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The electronic nursing clinical pathway was fully applied, and the evidence-based practice achievements of cancer patient symptom management was integrated into the electronic nursing clinical pathway in Fudan University Shanghai Cancer Center. Taking " comprehensive evaluation before chemotherapy" , " chemotherapy-related nausea and vomiting" , " chemotherapy-related diarrhea" as examples, the authors introduced the application of evidence-based practice project in nursing clinical pathway. Through the implementation of the project, a standardized operation flow of electronic nursing clinical pathway was formed; The nurses introduced new nursing tools, new processes and new technologies in the process of project implementation; Meanwhile, the project reduced the incidence of adverse symptoms and shortened the hospitalization time of patients. The project achieved the goal of " win-win" to reduce the burden of patients′ disease and improve the efficiency of tumor care.
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Objective:To promote evidence-based practice in the pre-chemotherapy nursing assessment among adult cancer patients.Methods:The Joanna Briggs Institute Practical Application of Clinical Evidence System and Getting Research into Practice audit tools were used. The project was conducted in Shanghai Cancer Center of Fudan University from May to October 2018, 12 audit criteria were developed in the program including nursing training, patient medical and allergic history, medical diagnosis, lab data and so on.Results:A baseline audit of pre-chemotherapy nursing assessment among adult cancer patients was conducted, with a sample size of 68 patients and 36 nursing staff, during this stage, the compliance of audit 11 and 12 were 100%. After the implementation of systematic strategies, a follow-up audit involving similar sample as first audit was conducted using the same audit criteria. In the follow-up audit, except criterion 4 and 10, the compliance of the remaining 8 criteria had significantly improved, and χ2 value was 10.29-132.06, P<0.01. The result of history adverse reaction in the follow-up audit showed that among 68 patients, 3 had experienced chemotherapy infusion reactions in the past (The drugs were oxaliplatin, gemcitabine and paclitaxel), 39 had chemotherapy-related symptoms before admission (most of them were relieved at admission), of which the top five were loss of appetite, fatigue, nausea, neurotoxicity and vomiting. Conclusions:The aims of the project were fulfilled. We achieved increased compliance with evidence-based best practice recommended by JBI in most of audit criteria. Further audit will need to be carried out to improve the validity and quality of nursing assessment.
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Objective@#To evaluate the reliability and validity of the Chinese version of the Supportive Care Needs Survey (SCNS-SF34) in patients with prostate cancer.@*Methods@#The Chinese version of SCNS-SF34 was translated and revised. The exploratory factor analysis was used to assess the structural validity of the tool, and the Cronbach α coefficient was used to evaluate the reliability of the scale.@*Results@#Two items of the Chinese version of SCNS-SF34 were deleted. Five factors were extracted by principal component analysis, including psychological, health systems and information, patient care and support, physical and daily living and sexuality needs. It was consistent with the structure of original scale. The cumulative variance contribution rate reached 70.500%. Except for item 17, the maximum load value was <0.4, and the other item load values were >0.4. The total Cronbach α coefficient of the questionnaire was 0.929, and the Cronbach α coefficient was 0.780-0.940.@*Conclusions@#The Chinese version of SCNS-SF34 has good psychometric properties and it can be used to assess the supportive care needs for patients with prostate cancer in China.
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Objective@#To analyze the reliability and validity of the Expanded Prostate cancer Index Composite 26-item version (EPIC-26) in Chinese patients with prostate cancer.@*Methods@#Totally 402 patients with prostate cancer at the Fudan University Shanghai Cancer Center were invited to fill in the Chinese version of EPIC-26. 402 samples were divided into two parts by random number table method. 201 samples were analyzed by exploratory factor analysis and another 201 samples were analyzed by confirmatory factor analysis.@*Results@#The total Cronbach alpha coefficient of Chinese version EPIC-26 was 0.845, and the Cronbach′s α coefficient of each domain ranged from 0.576 to 0.957. The results of exploratory factor analysis showed that the Chinese version of EPIC-26 was a 5-factor model, which could explain 63.456% of the total variance. The results of confirmatory factor analysis were as follows: χ2/df=1.641, GFI=0.863, AGFI=0.829, NFI=0.886, IFI=0.952, CFI=0.951, TLI=0.944, RMSEA= 0.057, which all met the standard of model fitting.@*Conclusion@#The Chinese version of EPIC-26 is a reliable and valid tool which is suitable for assessing the health-related quality of life of Chinese patients with prostate cancer.
