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Aim: Cognitive concerns are one of the most frequently reported symptoms by breast cancer survivors. This study aimed to evaluate perceived cognitive functioning in Portuguese women with breast cancer treated with chemotherapy. Methods: A cross‐sectional study enrolling 146 women (73 with breast cancer and 73 healthy) was conducted from August to October 2017, invited to participate through online dissemination. Participants completed self‐reported questionnaires to collect sociodemographic and clinical data and assess perceived cognitive functioning and psychological adjustment variables (anxiety and depression). Results: Compared to healthy women, women with breast cancer showed significantly lower scores on the Functional Assessment of Cancer Therapy‐Cognitive Function (FACT‐Cog) subscales and higher levels of depression. Both groups showed significant negative correlations between perceived cognitive functioning and anxiety and depression. Health status and depression seem to better explain perceived cognitive functioning, with health status adding significantly more explained variance beyond sociodemographic and psychological adjustment variables. Conclusion: The current findings provide evidence for the existence of more cognitive complaints among Portuguese women with breast cancer, compared to healthy individuals. Anxiety, depression, age and education also explain perceived cognitive functioning. Considering that health status and psychological adjustment seem to significantly explain perceived cognitive functioning, special attention should be given by health‐care professionals, including nurses, to designing clinical interventions for breast cancer patients to help manage cognitive impairment. Summary statement: What is already known about this topic? Cancer and associated treatments have diverse short‐ and long‐term side effects. Deficits in cognitive functions are one of the most frequently reported for breast cancer specifically due to chemotherapy.Subjective assessment of cognitive function is often neglected, although it might be clinically very useful and an important indicator of the impact of cognitive impairment on daily functioning.There is currently no Portuguese data on perceived cognitive impairment in cancer. What this paper adds? This Portuguese study shows that, compared to a matched healthy sample, breast cancer patients have significantly more cognitive complaints, as assessed by the FACT‐Cog scale.Furthermore, our findings showed that higher levels of anxiety and depression are associated with worse perceived cognitive functioning.Cognitive complaints in breast cancer patients are predicted by a complexity of factors, such as psychological adjustment, age, and education. The implications of this paper: Health‐care professionals, including nurses, should recognize cognitive complaints as legitimate in breast cancer patients.Findings may deepen nurses' knowledge about cognitive concerns in breast cancer patients, in order to improve the quality of care provided to this population.The results of the study highlight the importance of tackling this problem with specifically designed clinical interventions that target both the cognitive deficits and the psychological adjustment of patients, especially depressive symptomatology. [ABSTRACT FROM AUTHOR]

Background: There are controversial results about the effects of cancer and chemotherapy on the perception of distress. Aims: The purpose to the study is to explore the meaning of the distress experienced by patients with cancer and verify whether the cancer diagnosis, stage and receiving chemotherapy influence this experience. Design This is a mixed‐methods study with cancer patients. Methods: Data were collected in 2018 using a phenomenological interview (n = 18) and one suffering inventory (n = 100). Qualitative analysis was performed using the empirical‐comprehensive model and quantitative using statistical tests. The results were triangulated. Results: Distress originated from difficulties faced in health services, diagnosis confirmation, beginning treatment and interruption of life projects. Patients mobilized resources in the spiritual dimension that allowed them to redefine their distress positively. Chemotherapy brought hope back and promoted healing expectations. Higher average scores for distress were found in patients with advanced stage and receiving palliative chemotherapy. Not having begun chemotherapy and having head and neck cancer were associated with higher average scores for distress. Conclusion: Distress was greater among patients who had not yet begun chemotherapy; nearness of death and difficulty talking about feelings caused distress; distress was redefined by mobilization of spiritual resources. Summary statement: What is already known about this topic? There are conflicting results about distress between patients with cancer.The distress of cancer patients has been little reported or treated in cancer care units.There are no mixed‐method studies on distress in chemotherapy patients that have combined a measuring instrument and a phenomenological approach. What this paper adds? Distress among patients with cancer derives from elements that relate to health services, as well as the individual's ability to deal with the situation.Distress is greater among patients who have not begun chemotherapy and those who have head and neck cancer diagnoses.Phenomenological method can complement the use of scales to assess the subjective experience of distress in the context of cancer and chemotherapy. Implications of this paper Distress evaluation must encompass listening and the use of measurement instruments to strengthen the implementation of patient‐centred nursing care.Nurses are in a unique position to identify and approach distress, because they are often at the side of patients throughout the course of treatment.Professional training for reporting of difficult news is required. [ABSTRACT FROM AUTHOR]

