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Objective:To investigate the status quo and influencing factors of unsatisfied needs of patients after radical gastrectomy for gastric cancer through quantitative and qualitative mixed research methods, and to provide reference for the development of effective health management programs in the future.Methods:A total of 297 patients who were hospitalized in Tianjin Medical University Cancer Hospital from January to December 2021 after radical gastretomy were selected as subjects by convenient sampling method. The general data questionnaire and Short-Form Survivor Unmet Needs Survey (SF-SUNS) were used to investigate. Selected 12 patients with gastric cancer by objective sampling method for semi-structured in-depth interview and collate data by Colaizzi 7-step analysis method.Results:The total average score of 297 subjects who did not meet the requirements was (60.91 ± 16.00), which was in the middle level. The average score of each dimension from high to low was: continuous care unmet needs (2.37 ± 0.75) points, work economy unmet needs (2.22 ± 0.65) points, information unmet needs (2.20 ± 0.92) points, emotion unmet needs (1.72 ± 0.60) points. Educational background, main economic source of family and working state were the influencing factors of unmet demand ( t=5.32, -3.59, -3.28, all P<0.05). Qualitative research had extracted four themes: unmet needs for symptom network recognition and accurate symptom management, unmet needs for shared decision participation and disease perception trajectory, unmet needs for dignity maintenance and reconstruction of psychological stress mechanism, and unmet needs for "Internet plus" mobile medical continuous care. Conclusions:The problem of unmet needs of patients after radical gastritis is still prevalent and affected by a variety of factors. It is suggested that medical workers build an effective supportive care system based on the status quo of unmet needs of patients, promote the whole process of multidimensional health management services for patients with gastric cancer, and improve the quality of life.
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Objective:To explore the current situation of evidence-based practice competence of masters of nursing specialist at Class Ⅲ hospitals and its influencing factors so as to provide decision-making basis for optimizing the construction and educational management of clinical teaching base for masters of nursing specialist.Methods:From July to October 2021, 141 masters of nursing specialist of Class Ⅲ hospitals in Tianjin were selected as subjects by purposive sampling. All students were investigated with the Chinese version of Evidence Based Practice Evaluation Competence Questionnaire (EBP-COQ) and the Barriers to Research Utilization Scale. Multiple linear regression was used to analyze the influencing factors.Results:Among 141 masters of nursing specialist, the total scores of the EBP-COQ and the Barriers to Research Utilization Scale were 95.35 ± 11.90 and 72.52 ± 26.28 respectively. Multiple linear regression analysis showed that the influencing factors of evidence based practice competence of masters of nursing specialist included the results of availability and the awareness of evidence-based nursing ( r = -2.85, -2.41, both P<0.05). Conclusions:Masters of nursing specialist have the intermediate level of evidence-based practice competence and positive attitudes to evidence based practice, but their evidence-based knowledge and skills need to be improved. Clinical teaching base managers should pay attention to the training of evidence-based nursing practice ability of professional nursing master students, provide more supportive resources and environment, and promote the development of specialty nursing practice.
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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 translate the English version of Families′ Importance in Nursing Care-Nurses Attitudes Scale (FINC-NA) into Chinese,and test the reliability and validity of the scale for initially establishing a Chinese version of FINC-NA.Methods:A total of 661 clinical nurses were tested from Tianjin Medical University Cancer Institute and Hospital using the Chinese version of FINC-NA which was developed through the process of translation,back-translation and cultural adaptation to verify its reliability and validity according to Brislin model.Results:The Chinese version of FINC-NA was extracted for 4 factors by the factor analysis using the maximum orthogonal rotation,the cumulative contribution rate was 61.480%. Cronbach alpha coefficient for the overall scale was 0.918, the split-half reliability coefficient was 0.858.Conclusions:The Chinese version of of FINC-NA has been proved to be reliable and valid which can be used to objectively evaluate the nurses′ attitudes toward families′ importance in nursing care in China.
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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 explore the effect of self-efficacy on parenting stress among parents of children with malignant solid tumors.@*Methods@#Totally 100 parents of children with malignant solid tumors were investigated and analyzed by using the general questionnaire, parenting stress Index-Short Form(PSI-SF) and General Self-Efficacy Scale (GSES).@*Results@#The score of general self-efficacy for parents was 1.93±0.54, and the total score of parenting stress was 111.84±13.36. The general self-efficacy and parenting stress scores of parents with malignant solid tumors were significantly negatively correlated with the scores of parental misery, parent-child relationship and difficult children (r=-0.72, -0.65, -0.62 -0.55, all P<0.01). Hierarchical logistic regression analysis indicates that the parenting stress was influenced by self-efficacy, the gender of parents, education level and whether or not on position.@*Conclusions@#Self-efficacy is one of the most critical influencing factors on parenting stress of parents.A new approach to improve the self-efficacy is to be achieved to reduce the parenting stress level among parents of children with solid tumors.
