Relationships Between Chemotherapy-Related Cognitive Impairment, Self-Care Ability, and Quality of Life in Breast Cancer Survivors: A Cross-Sectional Study.

OBJECTIVES: It is not clear how chemotherapy-related cognitive impairment and self-care ability affect the quality of life of women with breast cancer. The purpose of this study was to explore the relationships between chemotherapy-related cognitive impairment, self-care ability, and quality of life in breast cancer patients, and test whether self-care ability plays a mediating role in the association between cognitive impairment and quality of life. METHODS: This study was a cross-sectional study, conducted in China in 2022. Self-reported scales were used to assess cognitive function, self-care ability, and quality of life. Data were analyzed using descriptive statistics, spearman correlation analysis and hierarchical multiple regression analyses, the SPSS Process program was used to explore the mediating effect of self-care ability. RESULTS: A total of 218 participants were investigated, and approximately 79.3% of patients experienced mild chemotherapy-related cognitive impairment, the mean quality of life score was 59.96 ± 14.15, and the mean self-care ability score was 107.4 ± 24.09. Significant correlations among cognitive impairment, self-care ability, and quality of life were observed (P < .05). Additionally, self-care ability played a partial mediating role between cognitive impairment and quality of life (P < .05), accounting for 24.3% and 22.3%, respectively. CONCLUSIONS: Chemotherapy-related cognitive impairment and self-care ability are factors affecting the quality of life of breast cancer survivors. Self-care ability mediates the relationship between cognitive impairment and quality of life. Enhancing patients' self-care ability can improve the quality of life of patients with cognitive impairment. IMPLICATIONS FOR NURSING PRACTICE: In the future, oncology nurses should not only pay attention to the severity of cognitive impairment, but also assess the level of patients' self-care ability, provide relevant medical and healthcare guidance, train self-management behavior and strengthen self-care ability by integrating multidisciplinary forces to improve the quality of life of breast cancer patients effectively.

Effectiveness of Virtual Reality-Based Interventions for Upper Limb Rehabilitation in Breast Cancer Patients: Systematic Review and Meta-Analysis.

Purpose: To investigate the effectiveness of virtual reality (VR)-based interventions for functional rehabilitation of the upper limb in breast cancer patients through a systematic review and meta-analysis. Methods: The PubMed, Cochrane, Web of Science, CINAHL, Scopus, CNKI, Wanfang, and VIP databases were systematically searched for relevant literature published from the establishment of the database to June 2023. Differences in the effectiveness of VR-based interventions and other intervention therapies were compared using random effects model meta-analysis and standard deviation (SMD). Results: Seven eligible articles were identified and included in the meta-analysis. The combined analysis found that VR-based interventions had a positive impact on patients' upper limb mobility in terms of flexion (SMD = 1.33, 95% confidence interval; CI [0.48-2.19], P = 0.002), abduction (SMD = 1.22, 95% CI [0.58-1.86], P = 0.0002), and external rotation (SMD = 0.94, 95% CI [0.48-1.40], P < 0.0001). In addition, VR-based interventions could significantly improve the postoperative pain of patients with breast cancer. However, in grip strength (SMD = 0.43, 95% CI [-3.05 to 3.92], P = 0.81), shoulder muscle strength in flexion strength (SMD = 0.05, 95% CI [-2.07 to 2.18], P = 0.96), abduction strength (SMD = -0.10, 95% CI [-1.32 to 1.12], P = 0.88), external rotation strength (SMD = 0.46, 95% CI [-1.96 to 2.88], P = 0.71), and lymphedema, VR was as effective as other intervention treatments. A subgroup analysis showed that patients younger than 55 years had more benefit with VR-based rehabilitation than with other interventions and showed improvements with the intervention within 2 weeks. The intervention effect of using auxiliary equipment such as robotic arms is better than VR exercise based solely on games. Conclusion: The results of meta-analysis show that the intervention measures based on VR have positive effects on the improvement of upper limb mobility and pain relief in breast cancer patients. However, considering the low quality of evidence and small sample size, more clinical studies should be conducted to improve the credibility of the results.

Experience of using a virtual reality rehabilitation management platform for breast cancer patients: a qualitative study.

PURPOSES: Postoperative rehabilitation of upper limb function is crucial for breast cancer. Therefore, we developed a rehabilitation management platform using virtual reality to improve rehabilitation compliance and effect. The purpose of this research was to understand the user usability experience of breast cancer patients about the postoperative rehabilitation management of upper limb function using virtual reality. METHODS: A qualitative descriptive research was designed. We used a maximum difference purpose sampling method. According to the inclusion and exclusion criteria, a 3-armor hospital in Changchun was selected for the recruitment. A one-on-one semi-structured interviews were conducted with patients after breast cancer operation. The Colaizzi seven-step analysis method was used to classify data under summarized themes. RESULTS: Twenty patients participated in this semi-structured interview. User experience could be summarized into four themes as follows: 1) experience and feeling after using the virtual reality rehabilitation management platform; 2) factors influencing the use of the virtual reality rehabilitation management platform; 3) willingness to recommend the virtual reality rehabilitation management platform to peers; and 4) suggestions to improve the virtual reality rehabilitation management platform. CONCLUSIONS: Breast cancer patients who used the rehabilitation management platform had a good experience, and their recognition and satisfaction were high. The use of the platform is influenced by many factors, and most patients are willing to recommend this platform to their peers. Future studies should be conducted according to patients' feedback and suggestions on how to further optimize and improve the platform.

