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@#Objective To analyze the changes of perioperative symptoms of lung cancer patients by using patient-reported outcomes at different time points. Methods A total of 109 patients who underwent thoracoscopic lung cancer resection in the department of thoracic surgery of our hospital from March to April 2021 were selected, including 55 (50.46%) males and 54 (49.54%) females. The mean age was 55.19±12.12 years. The postoperative symptom scale for lung cancer patients was used to investigate the changes of symptoms before surgery, 1 day after surgery, the day of discharge, and 30 days after surgery. Results The mean hospital stay was 6.89±2.25 days. None of the patients reported any clinical symptoms related to lung cancer before surgery. The most prominent symptoms 1 day after surgery were pain (3.33±0.96 points), nausea (2.81±1.18 points), dizziness (2.00±0.85 points), fatigue (1.89±0.79 points) and shortness of breath (1.79±1.37 points). The patients with dizziness, nausea, fatigue and other symptoms gradually decreased, and the symptoms were relieved significantly (P<0.05). However, the symptoms of conscious pain, cough and shortness of breath lasted for a long time. At 30 days after surgery, 70.64%, 64.22% and 33.03% of patients felt pain, cough and shortness of breath, respectively, and the degree of cough was aggravated (P<0.001). Conclusion Pain, cough, dizziness, shortness of breath and fatigue are the core postoperative symptoms of lung cancer patients. Most postoperative adverse symptoms can be effectively controlled in a short period of time, but pain, cough and shortness of breath still present persistent characteristics, which deserve further study.
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Objective:To explore the effect of health education based on symptom management strategy on the psychological status, self-management ability and quality of life of maintenance hemodialysis patients.Methods:A randomized controlled trial method was used. One hundred and fifty hemodialysis maintenance patients in the Blood Purification Center, Jinan People's Hospital from August 2019 to August 2020, were selected as the research subjects by convenience sampling. Patients were divided into a control group and observation group by random number table method, with 75 cases in each group. The control group was given routine health education, and the observation group was given health education based on symptom management strategies. Self-rating Anxiety Scale (SAS), self-rating Depression Scale (SDS), self-management ability scale of dialysis patients, and SF-36 quality of life scale were used to compare the improvement of negative emotion, self-management ability, and quality of life in the two groups.Results:There was no statistically significant difference between the control group and the observation group before the intervention (all P>0.05). After 3 months of intervention, the SAS and SDS scores of the patients in the observation group were (36.42 ± 4.09) and (35.74 ± 3.64) respectively, which were lower than those of the control group (46.37 ± 4.64) and (49.38 ± 2.49). The difference was statistically significant ( t=8.46, 9.42, P<0.05); the self-management score of patients in the observation group (80.11 ± 7.83) was higher than that in the control group (47.21 ± 6.62), with a statistically significant difference ( t=32.29, P<0.05); the total score of SF-36 quality of life in the observation group (594.32 ± 35.03) was higher than that in the control group (501.42 ± 32.78),with a statistically significant difference ( t=24.66, P<0.05). Conclusions:Health education based on symptom management strategy can improve the psychological status of maintenance hemodialysis patients, and has important value in improving their self-management ability and quality of life.
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Abstract Introduction Patients with head and neck cancer (HNC) experience unique physical and psychosocial challenges that impact their health and quality of life. Early implementation of palliative care has been shown to improve various health care outcomes. Objective The aim of the present study was to evaluate the patterns of referral of patients with HNC to outpatient palliative care as they relate to utilization of resources and end-of-life discussions. Methods We performed a retrospective review of 245 patients with HNC referred to outpatient palliative care services at two Louisiana tertiary care centers from June 1, 2014, to October 1, 2019. The control group consisted of those that were referred but did not follow-up. Reasons for referral were obtained, and outcome measures such as emergency department (ED) visits, hospital readmissions, and advance care planning (ACP) documentation were assessed according to predictive variables. Results There were 177 patients in the treatment group and 68 in the control group. Patients were more likely to follow up to outpatient palliative care services if referred for pain management. Hospital system, prior inpatient palliative care, and number of outpatient visits were associated with an increased likelihood for ED visits and hospital readmissions. Those in the palliative care treatment group were also more likely to have ACP discussions. Conclusion Early implementation of outpatient palliative care among patients with HNC can initiate ACP discussions. However, there are discrepancies in referral reasons to palliative care and continued existing barriers to its effective utilization.