Background: Post‐operative diarrhoea is a common adverse event after pancreatic surgery. While the risk factors for this condition have been identified, the increasing trend of administering chemotherapy before surgery might change these factors. This study aimed to identify the risk factors of post‐operative diarrhoea in patients with pancreatic ductal adenocarcinoma (PDAC) who underwent neoadjuvant chemotherapy. Design: A retrospective cohort study. Methods: Patients who underwent neoadjuvant chemotherapy and pancreatectomy because of PDAC between 2021 and 2023 were included. The preoperative characteristics of, operative details of and post‐operative outcomes in patients with and without post‐operative diarrhoea were collected and compared. The independent risk factors of post‐operative diarrhoea were identified using logistic regression analysis. STROBE checklist was used. Results: Post‐operative diarrhoea occurred in 65 out of 145 (44.8%) patients during hospitalization. Elevated white blood cell count, advanced tumour stage, and late abdominal drain removal were independent risk factors for post‐operative diarrhoea (p <.001, p =.006 and p =.009, respectively). Conclusions: Some perioperative factors influence post‐operative diarrhoea in patients who undergo neoadjuvant chemotherapy. More attention should be paid to patients at a higher risk of post‐operative diarrhoea, with an emphasis on high‐quality management for these patients. [ABSTRACT FROM AUTHOR]

Aims: To examine the prevalence and associated factors of chemotherapy‐related cognitive impairment (CRCI) in older breast cancer survivors (BCS). Design: Systematic review. Data Sources: We searched EMBASE, PubMed, PsychInfo, CINAHL, Cochrance Library, Web of Science, CNKI and SinoMed, without language restrictions, for studies published from the establishment of the database to September 2022. Review Methods: Two researchers independently examined the full texts, data extraction and quality assessment, and any discrepancies were resolved through discussion with a third reviewer. Quality of evidence was assessed using the Newcastle‐Ottawa Scale and the Agency for Healthcare Research and Quality Scale. Results: The seven included studies showed that the estimated prevalence of CRCI in older BCS ranged from 18.6% to 27% on objective neuropsychological tests and from 7.6% to 49% on subjective cognitive assessments. The areas most affected were attention, memory, executive functioning and processing speed. CRCI was associated with 10 factors in six categories, including sociodemographic (e.g. age, education level), physiological (e.g. sleep disorders, fatigue and comorbidities), psychological (e.g. anxiety, depression), treatment modalities (e.g. chemotherapy cycles, chemotherapy regimens), genetic (e.g. APOE2, APOE4) and lifestyle factor (e.g. physical inactivity). Conclusion: CRCI is multifactorial and has a relatively high prevalence. However, the results of subjective and objective cognitive examinations were inconsistent, possibly due to variations in tools used to evaluate different definitions of CRCI. Nevertheless, as there are few published studies of older BCS, this conclusion still require verification by well‐designed studies in the future. Impact: We found that the prevalence of CRCI in older adults is relatively high and multifactorial, providing evidence for further health care for this population. No Patient or Public Contribution: There was no patient or public involvement. [ABSTRACT FROM AUTHOR]

