Effects of motor imagery training on gait performance in individuals after stroke: a systematic review and meta-analysis.

PURPOSE: This review systematically explores and summarise the effects of motor imagery training (MIT) compared to conventional therapy on gait performance in individuals after stroke. MATERIALS AND METHODS: Randomised controlled trials (RCTs) were systematically searched in five electronic databases (PubMed, EMBASE, PsycINFO, OVID Nursing and CINAHL) from inception to 30 December 2022. Studies investigating MITs, targeted at individuals after stroke were eligible. Data were extracted related to study and intervention characteristics. RESULTS: Sixteen studies were included. Compared with 'routine methods of treatment or training', the meta-analyses showed that MIT was more effective in improving cadence immediately post intervention (SMD: 1.22, 95% CI: 0.59, 1.85, p = 0.0001, I2 = 25%) and at 1- or 2-months post intervention (SMD: 0.78, 95% CI: 0.35, 1.20, p = 0.0004, I2 = 46%). The results also showed that MIT improves the step length of the affected side and the unaffected side at 1- or 2-months post intervention. Separate meta-analyses were also conducted on different tests of walking endurance (assessed by the 6-Minute Walk Test) and functional mobility (assessed by the Timed-Up-and-Go test). CONCLUSIONS: MIT effectively improved gait performance. The findings in individuals after stroke remain inconclusive due to significant heterogeneity in included studies.

Restoring gait performance and daily functional abilities is an important goal of post-stroke rehabilitation.Motor imagery training (MIT) may be a promising method to improve gait restoration and is expected to provide another option for the effective rehabilitation of stroke patients.This review highlights the limited research on MIT and thus the limited evidence to guide clinical rehabilitation.In the stroke rehabilitation, clinical specialists may consider incorporating MIT into the treatment programme to improve patients' gait performance and ensure effective early lower limb rehabilitation.

Effects of music intervention combined with progressive muscle relaxation on anxiety, depression, stress and quality of life among women with cancer receiving chemotherapy: A pilot randomized controlled trial.

Beneficial effects of music intervention and progressive muscle relaxation alone on psychological issues were reported, however, studies evaluating their combined effects are limited. This study aimed to investigate the feasibility, acceptability and preliminary effects of music intervention combined with progressive muscle relaxation on anxiety, depression, stress, and quality of life among breast and gynaecological cancer patients receiving chemotherapy. METHODS: The study was carried out from March to May 2022 in an oncology hospital in Vietnam. A single-blinded randomized controlled trial was conducted among 24 women with breast and gynaecological cancer undergoing chemotherapy. The intervention group (n = 12) received a face-to-face training program about music listening and progressive muscle relaxation skills. They then performed the self-practice daily at home for three weeks. The control group (n = 12) received standard care, including health assessment, regular health advice and nutrition consultation. Ten participants in the intervention group were interviewed with open-ended questions to explore the acceptability of the intervention. Anxiety, depression and stress were measured using the Depression Anxiety Stress Scale, while The Functional Assessment of Cancer Therapy-General was used to evaluate the quality of life. The outcome measurements were collected at baseline (T0), post-intervention (3rd week, T1) and follow-up (6th week, T2). Appropriate descriptive statistics were used to depict the outcome measures across study time points. RESULTS: A total of 24 patients were eligible to join, and 20 of them completed the study. Greater reductions in anxiety, depression and stress were observed in the intervention group than in the control group at T1 and T2. Greater improvements on quality of life were found in the intervention group than control group at T1 and T2 with respect to T0. The content analysis supported the acceptable intervention of participants through two themes, perceived beneficial effects on psychological and physical health and willingness to keep practising in the future. CONCLUSIONS: Implementing music intervention combined with progressive muscle relaxation is feasible and had a trend in reducing anxiety, depression and stress levels. A larger scale randomized controlled trial is needed to confirm the effect of the intervention on outcomes. TRIAL REGISTRATION: This trial was registered on ClinicalTrials.gov with ID: NCT05262621.

Effectiveness of a nurse-led decision counselling programme on hepatocellular carcinoma screening uptake among patients with hepatitis B: A randomised controlled trial.