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Objective:To establish a postoperative thirst management strategy for liver cancer patients to improve patient comfort.Methods:A total of 100 patients with liver cancer resection in the First Affiliated Hospital of Guangxi Medical University from July to December 2020 were chosen as the research objects by convenient sampling method. They were divided into observantion group and control group by random number table method, 50 cases in each group. The control group received routing nursing, and the observation group adopted the thirst management strategy. The thirst score, salivary flow rate, salivary pH value, lip mucosa moistening degree and oral comfort score of the two groups were compared.Results:The scores of thirst at 2 h, 4 h and 6 h after operation in the observation group were (7.09 ± 1.01), (5.24 ± 0.94), (3.24 ± 1.03) points, which were significantly lower than (7.97 ± 1.26), (7.00 ± 1.25), (5.67 ± 1.34) points in the control group, the differences were statistically significant ( t=-3.12, -6.46, -8.24, all P<0.05); the salivary flow rate at 2 h, 4 h and 6 h after operation in the observation group were 0.18 (0.15, 0.20), 0.23 (0.20, 0.26), 0.30 (0.25, 0.33) ml/min, which were significantly higher than 0.13 (0.13, 0.18), 0.18 (0.15, 0.20), 0.23 (0.18, 0.25) ml/min in the control group. The differences were statistically significant ( Z=-3.94, -5.81, -6.85, all P<0.05); there was no significant difference in salivary pH between the observation group and the control group after intervention ( P>0.05). The scores of oral mucosa moistening degree at 2 h, 4 h and 6 h after operation in the observation group were 3 (2, 3), 3 (3, 3), 4 (4, 4), which were significantly higher than 2 (2, 2), 3 (2, 3), 3 (3, 3) in the control group, the difference was statistically significant ( Z=-4.04, -5.02, -8.70, all P<0.05); the oral comfort of the observation group after the intervention was (5.73 ± 1.04) points, significantly higher than (4.42 ± 0.61) points, the difference was statistically significant ( t=6.20, P<0.05). Conclusion:The symptom management strategy can effectively improve the thirst of patients after liver cancer resection and improve the comfort of patients.
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Objective:To investigate the effect of symptom management theory(SMT)-based nursing care for the prevention of postoperative abdominal distension in patients with primary hepatocellular carcinoma.Methods:A total of 80 primary hepatocellular carcinoma patients in the Second Affiliated Hospital of Wenzhou Medical University from May 2016 to May 2019 were assigned to the experimental group and the control group according to the admission time, there were 40 cases in each group. The patients in the control group received routine postoperative nursing care, while the patients in the experimental group added SMT-based intervention. The postoperative first exhaust time and defecation time were recorded; the abdominal distension degree after 1, 3, 7 days of surgery were evaluated. In addition, the symptom distress was assessed by The Symptom Module Specific to Primary Liver Cancer (TSM-PLC).Results:The postoperative first exhaust time and defecation time were (69.08±11.44), (78.80±15.54) h in the experimental group, which were significantly lower than those in the control group (76.03±12.26), (86.03±13.48) h, the differences were statistically significant ( t=2.62, 2.22, both P<0.05). After 3, 7 days of surgery, the abdominal distension degrees were significantly alleviated in the experimental group compared to the control group, the differences were statistically significant ( Z =2.31, 2.34, both P<0.05). After 7 days of surgery, the abdominal distension, weight loss, fever symptom scores in TSM-PLC were 1.80±0.28, 0.76±0.21, 0.48±0.19 in the experimental group, which were significantly lower than those in the control group 2.16±0.31, 0.93±0.25, 0.74±0.20, the differences were statistically significant ( t=5.38, 3.27, 5.90, all P<0.05). Conclusions:SMT-based intervention can promote the recovery of postoperative gastrointestinal function and alleviate abdominal distension symptom distress of patients with primary hepatocellular carcinoma.