Aims and Objectives: To describe the main acupuncture techniques and parameters that have been used in the most varied symptoms of different types of cancer. Background: Clinical evidence about the potential effectiveness of acupuncture and related therapies to control signs and symptoms associated with cancer or its treatment has been in several studies. Currently, there is already evidence of the use of acupuncture for the treatment of nausea and vomiting, fatigue, dry mouth, anxiety, depression, insomnia and pain. However, many studies lack firm rights or reproducible guidelines for treatment. Design: This study performs a systematic review of clinical trials related to the topic, based on the PRISMA protocol. Thus, a search was carried out in the Scopus, Pubmed and Web of Science databases, covering studies since January 2007. Methods: Structured and organised according to PICO standards, using keywords ("cancer" OR "malignant tumour" OR "chemotherapy" OR "radiotherapy") AND ("acupuncture" OR "electroacupuncture") AND ("pain" OR "nausea" OR "vomit" OR "fatigue" OR "xerostomia" OR "insomnia" OR "depression" OR "neuropathy"). Results: After the selection and evaluation phase, 23 studies were included and analysed. Conclusion: Based on this analysis, it is concluded that acupuncture is safe and there is evidence of the reduction of gastrointestinal symptoms, chemotherapy‐induced peripheral neuropathy, pain, dry mouth, fatigue, insomnia, and improvement of cognitive capacity. Relevance to clinical practice: Acupuncture treatments could act by minimising the side effects of conventional treatments and reducing symptoms induced by tumours. No Patient or Public Contribution: The patients had no direct involvement with the study in question. [ABSTRACT FROM AUTHOR]

Aims and Objectives: To identify symptom clusters and examine their association with health‐related quality of life. Background: Multiple myeloma patients undergoing chemotherapy suffer from disease symptoms and adverse effects during the course of the disease. However, single symptom management has little effect, and symptom management for these patients remains challenging. Symptom clusters open a new perspective and provide important clues for symptom management. Design: A cross‐sectional study. Method: Participants were invited to complete the Chinese version of the Memorial Symptom Assessment Scale and Quality of Life Questionnaire‐core 30. Appropriate indicators were used for descriptive statistics. Principal component analysis was used to identify symptom clusters. Associations between symptom clusters and quality of life were examined with Pearson correlation coefficients, Pearson correlation matrix and multiple linear regression. This study was reported following the STROBE checklist. Results: A total of 177 participants were recruited from seven hospitals in this study. We identified self‐image disorder, psychological, gastrointestinal, neurological, somatic and pain symptom clusters in multiple myeloma patients with chemotherapy. Approximately 97.65% of patients suffer from multiple symptom clusters. The pain, psychological and gastrointestinal symptom clusters have negatively influence on health‐related quality of life. The strongest association was found with the pain symptom cluster. Conclusion: Most of multiple myeloma patients suffer from multiple symptom clusters. When improving the multiple myeloma patients' health‐related quality of life, the clinical staff should prioritise relieving the pain symptom cluster. Relevance to Clinical Practice: When multiple myeloma patients undergoing chemotherapy suffer from multiple symptom clusters, nurses should prioritise relieving the pain symptom cluster to improve their health‐related quality of life. When drawing up and providing interventions, nurses should focus on the correlation among symptoms rather than single symptom. By relieving one symptom in a given cluster, other symptoms within the same symptom cluster may also be relieved. [ABSTRACT FROM AUTHOR]

Objective: To develop and test the model of association of social connectedness and health‐related quality of life (HRQoL) among patients with cancer undergoing chemotherapy and to describe their social connectedness through photo‐elicitation. Background: Social connectedness has been empirically associated with several well‐being outcomes. However, little is known on the association of social connectedness among patients with cancer undergoing chemotherapy. Methods: Employing a mixed‐methods design following the good reporting of a mixed methods study guideline, the quantitative approach involved 230 consecutively‐selected patients with cancer undergoing chemotherapy who answered a three‐part survey. From these patients, six informants participated in the photo‐elicitation and key informant interview sessions. Gathered data were quantitatively analyzed using structural equation modelling and qualitatively processed using polytextual thematic analysis. Results and Findings: Social connectedness had a positive influence on social well‐being (β =.22, p =.008) and emotional well‐being (β =.20, p =.023); however, it had a negative effect on functional well‐being (β = −.20, p =.007). The overall model revealed good model indices: χ2/df =.82, RMSEA =.01, GFI = 1.00. Qualitative analysis culled from photo‐elicitation uncovered five interconnected themes yielding the Honeycomb model of social connectedness which was composed of correspondence, cohesion, constitution, convergence and corroboration. Conclusion: HRQoL among patients with cancer undergoing chemotherapy is a multi‐factorial health construct affected by social connectedness. The presented model emphasises the importance of social connectedness and paves way for the development of appropriate strategies to promote social connectedness among patients with cancer undergoing chemotherapy. Relevance to Clinical Practice: The findings provide impetus in the modification and development of appropriate practices, policies and strategies in promoting social connectedness. These approaches are geared towards patient–family empowerment and health education techniques to ascertain that assistance from significant others is provided without limiting the patient's autonomy or independence. [ABSTRACT FROM AUTHOR]

