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Aims: To explore predictors of lymphedema self‐management behaviours among Chinese breast cancer survivors based on the Integrated Theory of Health Behaviour Change, and to clarify the interrelationship among these variables. Design: Further analysis of a multicentre cross‐sectional and survey‐based study. Methods: A total of 586 participants with breast cancer were recruited from December 2021 to April 2022 in different cities in China. We used self‐reported questionnaires to collect data. Descriptive analysis, bivariate analysis and structural equation model were performed. Results: The Integrated Theory of Health Behaviour Change is suitable for predicting lymphedema self‐management behaviours. The final structural model showed good model fit. Social support, self‐efficacy and lymphedema knowledge positively affected lymphedema self‐management behaviours, directly and indirectly. Self‐regulation acted as a crucial mediator between these variables and self‐management. The direct path between social support and self‐regulation was not significant. Lymphedema knowledge and social support also influenced self‐management via illness perception, self‐efficacy and self‐regulation, sequentially. These variables explained 55.9% of the variance in lymphedema self‐management behaviours. Conclusions: The modified model based on the Integrated Theory of Health Behaviour Change fitted well in predicting lymphedema self‐management behaviours among breast cancer patients. Lymphedema knowledge, illness perception, self‐efficacy, social support and self‐regulation directly and indirectly influenced lymphedema self‐management behaviours. Impact: This study provides a theoretical basis for the assessment and interventions of lymphedema self‐management behaviours in breast cancer patients. Lymphedema self‐management behaviours should be assessed regularly and comprehensively, taking these predictors into consideration to identify potential barriers. Further research is needed to explore effective interventions integrating these significant predictors. Reporting Method: This study was reported following Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist for cross‐sectional studies. Patient or Public Contribution: No patient or public contributed to the design or conduct of the study, analysis or interpretation of the data, or in the preparation of the manuscript. What Does This Paper Contribute to the Wider Global Clinical Community?: This study focused on identifying and predicting mechanism of self‐management based on a theory of behaviour change. The results can be applied among patients with other chronic diseases or high‐risk populations, and inspire the assessment and interventions facilitating self‐management behaviours. Study Registration: This study was registered as an observational study at Chinese Clinical Trial Registry: http://www.chictr.org.cn (ChiCTR2200057084). Implications for the Profession and/or Patient Care: For breast cancer patients with poor lymphedema self‐management behaviour, attention should be raised among nurses and involved healthcare staffs that lymphedema self‐management is multi‐faced. Strategies targeted at improving social support, self‐regulation, knowledge, self‐efficacy and illness perception should be also addressed in lymphedema self‐management programs, to facilitate more effective improvement of lymphedema self‐management behaviours. [ABSTRACT FROM AUTHOR]

Background: Case management has been regarded as the front line of necessary change for fragmented healthcare system. Aim: This study proposed a case management intervention that is suitable for Chinese colorectal cancer patients and explored its effectiveness over a 12‐month follow‐up. Methods: A quasi‐experimental study was conducted in an oncology hospital in China. A total of 188 patients were recruited from May 2015 to February 2017; 85 patients in the control group and 80 patients in the intervention group were included in data analysis. The intervention group was managed for 1 year by a case manager who organized the multidisciplinary team, provided regular assessment, a consulting service and referrals. Quality of life, anxiety and depression, symptom distress, treatment adherence and unplanned readmission rates were measured. Results: Repeated measurement ANOVA showed significant intervention and time effects in global quality of life, anxiety and depression, symptom distress and oral chemotherapy adherence. The intervention group showed statistically significantly better overall treatment adherence and lower unplanned readmission rate. Conclusion: Nurse‐led case management was effective in improving psychosocial outcomes, treatment adherence and unplanned readmission rate of colorectal cancer patients. A case management model is feasible and effective in colorectal cancer patients and in hospital‐dominated healthcare systems where primary care is underutilized. Summary statement: What is already known about this topic?: Current evidence of the effectiveness of case management is limited due to mixed results and single settings.Case management is rarely tested in single‐type cancer patients and in countries with underdeveloped primary care. What this paper adds?: Nurse‐led hospital‐based case management can effectively improve quality of life, anxiety, depression, symptom distress, treatment adherence and unplanned readmission rates.In countries with underdeveloped primary care, case management is a feasible way to provide continuous care to cancer patients and to improve healthcare utilization. The implications of this paper: Nurse case managers can serve as a pivot in multidisciplinary management of cancer patients to promote interdisciplinary cooperation and resource integration.A case management model is feasible and effective in colorectal cancer patients and in hospital‐dominated healthcare systems where primary care is underutilized.Future studies and nursing practice should develop an online case management platform and set up posts for full‐time case managers. [ABSTRACT FROM AUTHOR]

Purpose This study aimed to develop and test the psychometric properties of a Professional Nursing Support Scale for patients with cancer in mainland China. Methods: The study was conducted in two phases from January 2017 to January 2020. Phase I involved item generation and developing a preliminary version of Professional Nursing Support Scale through literature review, qualitative interviews, content validity evaluation and a pilot study. Phase II involved psychometric properties testing of the Professional Nursing Support Scale in 700 patients with cancer recruited from four public hospitals in Anhui Province, China. Results: A 49‐item Professional Nursing Support Scale was finally developed. Exploratory factor analysis showed a four‐factor structure of the 49‐item Professional Nursing Support Scale, accounting for 56.95% of variance. Cronbach's α ranged from 0.91 to 0.94 for the four subscales. Confirmatory factor analysis further confirmed the best model fit of four‐factor structure of the Professional Nursing Support Scale. The Professional Nursing Support Scale also showed an acceptable concurrent validity with Supportive Care Needs Scale short form 34 (r = 0.75, p < 0.001) and Psychological Distress Thermometer (r = 0.39, p < 0.001). Conclusions: The Professional Nursing Support Scale is a reliable and valid instrument to assess perceived needs of professional nursing support and support acquisition in relation to the care in Chinese patients with cancer. Summary Statement: What is already known about this topic? Nurses generally provide supportive care services and play imperative roles in supporting patients in cancer.Using a valid and reliable instrument to assess supportive care needs for patients with cancer is a critical step for the improvement of clinical practice and research. What this paper adds? Mixed methods were beneficial for developing the new self‐report and culturally appropriate instrument for Chinese patients with cancer.The Professional Nursing Support Scale (PNSS) is a reliable and valid instrument to assess perceived needs of professional nursing support and support acquisition in relation to the needs. The implications of this paper: The PNSS is expected to a reliable needs evaluation tool. [ABSTRACT FROM AUTHOR]

