性膀胱切除术(RC)后原位新膀胱(ONB)患者尿失禁(UI)的康复管理建立最佳证据,为临床实践提供理论基础。方法:系统检索基于证据的数据库、指南网络和专业协会网站,寻找膀胱癌术后ONB患者康复管理的相关文献。截止到2024年5月8日,以中英文发表的研究被纳入其中。训练有素的研究人员评估了文献的质量并总结了证据。结果:共纳入14份文献,包括8份指南、2份临床决策文件和4份专家共识报告。共发现证据43条,涵盖术前尿失速评估与咨询、预防措施、尿失速评估与诊断、保守治疗、护理设备的选择与使用、疗效评价、随访护理等7个重点领域。结论:膀胱癌ONB术后UI康复管理的最佳证据有助于规范患者护理和临床实践。医疗服务提供者应该根据当地的医疗环境、文化背景、障碍和患者偏好来调整这些证据。系统评价注册:本研究遵循复旦大学循证护理研究中心(注册号:ES20244165)。
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引用次数: 0
Symptoms associated with concurrent chemoradiotherapy in patients with cervical cancer: Application of latent profile analysis and network analysis 宫颈癌患者同步放化疗相关症状:潜伏剖面分析和网络分析的应用
IF 2.4 3区 医学 Q1 NURSING Pub Date : 2025-12-01 Epub Date: 2024-12-27 DOI: 10.1016/j.apjon.2024.100649
Xiangyu Lu , Lingling Zheng , Xue Jin , Yuejia Wang , Shengwu Wu , Yin Lv , Hua Du

Objective

This study aims to explore symptom subgroups and influencing factors among patients undergoing concurrent chemoradiotherapy (CCRT) for cervical cancer, to construct a symptom network, and to identify core symptoms within the overall sample and its various subgroups.

Methods

A cross-sectional survey was conducted with 378 patients undergoing CCRT for cervical cancer from June 2023 to May 2024 at a tertiary hospital in Anhui Province. Participants completed the General Information Questionnaire, the Symptom Assessment Scale for Patients Undergoing CCRT for Intermediate and Advanced Cervical Cancer, and the Dyadic Coping Inventory. Latent profile analysis (LPA) identified symptom subgroups, while multivariate logistic regression examined influences on these subgroups. Symptom networks were developed using R language to analyze centrality indices and identify core symptoms.

Results

Patients were classified into three subgroups: low symptom burden (n ​= ​200, 52.91%), moderate symptom burden with prominent intestinal response (n ​= ​75, 19.84%), and high symptom burden (n ​= ​103, 27.25%). Multivariate logistic regression indicated that age, tumor stage, chemotherapy frequency, and dyadic coping (DC) were predictive of subgroup membership (P ​< ​0.05). Network analysis revealed sadness (rs ​= ​1.320) as the core symptom for the overall sample, nausea (rs ​= ​0.801) for the low symptom burden group, and vomiting (rs ​= ​0.705, 0.796) for both the moderate symptom burden with intestinal response prominence group and the high symptom burden group.

Conclusions

Three symptom subgroups exist among patients undergoing CCRT for cervical cancer, with sadness, nausea, and vomiting identified as core symptoms. Health care professionals should provide individualized symptom management tailored to these subgroups.
目的:本研究旨在探讨宫颈癌同步放化疗(CCRT)患者的症状亚群及其影响因素,构建症状网络,在整体样本及其各亚群中识别核心症状。方法:对安徽省某三级医院于2023年6月至2024年5月行宫颈癌CCRT的378例患者进行横断面调查。参与者填写《一般情况问卷》、《中晚期宫颈癌CCRT患者症状评定量表》和《二元应对量表》。潜在特征分析(LPA)确定了症状亚组,而多变量逻辑回归检查了对这些亚组的影响。采用R语言构建症状网络,分析中心性指数,识别核心症状。结果:患者分为低症状负担组(n = 200, 52.91%)、中度症状负担组(n = 75, 19.84%)和高症状负担组(n = 103, 27.25%)。多因素logistic回归分析显示,年龄、肿瘤分期、化疗频率和二元应对(DC)是亚组成员的预测指标(P rs = 1.320),低症状负担组为恶心(r s = 0.801),中度症状负担伴肠反应突出组和高症状负担组均为呕吐(r s = 0.705, 0.796)。结论:宫颈癌行CCRT患者存在三个症状亚组,以悲伤、恶心和呕吐为核心症状。卫生保健专业人员应针对这些亚组提供个性化的症状管理。
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引用次数: 0
Factors facilitating effective collaboration between labor and social security attorneys and medical professionals in supporting cancer survivors balancing treatment and work 促进劳动和社会保障律师与医疗专业人员之间有效合作的因素,以支持癌症幸存者平衡治疗和工作
IF 2.4 3区 医学 Q1 NURSING Pub Date : 2025-12-01 Epub Date: 2025-05-27 DOI: 10.1016/j.apjon.2025.100732
Sono Sugitani , Shinobu Yamada

