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Objective:To investigate the present situation of lymphedema clinics in 60 hospitals and provide reference for the management and development of lymphedema nursing clinic.Methods:Convenience sampling method was used to select 60 hospitals that had set up lymphedema nursing outpatient service. A self-designed questionnaire was conducted for the heads of lymphedema nursing clinics from June 10th 2021 to August 15th, 2021 using electronic questionnaires.Results:Lymphedema clinics had been opened since 2015 and developed rapidly in recent years. The outpatient service mainly took the form of specialized outpatient service for lymphedema, accounted for 61.67%(37/60), and also existed in the form of combined breast rehabilitation, ostomy, catheter maintenance, etc. There was a great difference in the frequency of outpatient service in hospitals, 46.67%(28/60) had outpatient service every day, 36.67% (22/60) had outpatient service only half a day every week. The number of outpatient patients was relatively low, 61.67%(37/60) of the hospitals had no more than 10 patients per week, and only 8.33% (5/60) had more than 50 patients per week. There were only 26 full-time nurses accounted for 14.94%(26/174), and the international lymphedema therapist certification rate was 36.21% (63/174). Training institutions included foreign introduced training programs, domestic and foreign cooperation programs, overseas training and local training, etc. 100.00% (60/60) of the hospitals participating in the survey adopted comprehensive detumescence therapy, combined with auxiliary motor muscle energy binding technology 51.67% (31/60), air wave pressure therapy 48.33% (29/60), traditional Chinese medicine therapy 16.67% (10/60), etc. According to the survey of charging situation, only 14 hospitals accounted for 23.33%(14/60) had special charging, among which 12 hospitals accounted for 20.00%(12/60) had official charging approval.Conclusions:Lymphedema clinics have been developed and the ranks of lymphedema therapists are growing. The relevant departments should strengthen the standard management of lymphedema clinic, clarify the qualifications of visiting personnel, establish the standard of outpatient fees, promote the sustainable development of lymphedema clinic, and finally improve the quality of life of patients with lymphedema.
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Objective:To systematically evaluate the effect of couple-centered psychological intervention on breast cancer patients.Methods:Randomized controlled trials published in PubMed, Embase, Web of Science, Scopus, CINAHL, Cochrane Library, JBI, CNKI, Wanfang, Vip and CBM database on the effect of psychological intervention on breast cancer patients with husband and wife as the center were searched by computer. The retrieval time was from the establishment of the database to September 2020. Two reviewer independently conducted literature screening, data extraction and literature quality evaluation according to the inclusion and exclusion criteria, and Meta analysis was carried out using RevMan 5.3 software.Results:A total of 879 patients were included in 11 articles. Meta analysis results showed that the couple-centered psychological intervention not only improved the quality of life, but also improved the anxiety of breast cancer patients ( SMD=1.54, 95% CI 0.22-2.86, P=0.02) and depression ( SMD=1.22, 95% CI 0.12-2.33, P=0.03). Conclusions:After psychological intervention, the anxiety and depression of breast cancer patients were improved and the quality of life was also improved. Due to the inconsistency in the mode, frequency and evaluation index of psychological intervention, more large samples and high-quality studies are needed to further verify the effect of couple-centered psychological intervention on breast cancer patients and spouses centered on husband and wife.
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Objective:To explore and describe the experiences of young breast cancer survivors in transitional period, and to provide basis for the development of targeted rehabilitation nursing measures.Methods:This study was guided by phenomenological theory of qualitative research. 14 cases were deeply interviewed using a semi-structured questionnaire. The information of interview was analyzed, sorted, coded in according to Colaizzi′s analysis, and different themes were extracted.Results:6 themes of the experience of young breast cancer survivors in the transitional period were extracted including: trying to return to normal life, persistent side effects of treatment, problems of partnership and fertility, strong sense of insecurity and uncertainty, career planning and unmet needs.Conclusions:Young breast cancer survivors still face pressure from physiological, psychological and social aspects in the transitional period. Nurses can promote their smooth transition and early recovery by strengthening discharge assessment and planning, providing continuous care, paying attention to long-term symptom management, improving their self-care ability, encouraging their spouses to participate in support and other strategies.