Background: Trait emotional intelligence and fear of cancer recurrence could predict quality of life, but the mechanism between the three is poorly understood. Methods: The aim of this study was to investigate the associations between trait emotional intelligence, fear of cancer recurrence and quality of life in patients with breast cancer. A cross‐sectional study was conducted with 215 breast cancer patients recruited from two hospitals in China. Data were collected from December 2018 to April 2019. Questionnaires measured demographic and medical characteristics, trait emotional intelligence, fear of cancer recurrence and quality of life. Pearson correlation analysis and structural equation modelling were conducted to analyse the data. Results: As expected, trait emotional intelligence was positively related to quality of life and negatively correlated with fear of cancer recurrence. Fear of cancer recurrence was negatively associated with quality of life. This relationship between trait emotional intelligence and quality of life was mediated by fear of cancer recurrence. Conclusions: These results shed light on underlying mechanisms by which trait emotional intelligence affects quality of life. Trait emotional intelligence training could reduce fear of cancer recurrence to improve quality of life for cancer patients. Summary statement: What is already known about this topic? Trait emotional intelligence is a predictor of quality of life and can manage emotion.Fear of cancer recurrence in breast cancer patients is an important factor that impairs their quality of life.There is a lack of research on the mediating role of fear of cancer recurrence on the path from trait emotional intelligence to quality of life. What this paper adds? Trait emotional intelligence is associated with fear of cancer recurrence.Fear of cancer recurrence of breast cancer patients mediates the effect of trait emotional intelligence on their quality of life. The implications of this paper: Nurses can consider implementing trait emotional intelligence training, which may be a new type of psychological intervention for cancer patients to reduce fear of cancer recurrence and improve quality of life. [ABSTRACT FROM AUTHOR]

Aim: The aim of the study was to investigate the incidence of sleep disturbance and its relationship with anxiety and depression symptoms, social support and hope in breast cancer patients in China during chemotherapy. Design: A single‐centre cross‐sectional study. Methods: A total of 329 breast cancer patients were selected via convenience sampling method before they began chemotherapy (n = 115), before the 5th week of chemotherapy (n = 117) or 1 month after chemotherapy ended (n = 97) and administered paper‐and‐pencil questionnaires to evaluate sleep quality, depression and anxiety symptoms, social support and hope. Risk factors significantly associated with sleep disturbance during bivariate were incorporated in the multivariate analysis. Bivariate analyses showed that age, menopausal status, depression and anxiety symptoms, emotional/informational support, tangible support, affectionate support, positive social interaction and total support were predictors of sleep disturbance. Results: Sleep disturbance was prevalent in breast cancer patients before (27.0%), during (32.5%) and after (39.2%) chemotherapy, with 37.4%, 41.9% and 52.6% of participants, respectively, reporting sleeping below the recommended 7 h. Only 8.6%–15.5% of patients reported taking sedative‐hypnotic drugs during the chemotherapy. Multivariate analyses found that participants reporting clinically significant anxiety (HADS > 8) were 3.5 times more likely to report sleep disturbance (PSQI > 8) than participants without clinically significant anxiety, and each increment in emotional/informational support was associated with a 9.04% reduced risk of sleep disturbance. Moreover, age was an independent predictor of sleep disturbance during multivariate modelling. [ABSTRACT FROM AUTHOR]

Aim: To design a protocol based on the experiences of long‐term survivors to facilitate resilience for oesophageal cancer patients in rural China. Background: According to the latest Global Cancer Statistics Report, 604,000 new cases of oesophageal cancer were reported, of which over 60% of the disease burden is distributed in China. The incidence of oesophageal cancer in rural China (15.95/100,000) is twice as high as those in urban areas (7.59/100,000). To be sure, resilience can help patients better adapt to post‐cancer life. But universal interventions involving improving the resilience of oesophageal cancer patients have much less been explored, especially for rural patients. Methods: The two‐arm, parallel design, non‐blinded, randomised controlled trial will be implemented in 86 adults diagnosed with oesophageal cancer and will be randomly assigned to the control group or the intervention group via the blocked randomisation. The intervention group will undergo an intervention with one‐on‐one guidance from a nurse while viewing a CD of the experiences of long‐term survivors with oesophageal cancer in rural areas. Every 2 weeks, a theme session will be introduced, and the entire intervention will continue for 12 weeks. Psychosocial variables (resilience, self‐efficacy, coping mode and family support) will be surveyed at baseline, post‐intervention and 3 months after the intervention. The paper complies with the Standard Protocol Items: Recommendations for Intervention Trials 2013 and Consolidated Standards of Reporting Trials guidelines for study protocols adapted for designing and reporting parallel group randomised trials. Conclusion: The intervention programme transitions from hospitalisation to discharge, which includes one‐on‐one interventions by medical personnel and a portable CD describing the experiences of long‐term survivors with rural oesophageal cancer. Once the intervention's effectiveness is proven, this protocol will provide psychological support for massive oesophageal cancer patients. Relevance to clinical practice: The intervention programme may be used as an auxiliary therapy to promote patients' postoperative psychological rehabilitation. This programme has the advantages of being cost‐effective, flexible, accessible, and convenient and can be implemented without the limitation of time, place and clinical medical staff. Trial registration: The Chinese Clinical Trial Registration number is ChiCTR2100050047. Registered on 16 August 2021. [ABSTRACT FROM AUTHOR]

Introduction: Cancer patients and caregivers have myriad unmet needs which can have detrimental consequences on their psychosocial wellbeing. This systematic review aims to identify the unmet supportive care needs of immigrant and native Chinese cancer patients and caregivers. Methods: We systematically searched various electronic databases (e.g. Scopus, CINAHL, PsycInfo, etc.) from the earliest date available until January 2018. Additional studies were identified through reference lists and citation tracking. Eligibility criteria included: (a) qualitative, quantitative and/or mixed methods studies published in English; (b) immigrant and native Chinese cancer patients and/or caregivers (age ≥18 years); (c) unmet needs and/or their correlates. Studies were assessed for their risk of bias, and a narrative synthesis of findings was performed. Results: Forty‐seven papers from 45 studies met eligibility criteria. The most prevalent area of unmet needs was health system and information. Patients most commonly desired one member of the hospital to talk to about all aspects of their care. Caregivers preferred information about the patient's prognosis and likely outcome. Anxiety was most commonly associated with higher levels of health system and information needs. Conclusion: Chinese patients and caregivers experience a range of unmet health system and information needs, which differ depending on their stage along the cancer trajectory. [ABSTRACT FROM AUTHOR]