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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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Convergence of principles of palliative care and integrative medicine has led to the introduction of the new practice of integrative palliative care in which integrative therapies (including mind-body modalities, traditional Chinese medicine, Ayurveda, and dietary supplements) are used to provide symptom management for patients who are dying or experiencing the sequelae of serious illness and its treatment. We propose an East-West Integrative palliative care model using non-drug therapies, such as acupuncture, diet, exercise, and stress management that shift the paradigm from suppressing the symptoms of illness to addressing both the root cause of the symptoms and the imbalance and declining homeostatic reserve that perpetuate these symptoms. This whole-person model expands the reach of palliative care, prolonging a better quality of life and allowing the patient to maintain as many activities as possible by preventing symptoms and improving function. Through this approach we reframe the dialogue such that patients are "living better" rather than "dying better" when faced with serious illness or death. In this article, we provide an overview of the principles of palliative care, integrative medicine, and the novel area of integrative palliative care, and propose an East-West integrative palliative care model that incorporates and broadens the scope of these existing approaches.
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Humans , Acupuncture , Acupuncture Therapy , Integrative Medicine , Palliative Care , Quality of LifeABSTRACT
@#The postoperative symptom burden in patients with lung cancer is severe and adversely impairs their quality of life. Symptom management is the cornerstone of medical care. Patient-reported outcome (PRO)-based symptom management is being increasingly recognized as the best "patient-centered care" model in clinical practice. However, the precise implementation of this model in patients undergoing lung cancer surgery is hindered by the lack of a lung cancer surgery-specific scale, implementation standards, clinical application parameters and high-quality researches. The use of a precise and simple PRO scale and an electronic PRO platform may greatly improve the feasibility of implementing this model. Currently, the application of PRO-based symptom management in lung cancer surgery is still being explored and needs to be improved in clinical research and practice.
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OBJECTIVE@#Few studies to date have measured the real-time effects of consumption of common and commercially available Cannabis products for the treatment of headache and migraine under naturalistic conditions. This study examines, for the first time, the effectiveness of using dried Cannabis flower, the most widely used type of Cannabis product in the United States, in actual time for treatment of headache- and migraine-related pain and the associations between different product characteristics and changes in symptom intensity following Cannabis use.@*METHODS@#Between 06/10/2016 and 02/12/2019, 699 people used the Releaf Application to record real-time details of their Cannabis use, including product characteristics and symptom intensity levels prior to and following self-administration; data included 1910 session-level attempts to treat headache- (1328 sessions) or migraine-related pain (582 sessions). Changes in headache- or migraine-related pain intensity were measured on a 0-10 scale prior to, and immediately, following Cannabis consumption.@*RESULTS@#Ninety-four percent of users experienced symptom relief within a two-hour observation window. The average symptom intensity reduction was 3.3 points on a 0-10 scale (standard deviation = 2.28, Cohen's d = 1.58), with males experiencing greater relief than females (P < 0.001) and a trend that younger users (< 35 years) experience greater relief than older users (P = 0.08). Mixed effects regression models showed that, among the known (i.e., labeled) product characteristics, tetrahydrocannabinol levels 10% and higher are the strongest independent predictors of symptom relief, and this effect is particularly prominent in headache rather than migraine sufferers (P < 0.05), females (P < 0.05) and younger users (P < 0.001). Females and younger users also appear to gain greater symptom relief from flower labeled as "C. indica" rather than "C. sativa" or other hybrid strains.@*CONCLUSION@#These results suggest that whole dried Cannabis flower may be an effective medication for treatment of migraine- and headache-related pain, but the effectiveness differs according to characteristics of the Cannabis plant, the combustion methods, and the age and gender of the patient.