BACKGROUND: The globally endemic hepatocellular carcinoma induced by hepatitis B highlights the need for an ultrasonography-based screening strategy to reduce the tumour burden. However, patient non-adherence due to unawareness and complex decisions in weighting uncertainties of hepatocellular carcinoma screening has continuously challenged its continuum. OBJECTIVE: To examine the effectiveness and process of a nurse-led decision counselling programme for improving hepatocellular carcinoma screening among patients with hepatitis B. DESIGN: Single-blind randomised controlled trial. SETTING AND PARTICIPANTS: Between 12 March and 19 July 2021, 178 patients with hepatitis B were recruited from six inpatient wards of a university-affiliated hospital in northern China. METHODS: Participants were randomly allocated to receive usual care (n = 89) or usual care plus a nurse-led decision counselling programme (n = 89). Underpinned by the preventive health model, the programme consisted of health education, tailored information, and values clarification exercises to elicit informed and value-based preferences for hepatocellular carcinoma screening. Screening barriers were explored and addressed through procedural problem-solving. Hepatocellular carcinoma screening rate at six months post-baseline was the primary outcome. Secondary outcomes (knowledge, perceptions, and decision conflicts regarding hepatocellular carcinoma screening) were measured at baseline (T0), immediately after the intervention (T1), and the six-month follow-up (T2). A Medical Research Council framework-guided process evaluation was conducted by drawing on data from intervention documentation, WeChat discussions, and interviews with stakeholders (n = 13). RESULTS: With a mean age of 47.32 (8.78) years, participants mostly occupied rural residences (63.5 %). Compared with the control group, the intervention group had significantly higher hepatocellular carcinoma screening rates (75.6 % vs. 42.1 %, p < 0.001) and displayed greater improvements in the scores of hepatocellular carcinoma screening knowledge (ß = 3.643, 95 % confidence interval [CI] = 3.030, 4.255), salience and coherence (ß = 0.410, 95 % CI = 0.234, 0.586), response efficacy (ß = 0.327, 95 % CI = 0.181, 0.473), and perceived susceptibility (ß = 0.214, 95 % CI = 0.040, 0.388) at T1. Improvement in perceived susceptibility was not maintained, whereas a higher decrease of the decision conflict score was found at T2 (ß = -4.156, 95 % CI = -7.851, -0.461). The process evaluation revealed potential intervention mechanisms and contextual factors affecting intervention effectiveness, such as living status and natural disasters. CONCLUSION: The programme was effective in improving hepatocellular carcinoma screening and showed that nurses could play a decision counselling role in optimising the screening among patients with hepatitis B. TRIAL REGISTRATION: ClinicalTrials.govNCT04659005. Registration date: 9 December, 2020. TWEETABLE ABSTRACT: Nurse-led decision counselling improves hepatocellular carcinoma screening in patients with hepatitis B.

The moderating effects of nurses' background characteristics on the relationship between family-centred care perception and practice for hospitalized children and their families in Malawi.

PURPOSE: Globally, limited information is available on the relationship between the perception and practice of family-centered care (FCC), and the moderating effects of nurses' background characteristics on this relationship. This study investigated the relationship between FCC perception and FCC practice and the moderating effects of the nurses' background characteristics on this relationship. DESIGN AND METHODS: A cross-sectional study was conducted using a two-stage stratified sampling method. Data were collected from 444 nurses using the Family Centered Care Questionnaire-Revised and analyzed using IBM SPSS Version 25. The Hayes PROCESS macro model, version 3, was integrated into SPSS to examine the moderating effects at a significance level of 0.05. RESULTS: The response rate was 98%, and a statistically significant positive association was found between FCC perception and FCC practice (r = 0.353, p < .001). Gender of a nurse (ΔR2 = 0.0206, p < .002), having children (ΔR2 = 0.0231, p < .001), experience (ΔR2 = 0.0107, p = .028), and working in a medical-surgical ward (ΔR2 = 0.0208, p = .008) had a statistically significant moderating effect on the relationship between FCC perception and FCC practice. CONCLUSION: These findings provide minimal evidence of the existence of non-modifiable moderators of FCC. Future studies with modifiable moderators are therefore needed. PRACTICE IMPLICATIONS: Understanding the moderating effects of nurses' background characteristics on the relationship between FCC perception and FCC practice may facilitate the development of FCC interventions that favor these background characteristics and facilitate the integration of FCC into routine policies and practices.

Exploring the sources of cervical cancer screening self-efficacy among rural females: A qualitative study.