Objective

This study aims to identify the key factors that enable effective collaboration between labor and social security attorneys and health care professionals in supporting cancer survivors who are balancing treatment and work. By understanding what attorneys consider essential for successful collaboration with health care professionals, this research seeks to improve the interprofessional support system for cancer survivors managing both their health and work.

Methods

A questionnaire survey was conducted among labor and Social Security Attorneys in two prefectures in Japan's Kansai region. Qualitative text analysis and hierarchical cluster analysis were used to identify essential factors for smooth coordination between these professionals and medical practitioners.

Results

Twelve key factors were identified, including the need for clear medical information without reliance on internet searches, prognosis-based employment considerations, improved understanding of employment regulations by medical professionals, and enhanced information-sharing practices. Additionally, issues such as differences in perception between medical professionals and cancer survivors, the necessity of specifying work restrictions based on treatment policies, and the importance of estimated return-to-work timelines were highlighted.

Conclusions

Effective collaboration between Labor and Social Security Attorneys and medical professionals requires clear, structured communication of medical information tailored to individual work conditions. Medical professionals should ensure that their recommendations regarding employment are specific, practical, and easily interpretable by non-medical professionals. Strengthening multidisciplinary cooperation will contribute to better support systems for cancer survivors in maintaining their employment while undergoing treatment.
目的本研究旨在确定劳动和社会保障律师与卫生保健专业人员之间有效协作的关键因素,以支持平衡治疗和工作的癌症幸存者。通过了解律师认为与卫生保健专业人员成功合作的必要条件,本研究旨在改善癌症幸存者管理其健康和工作的跨专业支持系统。方法对日本关西地区两个县的劳动和社会保障律师进行问卷调查。定性文本分析和层次聚类分析被用来确定这些专业人员和医疗从业者之间顺利协调的基本因素。结果确定了12个关键因素,包括需要明确的医疗信息而不依赖于互联网搜索,基于预后的就业考虑,提高医疗专业人员对就业法规的理解,以及加强信息共享实践。此外,与会者还强调了诸如医疗专业人员与癌症幸存者之间的认知差异、根据治疗政策明确工作限制的必要性以及估计恢复工作时间表的重要性等问题。结论劳动和社会保障律师与医疗专业人员之间的有效协作需要针对个人工作情况进行清晰、结构化的医疗信息沟通。医疗专业人员应确保其关于就业的建议是具体的、实用的,并易于非医疗专业人员解释。加强多学科合作将有助于为癌症幸存者在接受治疗期间维持就业提供更好的支持系统。
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引用次数: 0
Evidence-based leakage management in cancer-preventive ileostomy care: A Delphi consensus integrating systematic review and clinical expertise 癌症预防回肠造口护理中的循证渗漏管理:系统评价与临床专业知识相结合的德尔菲共识
IF 2.4 3区 医学 Q1 NURSING Pub Date : 2025-12-01 Epub Date: 2025-04-21 DOI: 10.1016/j.apjon.2025.100703
Songxian Zhao , Xueling Ma , Yujue Wang , Yan Bai , Chongyu Yan

Objective

This study aimed to synthesize the best available evidence and integrate clinical expertise to develop a structured, evidence-based leakage management system for cancer-preventive ileostomy care.