Aims: To examine the differences in decisional conflict, decision regret, self‐stigma and quality of life among breast cancer survivors who chose different surgeries, as well as the effects of decisional conflict, decision regret and self‐stigma on quality of life. Design: Observational study. Methods: Paper and online surveys were used to collect data from March to September 2020. The Chinese version of the Decisional Conflict Scale, Decision Regret Scale, Self‐Stigma Form and Functional Assessment of Cancer Treatment‐B were used to measure the corresponding health outcomes for breast cancer survivors who chose different surgeries from three university‐affiliated hospitals. One‐way analysis of variance, Pearson's correlation coefficient and hierarchical multiple regression analysis were used for data analysis. Results: Among the 448 participants, only 21% chose breast conservative surgery, while 79% chose mastectomy with or without reconstruction. Women who chose mastectomy with reconstruction reported higher decisional conflict (p =.028) and more decision regret (p =.013) than women who chose breast conservative surgery; women who chose mastectomy without reconstruction indicated higher decisional conflict (p =.015), more decision regret (p <.001), and higher self‐stigma (p =.034) than women who chose breast conservative surgery. Decisional conflict (r = −.430), decision regret (r = −.495), and self‐stigma (r = −.561) were negatively correlated with quality of life. After controlling for sociodemographic and clinical variables, decisional conflict and decision regret explained 19.7% and self‐stigma explained 12.9% of the variance in quality of life. Conclusion: Decisional conflict, decision regret and self‐stigma vary according to different breast surgeries and are greatly associated with the quality of life of breast cancer survivors. Impact Future studies are warranted to investigate the decision‐making process and the underlying reasons for surgical choices. Decision support strategies pre‐surgery are needed to inform women about the risks and benefits of surgery options. Moreover, psychosocial support post‐surgery is warranted to relieve women's self‐stigma, thus improving their quality of life. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Background and objective Xuanwei and Fuyuan are rural counties, located in the late Permian coal poly area of eastern Yunnan and western Guizhou, where lung cancer mortality rates are among the highest in the China, with similarity for both men and women, younger age at diagnosis and death, and higher in rural areas than in urban areas. In this paper, long-term follow-up of lung cancer cases in local peasants was conducted to observe their survival prognosis and its influencing factors. Methods Data of patients diagnosed with lung cancer from January 2005 to June 2011, who had lived in Xuanwei and Fuyuan counties for many years, were collected from 20 hospitals at the local provincial, municipal and county levels. To estimate survival outcomes, individuals were followed up until the end of 2021. The 5-year, 10-year and 15-year survival rates were estimated using the Kaplan-Meier method. Survival differences were examined with Kaplan-Meier curves and Cox proportional hazards models. Results A total of 3,017 cases were effectively followed up (2,537 peasants and 480 non-peasants). The median age at diagnosis was 57 years, and the median follow-up time was 122 months. During the follow-up period, 2,493 cases (82.6%) died. The distribution of cases by clinical stage was as follows: stage I (3.7%), stage II (6.7%), stage III (15.8%), stage IV (21.1%) and unknown stage (52.7%). Treatment at the provincial, municipal and county-level hospitals accounted for 32.5%, 22.2% and 45.3%, respectively, and surgical treatment was performed in 23.3% of cases. The median survival time was 15.4 months (95%CI: 13.9-16.1), and the 5-year, 10-year and 15-year overall survival rates were 19.5% (95%CI: 18.0%-21.1%), 7.7% (95%CI: 6.5%-8.8%) and 2.0% (95%CI: 0.8%-3.9%), respectively. Peasants with lung cancer had a lower median age at diagnosis, higher proportion residing in remote rural areas, and higher use of bituminous coal as a household fuel. They also have a lower proportion of early-stage cases, treatment at provincial or municipal hospitals, and surgical treatment, leading to poorer survival outcomes (HR=1.57). Even when considering factors such as gender, age, residential location, clinical stage at diagnosis, histological type, hospital level of service, and surgical intervention, peasants still exhibit a survival disadvantage. Multivariable Cox model analysis comparing peasants and non-peasants reveals that surgical intervention, tumor-node-metastasis (TNM) stage, and hospital level of service are common factors influencing survival prognosis, while the use of bituminous coal as a household fuel, hospital level of service and adenocarcinoma (compared to squamous cell carcinoma) are independent prognostic factors for lung cancer survival among peasants. Conclusion The lower lung cancer survival rate among peasants is associated with their lower socioeconomic status, lower proportion of early-stage diagnoses, lower proportion of surgical interventions, and treatment at provincial-level hospitals. Furthermore, the impact of other factors such as high-risk exposure to bituminous coal pollution on survival prognosis requires further investigation. [ABSTRACT FROM AUTHOR]

Exploring the relationship between social support and the mental health of cancer patients is a vital endeavor for enhancing mental well-being. The objective of this study was to explore the relationship between social support and psychological well-being in cancer patients and to provide new empirical evidence for psychological improvement in cancer patients. This research holds significant practical implications for optimizing China’s public health system and strengthening the development of a healthy China. Using data from the 2018 China Health and Retirement Longitudinal Study (CHARLS) database, we empirically examined the influence of social support on the mental health of cancer patients. Models such as Ordered Probit and OLogit were used to provide empirical evidence and theoretical insights for enhancing the mental health of cancer patients in a context marked by a high prevalence of cancer. The findings indicated that both formal and informal social support mechanisms were effective in improving the mental health of cancer patients. Furthermore, we utilized the propensity score matching (PSM) model to eliminate the endogeneity issue associated with sample selectivity bias. The results obtained through PSM demonstrated robustness, underscoring the importance of addressing sample selectivity bias when assessing the impact of social support on the mental health of cancer patients. Therefore, the Chinese government is recommended to prioritize the use of social support as a means to proactively enhance the mental health of cancer patients, thereby continuously elevating their overall quality of life. [ABSTRACT FROM AUTHOR]