AIM: Evidence showed self-efficacy was relevant to rural females' cervical cancer screening behaviour. However, little is known about sources of self-efficacy in cervical cancer screening among rural females. This study aimed to explore sources of self-efficacy in cervical cancer screening among rural females. DESIGN: A qualitative descriptive study was conducted. Both users and providers of cervical cancer screening services in rural areas of China were recruited through maximum variation sampling. METHODS: Individual semi-structured interviews through telephone calls were conducted. Data were analysed via six main stages of the framework method, with the social cognitive theory as a reference. RESULTS: Four main sources were identified, including personal screening experience, hearing about other women's screening experiences, professional health education and consultation, and emotional status. Personal screening experience included enactive mastery of completing the screening behaviour and cognitive mastery of internalisation of the screening. Only the experience of completing cervical cancer screening behaviour was not strong enough to improve self-efficacy. Cognitive mastery showed more critical influence. CONCLUSION: These four sources of rural females' cervical cancer screening self-efficacy matched with the major sources of self-efficacy of the social cognitive theory. Cognition was critical to influencing the screening self-efficacy. Intervention strategies aimed at enhancing rural females' cervical cancer screening self-efficacy can be developed from these four major sources. PUBLIC CONTRIBUTION: A registered nurse with rich experience in cervical cancer-related research and qualitative study was the interviewer of this study. Rural females and cervical cancer screening services providers (healthcare professionals and village staff) were recruited as interviewees. The interview guides were developed by the research team and evaluated by an expert panel including two nurse leaders of gynaecological cancer, one doctor specialised in cervical cancer, and one medical director in a local rural hospital.

Literature review and development of pictorial action plan to promote self-management of chronic obstructive pulmonary disease.

OBJECTIVE: This study aimed to review relevant literature and develop a pictorial action plan (PAP) to enhance self-management among older patients with chronic obstructive pulmonary disease (COPD). METHODS: In Stage 1, an integrative review was conducted to identify key elements of respiratory self-management action plans. In Stage 2, cartoon pictograms with plain descriptions were designed. In Stage 3, the PAP was validated by 40 older patients with COPD and an expert panel. RESULTS: While the eight included studies demonstrated positive effects on knowledge and quality of life, key elements identified included: traffic light motif, plain and explicit language, and several action plan topics. The final PAP comprises three traffic light-coloured zones and 24 pictograms that introduce self-management strategies for normal, decreasing, and severely decreased airflow. After revising the cartoon characters, all of the pictograms received guessability ratings above 70% and acceptable mean translucency ratings. DISCUSSION: The integrative review provides evidence about the effectiveness and key elements of PAPs. The PAP developed was found to be valid and feasible for use among older patients with chronic respiratory conditions. PRACTICE IMPLICATIONS: This study offered an example of translating evidence into patient education practice to enhance self-management in older patients with COPD.

Advance Care Planning in Hong Kong.

Hong Kong is a well-developed city with outstanding healthcare services, leading to the highest life expectancy in the world. Paradoxically, the quality of end-of-life care in this city lagged behind that of many other high-income regions. Possibly, the advances in medicine contribute to the death denial culture, hindering communication about end-of-life care. This paper discusses challenges arisen due to poor public awareness and professional training and local initiatives to promote advance care planning in the community.

Development of a nurse-led decision counseling program for improving hepatocellular carcinoma screening: A typology-guided feasibility study.

Objective: Hepatocellular carcinoma (HCC) is frequently diagnosed late. Although ultrasound-based HCC screening is recommended, its effectiveness is restricted by underutilization. This study aimed to develop a nurse-led decision counseling program used to improve HCC screening in patients with hepatitis B and to evaluate its feasibility in terms of process, resources, management, and cultural acceptance. Methods: The nurse-led decision counseling program was developed following the Medical Research Council framework and the preventive health model. Its components were informed by a systematic review and a qualitative study that had explored empirical HCC screening barriers. Guided by typology of Tickle-Degnen, a feasibility study was conducted among twenty eligible patients with hepatitis B, who were randomized to receive the intervention plus usual care or usual care only. Multisets of feasibility data were collected from interviews, field notes, and minutes of discussions with participants, family members, and clinical specialists. Results: The program consists of health education, tailored information, values clarification exercises, and exploring and addressing barriers, which help to achieve informed and value-based HCC screening utilization. Feasibility assessments identified and improved process issues, such as restrictive inclusion criteria and cultural challenges, including (1) default mistrust, (2) discrimination and confidentiality concerns, (3) cultural reluctance to open discussions about HCC screening, and (4) social influence under a collectivist culture. Conclusions: The study informs an innovative feasibility typology for nursing interventions and contributes to a promising, feasible, and culturally relevant intervention to improve HCC screening and prevent advanced diagnosis in hepatitis B-induced HCC in China and other hepatitis B-prevalent Asian countries. Trial registration: Clinicaltrials.gov: NCT04659005.