Methods

A two-phase mixed-methods design was employed. First, a systematic review was conducted following the PIPOST framework (Population: cancer-preventive ileostomy patients; Intervention: leakage management strategies; Professionals: ostomy caregivers; Outcomes: leakage incidence and skin complications; Setting: hospitals; Evidence types: clinical decisions, guidelines, evidence summaries, best practices, systematic reviews, and expert consensus). Databases and clinical repositories were searched from inception to June 2024, yielding 23 high-quality documents. Second, a Delphi consensus process involving 15 ostomy nursing experts across six Chinese provinces refined the evidence into actionable clinical protocols through two iterative consultation rounds. Consensus thresholds included a Likert score ≥ 4 and coefficient of variation < 0.25.

Results

The finalized leakage management system comprises three domains—prevention, assessment, and intervention—organized into 11 themes and 46 actionable items. Key components include preventive strategies for ileostomy leakage, dynamic ostomy appliance selection, and protocols for managing leakage-related skin damage. Expert consensus highlighted the importance of individualized care, with adjustments based on effluent characteristics and gas production. The Delphi panel achieved high agreement (Cr ​= ​0.89, Kendall's W ​= ​0.194–0.137, P ​< ​0.05).

Conclusions

This study presents a robust, evidence-based leakage management system tailored to the needs of cancer-preventive ileostomy survivors. By integrating high-quality evidence with practical clinical insights, the system offers valuable guidance for improving patient outcomes and enhancing the quality of ostomy nursing care in real-world settings.

Systematic review registration

ES20245104.
目的综合现有的最佳证据,结合临床专业知识,建立一套结构化的、循证的回肠造口预防护理渗漏管理系统。方法采用两相混合法设计。首先,根据PIPOST框架(人群:癌症预防性回肠造口患者;干预措施:泄漏管理策略;专业:造口护理人员;结果:渗漏发生率及皮肤并发症;设置:医院;证据类型:临床决策、指南、证据摘要、最佳实践、系统评价和专家共识)。从开始到2024年6月,检索了数据库和临床知识库,产生了23份高质量的文档。其次,来自中国6个省份的15名造口护理专家参与了德尔菲共识过程,通过两轮反复咨询,将证据细化为可操作的临床方案。共识阈值包括李克特评分≥4和变异系数<;0.25.结果最终确定的泄漏管理体系包括预防、评估和干预三个领域,共分为11个主题和46个可操作项目。关键的组成部分包括预防策略的回肠造口漏,动态造口器具的选择,并处理泄漏相关的皮肤损伤的协议。专家共识强调了个性化护理的重要性,并根据流出物特征和产气量进行调整。德尔菲面板达到了高一致性(Cr = 0.89, Kendall's W = 0.194-0.137, P <;0.05)。本研究提出了一种针对癌症预防性回肠造口幸存者需求的可靠的、循证的泄漏管理系统。通过将高质量的证据与实际的临床见解相结合,该系统为改善患者预后和提高现实环境中造口护理的质量提供了有价值的指导。系统评价注册号:es20245104。
{"title":"Evidence-based leakage management in cancer-preventive ileostomy care: A Delphi consensus integrating systematic review and clinical expertise","authors":"Songxian Zhao ,&nbsp;Xueling Ma ,&nbsp;Yujue Wang ,&nbsp;Yan Bai ,&nbsp;Chongyu Yan","doi":"10.1016/j.apjon.2025.100703","DOIUrl":"10.1016/j.apjon.2025.100703","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to synthesize the best available evidence and integrate clinical expertise to develop a structured, evidence-based leakage management system for cancer-preventive ileostomy care.</div></div><div><h3>Methods</h3><div>A two-phase mixed-methods design was employed. First, a systematic review was conducted following the PIPOST framework (Population: cancer-preventive ileostomy patients; Intervention: leakage management strategies; Professionals: ostomy caregivers; Outcomes: leakage incidence and skin complications; Setting: hospitals; Evidence types: clinical decisions, guidelines, evidence summaries, best practices, systematic reviews, and expert consensus). Databases and clinical repositories were searched from inception to June 2024, yielding 23 high-quality documents. Second, a Delphi consensus process involving 15 ostomy nursing experts across six Chinese provinces refined the evidence into actionable clinical protocols through two iterative consultation rounds. Consensus thresholds included a Likert score ≥ 4 and coefficient of variation &lt; 0.25.</div></div><div><h3>Results</h3><div>The finalized leakage management system comprises three domains—prevention, assessment, and intervention—organized into 11 themes and 46 actionable items. Key components include preventive strategies for ileostomy leakage, dynamic ostomy appliance selection, and protocols for managing leakage-related skin damage. Expert consensus highlighted the importance of individualized care, with adjustments based on effluent characteristics and gas production. The Delphi panel achieved high agreement (<em>Cr</em> ​= ​0.89, <em>Kendall's W</em> ​= ​0.194–0.137, <em>P</em> ​&lt; ​0.05).</div></div><div><h3>Conclusions</h3><div>This study presents a robust, evidence-based leakage management system tailored to the needs of cancer-preventive ileostomy survivors. By integrating high-quality evidence with practical clinical insights, the system offers valuable guidance for improving patient outcomes and enhancing the quality of ostomy nursing care in real-world settings.</div></div><div><h3>Systematic review registration</h3><div>ES20245104.</div></div>","PeriodicalId":8569,"journal":{"name":"Asia-Pacific Journal of Oncology Nursing","volume":"12 ","pages":"Article 100703"},"PeriodicalIF":2.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144089103","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
Frailty level, cancer history and healthcare utilization among older adults: Results from the US National Health Interview Survey 老年人的虚弱程度、癌症病史和医疗保健利用:来自美国国家健康访谈调查的结果
IF 2.4 3区 医学 Q1 NURSING Pub Date : 2025-12-01 Epub Date: 2025-05-29 DOI: 10.1016/j.apjon.2025.100736
Siqi Liu , Mingzhu Su , Li Liu , Quan Wang , Tingting Qin , Fang Wang