Electronic health records in nursing from 2000 to 2020: A bibliometric analysis.

Background: Electronic health records (EHR) is the longitudinal data generated by patients in medical institutions and recorded by electronic medical information systems in the form of digital, which is also the most widespread application of big data in medicine. The purpose of this study was to explore the application of electronic health records in the field of nursing and determine the current research status and hotspots. Methods: A bibliometric analysis of electronic health records in nursing was undertaken from 2000 to 2020. The literature comes from Web of Science Core Collection database. We used CiteSpace (version 5.7 R5; Drexel University), which is a Java-based software that especially visualized collaborative networks and research topics. Results: A total of 2616 publications were included in the study. We found that publications increased year by year. The Journal of American Medical Informatics Association (n = 921) is the most cited. The United States (n = 1,738) has the most publications in this field. University Penn (n = 63) is the institution with the most publications. There is no influential cooperation network among the authors, of which Bates, David W (n = 12) have the largest number of publications. The relevant publications also focus on the fields of health care science and services, and medical informatics. In keywords, EHR, long-term care, mobile application, inpatient falls, and advance care planning has been researching hotspots in recent years. Conclusion: With the popularization of information systems, the publications of EHR in the nursing field have increased year by year. This study provides the basic structure, potential cooperation, and research trends of EHR in the field of nursing from 2000 to 2020, and provides a reference for nurses to effectively use EHR to help clinical work or scientific researchers explore the potential significances of EHR.

Spiritual needs and their associated psychosocial factors among women with breast cancer: A cross-sectional study.

AIMS: Guided by the biopsychosocial-spiritual model, this study aimed to evaluate the spiritual needs of Chinese women with breast cancer and explored factors associated with those spiritual needs. DESIGN: This study has a cross-sectional design. METHODS: This cross-sectional study involved 228 breast cancer patients in China, between May 2019 and July 2019. Data were collected using the general information form, the Spiritual Needs Scale, the Perceived Social Support Scale and the Hospital Anxiety and Depression Scale. Data were analysed by Spearman correlation analysis, univariate analysis and multiple linear regression, and a structural equation model (SEM) was constructed by maximum likelihood estimation. RESULTS: There was a slightly higher average score for spiritual needs. Of the five dimensions of spiritual needs, those with the highest and lowest levels were 'meaning and purpose' and 'relationship with transcendence' respectively. Religion, time since confirmed diagnosis and education level were related to spiritual needs. The proposed model linking spiritual needs perceived social support, anxiety, and depression revealed a satisfactory fit to the data. Specifically, a higher level of social support predicted lower levels of anxiety and depression, which in turn predicted stronger spiritual needs. CONCLUSIONS: The spiritual needs of breast cancer patients were associated with individual characteristics and psychosocial elements. Patients' spiritual needs should therefore be effectively evaluated, especially the needs of those who are not religious. Furthermore, comprehensive, needs-tailored interventions that incorporate spiritual, biological, psychological and social support should be formulated. IMPACT: Nurses should become more aware of the spiritual needs of breast cancer patients, incorporate a spiritual focus into their care and develop comprehensive needs tailored to their characteristics as well as interventions based on biopsychosocial factors.

Quality of Life and Hope of Women in China Receiving Chemotherapy for Breast Cancer.

We explore the association of hope and quality of life in breast cancer chemotherapy women. Their quality of life is related to treatment effects and disease outcomes. This cross-sectional study was conducted in City, China, in 2017. In a convenience sampling, 450 women who underwent breast cancer chemotherapy were selected from two hospitals. Descriptive statistics, single-factor analysis, Spearman correlation, linear regression, and structural equation modeling were used to analyze data. The mean quality of life score was 65.65. In linear regression analysis, we found patients' quality of life was significantly related to age, marital status, education level, chemotherapy cycle, and hope. Structural equation results showed the "temporality and future" and "interconnectedness" subscales of the HHI explained 43% of the variance in quality of life. We found hope is an important aspect in quality of life, and further research is needed to determine if nurses can influence this aspect of care.

Upper limb rehabilitation system based on virtual reality for breast cancer patients: Development and usability study.