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Objective To explore the effect of self-efficacy on parenting stress among parents of children with malignant solid tumors. Methods Totally 100 parents of children with malignant solid tumors were investigated and analyzed by using the general questionnaire, parenting stress Index-Short Form(PSI-SF) and General Self-Efficacy Scale (GSES). Results The score of general self-efficacy for parents was 1.93±0.54, and the total score of parenting stress was 111.84±13.36. The general self-efficacy and parenting stress scores of parents with malignant solid tumors were significantly negatively correlated with the scores of parental misery, parent-child relationship and difficult children(r=-0.72,-0.65,-0.62-0.55, all P<0.01). Hierarchical logistic regression analysis indicates that the parenting stress was influenced by self-efficacy, the gender of parents, education level and whether or not on position. Conclusions Self-efficacy is one of the most critical influencing factors on parenting stress of parents.A new approach to improve the self-efficacy is to be achieved to reduce the parenting stress level among parents of children with solid tumors.
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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 understand the experience of young breast cancer patients when disclosing the disease to children.@*Methods@#The phenomenological method was adopted in the study. Semi-structured interviews were performed in 13 young breast cancer patients. The date were analyzed by Colaizzi analysis method.@*Results@#Four themes were found: disclosing decision, professional information needs, feel guilty and worried about children, positive experiences with children.@*Conclusions@#The medical staff should reduce patients′ stress of disclosure and make intervention strategy to implement individual guidance.
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Objective To evaluate the effect of aromatherapy on chemotherapy-induced nausea and vomiting among lung cancer. Methods A total of 112 patient with lung cancer from Tianjin Cancer Hospital were selected and divided into control group(54 patients)and intervention group(58 patients)by random number table.The control group was given routine health care,while the intervention group was given aromatherapy and routine health care. Chinese Version of Gastroenteric Nausea and Vomiting Grading Criteria was adopted to assess chemotherapy-induced nausea and vomiting among before chemotherapy, 48 h and 5 to 7 days after chemotherapy. Functional Living Index-Emesis was used to measure quality of life among the first day, the sixth day and the eleventh day after chemotherapy. Results The study showed that there were statistical differences between two groups for acute nausea in the first(Z=-3.000, P=0.003) and third cycles (Z=-2.547, P=0.011), while there were no statistical differences in second(Z=-0.715, P=0.474) and fourth cycles (Z=-1.576, P=0.117). And for acute vomiting,all cycles had statistical significance(Z=-2.031,-2.291,-3.499,P=0.042,0.022,0.001)except the first cycle(Z=-2.830,P=0.777).There were differences among four cycles about delayed nausea and vomiting(Z=-3.475--2.144, P=0.001-0.032). It had statistical significance between control group and intervention group for quality of life(t=0.317-3.760,P=0.000-0.038). Conclusions Aromatherapy can obviously reduce extent of chemotherapy-induced nausea and vomiting, improve quality of life, so it is worth using widely in clinic.
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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 investigate the level of hope, personality characteristics and the care of burden of the primary caregivers of advanced cancer patients, and to analyze the correlation between the level of hope and personality characteristics and care of burden. Methods 201 primary caregivers of terminal cancer patients were selected from May to September in 2016. HHI, NEO-FFI and ZBI were used to investigate the participants. Results The hope of the participants were all in moderate to high levels. The level of hope of the participants was significantly positively correlated with the scores of extraversion and conscientiousness(r =0.165, 0.235, P<0.05). It was significantly negatively correlated with neuroticism, openness, agreeableness and burden care, r =-0.258--0.179, P<0.05. Conclusions The medical staff should give interventions timely according to the personality characteristics and care burden of the main caregivers of patients with advanced cancer, so that the level of hope could be improved in order to improve their psychological health.
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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.
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Objective To develop a curriculum of a training course for oncology nurses in regard to patient education in sexuality for breast cancer patients. Methods Delphi Method was used in the study. Two rounds of questionnaire investigation were conducted among 21 specialists in breast nursing care, sexology, and psychology. The curriculum was developed after revised based on the comments and suggestions brought up in the experts. Results The training curriculum in sexual health of the breast cancer patients for oncology nurse consisted of 5 sections, professional education, sexology, medicine, psychology and practice, which were divided into 45 teaching topics included in 13 courses. The comments of the specialists on the training curriculum were consistent. The coefficients of variation ranged from 0.07 to 0.20. The coordination coefficient was 0.344. Conclusions The current study developed an integral curriculum for oncology nurses in regard to patient education in sexuality for breast cancer patients, which will benefit oncology nurses for their nursing practice.
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Objective To investigate the relationship between the posttraumatic growth in cancer patients and patients' quality of life. Methods 123 cancer patients were measured with posttraumatic growth inventory (PTGI) and EORTC QLQ-C30. Means and standard deviations were used to describe the domain and the range change of posttraumatic growth. Correlation and multiple linear regression analysis were conducted to explore the relationship between the patients' posttraumatic growth and their quality of life. Results 4 of 5 factors in PTGI showed significant positive change, including connection with others [(28.17±7.97) scores], new possibilities [(16.15±6.06) scores], personal strength [(15.42±4.69) scores], and appreciation of life [(11.51±3.80) scores], meanwhile, the spiritual change [(5.07±2.67) scores] had no significant growth. The sum of PTGI was related positively to the role function of the patients. New possibilities (r=0.193), personal strength (r=0.290) and appreciation of life (r=0.284) were correlated positively with global health status. Multiple regression analysis indicated that personal strength (β=0.373, t=3.66) and appreciation of life (β=0.322, t=2.99) could predict positively to global health status, however, relating to others predicted negatively to global health status (β=-0.396, t=-3.63). Conclusion Posttraumatic growth has been found in cancer patients, including some predicting factors of patients' quality of life, such as personal strength, life appreciation and relating to others.