Previous studies have indicated that cancer patients may have a lower level of subjective well-being (SWB); nevertheless, the underlying factors for this phenomenon remain insufficiently investigated. Based on the characteristics of Chinese breast cancer patients and the unique culture, this study explored the independent contributions of death anxiety, self-esteem, and social support to SWB from the protective and risk perspectives. A cross-sectional survey recruited 514 females with breast cancer and collected participants' demographic and the above variables. The results found that death anxiety independently predicted SWB in a negative direction (β = −0.36, p < 0.001). In addition, self-esteem (β = 0.38, p < 0.001) and social support (β = 0.14, p < 0.001) also had the unique positive effects on SWB. These findings offer new insights into strengthening breast cancer patients' SWB, for instance, using relevant interventions to reduce death anxiety and improve self-esteem and social support. [ABSTRACT FROM AUTHOR]

Objective. Perceived control refers to an individual's subjective perception, affective experience, or cognitive beliefs regarding their level of control. The objective of this study was to examine the relationship between perceived control and quality of life (QoL) among breast cancer (BC) patients using a structural equation model. Method. Participants (N = 80) completed questionnaire surveys on perceived control and QoL using the Cancer Experience and Efficacy Scale (CEES) and the Quality of Life Questionnaire Core 30 (EORTC QLQ-C30 V3.0), respectively. Structural equation modeling was employed to examine the associations between perceived control factors, including cancer experience and control efficacy, and QoL. Results. The QoL in BC patients was found to be significantly negatively correlated with physical symptoms, accounting for 51.6%. This indicates that the QoL of patients decreased by 51.6% with each unit increase in physical symptoms. In terms of perceived control among BC patients, socioeconomic strain exerted the greatest influence on cancer experience, accounting for 44.3%, followed by emotional strain and personal strain at 40.08% and 34.6%, respectively. Group efficacy had the highest impact on control efficacy at 43.0%, followed by individual efficacy and medical efficacy at 41.8% and 29.7%, respectively. QoL in BC patients decreased by 4.2% with every unit increase in cancer experience but improved by 3.5% with every unit increase in control efficacy. Conclusion. The structural equation model facilitates a comprehensive understanding of the interrelationships among various variables in perceived control and QoL among BC patients. The cancer experience in perceived control is negatively correlated with the QoL, whereas control efficiency demonstrates a positive correlation with QoL. Consequently, healthcare professionals should implement appropriate interventions to alleviate physical symptoms and enhance control efficiency, thereby improving both perceived control and QoL levels among BC patients. This trial is registered with ChiCTR2300069476. [ABSTRACT FROM AUTHOR]

Background. Adherence to complete decongestion therapy (CDT) is of utmost importance for patients with breast cancer-related lymphedema (BCRL). However, past studies have demonstrated that adherence to CDT in BCRL patients is less than satisfactory. Our study aimed to describe the level of adherence to CDT among BCRL patients and utilize the Health Belief Model to analyse the key factors that influence adherence. Methods. We employed a convenient sampling method to select 158 patients with BCRL who were in the maintenance stage of CDT in a grade A tertiary tumour hospital in Guangzhou. A questionnaire survey was used to investigate patients' adherence to CDT, as well as their sociodemographic characteristics, medical history characteristics, disease knowledge, and health beliefs. Results. The CDT adherence score of BCRL patients was 96.46 ± 18.46 points, with an average score of 2.61 ± 0.50 points per item. The adherence rate was 65.18 ± 12.47%, indicating a moderate level of adherence. Factors that significantly influenced CDT adherence in BCRL patients included age under 45 years, having 0 or 1 child, experiencing 9 lymphedema symptoms, and having low levels of disease knowledge and health beliefs (p < 0.05). Conclusions. The level of adherence to CDT in BCRL patients is moderate and requires improvement. To enhance adherence to CDT, medical professionals should focus on patients who are younger, have fewer children, exhibit fewer symptoms of lymphedema, possess limited disease knowledge, and have weak health beliefs. [ABSTRACT FROM AUTHOR]

CHENG K.K.F. & YEUNG R.M.W. (2013) European Journal of Cancer Care 22, 70-78 Impact of mood disturbance, sleep disturbance, fatigue and pain among patients receiving cancer therapy This paper describes the prevalence of mood disturbance, sleep disturbance, fatigue and pain (MSFP), either alone or in combination in patients receiving cancer therapy, and determines its impact and whether it is a predictor for functional status and the impairment of quality of life (QoL). This is a cross-sectional study using secondary data from a sample of 214 patients being treated by chemotherapy or radiotherapy. In all, 87%, 68%, 66% and 38% of the patients reported MSFP respectively. Co-occurrence of any three and all of the four symptoms, were reported separately at rates of 29% and 31%. Patients with all four symptoms recorded significantly lower Karnofsky Performance Scale (KPS) scores (mean 77.7 ± 12.9) and QoL scores (mean subscales scores 9.0-17.6) than those with none or up to any three of the symptoms ( P < 0.001). Regression of the KPS and QoL scores against the MSFP revealed an increase in the explained variance of 25%, 43%, 27%, 37% and 41% respectively for KPS, physical, emotional, functional and total QoL. The results suggest that MSFP are highly prevalent, whether alone or in combination, in patients receiving cancer therapy, and may negatively influence the patient's functional status and QoL during cancer therapy. [ABSTRACT FROM AUTHOR]

zeng y.c., liu x. & loke a.y. (2012) Addressing sexuality issues of women with gynaecological cancer: Chinese nurses' attitudes and practice. Journal of Advanced Nursing 68(2), 280-292. Abstract Aim. This paper reports a study conducted to describe Chinese nurses' attitudes and practice in addressing the sexuality concerns of people with gynaecological cancer. Background. Women with gynaecological cancer face numerous challenges to their sexuality. The importance of addressing sexuality concerns of people with cancer is emphasized by a growing body of literature in Western countries. Methods. This is a descriptive and correlational study. An inventory was adopted to explore Chinese nurses' attitudes and practice related to sexuality care in nursing. Data were collected from December 2009 to February 2010. Results. A sample of 202 nurses working in gynaecological units in China was recruited. Study results revealed that the majority (77·7%) held the attitude that 'sexuality is too private an issue to discuss with patients'. Only 34·2%'make time to discuss sexual concerns with patients'. Regression analysis revealed that nurse' marital status and hospital type in which they were working influenced their practice in sexuality care. Nurses' conservative attitudes towards sexuality, their prejudices about gynaecological cancer, the lack of availability of private environment, the lack of sexuality care training and the failure to include sexuality care in routine nursing care, were found to be factors that significantly influenced sexual care and nursing practice (adjusted R2 = 0·542, P < 0·001). Conclusions. The study findings contribute to the understanding of Chinese nurses' attitudes and practice in addressing the sexuality concerns of people with gynaecological cancer. There is a need to increase Chinese nurses' awareness of their roles and the importance of equipping themselves with relevant skills in sexuality care in nursing practice. [ABSTRACT FROM AUTHOR]

