Symptom clusters and related factors in oesophageal cancer patients 3 months after surgery.

AIM: To explore symptom clusters experienced by patients with oesophageal cancer 3 months after surgery and examine whether symptom clusters are related to demographic, clinical and quality of life variables. BACKGROUND: There are multiple symptoms in patients with oesophageal cancer after surgery, which seriously affect their quality of life. Exploring the mechanics of concurrent symptoms such as symptom clusters may facilitate the development of strategies to reduce the impact of these symptoms and improve quality of life. DESIGN: Cross-sectional survey. The STROBE Statement was chosen as the EQUATOR checklist. METHODS: A convenience sample of 128 oesophageal cancer patients was followed up at 3 months after surgery. Participants completed the demographic questionnaire, the M. D. Anderson Symptom Inventory for Gastrointestinal Cancer, the Functional Assessment of Cancer Therapy-General and the Connor-Davidson Resilience Scale. Exploratory factor analysis, stepwise regression and correlation analysis were applied. RESULTS: Four symptom clusters were identified: dysphagia-psychological, chemoradiotherapy side-effect, digestive tract reconstruction and fatigue-sleep. Gender, stage of disease and resilience influenced the dysphagia-psychological symptom cluster. Gender, stage of disease, resilience and treatment were significant factors affecting the chemoradiotherapy side-effect and fatigue-sleep symptom clusters. Gender, stage of disease, resilience and anastomotic position were significant factors influencing the digestive tract reconstruction symptom cluster. The correlations between symptom clusters and quality of life were significant, with the highest correlation between the dysphagia-psychological cluster and quality of life. CONCLUSIONS: Nurses should pay more attention to symptom management in patients with oesophageal cancer 3 months after surgery by focusing on four symptom clusters. It is necessary to implement individualised care depending on the influence factors including gender, stage of disease, resilience, treatment and anastomotic position. RELEVANCE TO CLINICAL PRACTICE: These findings will help develop targeted interventions to facilitate further symptom management for transitional nursing from the peri-operative phase to long-term rehabilitation.

Emotional intelligence a academic procrastination among junior college nursing students.

AIMS: To explore nursing students' academic procrastination and its relationship with emotional intelligence (EI) and self-efficacy, and self-efficacy's mediation of the relationship between EI and academic procrastination. BACKGROUND: Academic procrastination can lead to a range of negative outcomes. Previous researches have suggested EI and self-efficacy are associated with academic procrastination, but the underlying mechanism of the relationships between them is not clear. Therefore, it is important to determine how these two factors affect academic procrastination. DESIGN: A cross-sectional survey. METHODS: A convenience sample of 347 nursing students was recruited from two junior colleges in Jinan City, Shandong Province, China. RESULTS: Emotional intelligence and self-efficacy were negatively associated with academic procrastination. Furthermore, self-efficacy mediated the relationship between EI and academic procrastination. CONCLUSIONS: Students who report lower EI and self-efficacy may be at a higher risk of academic procrastination. One way of weakening individuals' procrastination is to strengthen their EI. Another is to help them believe in their abilities rather than fear failure in achieving their goal. Focusing more on these influencing factors can help nursing educators develop intervention measures aimed at decreasing students' procrastination behaviour, such as through EI and self-efficacy training. IMPACT: The findings from the current study could have important implications for nursing education. That is, students who report lower EI and self-efficacy may be at a higher risk of academic procrastination. A larger focus on these influencing factors can help nursing educators and consultants develop intervention measures aimed at decreasing students' procrastination behaviour.

[Effects of acid rain stress on Eleocarpus glabripetalus seedlings leaf chlorophyll fluorescence characteristics and growth].