Background: A range of psychological issues often accompany breast cancer chemotherapy. Due to their ubiquity, mobile phones have been used to deliver supportive interventions addressing these issues. However, we currently lack sufficient evidence to guide the design of such interventions. Aim: To analyse and synthesise available evidence on the effectiveness of mobile‐phone‐based (mHealth) interventions in alleviating the psychological issues experienced by women receiving chemotherapy for breast cancer. Methods: A systematic literature search was conducted from 14 relevant databases. Revman 5.4 was used to pool the quantitative results from comparable studies for statistical meta‐analysis. For clinically heterogeneous studies where statistical pooling of results was not possible, a narrative summary was used to present the findings. Results: The review included nine RCTs which covered 1457 patients. The meta‐analysis results indicated a significant improvement in the quality of life (standardised mean difference [SMD] = 0.32, 95% confidence interval [CI] [0.07, 0.58], p =.01, I2 = 17%). No significant effects were found for anxiety (SMD = −0.01, 95% CI [−0.26, 0.25], p =.96, I2 = 53%) and depression (SMD = 0.02, 95% CI [−0.17, 0.20], p =.87, I2 = 0%). Individual studies suggest reduced symptom prevalence (p =.033, d = 0.27), symptom distress (p =.004, d = 0.34), symptom interference (p =.02, d = 0.51), supportive care needs (p <.05, d = 2.43); improved self‐efficacy (p =.03, d = 0.53), self‐esteem (p <.001, d = 0.87) and emotional functioning (p =.008, d = 0.30). The methodological quality ranged from low to moderate. Conclusion: mHealth interventions might help address certain psychological issues experienced by this population, although the evidence is still being gathered and not yet conclusive. More rigorous trials are warranted to confirm the suitable duration while addressing the methodological flaws found in previous studies. PROSPERO registration number: CRD42021224307. [ABSTRACT FROM AUTHOR]

The article focuses on cancer as a leading cause of global death, with a projected increase in cases by 47% by 2040. It authors conducted a systematic review on the efficacy of acupuncture in cancer patients undergoing chemotherapy or radiotherapy, highlighting its safety and potential benefits in reducing various symptoms associated with cancer treatments.

Aims and objectives: This study set out to understand the experiences and expectations of scalp cooling among women with early‐stage breast cancer. The objective was to develop patient co‐produced information resources to better inform and prepare women considering scalp cooling during chemotherapy. Background: Treatment‐induced alopecia is a common concern among women preparing for chemotherapy. Evidence indicates that many women feel inadequately prepared for scalp cooling, resulting in potentially mitigable distress and disappointment. Design: A single‐site, sequential, explanatory mixed‐methods design was used. Participants included women with early‐stage breast cancer who had previously or were currently using, scalp cooling. Women completed an online survey exploring scalp cooling experiences and expectations and self‐selecting participants took part in one semi‐structured, audio‐recorded interview. Guidelines for Good Reporting of a Mixed Methods Study were followed. Results: Forty‐nine women (69%) consented to take part in the survey and 23 took part in an interview. Most women described losing more hair than they expected. Many described feeling inadequately prepared for the discomfort of scalp cooling; the additional time needed to accommodate scalp cooling during treatment and, that they lacked information about self‐ care to help minimise hair loss. Importantly, several participants described variability in nurses' knowledge and practical skills regarding scalp cooling. Conclusions: To optimise experience of scalp cooling, women need comprehensive preparatory information about variability in efficacy of scalp cooling; time needed to accommodate scalp cooling; hair care during treatment, and the potential discomfort associated with it. They also need nurses to be confident and well informed about scalp cooling processes. Relevance to clinical practice: Our study led to the development of online, patient co‐produced resources to help prepare and inform women considering using scalp cooling; and an online scalp cooling training module and checklist for nurses. Links to the resources are included in the manuscript. [ABSTRACT FROM AUTHOR]