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OBJECTIVE@#Few studies to date have measured the real-time effects of consumption of common and commercially available Cannabis products for the treatment of headache and migraine under naturalistic conditions. This study examines, for the first time, the effectiveness of using dried Cannabis flower, the most widely used type of Cannabis product in the United States, in actual time for treatment of headache- and migraine-related pain and the associations between different product characteristics and changes in symptom intensity following Cannabis use.@*METHODS@#Between 06/10/2016 and 02/12/2019, 699 people used the Releaf Application to record real-time details of their Cannabis use, including product characteristics and symptom intensity levels prior to and following self-administration; data included 1910 session-level attempts to treat headache- (1328 sessions) or migraine-related pain (582 sessions). Changes in headache- or migraine-related pain intensity were measured on a 0-10 scale prior to, and immediately, following Cannabis consumption.@*RESULTS@#Ninety-four percent of users experienced symptom relief within a two-hour observation window. The average symptom intensity reduction was 3.3 points on a 0-10 scale (standard deviation = 2.28, Cohen's d = 1.58), with males experiencing greater relief than females (P < 0.001) and a trend that younger users (< 35 years) experience greater relief than older users (P = 0.08). Mixed effects regression models showed that, among the known (i.e., labeled) product characteristics, tetrahydrocannabinol levels 10% and higher are the strongest independent predictors of symptom relief, and this effect is particularly prominent in headache rather than migraine sufferers (P < 0.05), females (P < 0.05) and younger users (P < 0.001). Females and younger users also appear to gain greater symptom relief from flower labeled as "C. indica" rather than "C. sativa" or other hybrid strains.@*CONCLUSION@#These results suggest that whole dried Cannabis flower may be an effective medication for treatment of migraine- and headache-related pain, but the effectiveness differs according to characteristics of the Cannabis plant, the combustion methods, and the age and gender of the patient.
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Background: Pregnancy-Induced Hypertension (PIH) is a high-risk condition which implies a threat to pregnancy, either by means of the mother’s health or the health of the fetus. In PIH, the underlying basic pathology is endothelial dysfunction and intense vasospasm affecting almost all the vessels, particularly those of uterus, kidney, placental bed, and brain result the symptoms called vascular symptoms. Thus, PIH affects QOL of pregnant women and perinatal outcome. Objectives: The aim of this study was to assess the effect of Vascular Symptom Management Package (VSMP) on vascular symptoms, QOL of pregnant women with PIH & perinatal outcome. Materials and Methods: Quantitative approach with true experimental design was adopted. Ten pregnant women with PIH were selected for the study using purposive sampling technique. Subjects were randomly assigned to the experimental and control group using Sequentially Numbered, Opaque Sealed Envelopes (SNOSE) (5 in the experimental group and 5 in the control group). VSMP includes two sessions: 1-Instructions on strategies to manage each vascular symptoms, fetal well-being assessment, sleep health behavior education, warning signs of complications, and importance of compliance to interventions. 2- Demonstration on Systematic muscle relaxation techniques, Diaphramatic breathing and muscle stretching exercises. The tools used to collect the data were as follows: (1) Demographic questionnaire, (2) vascular symptom assessment scale, (3) Women’s Health Initiative Insomnia Rating Scale (WHIIRS), (4) Edinburg Postnatal Depression Scale (EPDS), (5) WHOQOL–BREF, and (6) perinatal outcome questionnaire. Informed written consent was taken from each participant. Baseline assessment was done on the 1st day and the first session of intervention was implemented on the same day. The second session of intervention was implemented after 1 week. Post-assessment was done after 4 weeks. Mothers were followed till immediate puerperium and perinatal outcome was assessed. Phone calls & weekly meeting were done to make the mother to adhere in practice. The data analyzed using descriptive and inferential statistics. Results: The post-test mean rank of vascular symptoms of the experimental group was lower (P ≤ 0.05) than that of the control group. The mean post-QOL score of the experimental groups was higher (P ≤ 0.05) than that of mean post-QOL score of the control group. The mean rank of all parameters of perinatal outcome in the experimental group was lower (P ≤ 0.05) than that of the control group. Hence, it can be interpreted that VSMP is effective to improve the reduce the vascular symptoms, improve the QOL & perinatal outcome. Conclusion: PIH is a life-threatening condition. The findings of this study show that the effectiveness of VSMP improves the QOL. Hence, VSMP is a nurse-led intervention which can be implemented to effectively reduce the vascular symptoms and improve the QOL of pregnant women with PIH.