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Objective@#To assess the symptom burden and its predictive factors in patients with prostate cancer.@*Methods@#A cross-sectional study of 370 men with prostate cancer were conducted in the department of urology, Fudan University Shanghai Cancer Center. The questionnaire included a general questionnaire, Expanded Prostate Cancer Index Composite 26-item version (EPIC-26) and Hospital Anxiety and Depression Scale (HADS).@*Results@#The average score of EPIC-26 in patients with prostate cancer was 25.32±12.00. The sexual function (15.59±7.38) and endocrine disorder (4.09±3.70) scored higher in five domains. There were significant differences in symptom burden scores among different treatment methods (P < 0.01). Multiple linear regression showed that endocrine therapy, anxiety, prostate specific antigen (PSA) and income were the influencing factors of symptom burden in this population, which could explain 49.3% of symptom burden.@*Conclusions@#The symptom burden of patients with prostate cancer is heavy, especially during endocrine therapy. Health care provider should focus on assessing the psychology of them. What′s more, it is important to develop the symptom management and psychological support, especially for patients with lower income and advanced patients.
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Objective To evaluate the reliability and validity of the Chinese version of the Supportive Care Needs Survey (SCNS-SF34) in patients with prostate cancer. Methods The Chinese version of SCNS-SF34 was translated and revised . The exploratory factor analysis was used to assess the structural validity of the tool, and the Cronbach α coefficient was used to evaluate the reliability of the scale. Results Two items of the Chinese version of SCNS-SF34 were deleted. Five factors were extracted by principal component analysis, including psychological, health systems and information, patient care and support, physical and daily living and sexuality needs. It was consistent with the structure of original scale. The cumulative variance contribution rate reached 70.500% . Except for item 17, the maximum load value was<0.4, and the other item load values were>0.4. The total Cronbach α coefficient of the questionnaire was 0.929, and the Cronbach α coefficient was 0.780-0.940. Conclusions The Chinese version of SCNS-SF34 has good psychometric properties and it can be used to assess the supportive care needs for patients with prostate cancer in China.
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Objective To analyze the reliability and validity of the Expanded Prostate cancer Index Composite 26-item version (EPIC-26) in Chinese patients with prostate cancer. Methods Totally 402 patients with prostate cancer at the Fudan University Shanghai Cancer Center were invited to fill in the Chinese version of EPIC-26. 402 samples were divided into two parts by random number table method. 201 samples were analyzed by exploratory factor analysis and another 201 samples were analyzed by confirmatory factor analysis. Results The total Cronbach alpha coefficient of Chinese version EPIC-26 was 0.845, and the Cronbach′s α coefficient of each domain ranged from 0.576 to 0.957. The results of exploratory factor analysis showed that the Chinese version of EPIC-26 was a 5-factor model , which could explain 63.456% of the total variance. The results of confirmatory factor analysis were as follows: χ2/df=1.641, GFI=0.863, AGFI=0.829, NFI=0.886, IFI=0.952, CFI=0.951, TLI=0.944, RMSEA= 0.057, which all met the standard of model fitting. Conclusion The Chinese version of EPIC-26 is a reliable and valid tool which is suitable for assessing the health-related quality of life of Chinese patients with prostate cancer.
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Objective To assess the symptom burden and its predictive factors in patients with prostate cancer. Methods A cross-sectional study of 370 men with prostate cancer were conducted in the department of urology, Fudan University Shanghai Cancer Center. The questionnaire included a general questionnaire, Expanded Prostate Cancer Index Composite 26-item version (EPIC-26) and Hospital Anxiety and Depression Scale (HADS). Results The average score of EPIC-26 in patients with prostate cancer was 25.32±12.00. The sexual function (15.59±7.38) and endocrine disorder (4.09±3.70) scored higher in five domains. There were significant differences in symptom burden scores among different treatment methods (P<0.01). Multiple linear regression showed that endocrine therapy, anxiety, prostate specific antigen (PSA) and income were the influencing factors of symptom burden in this population, which could explain 49.3% of symptom burden. Conclusions The symptom burden of patients with prostate cancer is heavy, especially during endocrine therapy. Health care provider should focus on assessing the psychology of them. What′s more, it is important to develop the symptom management and psychological support, especially for patients with lower income and advanced patients.
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Objective To evaluate the effect of nurse-led follow-up on medication adherence and quality of life for breast cancer patients receiving adjuvant hormonal therapy.Methods A randomized controlled trial was conducted with 157 patients in the intervention group and 154 in the control group.A self-design web-database medication monitoring platform was designed for managing patients such as texting,reminding and mailing.Participants were randomized to follow-up care as usual(yearly outpatient clinic visits) or nurse-led telephone follow-up(monthly consultation with structured intervention).Telephone follow-up was performed by four trained breast care nurses (BCN) and consisted of a semi-structured interview including managing the side-effects of endocrine therapy,compliance with hormonal therapy and an open discussion of these issues.Patients' medication adherence and quality of life were evaluated by Morisky Medication Adherence Questionnaire(MAQ) and FACT-B at baseline and 3,6 18 and 24 months,respectively.Results The Nurse-led telephone follow-up did not significantly improve the quality of life(P＞0.05).MAQ score in the intervention group was significantly greater than that in the control group(P＜0.05) at 3,6,18 and 24 months.Conclusion Nurse-led follow-up using computer-based monitoring system can improve patients' medication adherence,but there is no obvious increase in quality of life.