Objective

Limited information exists on the association among frailty, cancer history, and health care utilization in older adults, particularly cancer survivors. This study aimed to examine the relationship between frailty level, cancer history, and health care utilization among older adults.

Methods

A total of 14,562 older adults were identified from the 2019 and 2020 National Health Interview Survey, including cancer survivors (n = 3944) and those without a cancer history (n = 10,618). Frailty was assessed using a modified FRAIL Scale (Fatigue, Resistance, Ambulation, Illness, and Low body mass index). Health care utilization outcomes included urgent care, emergency care, hospitalization, delayed care, and needed but did not get care due to cost. Multivariate logistic regressions examined the association between cancer-frailty characteristics and health care utilization.

Results

Participants with cancer were more likely to be older, with a higher proportion aged 75–84 (37.1% vs. 27.4%) and 85+ (12.6% vs. 9.4%) years, compared to those without a cancer history. Cancer survivors also showed higher rates of frailty (23.8% vs. 14.5%) and pre-frailty (36.0% vs. 33.7%). In adjusted analyses, both higher frailty severity and cancer history were independently associated with increased odds of emergency care and hospitalization. Frail older cancer survivors had the highest likelihood of these outcomes, with odds ratios of 4.738 for emergency care and 5.643 for hospitalization. Sensitivity analyses confirmed the robustness of these findings.

