ABSTRACT
BACKGROUND: Breast cancer is one of the most common female "malignancies" reported worldwide in recent years. This study is aimed to understand the degree of acceptance of breast reconstruction among breast cancer patients in Chinese women and to explore the related factors. METHODS: Breast cancer patients were asked to fill in the demographic questionnaire, and consent for evaluation of Breast Reconstruction Acceptance Scale, Social Support Scale, and Functional Assessment of Cancer Therapy-breast Quality of Life Instrument (FACT-B). The data were assessed using multivariate logistic regression analysis for the correlations between the degree of acceptance of breast reconstruction and age, marital status, family monthly income, quality of life, and social support. RESULTS: 57.5% of 715 patients were not familiar with breast reconstruction. Results showed correlation with the degree of acceptance of breast reconstruction. Multivariate analysis indicated that age (41-50 years old, OR: 0.25, 95% CI: 0.08-0.76; > 50, OR: 0.05, 95% CI: 0.02-0.15), marital status (married, OR: 0.15, 95% CI: 0.05-0.43; divorced/widowed, OR: 0.11, 95% CI: 0.03-0.42), family income (3-10 thousand RMB, OR: 2.01, 95% CI: 1.08-3.76; > 10 thousand RMB, OR: 2.14, 95% CI: 1.05-4.37), quality of life (fair, OR: 0.59, 95% CI: 0.39-0.91), and social support (excellent, OR: 0.50, 95% CI: 0.30-0.83) were all correlated with the degree of acceptance of breast reconstruction. CONCLUSION: Chinese breast cancer patients have a low degree of acceptance of breast reconstruction. The degree of acceptance was found to be correlated with age, marital status, family monthly income, quality of life, and social support. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
Subject(s)
Breast Neoplasms/surgery , Health Knowledge, Attitudes, Practice , Mammaplasty/methods , Mammaplasty/psychology , Patient Acceptance of Health Care/psychology , Surveys and Questionnaires , Adult , Asian People/psychology , Asian People/statistics & numerical data , Attitude to Health , Breast Neoplasms/ethnology , Breast Neoplasms/pathology , China , Cohort Studies , Confidence Intervals , Female , Humans , Logistic Models , Mastectomy/methods , Middle Aged , Multivariate Analysis , Patient Acceptance of Health Care/statistics & numerical data , Quality of Life , Retrospective StudiesABSTRACT
AIM: To evaluate the effectiveness of nurse-led care for obstructive sleep apnoea compared with physician-led care. BACKGROUND: The incidence of obstructive sleep apnoea is increasing worldwide. There is a need for cost-effective care models to ease off the pressure on tertiary care centres and divert care to the community. DESIGN: Systematic review and meta-analysis. DATA SOURCES: We searched major electronic databases (MEDLINE, EMBASE, AMED, British Nursing Index, CINAHL, HMIC, PsycINFO, Health Business Elite and the Cochrane Central Register of Controlled Trials CENTRAL) from inception till December 2016 using a structured search strategy for all randomized trials evaluating nurse-led treatment interventions for adults with obstructive sleep apnoea compared with physician-led ones. We screened relevant articles against a predefined inclusion criterion. We applied no search limitations. REVIEW METHODS: We assessed the risk of bias as per Cochrane recommendations. We calculated weighted mean difference with 95% confidence intervals for continuous outcomes and used a random-effects model to meta-analyse data. RESULTS: We screened 309 articles and only four studies met our inclusion criteria. All studies used continuous-positive airway pressure as the main treatment strategy with similar compliance rate in both comparison groups. The scores of the Epworth Sleepiness Scale, the SF-36 questionnaires for vitality, physical function and the SF-36 mental health were all similar between the two groups. There was a significant heterogeneity in all meta-analyses (I2 > 92%). CONCLUSION: Nurse-led care for adults with obstructive sleep apnoea is non-inferior to physician-led care. More research is needed to standardize nurse-led interventions and evaluate their long-term effectiveness and cost-effectiveness.
