Asia-Pacific Journal of Oncology Nursing最新文献_第7页

Machine learning-based prediction of permanent ileostomy in older adults after laparoscopic anterior resection for rectal cancer. 基于机器学习的预测老年人腹腔镜直肠癌前切除术后永久性回肠造口。

IF 2.8 3区医学 Q1 NURSING

Asia-Pacific Journal of Oncology Nursing

Pub Date : 2025-08-09 eCollection Date: 2025-12-01 DOI: 10.1016/j.apjon.2025.100771

Meida Zhang, Yiming Li

Objective: Conversion from temporary stoma to a permanent stoma (PS) following loop ileostomy (LI) significantly impairs patients' quality of life and prognosis. However, few predictive tools are currently available in clinical practice. This study aims to develop and validate a machine learning (ML) model to predict the risk of PS following laparoscopic anterior resection (LAR) in older adults with rectal cancer.

Methods: Clinical data were retrospectively collected from 956 older adults (age ≥ 60 years) who underwent LAR with LI between June 2015 and December 2024 at two campuses of the First Hospital of China Medical University. After random stratification into training and test sets (7:3 ratio), variables were selected using the Least Absolute Shrinkage and Selection Operator (LASSO) regression and multivariate logistic regression. Seven ML algorithms-logistic regression (LR), support vector machine (SVM), decision tree (DT), random forest (RF), extreme gradient boosting (XGBoost), light gradient boosting machine (LGBM), and neural network (NNet)-were employed to construct predictive models. Hyperparameter optimization was performed using five-fold cross-validation. Model performance was assessed using the area under the receiver operating characteristic curve (AUROC), the precision-recall area under the curve (PRAUC), confusion matrix metrics, calibration plots, and decision curve analysis (DCA). Model interpretability was enhanced using SHapley Additive Explanation (SHAP) values, and a nomogram was developed to facilitate clinical utility.

Results: The incidence of PS in the cohort was 22.4% (214/956). The LR model demonstrated superior predictive performance, achieving an AUROC of 0.822 (95% CI: 0.763-0.881) and a PRAUC of 0.587 (95% CI: 0.464-0.705), along with optimal balanced accuracy (0.752), recall (0.719), and F1 score (0.582). SHAP analysis identified age, diabetes, and postoperative adjuvant therapy as the most influential predictors of PS.

Conclusions: The LR-based model exhibited robust discriminative ability and clinical applicability for predicting PS in older patients following LAR. This tool facilitates the early identification of high-risk individuals, thereby enabling personalized interventions to mitigate adverse outcomes.

目的：回肠袢造口术后临时造口转化为永久造口会显著影响患者的生活质量和预后。然而，目前在临床实践中可用的预测工具很少。本研究旨在开发和验证机器学习（ML）模型，以预测老年直肠癌患者腹腔镜前切除术（LAR）后发生PS的风险。方法：回顾性收集2015年6月至2024年12月在中国医科大学第一医院两个校区接受LAR合并LI的956例老年人（年龄≥60岁）的临床资料。随机分层为训练集和测试集（比例为7:3）后，使用最小绝对收缩和选择算子（LASSO）回归和多元逻辑回归选择变量。采用逻辑回归（LR）、支持向量机（SVM）、决策树（DT）、随机森林（RF）、极端梯度增强（XGBoost）、轻梯度增强机（LGBM）和神经网络（NNet） 7种机器学习算法构建预测模型。采用五重交叉验证进行超参数优化。采用受试者工作特征曲线下面积（AUROC）、曲线下精确召回面积（PRAUC）、混淆矩阵指标、校准图和决策曲线分析（DCA）来评估模型的性能。使用SHapley加性解释（SHAP）值增强了模型的可解释性，并开发了一种nomogram以促进临床应用。结果：队列中PS的发生率为22.4%（214/956）。LR模型表现出卓越的预测性能，AUROC为0.822 (95% CI: 0.763-0.881)， PRAUC为0.587 (95% CI: 0.464-0.705)，以及最佳平衡准确率（0.752），召回率（0.719）和F1评分（0.582）。SHAP分析发现，年龄、糖尿病和术后辅助治疗是影响PS的最重要的预测因素。结论：基于lr的模型对预测老年LAR术后患者PS具有强大的判别能力和临床适用性。该工具有助于早期识别高风险个体，从而实现个性化干预以减轻不良后果。

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引用次数: 0

Corrigendum to “A nature-immersive virtual reality intervention to support hospice family caregivers: Qualitative findings from a pilot study” [Asia-Pacific J Oncol Nursing 11 (2024) 100616] “自然沉浸式虚拟现实干预支持临终关怀家庭照护者：一项试点研究的定性结果”[亚太肿瘤学杂志护理11 (2024)100616]