Conclusions

Using nationally representative data, this study demonstrates that frailty and cancer history are independently associated with increased emergency care and hospitalization among older adults.
目的:老年人,特别是癌症幸存者,身体虚弱、癌症病史和医疗保健利用之间的关系信息有限。本研究旨在探讨老年人虚弱程度、癌症病史和医疗保健利用之间的关系。方法从2019年和2020年全国健康访谈调查中共确定14,562名老年人,包括癌症幸存者(n = 3944)和无癌症病史的老年人(n = 10,618)。使用改进的虚弱量表(疲劳、抵抗、活动、疾病和低体重指数)评估虚弱程度。医疗保健利用结果包括紧急护理、急诊护理、住院治疗、延迟护理和因费用原因需要但未得到护理。多变量logistic回归检验了癌症脆弱特征与医疗保健利用之间的关系。结果与没有癌症病史的参与者相比,癌症患者的年龄更大,75-84岁(37.1%对27.4%)和85岁以上(12.6%对9.4%)的比例更高。癌症幸存者也显示出更高的衰弱率(23.8%比14.5%)和衰弱前(36.0%比33.7%)。在调整分析中,较高的虚弱严重程度和癌症病史与急诊和住院的几率增加独立相关。体弱多病的老年癌症幸存者出现这些结果的可能性最高,急诊治疗的优势比为4.738,住院治疗的优势比为5.643。敏感性分析证实了这些发现的稳健性。使用具有全国代表性的数据,本研究表明,老年人的虚弱和癌症病史与急诊和住院治疗的增加独立相关。
{"title":"Frailty level, cancer history and healthcare utilization among older adults: Results from the US National Health Interview Survey","authors":"Siqi Liu ,&nbsp;Mingzhu Su ,&nbsp;Li Liu ,&nbsp;Quan Wang ,&nbsp;Tingting Qin ,&nbsp;Fang Wang","doi":"10.1016/j.apjon.2025.100736","DOIUrl":"10.1016/j.apjon.2025.100736","url":null,"abstract":"<div><h3>Objective</h3><div>Limited information exists on the association among frailty, cancer history, and health care utilization in older adults, particularly cancer survivors. This study aimed to examine the relationship between frailty level, cancer history, and health care utilization among older adults.</div></div><div><h3>Methods</h3><div>A total of 14,562 older adults were identified from the 2019 and 2020 National Health Interview Survey, including cancer survivors (<em>n</em> = 3944) and those without a cancer history (<em>n</em> = 10,618). Frailty was assessed using a modified FRAIL Scale (Fatigue, Resistance, Ambulation, Illness, and Low body mass index). Health care utilization outcomes included urgent care, emergency care, hospitalization, delayed care, and needed but did not get care due to cost. Multivariate logistic regressions examined the association between cancer-frailty characteristics and health care utilization.</div></div><div><h3>Results</h3><div>Participants with cancer were more likely to be older, with a higher proportion aged 75–84 (37.1% vs. 27.4%) and 85+ (12.6% vs. 9.4%) years, compared to those without a cancer history. Cancer survivors also showed higher rates of frailty (23.8% vs. 14.5%) and pre-frailty (36.0% vs. 33.7%). In adjusted analyses, both higher frailty severity and cancer history were independently associated with increased odds of emergency care and hospitalization. Frail older cancer survivors had the highest likelihood of these outcomes, with odds ratios of 4.738 for emergency care and 5.643 for hospitalization. Sensitivity analyses confirmed the robustness of these findings.</div></div><div><h3>Conclusions</h3><div>Using nationally representative data, this study demonstrates that frailty and cancer history are independently associated with increased emergency care and hospitalization among older adults.</div></div>","PeriodicalId":8569,"journal":{"name":"Asia-Pacific Journal of Oncology Nursing","volume":"12 ","pages":"Article 100736"},"PeriodicalIF":2.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144290679","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
Joint developmental trajectories of fear of recurrence and coping behaviors among patients with lung cancer: A parallel process latent class growth analysis 肺癌患者复发恐惧与应对行为的共同发展轨迹:平行过程潜在类增长分析
IF 2.4 3区 医学 Q1 NURSING Pub Date : 2025-12-01 Epub Date: 2025-05-19 DOI: 10.1016/j.apjon.2025.100728
Yonglin Li , Yiyang Lin , Shuting Lin , Jialing Lin , Wei-Ti Chen , Feifei Huang

Objective

This study aimed to investigate the joint developmental trajectories of fear of cancer recurrence (FCR) and coping behaviors in patients with lung cancer and analyze the influences of family resilience and quality of life (QOL) on each latent trajectory.

Methods

Longitudinal observation data from 310 patients with lung cancer were evaluated at 1, 3, 6, and 12 months postdiagnosis (T1-T4). The participants completed a comprehensive set of questionnaires. Parallel-process latent class growth analysis was used to delineate the joint developmental trajectories.

Results

Three types of joint developmental trajectories were identified: the high FCR-poor coping-sudden change group (28.4%, 88/310), the moderate FCR-medium coping-stable change group (31.9%, 99/310), and the low FCR-good coping-stable change group (39.7%, 123/310). Gender, residential location, educational level, and medical insurance were predictors of trajectory class membership. There were significant differences in family resilience and QOL across the three classes.