BACKGROUND: Functional exercise is crucial for breast cancer patients after surgery, and the use of virtual reality technology to assist patients with postoperative upper limb functional rehabilitation has gradually attracted the attention of researchers. However, the usability of the developed rehabilitation system is still unknown to a large extent. The purpose of this study was to develop a virtual reality upper limb rehabilitation system for patients after breast cancer surgery and to explore its usability. METHODS: We built a multidisciplinary team based on virtual reality and human-computer interaction technology and designed and developed an upper limb function rehabilitation system for breast cancer patients after surgery. Breast cancer patients were recruited from a grade III-a general hospital in Changchun city for the experiment. We used the System Usability Scale to evaluate the system availability, the Presence Questionnaire scale to measure the immersive virtual reality scene, and the Simulator Sickness Questionnaire subjective measurement scale for simulator sickness symptoms. RESULTS: This upper limb rehabilitation system hardware consisted of Head-mounted Display, a control handle and notebook computers. The software consisted of rehabilitation exercises and game modules. A total of 15 patients were tested on this system, all of whom were female. The mean age was 54.73±7.78 years, and no patients were excluded from the experiment because of adverse reactions such as dizziness and vomiting. The System Usability Scale score was 90.50±5.69, the Presence Questionnaire score was 113.40±9.58, the Simulator Sickness Questionnaire-nausea score was 0.93±1.16, the Simulator Sickness Questionnaire-oculomotor score was 0.80±1.27, the Simulator Sickness Questionnaire-disorientation score was 0.80±1.27, and the Simulator Sickness Questionnaire total score was 2.53±3.40. CONCLUSIONS: This study fills in the blanks regarding the upper limb rehabilitation of breast cancer patients based on virtual reality technology system usability research. As the starting point of research in the future, we will improve the system's function and design strictly randomized controlled trials, using larger samples in the promotion, to evaluate its application in breast cancer patients with upper limbs and other physiological functions and the feasibility and effects of rehabilitation.

Predicting breast cancer 5-year survival using machine learning: A systematic review.

BACKGROUND: Accurately predicting the survival rate of breast cancer patients is a major issue for cancer researchers. Machine learning (ML) has attracted much attention with the hope that it could provide accurate results, but its modeling methods and prediction performance remain controversial. The aim of this systematic review is to identify and critically appraise current studies regarding the application of ML in predicting the 5-year survival rate of breast cancer. METHODS: In accordance with the PRISMA guidelines, two researchers independently searched the PubMed (including MEDLINE), Embase, and Web of Science Core databases from inception to November 30, 2020. The search terms included breast neoplasms, survival, machine learning, and specific algorithm names. The included studies related to the use of ML to build a breast cancer survival prediction model and model performance that can be measured with the value of said verification results. The excluded studies in which the modeling process were not explained clearly and had incomplete information. The extracted information included literature information, database information, data preparation and modeling process information, model construction and performance evaluation information, and candidate predictor information. RESULTS: Thirty-one studies that met the inclusion criteria were included, most of which were published after 2013. The most frequently used ML methods were decision trees (19 studies, 61.3%), artificial neural networks (18 studies, 58.1%), support vector machines (16 studies, 51.6%), and ensemble learning (10 studies, 32.3%). The median sample size was 37256 (range 200 to 659820) patients, and the median predictor was 16 (range 3 to 625). The accuracy of 29 studies ranged from 0.510 to 0.971. The sensitivity of 25 studies ranged from 0.037 to 1. The specificity of 24 studies ranged from 0.008 to 0.993. The AUC of 20 studies ranged from 0.500 to 0.972. The precision of 6 studies ranged from 0.549 to 1. All of the models were internally validated, and only one was externally validated. CONCLUSIONS: Overall, compared with traditional statistical methods, the performance of ML models does not necessarily show any improvement, and this area of research still faces limitations related to a lack of data preprocessing steps, the excessive differences of sample feature selection, and issues related to validation. Further optimization of the performance of the proposed model is also needed in the future, which requires more standardization and subsequent validation.

Hope and symptom burden of women with breast cancer undergoing chemotherapy: A cross-sectional study.

AIM: This research aimed to explore the level of hope and symptom burden of breast cancer women undergoing chemotherapy, and predictive factors of hope were also investigated. BACKGROUND: Chemotherapy brings physical and psychological stress to breast cancer patients. As an effective coping strategy, hope gives them the courage to overcome difficulties and improve prognosis and survival. Therefore, efforts are needed to raise hope. DESIGN/METHODS: A total of 450 women who were undergoing breast cancer chemotherapy participated in this cross-sectional study. Sociodemographic data, disease characteristics, and measures of hope and symptom burden were collected using questionnaires. Hope was assessed using the validated Herth Hope Index, and the previously validated Memorial Symptom Assessment Scale was used to assess symptom burden. This paper adhered to the STROBE guidelines. RESULTS: Chinese breast cancer chemotherapy women hope average scores of 30.15 ± 4.82 were in the medium range of the Hearth Hope Index as specified by Herth to be 24-35. Patients with age ≤45, religious beliefs and lighter symptom burden have a higher level of hope. These variables explained a total of 22.9% of the variation in hope. CONCLUSIONS: The level of hope for women undergoing breast cancer chemotherapy still needs to be further improved. Symptom burden can negatively predict hope. RELEVANCE TO CLINICAL PRACTICE: If nurses can decrease breast cancer chemotherapy women symptom burden, there is an impact on increasing levels of hope.