A pot experiment was conducted to study the Eleocarpus glabripetalus seedlings leaf chlorophyll fluorescence characteristics and growth in different seasons under simulated acid rain stress (heavy, pH = 2. 5; moderate, pH = 4.0; and control, pH = 5.6). In the same treatments, the leaf relative chlorophyll content (SPAD), maximum PS II photochemical efficiency (F(v)/F(m)), actual PSII photochemical quantum yield (phi(PS II)), plant height, and stem diameter in different seasons were all in the order of October > July > April > January. In the same seasons, all the parameters were in the order of heavy acid rain > moderate acid rain > control. The interactions between different acid rain stress and seasons showed significant effects on the SPAD, F(v)/F(m), plant height, and stem diameter, but lesser effects on phi(PS II), qp and qN.

[Effects of simulated acid rain on Quercus glauca seedlings photosynthesis and chlorophyll fluorescence].

Taking the seedlings of Quercus glauca, a dominant evergreen broadleaf tree species in subtropical area, as test materials, this paper studied their photosynthesis, chlorophyll fluorescence, and chlorophyll content under effects of simulated acid rain with pH 2.5, 4.0, and 5.6 (CK). After 2-year acid rain stress, the net photosynthetic rate of Q. glauca increased significantly with decreasing pH of acid rain. The acid rain with pH 2.5 and 4.0 increased the stomatal conductance and transpiration rate, and the effect was more significant under pH 2.5. The intercellular CO2 concentration decreased in the order of pH 2.5 > pH 5.6 > pH 4.0. The maximum photosynthetic rate, light compensation point, light saturation point, and dark respiration rate were significantly higher under pH 2.5 and 4.0 than under pH 5.6, while the apparent quantum yield was not sensitive to acid rain stress. The maximal photochemical efficiency of PS II and the potential activity of PS II under pH 2.5 and 4.0 were significantly higher than those under pH 5.6. The relative chlorophyll content was in the order of pH 2.5 > pH 5.6 > pH 4.0, and there was a significant difference between pH 2.5 and 4.0. All the results suggested that the photosynthesis and chlorophyll fluorescence of Q. glauca increased under the effects of acid rain with pH 2.5 and 4.0, and the acid rain with pH 2.5 had more obvious effects.

[Treatment and prognosis of tracheal invasion by papillary thyroid carcinoma].

OBJECTIVE: To explore the treatment and prognosis on patients with tracheal invasion by papillary thyroid carcinoma (PTC). METHODS: Forty-five patients treated for PTC with tracheal invasion between 1980 and 1995 were retrospectively analyzed. The different kinds of surgical modalities were performed according to the extent and degree of tracheal invasion by PTC. Neck dissect was performed in 39 patients. External beam radiotherapy was used postoperatively in patients with gross residual tumor or microscopic residual tumor in pathologic margins after resection. Survival was evaluated using the Kaplan-Meier method. RESULTS: (1) Twenty-eight patients with limited tracheal invasion were treated with shave excision, the 5- and 10-year survival rates were 85.0% and 62.6%, respectively. After a shave excision, the differences of 5- and 10-year survival rates between irradiated and nonirradiated patients were not statistically significant (P > 0.05). (2) Ten patients were radical excision for intraluminal involvement extending through the tracheal cartilage, including circumferential sleeve resection (4 cases), tracheal window resection (5 cases) and total laryngectomy (1 case), the survival rate was 80.0% for five years and 58.3% for ten years. After a radical excision, the differences of 5- and 10-year survival rates between irradiated and nonirradiated patients were not statistically significant (P > 0.05). (3) For 7 patients performing the palliative operation, the 5-and 10-year survival rates were 42.9% and 28.6%, respectively. For 4 patients received postoperative radiotherapy, the 5-and 10-year survival rates were 50.0% and 50.0%, respectively. Three patients didn't received postoperative radiotherapy, the 5-year survival rate was 33.3%, no patient survived for ten years. In these patients of incomplete resection, the differences of 5-and 10-year survival rates between irradiated and nonirradiated patients were not statistically significant (P > 0.05). CONCLUSIONS: PTC with limited involvement of the trachea could be treated successfully by shaving tumor off the tracheal cartilage. Intraluminal involvement extending through the tracheal cartilage could be resected radically in patients with PTC. Postoperative radiotherapy could improve the survival of the patients with PTC with tracheal invasion who have been performed incomplete resection.