A theory-driven, culture-tailored educational intervention for cervical cancer screening among rural Chinese females: A feasibility and pilot study.

Objective: This study aimed to evaluate the feasibility and preliminarily estimate the effects of a theory-driven, culture-tailored, community-based educational intervention promoting cervical cancer screening among rural females. Methods: An experimental study with the two-arm parallel, nonrandomized control trial design was implemented, followed by individual semi-structured interviews. Thirty rural females between 26 and 64 were recruited, with 15 in each group. Both groups were exposed to the usual care about cervical cancer screening promotion from the local clinics, while participants in the intervention group additionally received five educational sessions in 5 weeks. Data were collected at baseline and immediately postintervention. Results: All participants completed the study, and the retention rate was 100%. Participants in the intervention group had more significant increments in cervical cancer screening-related self-efficacy (P â€‹< â€‹0.001), knowledge (P â€‹< â€‹0.001), and intention levels (P â€‹= â€‹0.003) than those in the control group. Most participants showed acceptance and satisfaction with this educational intervention. Conclusions: This study revealed that the theory-driven, culture-tailored, community-based educational intervention was feasible among the rural populations to promote cervical cancer screening. A large-scale interventional study with a prolonged follow-up duration is warranted to explore this educational intervention's effectiveness further.

Nurse-delivered acupressure on early postoperative gastrointestinal function among patients undergoing colorectal cancer surgery.

Objective: Postoperative gastrointestinal dysfunction occurred up to 25% of patients who undergo colorectal cancer surgery, which could cause severe complications and increase economic burden. This study aims to evaluate the effectiveness of nurse-delivered acupressure on early postoperative gastrointestinal function among patients undergoing colorectal cancer surgery. Methods: A total of 112 adult patients (≥ 18 years) scheduled to receive colorectal cancer surgery were randomized into two groups. Acupressure was practiced at ST36 for five days after operation, while the control group used gently rubbing skin. Primary outcomes were the time to first passage of flatus and defecation, while the secondary outcomes were the degree of abdominal distention and bowel motility. The Student's t-test and Mann-Whitney U test or Chi-square test and regression analyses were used, while for repeated measures of outcomes, area under the curve (AUC) was compared between groups and subgroups. Results: After adjusting for potential confounding variables, acupressure significantly shortened the time to have first flatus passage by 11.08 â€‹h (95%CI: -19.36 to -2.81; P â€‹< â€‹0.01). The first passage time of defecation (mean, 77.00 â€‹± â€‹36.27 â€‹h vs. 80.08 â€‹± â€‹28.88 â€‹h), abdominal distention (AUC, 5.68 â€‹± â€‹5.24 vs. 5.92 â€‹± â€‹4.03), and bowel motility (AUC, 12.09 â€‹± â€‹4.70 vs. 11.51 â€‹± â€‹3.00) in the intervention group had some improvement although the differences were not statistically significant (P â€‹> â€‹0.05). Conclusions: This study indicated that acupressure done by trained nurses could be an effective and feasible solution to promote early gastrointestinal function recovery among patients undergoing colorectal cancer surgery. Trial registration: Chinese Clinical Trial Registry (ChiCTR-IOR-17012460).

Is high-fidelity simulation-based training in emergency nursing effective in enhancing clinical decision-making skills? A mixed methods study.