Objectives: Although Chinese-Australian women are at higher risk of developing breast cancer after migration to Australia, information on their experience is limited. This paper explores Chinese- Australian women's perceptions of the meaning and experience of a breast cancer diagnosis, treatment and coping mechanism. Methods: Three focus groups were conducted with 23 Chinese-Australian women diagnosed with breast cancer in their native language (Cantonese or Mandarin). Following transcription and translation, interview data was analysed by content analysis. Results: Culturally specific values, beliefs and language barriers played a significant role in shaping the women's breast cancer experiences and their response to the diagnosis. Of note these women found the experience isolating and distressing, factors that were compounded by the lack of culturally sensitive resources and information. Conclusions: In providing information for Chinese-Australian women with breast cancer, culture, language and migration experience need to be taken into account. [ABSTRACT FROM AUTHOR]

Background: Cancer-related fatigue is a complex multidimensional concept. However, little is known about the experience of cancer-related fatigue in people with advanced lung cancer. How they emotionally react to and cope with the experience of cancer-related fatigue according to cultural influences has not been extensively explored. Aim: To explore the experience of cancer-related fatigue, its impacts and emotional reactions to and coping strategies for cancer-related fatigue amongst people with advanced lung cancer in China. Design: This was a cross-sectional, descriptive qualitative study with face-to-face semi-structured interviews. Data were analysed using content analysis. Setting/participants: Twenty-one people with advanced lung cancer who experienced cancer-related fatigue were recruited in a hospital setting. Results: Four themes were identified: multifaceted experiences of cancer-related fatigue, impacts of cancer-related fatigue, negative perceptions of cancer-related fatigue and avoiding cancer-related fatigue. The multifaceted experience of cancer-related fatigue had physical, psychological and social impacts along the cancer trajectory. Informants regarded it as a sign of a 'bad ending', searched for root causes and had negative attitudes towards role changes. Avoiding coping strategies included not discussing cancer-related fatigue, refusing encouragement and support, hiding feelings, withdrawing from social life and attempting to control cancer-related fatigue. Conclusion: The findings provide insights into the lack of flexibility of people with advanced lung cancer to adapt to the multidimensional experience of cancer-related fatigue. The reactions and coping towards cancer-related fatigue are profoundly influenced by Chinese culture. Developing psychological interventions based on the cultural background are highly recommended to cultivate the ability to cope flexibly with stressful events and live a meaningful cancer life. [ABSTRACT FROM AUTHOR]

Aim: The aim of the study was to develop and psychologically test the mobile health information‐seeking behaviour (MHISB) questionnaire in people with cancer. Design: Instrument development. Methods: The study was conducted in three phases in a southeastern city of China from May 2017 to April 2018. In phase one, an item pool was constructed based on a literature review and semistructured interviews. In phase two, expert evaluation and cognitive interviews were used to evaluate the content validity of the questionnaire. In phase three, a cross‐sectional study was conducted with people with cancer. Cronbach's α was calculated for reliability analysis. Validity evaluation included content validity and construct validity. Results: The developed MHISB questionnaire has four dimensions (information‐seeking frequency, information‐seeking self‐efficacy, health information evaluation and information‐seeking willingness) and 25 items. Psychometric findings were satisfactory and supported the questionnaire's reliability. Conclusions: The construction process of the MHISB questionnaire was scientific and feasible. The MHISB questionnaire had acceptable validity and reliability, and it requires further improvement in future studies. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the clinical effect of a multidisciplinary collaboration team combined with a palliative care model in patients with terminal cancer. Method: A total of 84 patients diagnosed with terminal cancer in our hospital were included and randomly divided into an intervention group and a control group, with 42 cases in each group. Patients in the intervention group were treated by a multidisciplinary collaborative team combined with the palliative care model, and patients in the control group were treated by routine nursing intervention. The Self-rating Anxiety Scale (SAS) and the Self-rating Depression Scale (SDS) were used to evaluate negative emotions and anxiety and depression of patients before and after intervention. The Quality of Life Scale (European Organization for Research and Treatment of Cancer [EORTC] QLQ-C30) and Social Support Scale (SSRS) were used to evaluate the quality of life and social support of patients. This study has been registered in 13/01/2023 (ClinicalTrials.gov Identifier: NCT05683236). Result: The general data of the two groups were comparable. After intervention, the SAS (43.7 ± 7.4 vs. 54.2 ± 9.3) and SDS scores (38.4 ± 6.5 vs. 53.1 ± 8.4) of the intervention group were significantly lower than those of the control group. The total SSRS score, subjective support score, objective support score and utilisation of support of the intervention group were significantly higher than those of the control group (P < 0.05). The overall quality of life score of the intervention group was higher than that of the control group, and the difference was statistically significant (79.5 ± 4.5 vs. 73.2 ± 3.6, P < 0.05). The scores of each functional scale were significantly higher than those of the control group (P < 0.05). Conclusion: Compared with conventional nursing, the application of the multidisciplinary collaborative team combined with tranquilisation therapy in patients with terminal cancer can significantly reduce the anxiety and depression of patients, enable patients to obtain comprehensive social support, and effectively improve the quality of life of patients. Trial registration: ClinicalTrials.gov Identifier NCT05683236, 13/01/2023, Retrospectively registered. [ABSTRACT FROM AUTHOR]