IF 2.4 3区医学 Q1 NURSING

Asia-Pacific Journal of Oncology Nursing

Pub Date : 2025-06-10 DOI: 10.1016/j.apjon.2025.100721

Arienne Patano , Mohammed Alanazi , Rebecca Lehto , Dawn Goldstein , Gwen Wyatt

引用次数: 0

Facilitators and barriers associated with returning to work for cancer survivors: A systematic review 癌症幸存者重返工作岗位的促进因素和障碍：系统回顾

IF 2.4 3区医学 Q1 NURSING

Asia-Pacific Journal of Oncology Nursing

Pub Date : 2025-05-31 DOI: 10.1016/j.apjon.2025.100734

Jiayi Liu , Jinnan Xiao , Suqi Ou , Jiarui Chen , Siyuan Tang

Objective

To analyze facilitators and barriers affecting cancer survivors' return to work based on the views of survivors and various stakeholders, using the social ecological model.

Methods

Five electronic databases were searched in April 2025. Relevant studies and extracted data were selected by two researchers independently. Qualitative synthesis followed the Joanna Briggs Institute three-step process and drew on the five interrelated layers of the social ecological model.

Results

Of 5535 initial studies, 13 qualitative studies were included. Intrapersonal factors consisted of personal characteristics, disease diagnosis, post-treatment physical symptoms, post-treatment emotional states, the perceived impacts of the disease and treatments on work, understanding of and attitudes toward work, and strategies for coping with return-to-work issues. Interpersonal factors included the opinions of employers and interpersonal relations at work, as well as interpersonal support. Organizational factors consisted of occupational return-to-work arrangements and occupational support. Community factors included community support and public cognition and atmosphere. Public policy factors included the dissemination of related policies, the deficiency of related legislation, and the impacts and implementation criteria of welfare policies. The differences between cancer survivors' and stakeholders' perspectives were compared.

Conclusions

Multiple factors directly or indirectly influence cancer survivors' return-to-work decisions and experience. Cancer survivors should develop their awareness and learn more strategies in dealing with return-to-work problems. Stakeholders should care about the health status of cancer survivors, offering increased understanding and collaboration. Further studies should explore the relationships among the factors. Multi-component interventions are recommended to address return-to-work issues.

Systematic review registration

PROSPERO CRD42024555929.

目的基于癌症幸存者和各利益相关方的观点，运用社会生态模型分析影响癌症幸存者重返工作岗位的因素和障碍。方法于2025年4月检索5个电子数据库。相关研究和提取的数据由两位研究者独立选择。定性综合遵循乔安娜布里格斯研究所的三步过程，并借鉴了社会生态模型的五个相互关联的层面。结果在5535项初始研究中，纳入了13项定性研究。个人因素包括个人特征、疾病诊断、治疗后身体症状、治疗后情绪状态、疾病和治疗对工作的感知影响、对工作的理解和态度以及应对重返工作问题的策略。人际因素包括雇主的意见、工作中的人际关系以及人际支持。组织因素包括职业重返工作安排和职业支持。社区因素包括社区支持度和公众认知氛围。公共政策因素包括相关政策的传播、相关立法的缺失以及福利政策的影响和实施标准。比较了癌症幸存者和利益相关者观点的差异。结论多种因素直接或间接影响癌症幸存者重返工作岗位的决定和体验。癌症幸存者应该提高他们的意识，学习更多的策略来处理重返工作岗位的问题。利益相关者应该关心癌症幸存者的健康状况，提供更多的理解和合作。进一步的研究应探讨这些因素之间的关系。建议采取多种干预措施来解决重返工作岗位的问题。系统评价注册号prospero CRD42024555929。

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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

Asia-Pacific Journal of Oncology Nursing

Pub 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。

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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

Asia-Pacific Journal of Oncology Nursing

Pub 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

Perioperative respiratory physiotherapy in patients with thoracic tumors: Summary of best evidence and recommendations 胸部肿瘤患者围手术期呼吸物理治疗：最佳证据和建议总结

IF 2.4 3区医学 Q1 NURSING

Asia-Pacific Journal of Oncology Nursing

Pub Date : 2025-05-23 DOI: 10.1016/j.apjon.2025.100730

Shaofei Liu , Yangyang Liao , Dandan Liu, Ziya Xin, Jiudi Zhong, Juan Yuan , Lu Kang

Objective

To summarize the best evidence-based perioperative respiratory physiotherapy strategies for patients with thoracic tumors and to provide a reference for clinical practice.