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At present,peripherally inserted central catheter (PICC) and totally implantable access port (TIAP) are most commonly used for the medium-term and long-term ccntral vcnous infusion in China,which is mainly adopted for long-term repeated chemotherapy,nutritional support and other clinical treatments.As an advanced infusion route,this technique needs to be further popularized in clinical practice to benifit the majority of patients.However,in aspect of the implantation,use,maintenance,and the diagnosis and treatment of complications of long-term central venous access,there are still a lot of problems,to which sufficient attention should be paid.Standard implantation and maintenance are of great importance for the safe implantation of central venous access and long-term safe use.This paper aims to make a comprehensive review concerning the problems of long-term indwelling of central venous access,the basic solutions,and the whole course management of central venous access.In order to promote the technique of central venous access to continually develop,the multidisciplinary collaborative team with tacit cooperation,standardized system and regulatory process should be emphasized.
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Breast cancer is one of the most common malignant tumor in the world. medical delay always leads to more advanced stage, larger tumor and more metastasis. This literature review dealt about status, influencing factors and intervention related to medical delay of breast cancer, as a reference to promote health- seeking behavior of breast cancer.
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Objective To evaluate the efficiency and safety of exercise interventions on cancer related fatigue. Methods Cochrane Library, JBI Database of Systematic Reviews, MEDLINE, EMbase, CINAHL, Chinese Journal Full- text Database, Chinese Biomedical Literature Database, and Wanfang Databse were searched from the inception to November 2014 to screen the systematic review and Meta-analysis conforming to the inclusion criteria. Two authors independently appraised their methodological qualities with Overview Quality Assessment Questionnaire (OQAQ), and analyzed the data using descriptive analysis. The primary outcome included the scaling of cancer related fatigue, the secondary outcome included adherence to exercise intervention and the incidence of adverse events. Results Fourteen systematic review/Meta-analysis were identified, twelve of them had a high methodological quality (Scoring 5-7). Six systematic review/Meta-analysis found that aerobic exercise could effectively alleviate cancer related fatigue, especially for breast cancer patients;seven articles showed that exercise could modulate cancer related fatigue of patients under active treatments;seven articles reported the compliance to the exercise intervention, four articles reported adverse events occurring during the intervention, very few of them resulted directly from the exercise intervention. Conclusions Exercise intervention can modulate cancer related fatigue with good safety.
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Objective To evaluate the effect of a nurse-led case management intervention on arm function and uncertainty for women with breast cancer.Methods 90 women with breast cancer were divided into the intervention group and the control group according to their nurses,with 45 patients in each group.All participants were followed six months after surgery.The intervention group attended a 6-month nurse-led case management program,while the control group received the routine care and follow-up only.Questionnaires on arm function and uncertainty were administered 1 month,3 months and 6months after the surgery respectively.Score changes were compared by repeated-measure ANOVA and MANOVA.Results The arm function of the intervention group was better than the control group,except for the 10th day after the operation,there were significant differences at other three time points.The disease uncertainty level of the intervention group was better than that of the control group,except for the dimension of unpredictability,there were evident differences in other dimensions at other three time points.Conclusions The nurse-led case management intervention could improve arm function recovery and decrease the uncertainty to disease of breast cancer survivors.
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Objective To evaluate the effectiveness of music therapy on anxiety and adverse reactions induced by chemotherapy in breast cancer patients after modified radical mastectomy. Methods One hundred and ten breast cancer patients were divided into intervention group and control group. The patients in the intervention group received music therapy,progressive muscle relaxation and guided inner image in addition routine nursing care. State Anxiety Inventory and Rotterdam Symptom Checklist (RSCL) were administered before the 2nd chemo-cycle and before the 3rd chemo-cycle. Results There was trend of lower scores on the Rotterdam Symptom Checklist total score and the State Anxiety score in intervention group than in control group (P＜0.05). Conclusion Music relaxation therapy can alleviate chemotherapy related adverse reactions and anxious.Therefore,music relaxation therapy is a practical psychological behavioral intervention for the breast cancer patients during the chemotherapy after modified radical mastectomy.
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Objective To discuss changes of anxiety and adverse reaction before and after chemotherapy for patients with breast cancer, giving selective nursing intervention for coping with chemotherapy in order to reduce patients pain and increase life quality. Methods The changes of anxiety level and adverse reaction degree of 50 patients with breast cancer after modified radical mastectomy were investigated with questionnaires before the first, second and third time of chemotherapy. Results The postoperative patients showed significant difference in total score of Rotterdam symptom checklist, score of physiological domain, psychological domain and state anxiety, among which the adverse reactions such as lack of appetite, fatigue, lack of energy, nausea, acid ingestion, sore mouth, hair lost, irritability, depressed mood and tension increased after beginning chemotherapy. Conclusions Nurses should help patients to understand correctly chemotherapy and its possible adverse reaction, teach them correct coping method in order to reduce uncomfortable symptom, promote whole rehabilitation and increase life quality.