The objective of this study was to estimate the willingness to pay (WTP) per quality-adjusted life year (QALY) among people with malignancies in China. The WTP for a QALY was estimated using a contingent valuation survey. Health utility was measured in EuroQol-5 dimensions (EQ-5D). The questionnaires were completed in face-to-face interviews. Respondents consisted of patients with malignant tumors and their family members and came from three tertiary hospitals in different cities with high, medium, and low gross domestic product (GDP) levels. In this study, we offered lump-sum payments and 10 year installment plans to respondents. Finally, we conducted sensitivity analysis and stepwise regression analyses to identify factors that affected the WTP/QALY ratios. A total of 1264 people participated in this survey, and 1013 people gave WTP responses for further analysis. The mean and median WTP/QALY values based on the lump-sum payments were 366,879 RMB (53,171USD, 5.1 times the GDP per capita) and 99,906 RMB (14,479USD, 1.39 times the GDP per capita) for the overall sample; 339,330 RMB (49,178USD, 4.71 times the GDP per capita) and 83,875 RMB (12,156USD, 1.16 times the GDP per capita) for the patient group; and 407,396 RMB (59,043USD, 5.66 times the GDP per capita) and 149,436 RMB (21,657USD, 2.08 times the GDP per capita) for the family group. Considering the skewedness of the data distribution, we suggest setting the cost-utility threshold with reference to the median. When the payment plan changed to 10-year installments, the median increased to 134,734RMB (19,527USD), 112,390 RMB (16,288USD) and 173,838 RMB (25,194USD) for the above groups, respectively. EQ-5D-5L health utility, annual household income per capita, patients with other chronic diseases, occupation, regular physical examinations (patients) and age (family members) were significantly related to WTP/QALY. This study provides empirical evidence of the monetary value of a QALY from a sample of the Chinese population with malignancies. In addition, the ratio of the WTP/QALY to GDP per capita was related to the disease and hypothetical scenario, and a higher ratio of GDP per capita for malignant tumor therapies should be considered. [ABSTRACT FROM AUTHOR]

Aims and objectives: This study examines the effects of family beliefs and family strength on individual resilience and quality of life among young breast cancer survivors and determines whether family strength mediates the effect of family beliefs on individual resilience and quality of life. Background: Family beliefs and family strength are meaningful protective factors that help individuals maintain physical and mental health. However, few studies have explored their impact on individual resilience and quality of life. Design: This study was conducted using a cross‐sectional survey with a three‐stage, stratified, convenience sampling approach following the STROBE guideline. Methods: From August 2020 to May 2021, participants completed the shortened Chinese version of the Connor–Davidson Resilience Scale, the Chinese version of the Family Beliefs Scale, the Family Strength Scale and the Functional Assessment of Cancer Therapy‐Breast scale. Structural equation modelling and multiple mediation effects test were used to explore the relationships among family beliefs, family strength, individual resilience and quality of life. Results: The final model accounted for 44.5% and 78.1% of the total variance of individual resilience and quality of life, respectively. Family beliefs had an indirect effect on both individual resilience and quality of life through family strength. Family strength had a direct effect on individual resilience and had both a direct and an indirect effect on quality of life. Family strength mediated the correlations of family beliefs with individual resilience and quality of life. Conclusion: Mobilising family resources to establish healthy family beliefs and exert positive family strength will help increase young breast cancer survivors' individual resilience and improve quality of life. Relevance to clinical practice: This study confirms the importance for clinical nursing practice to mobilise family resources and develop interventions centred on family beliefs and family strength. [ABSTRACT FROM AUTHOR]

Background: Young breast cancer survivors with body image disturbance have poor quality of life. Self-compassion and different coping styles can influence their body image. The purpose of the study was to investigate the relationship between self-compassion, coping styles, and body image disturbance, and examined the mediation role of coping styles between self-compassion and body image disturbance among young breast cancer survivors in China. Methods: In the cross-sectional study, a total of 310 young women with breast cancer were assessed on self-compassion, coping styles, and body image disturbance by self-reported questionnaires in China. Spearman's correlation was used to test the links between variables and to verify the indirect effects between variables by constructing a structural equation model. Results: There were correlations between self-compassion, different coping styles, and body image disturbance. Confrontation, avoidance, and acceptance-resignation coping had significant mediation effects on the association between self-compassion and body image disturbance. The mediation effects of confrontation coping were greater than avoidance, and acceptance-resignation coping. Conclusions: In this study, different coping styles acted as mediators between self-compassion and body image disturbance, providing support for further understanding the mechanism between self-compassion and body image disturbance, and developing comprehensive interventions for body image disturbance. Oncology nurses should pay attention to the breast cancer survivors' self-compassion and coping styles and encourage them to adopt adaptive coping strategies, which can reduce body image disturbance. [ABSTRACT FROM AUTHOR]

To examine Chinese-immigrant cancer patients' openness to advance care planning (ACP) in an outpatient oncology setting. Retrospective review of social work assessment data. 150 Chinese-immigrant patient charts were reviewed (55% Cantonese, 45% Mandarin). Data were summarized descriptively and with logistic regression analyses. Sixteen percent of patients had completed ACP prior to meeting with the oncology social worker (OSW). Twenty percent of patients agreed to complete a health care proxy (HCP) after receiving culturally-tailored education in their language of origin from the OSW, while 75% remained open to ongoing consideration of ACP and HCP completion. This study illuminates how Chinese immigrants engage in ACP discussions in an oncology setting. OSWs can play an integral role in advocating, educating, and intervening with this population and can assist the interdisciplinary team in understanding the importance of the cultural differences, even if the OSW's primary language differs from that of a patient's. [ABSTRACT FROM AUTHOR]

Chordomas are very rare malignant bone tumors. Following surgery, their effects on neurological, physical, psychological, social, and emotional functioning are substantial and can have a major impact on a patients' quality of life (QOL). In this survey, we aimed to characterize the postoperation health-related QOL and emotional problem in patients with chordoma using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire 30 (EORTC QLQ-C30) and Hamilton Depression Rating Scale (HAMD). The cohort included 100 patients who underwent resection surgery between 2014 and 2020. Being single or divorced, living in a rural area, receiving a diagnosis of sacrococcygeal chordoma, Karnofsky performance status (KPS) ≤ 70, and weight loss were associated with increased likelihood of depression (p < 0.05). Patients who were single or divorced, with KPS ≤ 70, and experiencing weight loss had a higher likelihood of a worse QOL (p < 0.05). The uni- and multivariate logistic regression analyses indicated that the KPS level (p = 0.000) and postoperative radiation therapy (p = 0.009) were related to depression; marital status (p = 0.029), KPS level (p = 0.006), and tumor location (p = 0.033) were related to worse QOL. Certain characteristics placed patients with chordoma at increased risk of emotional problems, which are associated with a lowered QOL and a higher symptom burden. Further knowledge regarding emotional problems is key to improving the QOL for patients with chordoma. [ABSTRACT FROM AUTHOR]