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Objective@#To assess and analyze clinical nursing workload of tertiary general hospitals in Tianjin.@*Methods@#4 tertiary general hospitals in Tianjin were recruited by convenience sampling. 13 representative departments of the medical system and the surgical system were selected as the investigation departments. All the clinical duty nurses of every day work in selected departments were taken as the observation objects. Unified training investigators used work sampling method to observe and record the "operation" , "movement", "waiting" and "others" four types of activities of nurses, taking an observation point in a minute; SPSS17.0 was used for analysis.@*Results@#Totally 172 800 sampling points were selected. Besides 2.62% (4 534/172 800) of other affairs, the total nursing workload in one day was 97.38% (168 264/272800), with 85.03% (146 923/172 800) operating time including direct nursing accounting for 33.64% (58 144/172 800), indirect nursing accounting for 8.92% (15 422/172 800), and 42.46% (73 363/172 800) of related nursing. Movement accounted for 11.71% (20 228/172 800), while waiting accounted for 0.65% (1 113/172 800).@*Conclusion@#Generally, nurses in tertiary general hospitals have long working time and heavy workload, but direct nursing which can reflects the value and connotation of nursing work is low. In nursing work, the "waiting" caused by the lack of personnel, material, equipment, environment problems made a waste of time and human resources to certain extent. Therefore, results of the present study can provide reference for tertiary hospitals to optimize the allocation of nursing human resources, improve the quality of nursing service, reduce the workload of nurses and construct lean management system.
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Objective To investigate the status of anxiety, depression, fatigue, Body Image and quality of life among post-surgery breast cancer patients undergoing chemotherapy, and explore the relationship between these variables and quality of life. Methods Participants meeting the inclusion and exclusion criteria were investigated by the self-designed general information questionnaire, Self-Rating Anxiety Scale(SAS), Self-Rating Depression Scale(SDS), Cancer Fatigue Scale(CFS), Body Image After Breast Cancer Questionnaire (BIBCQ), Functional Assessment of Cancer Therapy-Breast(FACT-B). Statistical analysis included descriptive analysis, variance analysis, correlation and regression analysis. Results Totally 162 participants were investigated. Total score of FACT-B was (91.99 ± 19.90) points, function dimension scored lowest;total score of BIBCQ was (129.49±21.71) points;total score of CFS was (24.42 ± 9.91) points;the percent of anxiety was 12.34％(20/162);the percent of depression was 36.42％(59/162). Score of FACT-B showed differences on religious belief, whether have minor children, family per capita monthly income, ways of medical payment (t=4.882,6.660, F=3.796, 4.771,P<0.05); anxiety, depression, fatigue and body image were all negatively correlated (r=-0.648--0.179, P<0.05);Stepwise regression analysis showed that the effect of whether have minor children, depression, fatigue and body image on sexual function were significant (F=35.641, P<0.01, adjusted R2=0.601). Conclusions All variables significant should be taken into consideration while caring for post-surgery breast cancer patients undergoing chemotherapy, by providing targeted care to relieve symptom burden, paying attention to psychological health. Nursing interventions including health education, image guidance, supportive psychotherapy, mindfulness reduction, exercise guidance and so on could be concerned, to help patients relieve anxiety and depression, improve fatigue, and self image, and improve their overall quality of life.
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Objective To investigate the current status and influencing factors of caring behaviors for oncology specialized nurses. Methods Using general information questionnaire and Caring Behaviors Inventory (CBI) to investigate oncology specialized nurses from the city of Beijing, Shanghai, Sichuan, Chongqing, Guangzhou and Tianjin. Results The total score of self-assessment CBI in oncology specialized nurses was relatively high (82.42±10.42), the scores of sub-scales from high to low in the order were assurance, respectful, knowledge and skill, and connectedness. Multiple stepwise regression analysis showed that degree of family care, whether the one-child and working years were influencing factors of caring behavior of oncology specialized nurses (t=11.995, 3.061, 2.608, P<0.01). Conclusions Nursing managers should put forward humanism-oriented theory into all parts of nursing work on the basis of scientific allocation of human resources, establish integrative care training model combing the school and hospital in order to improve caring behaviors of nurses.
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Objective To get further insight into the breakthrough pain experiences in advanced cancer patients in order to provide targeted nursing measures for breakthrough pain patients. Methods Semi structured interviews were performed in 12 advanced cancer patients. Colaizzi analysis program was used to analyze, induct and extract the themes. Results The breakthrough pain experiences of advanced cancer patients were as follows:overall perception of breakthrough pain;the experience when experiencing breakthrough pain; personal growth related to breakthrough pain. Conclusions Nurses should provide sufficient information to patients timely, consider patients′needs and combine with non-drug methods to better manage breakthrough pain to improve patients′experience about breakthrough pain.