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Objetivo: describir el cuidado espiritual a partir de la revisión de literatura científica relacionada con el cuidado paliativo y su arti - culación con los componentes del modelo conceptual del manejo de síntomas de Patricia Larson y colaboradores. Metodología: revisión sistemática de la literatura científica sobre cuidado espiritual y paliativo, publicada entre el 2002 y el 2018, siguiendo los lineamientos de Ganong y teniendo en cuenta los componentes del modelo del manejo de síntomas de Patricia Larson y cola - boradores: experiencia del síntoma, estrategia de manejo del síntoma y resultado del manejo del síntoma. Resultados: de los 56 artículos identificados inicialmente, 50 cumplieron con los criterios de selección y se clasificaron según los componentes del modelo del manejo de síntomas. Se encontró conceptualización de espiritualidad, escalas de valoración, intervenciones y beneficios del cuidado espiritual en pacientes con necesidades paliativas. Conclusiones: el cuidado espiritual parte de percibir la experiencia del proceso de enfermedad o etapa de fin de vida, para identificar las necesidades espirituales de las personas a través de la valoración con escalas validadas y el uso de diagnósticos relacionados con la dimensión espiritual. Las estrategias de manejo que incluyen el cuidado espiritual comienzan con el acompañamiento y la escucha activa del paciente, de donde se derivan las intervenciones de segundo y tercer nivel descritas en la literatura. Se requiere preparación de los profesionales en enfermería para orientar planes de cuidado espiritual fundamentados desde el modelo que exponen Larson y colaboradores para el manejo de síntomas.
Objective: To describe spiritual care from the perspec - tive of scientific literature related to palliative care, taking into account the components of the Conceptual Model of Symptom Management, as stated by Patricia Larson and collaborators. Methodology: Systematic review, following Ganong's guidelines, of publications made between 2002 and 2018 that are related to spiritual care and palliative care and articulated with the components of Patricia Larson's Symptom Management Model: symptom experience, symptom management strategy, and result of symptom management. Results: Of the 56 articles initially identified, 50 met the selection criteria and were classified according to the components of the Symptom Management Model. We found conceptualization of spirituality, scales for its assess - ment, interventions and benefits of spiritual care in patients with palliative needs. Conclusions: Spiritual care starts with perceiving the experience during the disease process or end-of-life stage, and includes timely identification of spiri - tual needs, their assessment through validated scales, and the use of diagnoses related to the spiritual dimension. The management strategies involved in spiritual care start from the accompaniment and active listening to the patient, from which the second and third level interventions described by the literature are derived. It is necessary to prepare nursing professionals which guide management strategies through the use of the model of Larson and collaborators, to manage - ment of symptoms in clinical practice.
Objetivo: descrever cuidados espirituais a partir da revisão da literatura científica relacionada aos cuidados paliativos, levando em conta os componentes do Modelo Conceitual de Manejo dos Sintomas de Patricia Larson, e colaboradores. Metodologia: revisão sistemática, seguindo as orientações de Ganong, de publicações realizadas entre 2002 e 2018, relacionadas aos cuidados espirituais e cuidados paliativos, articuladas aos componentes do Modelo de Gerenciamento de Sintomas de Patricia Larson: experiência, estratégia e resultado do manejo do sintoma. Resultados: dos 56 artigos inicialmente identificados, 50 preencheram os critérios de seleção e foram classificados de acordo com os componentes do Modelo de Gerenciamento de Sintomas. Encontramos conceituação de espiritualidade, escalas para sua avaliação, intervenções e benefícios do cuidado espiritual em pacientes com necessidades paliativas. Conclusões: o cuidado espir - itual começa com a percepção da experiência do processo da doença ou do estágio final da vida, e inclui a identificação de necessidades espirituais, sua avaliação através de escalas validadas, e o uso de diagnósticos relacionados à dimensão espiritual. As estratégias de manejo que incluem o cuidado espiritual partem do acompanhamento e da escuta ativa do paciente, a partir dos quais derivam as intervenções de segundo e terceiro nível descrito na literatura. É necessário preparar e capacitar os profissionais de enfermagem que orientam as estratégias de gestão através do o modelo de Larson e colaboradores.