Conclusions

Targeted interventions should be developed at specific time points to reduce FCR levels and enhance coping behaviors among patients with lung cancer. The importance of addressing and managing the fear of cancer recurrence and coping behaviors among patients with lung cancer to enhance their family resilience and QOL is discussed. Healthcare providers should be particularly attentive to patients with lung cancer who are males, those living in rural areas, those with less than a bachelor's degree, and those without medical insurance.
目的探讨肺癌患者癌症复发恐惧(FCR)与应对行为的共同发展轨迹,并分析家庭心理韧性和生活质量(QOL)对各潜迹的影响。方法对310例肺癌患者在诊断后1、3、6、12个月(T1-T4)进行纵向观察。参与者完成了一套全面的问卷调查。平行过程潜类生长分析用于描述联合发育轨迹。结果发现3种联合发育轨迹:高fcr -差应对-突变组(28.4%,88/310)、中等fcr -中应对-稳定变化组(31.9%,99/310)和低fcr -好应对-稳定变化组(39.7%,123/310)。性别、居住地、教育程度和医疗保险是轨迹班级成员的预测因子。家庭弹性和生活质量在三个班级之间存在显著差异。结论应在特定时间点制定有针对性的干预措施,降低肺癌患者的FCR水平,增强患者的应对行为。讨论了解决和管理肺癌患者对癌症复发的恐惧和应对行为对提高其家庭复原力和生活质量的重要性。医疗保健提供者应特别关注男性肺癌患者、农村地区患者、本科以下学历患者和无医疗保险患者。
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引用次数: 0
Effects of Swanson theory-based auricular acupressure on chemotherapy-induced peripheral neuropathy, and broader health-related outcomes in patients with breast cancer: A randomized controlled trial 基于Swanson理论的耳穴按压对乳腺癌患者化疗诱导的周围神经病变和更广泛的健康相关结局的影响:一项随机对照试验
IF 2.4 3区 医学 Q1 NURSING Pub Date : 2025-12-01 Epub Date: 2025-05-21 DOI: 10.1016/j.apjon.2025.100729
Yuanyuan Mi , Ying Chen , Jing Li , Xinxin Liu , Zhengrong Li , Quanlian Ye , Jinli Guo , Yuanfei Liu

Objective

Chemotherapy-induced peripheral neuropathy (CIPN) is common in patients with breast cancer who received taxane-based chemotherapy. While auricular acupressure has shown promise in symptom management, its effects within a caring framework remain underexplored. This study aims to examine the effects of Swanson theory-based auricular acupressure on CIPN and broader health-related outcomes (e.g., sleep and quality of life) and the potential mediating role of inflammatory biomarkers.

Methods

Seventy-four participants with breast cancer were recruited with 1:1 random assignment in intervention group and control group. Participants in the intervention group were instructed by nurses to do Swanson theory-based auricular acupressure during the 6 cycles of chemotherapy. Auricular acupressure was applied to10 ear points with each of them evenly for 1–2 minutes at a time and 3–5 times a day according to their feeling of discomfort. CIPN symptoms, sleep quality, inflammatory biomarkers, quality of life and patient-reported nurse-patient relationship were measured. Two-factor repeated measures analysis of variance was used to assess differential change in these outcomes between the two groups over time.

Results

The levels of inflammatory biomarkers decreased over time in both groups. Compared to the control group, the intervention group experienced significantly larger reduction in Tumor Abnormal Protein level (P ​< ​0.001), smaller increases in CIPN symptom severity (P ​< ​0.001), improved sleep quality (P ​< ​0.001), and higher levels of trust in nurses (P ​< ​0.001) across chemotherapy cycles.

Conclusions

Swanson theory-based auricular acupressure may have a potential benefit to mitigate the worsening of CIPN symptoms, improve sleep and quality of life, reduce inflammatory biomarkers, and enhance the nurse-patient relationship during chemotherapy. These findings support the integration of auricular acupressure within holistic cancer care, highlighting the value of compassionate, theory-driven nursing interventions. Further large-scale studies are recommended to confirm these outcomes and explore underlying mechanisms.