AIM: To evaluate the effects of a high-fidelity simulation-based training in emergency nursing and the relationships between study outcomes. The objectives were to: (1) evaluate the effects of high-fidelity simulation-based training in emergency nursing on final-year nursing students' generic capabilities, self-confidence and anxiety during clinical decision-making; (2) examine the relationships between the outcomes of generic capabilities and clinical decision-making skills; (3) examine participants' satisfaction with the simulation experience; and (4) explore their experiences and opinions of the training module. BACKGROUND: Following the emergence of coronavirus disease 2019, safety and other considerations have limited the clinical training opportunities available to nursing students. This has resulted in the increased use of high-fidelity simulations to provide clinical training for nursing students. However, evidence of the effects of such training modalities on generic capabilities, clinical decision-making skills and learning satisfaction remains lacking. In particular, the effectiveness of high-fidelity simulations of emergency clinical situations in training has not been closely evaluated. DESIGN: A mixed methods study incorporating quasi-experimental and qualitative components. METHODS: We recruited a convenience sample of 255 final-year pre-registration nursing students (183 bachelor and 72 master students) from a government-funded local university in Hong Kong. Four case scenarios of emergency nursing were developed and simulated in the simulation wards of the study institution in May and June 2021. We assessed the pre- and post-intervention outcomes of generic capabilities and clinical decision-making skills. We also explored the participants' post-intervention satisfaction, experiences and opinions. RESULTS: Post-intervention, the participants reported significant improvements in generic capabilities, self-confidence and anxiety during clinical decision-making. They expressed a high level of satisfaction with the simulation experience. Additionally, we detected significant relationships between generic capabilities and clinical decision-making skills. Qualitative data analysis yielded four themes that either confirmed or complemented the quantitative findings. CONCLUSIONS: This study provides evidence of the effectiveness of high-fidelity simulation-based training in emergency nursing in enhancing students' learning outcomes. Further studies should include a control group, evaluate students' knowledge and skills, and retention of knowledge to confirm the true impact of such training.

Nurses' and Families' perceptions and practices and factors influencing the implementation of family-centred care for hospitalised children and their families.

AIMS AND OBJECTIVES: To explore the perceptions of family-centred care among nurses and the family members of hospitalised children and investigate the facilitators of and barriers to the implementation of family-centred care in Malawi. BACKGROUND: In Malawi, approximately 34% of children have long-term illnesses that require hospitalisation. Family-centred care ensures that the delivery of healthcare is grounded in partnerships between healthcare providers, patients and their families, which can improve the psychological well-being of families. However, there is lack a good understanding of how families and nurses perceive this concept, its facilitators and the barriers. DESIGN: This was an exploratory qualitative study. Data were analysed deductively and inductively using the five-step qualitative content analysis method. METHODS: Twenty-nine nurses and 31 families were recruited. Data were collected through in-depth, semi-structured and face-to-face individual interviews. The study was reported using the COREQ checklist. RESULTS: Both nurses and families of hospitalised children recognised the importance of nurse-family partnerships in family-centred care. Four themes emerged as follows: Perceptions of family-centred care, elements of family-centred care, facilitators of family-centred care and barriers to family-centred care. Specific information to families and the religious beliefs of families were identified as important facilitator and barrier to family-centred care, respectively. CONCLUSION: The implementation of family-centred care is promising in Malawi, as it is positively perceived by nurses and families, and its implementation is consistent with the Institute for Patient and Family-Centred Care Framework. RELEVANCE TO CLINICAL PRACTICE: Our findings present the best practices, gaps and challenges in the context of a low-income country regrading implementation of family-centred care. Education programmes on family-centred care are crucial for sustaining the current gains.

A qualitative study on stress, coping strategies and feasibility of music intervention among women with cancer receiving chemotherapy during COVID-19 pandemic in Vietnam.

Breast and gynaecological cancer (BGC) patients receiving chemotherapy may experience high levels of stress during the COVID-19 pandemic. Music interventions may be effective in lowering their stress levels. This study explored stressors, coping strategies, and the feasibility of music interventions among BGC patients in Vietnam. An exploratory qualitative study with individual face-to-face semi-structured interviews was conducted. A convenience sample of BGC patients receiving chemotherapy was recruited from the oncology centre of a public hospital in Vietnam. Twenty patients were interviewed with open-ended questions developed based on the transactional model of stress and coping to explore stress-causing factors and coping strategies and based on guidelines for music therapy practice to explore their music preferences and perceptions. Field notes and interview transcripts were analysed following the qualitative content analysis approach. Two stressor themes were identified: undesirable experiences during treatment and patients' inability to fulfil their own roles and responsibilities. Our findings revealed a new coping strategy-self-realisation of responsibilities towards the family-that is not listed in the transactional model of stress and coping. Future psychological interventions for stress management among BGC patients should focus on raising the patients' awareness of their values and responsibilities towards their families. Three categories of preferred music genres for stress reduction were identified: religious, softly melodic, and revolutionary music. The patients were aware of the positive effects of music and had different musical preferences. This study also explored the acceptance of music interventions and facilitators and barriers to implementing them among BGC patients in Vietnam. The findings suggest that before implementing music interventions, the musical preferences, religions, and beliefs of each individual should be considered to achieve desirable results. Music interventions for BGC patients receiving chemotherapy in Vietnam are feasible. Further intervention studies are needed to evaluate their effectiveness.

