Asia-Pacific Journal of Oncology Nursing最新文献

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.

Objective: This study aimed to develop patient-caregiver dyadic personas in ambulatory chemotherapy settings. These personas will enable clinicians to rapidly identify behavioral heterogeneity in dyadic illness management behaviors and deliver targeted support and guidance.

Methods: An interpretive phenomenological study was conducted at a tertiary cancer hospital in mainland China from March to June 2025. Patient-caregiver dyads participating in ambulatory chemotherapy were recruited through purposive sampling. Semi-structured interviews explored their dyadic illness management experiences, adhering to the inductive principles of phenomenological inquiry. The data were first analyzed to identify emergent themes and patterns from the participants' lived experiences. Subsequently, the COM-B framework was employed as a heuristic lens to systematically interpret and characterize the underlying behavioral mechanisms of the identified patterns, leading to the development of dyadic personas.

Results: Twenty-five eligible patient-caregiver dyads were included. Using the COM-B framework, five distinct personas were identified: Full-Collaboration Dyads, Patient-Led Dyads, Caregiver-Led Dyads, Phase-Responsibility Dyads, and Guidance-Dependent Dyads, reflecting heterogeneous dyadic illness management behaviors and needs in ambulatory chemotherapy.

Conclusions: Understanding management heterogeneity through dyadic personas is valuable for optimizing ambulatory chemotherapy care. This study established five behavioral personas specific to patient-caregiver dyads, offering a structured approach to develop individualized interventions that address diverse needs across the treatment continuum.

Objective: This study aimed to identify upper-limb symptom clusters among breast cancer survivors and examine their associations with postoperative surgical complications.

Methods: In this cross-sectional study, women who underwent axillary lymph node dissection between January 2020 and December 2024 were evaluated using the Lymphedema Breast Cancer Questionnaire. Exploratory and confirmatory factor analyses were conducted to identify symptom clusters, and multiple linear regression analyses were used to assess associations between the identified clusters and surgical complications.

Results: A total of 768 women were included. Four symptom clusters were identified: scar-related symptom cluster (tightness, stiffness, and arm weakness), infection-related symptom cluster (high temperature, redness), lymphedema-related symptom cluster (heaviness, arm swelling), and paresthesia-related symptom cluster (aching, numbness). Wound dehiscence and seroma were significantly associated with the scar- and paresthesia-related symptom clusters; infection was significantly associated with the infection-related symptom cluster; and lymphedema and seroma were significantly associated with the lymphedema-related symptom cluster.

Conclusions: Breast cancer survivors experienced distinct symptom clusters that were significantly associated with surgical complications. These findings highlight the importance of targeted prevention and management strategies, particularly for seroma, to reduce postoperative symptom burden.

Objective: With increasing attention to fertility preservation (FP) among women with cancer, nursing support for FP decision-making remains insufficient and lacks standardization. Nurses often face challenges such as limited knowledge, inconsistent practices, and the absence of structured decision-support frameworks. This study aimed to develop and psychometrically validate a scale to assess nursing practices that support FP decision-making in women with cancer.

Methods: The study comprised two phases: scale development and psychometric evaluation. In Phase 1, an initial item pool was generated through a literature review, expert consultation, and content validity assessment. In Phase 2, a cross-sectional survey was conducted among 600 nurses, who were divided into exploratory factor analysis (EFA; n ​= ​282) and confirmatory factor analysis (CFA; n ​= ​318) groups. Construct validity was examined using EFA and CFA, and criterion-related, convergent, and discriminant validity were evaluated. Reliability was tested using Cronbach's α.

Results: The preliminary 22-item, four-factor scale demonstrated strong content validity. Subsequent analyses produced a refined 12-item scale comprising three factors: (1) providing professional support for patients'FP decision-making, (2) facilitating communication between patients and families, and (3) promoting system-based and team-oriented FP support. The scale demonstrated excellent internal consistency (Cronbach's α ​= ​0.921). CFA indicated good model fit (Comparative Fit Index ​= ​0.969, Tucker-Lewis Index ​= ​0.960, Root Mean Square Error of Approximation ​= ​0.077; P ​< ​0.001).

Conclusions: This study developed a reliable and valid 12-item, three-factor scale to assess nursing practices supporting FP decision-making in women with cancer. The scale may serve as a useful tool for evaluating and enhancing patient-centered FP care in oncology nursing practice.

Objective: To integrate the best available evidence with the clinical practice for nursing care of radiation-induced oral mucositis (RIOM) in patients with head and neck cancer, develop an evidence-based practice protocol, and evaluate its effectiveness in clinical application.

Methods: Guided by the Knowledge-to-Action (KTA) framework, this study summarized the best available evidence for nursing care of RIOM in patients with head and neck cancer and adapted it to the clinical scenario based on expert opinions. An evidence-based practice protocol was developed by integrating the results of a baseline review and an analysis of barriers to implementation. The protocol was implemented in clinical settings, and its effectiveness was evaluated by assessing changes in outcomes before and after implementation, including nurses' implementation rate of review indicators, the incidence of severe RIOM, oral pain scores, and the onset time of different RIOM grades.

Results: After the clinical application of the evidence-based practice, the implementation rate of the 9 review indicators of nurses was significantly improved (P ​< ​0.05). The incidence of severe RIOM at the end of radiotherapy decreased from 43.64% to 24.07%. The oral pain score was significantly reduced from 5.53 ​± ​1.62 to 4.44 ​± ​1.54 (P ​< ​0.05). Additionally, the onset of grade I RIOM was significantly delayed during radiotherapy (P ​< ​0.05), while no significant changes were observed in the onset time of grade II and III RIOM (P ​> ​0.05).

Conclusions: The implementation of an evidence-based practice protocol for the nursing care of RIOM in patients with head and neck cancer could enhance nurses' clinical performance, reduce the incidence of severe RIOM at the end of radiotherapy, alleviate oral pain, and delay the onset of mucositis. It could bridge the gap between evidence and clinical practice and enhance the quality of nursing care.