Aim: To develop and test the psychometric properties of the Taiwanese safety climate instrument suitable for nurses handling chemotherapy drugs. Design: This is an instrument development study. Method: All four stages, including questionnaire design, expert consultation, cognitive testing and psychometric validation, were used in this study. The data were collected between August and December 2018. Nurses with experience in handling chemotherapy drugs (N = 484) at one medical centre and two regional hospitals in Taiwan completed this instrument. Data were randomly split into two groups: one group (N = 237) for exploratory factor analysis and the other (N = 247) for confirmatory factor analysis. Results: The instruments' items were based on qualitative research, and the content validity index levels exceeded the acceptable value. An exploratory factor analysis revealed 43 items remaining in six factors, which accounted for 74.4% of variance. The result of the confirmatory factor analysis verified the acceptability of a 43‐item model. The composite reliability values, Cronbach's alpha values, convergent validity and discriminant validity for each factor exceeded the acceptable value. Conclusion: Most climate safety instruments used in the health care sector focus mainly on patient safety outcomes. Furthermore, there is no safety climate instrument for handling chemotherapy drugs, and there is a cultural difference. Through the development and validation process, we have developed a new instrument suitable for nurses handling chemotherapy drugs, which has good psychometric properties. Impact This instrument is valuable as its development was based on the concept of a safety climate for health care perceptions and qualitative survey findings. Hospital managers can use this instrument regularly to evaluate nurses' perceptions of the safety climate to determine the strengths and weaknesses of their workplace, thereby assisting organizational managers in proposing concrete actions. [ABSTRACT FROM AUTHOR]

Aims: To examine patient-caregiver concordances about psychological distress among Chinese patients with breast cancer undergoing chemotherapy and identify factors related to concordance among patients and family caregivers. Design: Cross-sectional study. Methods: From October 2019 to June 2020, 137 patient-caregiver dyads were enrolled. Sociodemographic information, the distress thermometer (including the problem list), the Distress Disclosure Index and the Family Adaptability and Cohesion Evaluation Scale were used to collect data. Data were analysed using intraclass correlation coefficients (ICC), kappa statistics, two related samples test, chi-square tests and/or Fisher's exact tests and binary logistic regression. Results: Overall, fair agreement was identified between patients' and caregivers' reports (intraclass correlation coefficients [ICC] = .528). Patients reported significantly higher psychological distress scores than paired caregiver reports. Lower psychological distress concordance was found among patients with comorbidities (odds ratio [OR], 0.352; 95% confidence interval [CI], 0.155-0.798) and lower levels of self-disclosure (OR, 0.402; 95% CI, 0.186-0.868). Conclusion: There was relatively low concordance between patients' reports and caregivers' perceptions of psychological distress. Family caregivers tended to underestimate patients' psychological distress. A comorbid condition and lower levels of self-disclosure contributed to this bias. Impact: Having an awareness of the incongruence between patient and caregiver may help healthcare providers better interpret caregiver assessments. Healthcare providers should reinforce patient-caregiver dyadic psychosocial education to improve concordance. More psychological care and substantial emotional support should be provided for Chinese breast cancer patients undergoing chemotherapy by family caregivers and healthcare providers. [ABSTRACT FROM AUTHOR]