The effectiveness of WeChat couple-based psychosocial support for gynaecological cancer: A randomised controlled trial.

OBJECTIVE: This study aimed to evaluate the effectiveness of an 8-week electronic couple-based psychosocial support platform (WeChat) for gynaecological cancer. DESIGN: Randomised controlled trial. SETTING: Oncology hospital in Shaanxi Province, China. PARTICIPANTS: A total of 98 dyads of women with gynaecological cancer and their intimate male partners were included. METHODS: Couple dyads were randomly allocated to either the WeChat couple-based psychosocial support or to a control group receiving eight WeChat articles on general education content related to diet and exercise. MAIN OUTCOME MEASURES: The primary outcome was sexual function assessed with the Female Sexual Function Index. The secondary outcomes of relationship satisfaction and quality of life were assessed with the Chinese version of Revised Dyadic Adjustment Scale, Functional Assessment of Cancer Therapy-General and The World Health Organization Quality of Life BREF. These outcomes were assessed before randomisation, and immediately and 3 months after the intervention. RESULTS: The study showed that the sexual function of women participants in the intervention group did not reach a significant level compared with the control group. Relationship satisfaction in the intervention programme improved significantly (adjusted mean difference 4.7, 95% confidence interval [CI] 2.0-7.4; p = 0.001) and quality of life (QoL 6.9, 95% CI 0.5-13.3; p = 0.035) 3 months after the intervention in women with gynaecological cancer. The intervention programme also showed significant positive effects on optimising relationship satisfaction (adjuste mean difference 3.0, 95% CI 0.3-5.7; p = 0.027) of male partners. CONCLUSIONS: The results provided additional knowledge and an evidence base for the application of the support programme to improve relationship satisfaction and QoL among couples living with gynaecological cancer.

Development of an evidence­based, theory­driven, and culturally appropriate character strengths-based intervention for breast cancer patients, following the Medical Research Council Framework.

PURPOSE: To design and develop a complex, evidence­based, theory­driven, and culturally appropriate character strengths-based intervention (CSI) for breast cancer patients, following the Medical Research Council (MRC) framework. METHODS: From 2018 September to 2020 November, a complex intervention perspective was adopted. The rationale, methods, and processes employed in carrying out the study were reported. The acceptability and feasibility of intervention program were evaluated as a part of subsequent pilot study. Based on piloting, a refined and optimized definitive intervention was obtained. The development of the intervention is an iterative process involving input from three key stakeholders: experts, medical staff, and patient representatives. RESULTS: The systematic review revealed CSIs were effective and the selected theory served as a guide and indicated theory-inspired modifications. A representative team of breast cancer patients and oncology nurses collaboratively developed and tailored the intervention content and format with attention to the acceptability and feasibility. Five main strategies, including peripheral, evidential, linguistic, constituent-involving, and sociocultural strategies, were used to achieve and strengthen the cultural appropriateness. After the pilot phase, several refinements were made on the CSI program, such as editorial changes in the booklet or alternative suggestions for difficult strengths-based activities (e.g., outdoor activities). All participants not only expressed satisfaction with the program in process evaluation, but also reported perceived benefits such as enjoyable and sociable experience, better well-being, and increased confidence. CONCLUSION: Consideration of the MRC framework, theory guidance, and suggestions from stakeholders during intervention development can optimize uptake and sustainability in the clinical setting. It is recommended that randomized controlled trial be used in future studies to assess the intervention, the process and the mechanisms of the intervention. Our approach may offer implications for the design and implementation of similar initiatives to support cancer patients. TRIAL REGISTRATION: ClinicalTrials.gov Register Identifier: NCT04219267, 07/01/2020, retrospectively registered.

Educational Interventions to Promote Cervical Cancer Screening among Rural Populations: A Systematic Review.