Trial registration

This study was registered in the National Health Security Information Platform (Medical Research Registration and Information System, https://www.medicalresearch.org.cn/) (MR-14-24-054013).
目的化疗引起的周围神经病变(CIPN)在接受紫杉烷类化疗的乳腺癌患者中很常见。虽然耳穴按压在症状管理方面显示出希望,但其在护理框架内的效果仍未得到充分探讨。本研究旨在研究基于Swanson理论的耳穴按压对CIPN和更广泛的健康相关结果(如睡眠和生活质量)的影响,以及炎症生物标志物的潜在介导作用。方法74例乳腺癌患者按1:1随机分配分为干预组和对照组。干预组在护士指导下,在6个化疗周期内进行Swanson理论耳穴按压。根据感觉不适情况,均匀按压10个耳穴,每次1 ~ 2分钟,每天3 ~ 5次。测量CIPN症状、睡眠质量、炎症生物标志物、生活质量和患者报告的护患关系。采用双因素重复测量方差分析来评估两组间这些结果随时间的差异变化。结果两组患者炎症标志物水平均随时间降低。与对照组相比,干预组肿瘤异常蛋白水平(P <;0.001), CIPN症状严重程度的增加较小(P <;0.001),改善睡眠质量(P <;0.001),对护士的信任度较高(P <;0.001)。结论基于swanson理论的耳穴按压可能在缓解CIPN症状恶化、改善睡眠和生活质量、降低炎症生物标志物、改善化疗期间护患关系等方面具有潜在的益处。这些发现支持在整体癌症护理中整合耳穴按摩,突出了富有同情心,理论驱动的护理干预的价值。建议进一步的大规模研究来证实这些结果并探索潜在的机制。本研究已在国家卫生安全信息平台(医学研究注册与信息系统,https://www.medicalresearch.org.cn/)注册(MR-14-24-054013)。
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引用次数: 0
An ideal portrait of the professional competence of clinical research nurses: A qualitative study 临床研究护士专业能力的理想描述:一项定性研究
IF 2.4 3区 医学 Q1 NURSING Pub Date : 2025-12-01 Epub Date: 2025-03-08 DOI: 10.1016/j.apjon.2025.100682
Heng Yang , Yipei Chen , Xin Peng

Objective

This study aims to identify and define the ideal professional competencies of Clinical Research Nurses (CRNs) in China, focusing on the essential knowledge, skills, and personal attributes required for effective practice in clinical trials.

Methods

Interviews were conducted with CRNs, Nurse Managers (NMs), Principal Investigators (PIs), Sub-Investigators (SIs), Clinical Research Coordinators (CRCs), Clinical Research Associates (CRAs), and subjects. Thematic analysis was performed using Colaizzi's seven-step method to analyze interview data and identify key competencies.

Results

The study identified four primary themes that characterize the ideal CRN profile: (1) theoretical knowledge ability, (2) practical technical ability, (3) professional quality and ability, and (4) personal traits. A total of 21 specific indicators were delineated, reflecting the diverse expectations of various stakeholders in clinical trials.

Conclusions

The findings highlight the multifaceted nature of CRN competencies, emphasizing the importance of comprehensive training programs tailored to the needs of CRNs. This study provides a foundational framework for enhancing CRN training and professional development in China.
目的本研究旨在识别和定义中国临床研究护士(crn)的理想专业能力,重点关注临床试验中有效实践所需的基本知识,技能和个人属性。方法对crn、护士管理人员(NMs)、首席研究员(pi)、副研究员(si)、临床研究协调员(CRCs)、临床研究助理(CRAs)和被试进行访谈。主题分析采用Colaizzi的七步法来分析访谈数据并确定关键能力。结果本研究确定了理想CRN特征的四个基本主题:(1)理论知识能力,(2)实践技术能力,(3)专业素质和能力,(4)个人特质。共描述了21个具体指标,反映了临床试验中各利益相关者的不同期望。研究结果强调了CRN能力的多面性,强调了针对CRN需求制定综合培训计划的重要性。本研究为加强中国CRN培训和专业发展提供了基础框架。
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引用次数: 0
New year greetings from the Editor-in-Chief of the Asia–Pacific Journal of Oncology Nursing 亚太肿瘤护理杂志总编辑向您致以新年的问候
IF 2.4 3区 医学 Q1 NURSING Pub Date : 2025-12-01 Epub Date: 2025-01-28 DOI: 10.1016/j.apjon.2025.100660
Winnie K.W. So
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引用次数: 0
期刊
Asia-Pacific Journal of Oncology Nursing
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