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Palliative Care , Spirituality , Empathy , Review Literature as Topic , Nursing CareABSTRACT
Objective To study the effects of interdisciplinary nursing model on physical condition, mood and satisfaction of postoperative patients with thyroid cancer. Methods A total of 296 patients who underwent thyroid surgery at the First Affiliated Hospital of China Medical University and were diagnosed with thyroid cancer were randomly selected from March 2016 to March 2017. The general situation of all patients was recorded, the above patients were divided into the intervention group and the control group according to whether they were willing to accept the interdisciplinary care model. The intervention group received an interdisciplinary care model and the control group chose a general care model. The symptom score and satisfaction score of the intervention group and the control group were evaluated 1 month after surgery. Results Postoperative symptom scores in the two groups were statistically different between happiness, fatigue, anxiety, depression, pain, lethargy, loss of appetite, and shortness of breath (t=1.18-3.18, P<0.05). Satisfaction rating reminder: After feeling the medical staff to solve their own concerns, trust the medical staff, feel the respect of the medical staff, feel the teamwork of the medical staff, and recommend other patients to our hospital for treatment (t=3.83-8.13, P<0.05). Conclusions Interdisciplinary care can significantly alleviate the symptoms of postoperative patients with thyroid cancer, relieve anxiety and depression, and improve patient satisfaction.
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Objective To construct the continuing nursing management model for lung cancer chemotherapy complications based on m-health. Methods Literature research, qualitative interviews and expert group meeting were used to build the continuing nursing management model for lung cancer chemotherapy complications based on m-health. Results The nursing management model of lung cancer chemotherapy complications including service objectives, service providers, service objects, service time, service flow, service platform and related personnel responsibilities were determined. Conclusions The continuing nursing management model for lung cancer chemotherapy complications based on m-health has strong scientific and practical characteristics, which is helpful for patients to timely monitor the occurrence of complications of chemotherapy, access the corresponding prevention and intervention measures.
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Palliative Care (PC), is the set of actions and tools that seek relief from symptoms and suffering of patients and their families to diseases that threaten their lives. This support includes different types of resources covering the clinical, socio‑economic, emotional, psychological and spiritual aspects. Due to increasing life expectancy of humans and the fact that chronic diseases account for 60% of premature death, mainly due to cardiovascular diseases, neurological and malignant tumors; has been the global need to create, implement, and enhance knowledge and PC local programs. In pediatrics, there are four main reasons why a child can and should receive pediatric palliative care (PPC): Cancer, Cystic fibrosis, Metabolic or Mitochondrial and/or Progressive Muscle Diseases and Neurological Disorders. In this article we analyze synthetically the definition, types and basic definitions on the CPP matter. Also, we share the local experience about the first pediatric palliative care program focus in oncologic patients on the Dominican Republic. To review the basics and history of palliative care. To establish the goals and definition of pediatric palliative care, symptom management, terminal illness and integral support. To describe the local pediatric palliative care in oncology unit at Dr. Robert Reid Cabral Children’s Hospital in Dominican Republic as the first PPC local program in the country for children with cancer.