The urban-rural gap in cervical cancer screening uptake is a significant public health consideration. Educational interventions are commonly adopted to promote cervical cancer screening among females in rural areas; however, the characteristics and effectiveness of these educational interventions remain unclear. In this review, we aimed to identify the characteristics of educational interventions used in rural populations and to evaluate the effects of these interventions on cervical cancer screening-related outcomes. Seven English databases were searched in January 2022. Randomized controlled trials (RCTs) and quasi-experimental studies were included. The Joanna Briggs Institute (JBI) Critical Appraisal Checklist for Randomized Controlled Trials and the JBI Critical Appraisal Checklist for Quasi-Experimental Studies were used for quality appraisal. RevMan 5.4 software was used for the meta-analysis. A narrative synthesis was conducted in instances where a meta-analysis was inappropriate. Three RCTs and seven quasi-experimental studies conducted in six countries were included. A social cognitive theory-based framework, the community setting, group sessions, healthcare professional-led approaches, and culture-tailored materials were implemented in the educational interventions for cervical cancer screening. The educational content mainly included basic information on cervical cancer screening, psychological issues, barriers and strategies to overcome them, and locally available resources. Educational interventions increased the knowledge and uptake of cervical cancer screening in the rural population. However, the studies only evaluated the short-term effects of these educational interventions, with the cervical screening behavior only being assessed in one instance for each participant. Educational interventions promote cervical cancer screening among females in rural areas. Theory-driven, community-involved, group-based, and healthcare professional-led approaches should be prioritized in the application of educational interventions in rural populations. Both the short- and long-term, influences of educational interventions on the cervical cancer screening behavior of females in rural areas need to be recognized.

The Chinese version of the Revised Dyadic Adjustment Scale for gynaecological cancer patients and their partners: Translation and psychometric evaluation.

Objective: The objective of the study was to translate the revised dyadic adjustment scale into Chinese and evaluate its psychometric properties in gynaecological cancer patients and their male partners. Methods: A cross-sectional design with a random subsample re-tested at the one-week interval was adopted. Gynaecological cancer patients and their partners were asked to complete the Chinese version of the revised dyadic adjustment and quality of marriage index. Internal consistency, test-retest reliability, convergent validity, structural validity and known-group validity was assessed. Results: A total of 252 participants (i.e., 126 female patients and 126 male partners) were recruited. The Chinese version of the Revised Dyadic Adjustment showed good internal consistency (Cronbach's α â€‹= â€‹0.85), test-retest reliability (r â€‹= â€‹0.88), known group validity and adequate convergent validity with a significant positive correlation (r â€‹= â€‹0.60) with the Quality of Marriage Index. Confirmatory factor analysis indicated an acceptable model fit to a second-order three-factor structure (GFI â€‹= â€‹0.913, RMR â€‹= â€‹0.046, CFI â€‹= â€‹0.932). Conclusions: The Chinese version of revised dyadic adjustment demonstrated good reliability and acceptable validity in gynaecological cancer patients and male partners. The scale can be used to assess the effectiveness of clinical nursing services for couples on their relationship and to compare marital satisfaction and adjustment between China and other parts of the world.

Psychometric validation of the Chinese version of the M. D. Anderson Symptom Inventory-Head and Neck Module in patients with nasopharyngeal carcinoma.

Objective: The Chinese version of the M. D. Anderson Symptom Inventory-Head and Neck Module (MDASI-HN-C) has been linguistically validated. However, its psychometric properties have not been established yet. The purpose of the study was to psychometrically validate the MDASI-HN-C in patients with nasopharyngeal carcinoma (NPC). Methods: 130 Chinese NPC patients who were undergoing radiotherapy (RT) participated in this cross-sectional study. The content, convergent, and construct validity of the MDASI-HN-C were examined. The reliability of the instrument was tested by examining the internal consistency and test-retest reliability. Results: Cronbach's α coefficients ranged from 0.85 to 0.91 for the three subscales of the MDASI-HN-C. The 3-day test-retest reliability was acceptable with intraclass correlation coefficients (ICC) ranged from 0.52 to 0.71. The scale content validity index (S-CVI) was satisfactory (0.97). Subscale scores of the MDASI-HN-C were negatively correlated with the total score of the Chinese version of the Functional Assessment of Cancer Therapy-Head and Neck Scale (FACT-H&N-C) as hypothesized (r â€‹= â€‹-0.484 to -0.563, all P â€‹< â€‹0.01). Exploratory factor analysis (EFA) revealed two factors for the 13 core and another two for the nine HNC-specific items. Only one factor was generated for the six interference items. Conclusions: The MDASI-HN-C shows desirable psychometric properties for evaluating symptom burden in NPC patients, which can be used in both clinical and research contexts.