Aim and objectives: This qualitative study explores why breast cancer patients do not share disease‐related information with their dependent children. Background: 'Open' communication between breast cancer patients and their children is beneficial to both. However, some still try to avoid discussing their diagnosis and related information with their children. Some worries lie in communicating with dependent children, but the underlying cause remains unclear. Design: Qualitative descriptive study. Methods: Semi‐structured interview was used in this study. Twenty breast cancer patients with children (aged 8–18 years) were recruited at two urban tertiary hospitals in mainland China. Qualitative content analysis was conducted to analyse and identify themes and subthemes. This study followed the COREQ checklist for qualitative studies. Results: Three main themes were identified: (1) Uncertainty about the future: Their struggles with cancer remain a sensitive subject with their children. They described the uncertainty surrounding their disease prognosis and their children's response. They were also unsure whether, when and how to inform their children of their conditions; (2) Useless and risky for their children to know the truth: They considered it useless because their children can neither understand nor change the existing facts. They were concerned that it could affect their children's emotional state, character and academic performance; and (3) All for their children's sake: They were willing to take care of their affairs without troubling their dependent children as much as possible. Conclusion: Most mothers delayed communicating disease‐related information to their dependent children. However, they often underestimated children's abilities and ignored their thoughts and wishes. Motherhood leads to avoidance and concealment in discussing health issues with their children. Relevance to clinical practice: Mothers should try to understand their children's views towards cancer earlier. Healthcare professionals, especially nurses, should provide further consultation and intervention services to assist mothers and their children. [ABSTRACT FROM AUTHOR]

Background. To evaluate the associations between long-term oral Chinese herbal medicines (CHMs) and recurrence and metastasis (R&M) in patients with stage II and III colorectal cancer (CRC). Furthermore, we aimed to determine the correlation between different syndrome patterns and prognosis and summarized the regularities among CHMs prescriptions, providing reference for clinical practice. Methods. An ambispective cohort study was conducted. All CRC patients who sought evaluation and treatment at Xiyuan Hospital and Beijing Cancer Hospital from August 2014 to August 2016 were included. In this study, "whether patients voluntarily take CHMs" was taken as the exposure factor, and the exposure degree was "the duration of CHM use." Stratification was performed according to the duration of TCM use to determine the relationship with R&M of CRC. The primary outcome was disease-free survival. Patients who had R&M of CRC after taking CHMs for ≥6 months were defined as "worst patients." R software was used for statistical analysis. The Kaplan–Meier method and Cox regression analysis were used to determine the prognosis. IBM SPSS was used to model a priori association rules; drug use rules were analyzed on this basis. Results. A total of 186 patients with stage II and III CRC after radical resection were enrolled. All patients reached the study endpoint by August 2021. The difference in disease-free survival between the two groups was most significant when the cutoff value for CHMs was 18 months (P = 0.0012). Multivariate analysis showed that 18 CHMs were independent protective factors for R&M of CRC (P = 0.001 , HR = 0.20, 95% CI = 0.08–0.53). The ratio of Pi (spleen) and Shen (kidney) deficiency in the worst cases was higher than patients without R&M (P = 0.018). Sijunzi and Liuwei Dihuang decoctions were the most frequently used prescriptions in the anti-R&M phase. Conclusion. CHMs complying with the "Jianpi Bushen" principle may attenuate the risk of R&M in patients with stage II and III CRC. Pi (spleen) and Shen (kidney) deficiency in patients receiving TCM intervention for the first time within 6 months of radical resection may be associated with a higher CRC R&M rate. Further research is warranted to validate these findings and elucidate underlying biological mechanisms. [ABSTRACT FROM AUTHOR]

Objective: This pilot clinical trial investigated solution-focused brief therapy (SFBT) for psychological distress among adolescent and young adult (AYA) patients with cancer in China. Methods: Fifty Chinese AYA patients diagnosed with cancer were randomized into the treatment group (SFBT) and control group (active control). Psychological distress was measured by the brief symptom inventory and hope was measured by the Herth-Hope-Index. Treatment effects were analyzed using analysis-of-covariance and between-group small-sample-size corrected Hedges' g. Results: The results indicated that SFBT resulted in a significant reduction in the psychological distress and improvement in hope of AYA patients with cancer. Analyses of the 4-week posttreatment score suggest the short-term sustainability of SFBT for psychological distress among AYAs diagnosed with cancer. Conclusions and Implications. This study has demonstrated that SFBT's impact is statistically significant and clinically meaningful. The inclusion of positive emotions, i.e., hope, as part of the investigation also highlighted the significance of promoting positive emotions among AYA patients with cancer. [ABSTRACT FROM AUTHOR]

Rates of lung cancer in China are rising rapidly, creating an urgent need for prevention. Effective prevention measures require understanding local beliefs and perceptions about the risk for developing lung cancer. This article explores the explanations that Chinese lung cancer patients and their families give about the aetiology of their disease. Fifty-three interviews were conducted among lung cancer patients and their family members at a large tumour hospital in southern China. Participants presented a complex multifactorial explanation of lung cancer associating their disease with risks like tobacco use, occupational exposures, environmental pollution, lifestyle changes, and personal characters. While these are all standard risk factors commonly associated with lung cancer, participants presented them within a larger contextual frame of structural issues that impede their ability to change their behaviours. Using a social ecological model, we demonstrate how China's socio-cultural environment shapes assumptions about the risk of lung cancer with particular reference to work, home, social situations, and the natural environment. [ABSTRACT FROM AUTHOR]