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Objective To explore symptom clusters and changes with time goes among inpatients of lung cancer to provide the basis for clinical nursing staff on symptom management. Methods Using the Chinese version of the M.D. Anderson Symptom Inventory (MDASI-C) and the revised lung cancer module on 217 cases of inpatients with lung cancer, and the follow-up after 1 month, 3 months by telephone. Results The result of principal component analysis of three times:there are same symptom clusters on three times evaluation, fatigue-related symptom cluster, lung cancer specific symptom cluster, chemotherapy-related symptom cluster and psychological symptom cluster. The first and third time assessment also contains respiratory symptom cluster. Over time some kinds of symptom clusters company with the disease trajectories. Fatigue-related symptom cluster is the major cluster and correlate to psychological and other symptom clusters. Conclusions Clinical workers should perfect the symptom management of patients all the time according to severity and changes of symptom clusters to benefit patients with lung cancer.
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Objective The research aimed to identify symptom clusters of head and neck cancer (HNC) patients.Methods The M.D.Anderson Symptom Inventory-Head & Neck (MDASI-H&N) was applied to measure symptoms of 247 HNC inpatients.Factor analysis was applied to identify symptom clusters.The Spearman correlation analysis was used to find the relationship of symptoms within symptom clusters.Results Five clusters were identified and the Cronbach's α coefficients of symptom clusters were 0.904,0.928,0.898,0.815 and 0.662 respectively.Symptoms within clusters were all significantly interrelated to each other (r=0.393-0.856,P＜0.01).Conclusions Symptoms of HNC patients tend to occur not in isolation,but in symptom clusters.Effective management can not only eliminate or alleviate the symptom burden of HNC patients,but also be cost-effective.
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Objective To explore how medical staff in the oncology department understand management of cancer related fatigue (CRF), and explore what factors influencing the effective practice of CRF management. Methods Qualitative inquiry was adopted. Ten medical staffs in the oncology department were selected for in- depth interview. Generic analysis was applied to code, categorize and interpret the qualitative data. Results Participants believed that many factors influenced the CRF, which hadn′t been assessed as an independent symptom and lacked the systematic, effective and specific interventions. The medical staff, patients and their families neglecting the CRF management was the main barrier. Strengthening system construction and staff training was mentioned as major area which needed to be improved. Conclusions CRF management guideline should be formulated according to our national situations based on the clinical practices, besides, the training of correlated clinical knowledge and skills of medical staff should be strengthened and eventually promote the cancer patients′quality of life.
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This paper aimed to analyze the concept of symptom experience according to the aspects of definition,defining characteristics,antecedents and consequence.Symptoms experience is the perception of the frequency,intensity,distress,and meaning of symptoms as they are produced and expressed.Through the analysis of the symptom experience,to help nurses roundly understand the effects of symptoms on patients,improve symptom management and provide the basis for further research.
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Objective: To revise the lung cancer module of MDASI (MD Anderson Symptom Inventory) and assess the included items and the reliability and validity of the revised lung cancer module. Methods: The original item pool was formulated through literature review, patient interview and expert interview and based on existing instruments measuring multiple cancer symptoms. After two rounds of expert evaluation, the preliminary scale was developed. The reliability, validity and sensitivity were tested among 195 lung cancer patients using the revised lung cancer module combined with MDASI. Results: (1) Feasibility: The scale recovery was 100%, the completion rate of the scale was 92.3%, and the time spent on completing this scale was 10-15 min. (2) Reliability: The values of Cronbach's alpha of the revised lung cancer module, MDASI and the combined scale were 0.773, 0.914 and 0.922, respectively. (3) Validity: The revised 6-item lung cancer module was formulated after two rounds of expert evaluation. The range of content validity index of items was 0.833-1.000. The scale-level content validity index/average was 0.944. The exploratory factor analysis was used to evaluate the construct validity. There was one common factor, which explained for 48.059% of variance. The criterion-related validity was significant (P < 0.01). (4) Sensitivity: The scores of the revised lung cancer module were significantly different among the lung cancer patinets by ECOG PS (Eastern Cooperative Oncology Group perfomance status) score (P < 0.01). Conclusion: The revised lung cancer module has good feasibility, reliability, validity and sensitivity. It is appropriate to apply this revised lung cancer module in combination with MDASI to assessment of lung caner-related symptoms in China. Copyright © 2013 by TUMOR.