Effect of a family-based multimedia intervention on the uptake of faecal immunohistochemical test among South Asian older adults: A cluster-randomised controlled trial.

BACKGROUND: Colorectal cancer screening, including faecal immunohistochemical test, is an effective method for detecting colorectal cancer early. Nevertheless, faecal immunohistochemical test uptake among South Asian ethnic minorities is low because they have limited knowledge of and face barriers in accessing colorectal cancer screening. Tailored education and appropriate messaging has potential to convey to this population group the importance of colorectal cancer screening. OBJECTIVES: This study aimed to assess the acceptability and effectiveness of a family-based multimedia intervention to raise awareness of colorectal cancer screening and increase the uptake of faecal immunochemical tests among South Asian older adults. DESIGN: A cluster-randomised controlled trial with a wait-list control group. PARTICIPANTS: Three-hundred and twenty dyads of South Asian older adults and their younger family members were recruited at South Asian community centres and non-governmental organisations providing support services to local South Asians in six Hong Kong districts. METHODS: Group allocation of dyads during cluster randomisation was based on the group assignment of the district where they were recruited. The intervention comprised a multimedia health talk, conveying the importance of colorectal cancer screening and support from younger family members in encouraging their older relatives to undergo screening. Site coordinators assisted participants in accessing faecal immunohistochemical test. The primary outcome was increased uptake of faecal immunohistochemical test among South Asian older adults. Secondary outcomes included younger family members' encouragement of their older relatives to undergo faecal immunohistochemical test and their readiness to assist their relatives with the test. Acceptability of the intervention was measured by dyad satisfaction with the intervention. RESULTS: The proportion of older adults participating in faecal immunohistochemical testing was significantly higher among intervention dyads compared with controls (71.8% vs 6.8%, p < 0.001). No significant within-group change was observed on the willingness of younger family members in the intervention group to encourage older adults to undergo faecal immunohistochemical test, nor their readiness to assist older adults in doing so, although a decrease in both outcomes was observed among the control group. Most participants (>86%) were satisfied with the intervention. CONCLUSIONS: Our findings demonstrate the acceptability and effectiveness of the intervention in enhancing faecal immunohistochemical test uptake among South Asian older adults, and the benefit of using a family-based approach in the implementation of cancer screening interventions for these individuals. Implementation of the intervention as a component of usual care within South Asian communities is recommended. Trial registration ISRCTN72829325, 10 July 2018.

A nurse-led sexual rehabilitation programme for rebuilding sexuality and intimacy after treatment for gynaecological cancer: Study protocol for a randomized controlled trial.

AIM: To implement a nurse-led sexual rehabilitation programme for gynaecological cancer (GC) survivors and to evaluate its effects on their sexual functioning, sexual distress and marital satisfaction. DESIGN: An assessor-blinded, randomized controlled trial. METHODS: The development of the nurse-led sexual rehabilitation intervention was guided by the concept of sexual health, as stated in the Neotheoretical Framework of Sexuality; the explicit permission giving, limited information, specific suggestions and intensive therapy model; and evidence-based nursing interventions for sexuality. Four intervention sessions will be delivered along the treatment trajectory. Women newly diagnosed (within 3 months) with GC will be recruited from the gynaecological units of three hospitals in Hong Kong. The participants (N = 172) will be randomly assigned to the intervention group to receive the nurse-led sexual rehabilitation programme, or to an attention control group to receive attention on four occasions during the same period when the intervention group receives the intervention. Sexual functioning, sexual distress and marital quality will be measured at baseline, 1 month after the completion of cancer treatment, after completion of the sexual rehabilitation programme and 12 months after cancer treatment. Semi-structured interviews will be conducted with the participants in the intervention group to explore their experiences with and feelings towards the programme. The study was funded in March 2019 and ethics approval was obtained in January 2019. DISCUSSION: Positive outcomes of the nurse-led sexual rehabilitation programme will contribute to scientific and practical knowledge about nursing interventions to help GC survivors and their partners to resume a satisfying intimate relationship and adapt to changes in sexuality after treatment. IMPACT: This study will contribute to the evidence for and advance research on the effectiveness of nurse-led sexuality rehabilitation interventions to support women and their partners to rebuild sexuality and intimacy after treatment for GC.