Methods

The review was conducted following the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. A systematic search of evidence on the perioperative respiratory physiotherapy in patients with thoracic tumors was performed in computerized decision systems, guideline websites, professional association websites, and comprehensive databases from the date of creation to 30 April 2024. The types of evidence included were clinical decisions, guidelines, expert consensuses, evidence summaries, systematic reviews, and meta-analyses. Two independent researchers evaluated the quality of the literature and extracted and summarized the included evidence.

Results

A total of 24 articles were included for analysis, comprising one clinical decision, three guidelines, four expert consensuses, two evidence summaries, and 14 systematic reviews. The overall quality of the literature was high. Thirty-seven pieces of evidence were summarized, focusing on four areas: assessment, preoperative respiratory physiotherapy strategies, postoperative respiratory physiotherapy strategies, and home-based management.

Conclusions

This study synthesizes the best evidence on implementing perioperative respiratory physiotherapy in patients with thoracic tumors, providing a reference for clinical practice. More comprehensive and high-quality guidance documents focused on home-based management of respiratory physiotherapy are needed.

Systematic review registration

This study was registered at the Fudan University Centre for Evidence-based Nursing (Registration No. ES20245066).

目的总结胸部肿瘤围手术期最佳循证呼吸物理治疗策略，为临床提供参考。方法按照系统评价和荟萃分析的首选报告项目（PRISMA）指南进行综述。系统检索自创刊之日起至2024年4月30日，在计算机决策系统、指南网站、专业协会网站和综合数据库中检索胸部肿瘤患者围手术期呼吸物理治疗的相关证据。纳入的证据类型包括临床决策、指南、专家共识、证据摘要、系统评价和荟萃分析。两名独立研究人员评估了文献的质量，提取并总结了纳入的证据。结果共纳入24篇文献进行分析，包括1篇临床决策、3篇指南、4篇专家共识、2篇证据摘要和14篇系统评价。文献的整体质量很高。总结了37项证据，重点关注四个方面：评估、术前呼吸物理治疗策略、术后呼吸物理治疗策略和家庭管理。结论本研究综合了胸部肿瘤患者围手术期实施呼吸物理治疗的最佳证据，为临床实践提供参考。需要更全面和高质量的指导文件，侧重于以家庭为基础的呼吸物理治疗管理。系统评价注册本研究在复旦大学循证护理研究中心注册(注册号：ES20245066)。

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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

Asia-Pacific Journal of Oncology Nursing

Pub 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

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

Asia-Pacific Journal of Oncology Nursing

Pub 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

“We hope to, but…”: Chinese frontliners' barriers in providing psychosocial care for cancer survivors “我们希望，但是……”：中国一线人员为癌症幸存者提供心理关怀的障碍

IF 2.4 3区医学 Q1 NURSING

Asia-Pacific Journal of Oncology Nursing

Pub Date : 2025-05-19 DOI: 10.1016/j.apjon.2025.100725

Ziqi Peng , Xiaohui Su , Suet Lin Hung

Objective

In recent years, there has been an emerging trend of psychosocial oncology caring strategies within the Chinese context. However, many survivors undergoing different stages of the cancer journey continue to report significant life disruptions and unmet psychosocial care needs. While the crucial role frontline professionals play in providing this care, little is known about the critical barriers they encounter. This study aims to provide a comprehensive understanding of the barriers Chinese frontline professionals face in providing psychosocial oncology care.

Methods

This study employed a qualitative design with semi-structured interviews. Twenty oncology nurses and social workers with at least one year of experience in relevant specializations were recruited. The interview data were audio-recorded, transcribed, and thematically analyzed to identify themes.

Results

Three dominant themes and subthemes were identified: (1) Overburdened clinical work and inadequate training, (2) Emotional and social struggles faced by survivors and their families that hinder the employment of psychosocial care, (3) System failures: social, structural, and policy barriers.

Conclusions

The findings shed light on the complexities and barriers among frontline professionals in providing psychosocial oncology care. A central paradox emerged between professionals' desire to offer comprehensive care and the systemic barriers encountered, including limited institutional support and resources, and low public awareness. This study highlighted the need for a context-specific psychosocial oncology framework for research and practice. Interdisciplinary collaboration should be made among research, policy, and social education, which aims to enrich public awareness of psychosocial oncology and provide financial and resource support for practices.

目的近年来，肿瘤社会心理护理策略在中国出现了新的发展趋势。然而，许多处于癌症旅程不同阶段的幸存者继续报告严重的生活中断和未满足的社会心理护理需求。虽然一线专业人员在提供这种护理方面发挥着至关重要的作用，但人们对他们遇到的关键障碍知之甚少。本研究旨在全面了解中国一线专业人员在提供心理社会肿瘤护理时面临的障碍。方法本研究采用半结构化访谈的定性设计。招募了20名具有一年以上相关专业经验的肿瘤护士和社会工作者。访谈数据被录音、转录，并进行主题分析以确定主题。结果确定了三个主要主题和副主题：(1)临床工作负担过重和培训不足；(2)幸存者及其家人面临的情感和社会斗争阻碍了心理社会护理的使用；(3)系统失败：社会、结构和政策障碍。结论研究结果揭示了一线专业人员在提供心理社会肿瘤护理方面的复杂性和障碍。专业人员提供全面护理的愿望与遇到的系统性障碍（包括有限的机构支持和资源，以及低公众意识）之间出现了一个核心矛盾。这项研究强调了为研究和实践建立一个特定情境的社会心理肿瘤学框架的必要性。应在研究、政策和社会教育方面进行跨学科合作，以提高公众对社会心理肿瘤学的认识，并为实践提供资金和资源支持。

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引用次数: 0

Knowledge, attitudes, and practices of family members of children undergoing chemoradiotherapy regarding oral mucositis 接受放化疗儿童家庭成员关于口腔黏膜炎的知识、态度和实践

IF 2.4 3区医学 Q1 NURSING

Asia-Pacific Journal of Oncology Nursing

Pub Date : 2025-05-15 DOI: 10.1016/j.apjon.2025.100724

Hui Gan , Kailan Chen , Li Tao, Qian Hu, Cheng Yang, Xi Xu

Objective

To explored the knowledge, attitudes, and practices (KAP) of family members of children receiving chemoradiotherapy concerning oral mucositis.

Methods

A cross-sectional study was conducted from August 15, 2023, to May 31, 2024, in the oncology ward of Wuhan Children's Hospital of Tongji Medical College, Huazhong University of Science and Technology, using a custom-designed KAP questionnaire.

Results

Of the 364 valid responses, 63.19% were from female family members. Most children (45.33%) received treatment for over six months, and 38.74% were diagnosed with oral mucositis. The participant's median (P25–P75) for knowledge, attitude, and practice scores were 6 (5, 7) (possible range: 0–7), 27 (24, 30) (possible range: 6–30), and 17 (14, 21) (possible range: 5–30), respectively. A significant 36.26% were unsure about the link between radiotherapy and oral mucositis. Only 14.56% were neutral or disagreed on the importance of special oral care. On the practical side, 69.78% of children never used dental floss and 31.59% had never visited the hospital for oral check-ups, though most participants preferred receiving information from medical professionals. Further correlation analysis revealed positive correlations between knowledge scores and attitude scores (r = 0.270, P < 0.001), as well as between knowledge scores and practice scores (r = 0.164, P = 0.002). Additionally, attitude scores were positively correlated with practice scores (r = 0.280, P < 0.001).

Conclusions

Family members of children undergoing chemoradiotherapy have adequate knowledge and positive attitudes about oral mucositis, but this does not always lead to proactive practices. Educational interventions should enhance knowledge and encourage its application in daily caregiving to manage oral mucositis effectively.

目的探讨儿童放化疗家庭成员对口腔黏膜炎的认识、态度和行为。方法于2023年8月15日至2024年5月31日在华中科技大学同济医学院武汉儿童医院肿瘤科病房采用定制的KAP问卷进行横断面研究。结果364份有效问卷中，女性家庭成员占63.19%。大多数患儿（45.33%）接受治疗6个月以上，其中38.74%诊断为口腔黏膜炎。被试的知识、态度和实践得分中位数（P25-P75）分别为6(5,7)（可能范围：0-7）、27(24,30)（可能范围：6 - 30）和17(14,21)（可能范围：5 - 30）。36.26%的患者不确定放射治疗与口腔黏膜炎的关系。只有14.56%的人对特殊口腔护理的重要性持中立或不同意态度。在实践方面，69.78%的儿童从未使用过牙线，31.59%的儿童从未去过医院进行口腔检查，尽管大多数参与者更愿意从医疗专业人员那里获得信息。进一步的相关分析显示，知识得分与态度得分呈正相关(r = 0.270, P <；0.001)，知识得分与实践得分之间也存在差异（r = 0.164, P = 0.002）。此外，态度得分与练习得分呈正相关(r = 0.280, P <；0.001)。结论接受放化疗的儿童家属对口腔黏膜炎有足够的认识和积极的态度，但这并不总是导致积极的实践。教育干预应提高知识和鼓励其在日常护理中的应用，以有效地管理口腔黏膜炎。

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