Objective: Acoustic neuroma (AN) is a common benign tumor. Little is known of neuropsychological studies in patients with acoustic neuroma, especially cognitive neuropsychology, and the neuropsychological abnormalities of patients affect their life quality. The purpose of this study was to explore the changes in the cognitive function of patients with acoustic neuroma, and the possible mechanism of these changes by structural magnetic resonance imaging. Materials and methods: We used a neuropsychological assessment battery to assess cognitive function in 69 patients with acoustic neuroma and 70 healthy controls. Then, we used diffusion tensor imaging data to construct the structural brain network and calculate topological properties based on graph theory, and we studied the relation between the structural brain network and cognitive function. Moreover, three different subnetworks (shortrange subnetwork, middle-range subnetwork, and long-range subnetwork) were constructed by the length of nerve fibers obtained from deterministic tracking. We studied the global and local efficiency of various subnetworks and analyzed the correlation between network metrics and cognitive function. Furthermore, connectome edge analysis directly assessed whether there were differences in the number of fibers in the different brain regions. We analyzed the relation between the differences and cognitive function. Results: Compared with the healthy controls, the general cognitive function, memory, executive function, attention, visual space executive ability, visual perception ability, movement speed, and information processing speed decreased significantly in patients with acoustic neuroma. A unilateral hearing loss due to a left acoustic neuroma had a greater impact on cognitive function. The results showed that changes in the global and local metrics, the efficiency of subnetworks, and cognitively-related fiber connections were associated with cognitive impairments in patients with acoustic neuroma. Conclusion: Patients exhibit cognitive impairments caused by the decline of the structure and function in some brain regions, and they also develop partial compensation after cognitive decline. Cognitive problems are frequent in patients with acoustic neuroma. Including neuropsychological aspects in the routine clinical evaluation and appropriate treatments may enhance the clinical management and improve their life quality. [ABSTRACT FROM AUTHOR]

Objectives. The integration of patient-reported health status has been increasingly emphasised for delivering high-quality care to advanced cancer patients. This research is designed to track health status changes over time in Chinese advanced cancer patients to explore the risk factors affecting their health status. Methods. Advanced cancer patients were recruited from Peking University Cancer Hospital. An electronic patient-reported outcome (ePRO) system with validated measurements was used to collect the data. ANOVA, the chi-square test, the nonparametric Kruskal–Wallis H test, and generalized estimating equation (GEE) analysis were used for the data analysis. Results. One hundred and three patients completed a baseline survey (T = 0) and two follow-up surveys (T1 = 14 days, T2 = 28 days). Chi-square test results indicate a significant decrease in the percentage of patients reporting moderate or severe difficulty experienced by patients in terms of mobility, pain/discomfort, and anxiety/depression. However, there is a significant increase in the percentage of patients reporting moderate or severe difficulty in self-care and usual activities. Scores on the visual analogue scale in the EQ-5D-5L instrument (EQ-VAS) are associated with patients' income, and the degree of moderate or severe anxiety/depression is found to be associated with employment status. The GEE results show that pain, loss of appetite, poor walking status effected by symptoms, depression, and anxiety has worsened the health status. Conclusions. The health status of Chinese advanced cancer patients under ePRO follow-up in China significantly improves in the physical and psychological dimensions, accompanied by a decrease in usual activities and self-care. Routine screening and rational supportive care are recommended in oncology for cancer care. Based on the rational application of ePRO, longitudinal studies exploring the potential mechanisms of health status changing would provide more beneficial guidance for improving the quality of life in patients with advanced cancer. [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]

li x.-m., zhou k.-n., yan h., wang d.-l. & zhang y.-p. (2011) Effects of music therapy on anxiety of patients with breast cancer after radical mastectomy: a randomized clinical trial. Journal of Advanced Nursing 68(5), 1145-1155. Abstract Aim. This paper is a report of a clinical trial of the effects of music therapy on anxiety of female breast cancer patients following radical mastectomy. Background. There is insufficient evidence on the effects of music therapy on state anxiety of breast cancer patients following radical mastectomy. Methods. A Hall's Core, Care, and Cure Model-based clinical trial was conducted in 120 female breast cancer patients from March to November 2009. A randomized controlled design was utilized. The patients were randomly allocated to the experimental group ( n = 60) received music therapy in addition to routine nursing care, and the control group ( n = 60) only received routine nursing care. A standardized questionnaire and the State Anxiety Inventory were applied. The primary endpoint was the state anxiety score measured at pretest (on the day before radical mastectomy) and at three post-tests (on the day before patients were discharged from hospital, the second and third time of admission to hospital for chemotherapy respectively). Results. The pretest score revealed that the majority of the patients had a moderate level (77·5%) and 15% had severe level of state anxiety. The repeated-measure ancova model analysis indicated that the mean state anxiety score was significantly lower in the experimental group than those in the control group at each of the three post-test measurements. The mean difference between the experimental and control group together with 95% confidence intervals were −4·57 (−6·33, −2·82), −8·91 (−10·75, −7·08) and −9·69 (−11·52, −7·85) at the 1st post-test, 2nd post-test and 3rd post-test respectively. Conclusion. Music therapy is found to have positive effects on decreasing state anxiety score. [ABSTRACT FROM AUTHOR]

Introduction: Withholding the malignant bone tumors disclosure from patients is common in China. The purpose of the study was to explore the perceptions of patients, families, doctors, and nurses regarding the disclosure of malignant bone tumors in China. Method: Semistructured interviews were conducted with 25 cases, consisting of 69 participants (14 patients, 25 family members, 17 doctors, and 13 nurses), and the transcripts were analysed using Colaizzi's (1978) descriptive phenomenological analysis process. Results: Five themes were identified: (1) doctors preferred to inform the family members first, (2) family members' decisions depended on different situations, (3) the patients agreed that disclosure should be different for each person/personally, (4) care from nurses reduced the overreaction of patients, and (5) key points improve the informing quality. Discussion: Family participatory cancer disclosure and multidisciplinary teams could improve the quality of cancer disclosure. Culturally congruent health care and culturally sensitive interventions in cancer disclosure are suggested. [ABSTRACT FROM AUTHOR]

Objective Sex and intimacy are basic needs and important aspects of quality of life among humans. This focus of this review was to synthesise and present the best available qualitative evidence on the sexual life experiences and needs of Chinese adults living with cancer. Moreover, the first‐hand experience, meaning and perspective about the sexual life changes and support needs during the survival and extended treatment period were synthesised in this study. Methods: A systematic review of qualitative studies was undertaken using the Joanna Briggs Institute System for the Unified Management, Assessment and Review of Information (JBI‐SUMARI). A comprehensive search of five databases: CINAHL, MEDLINE, PubMed, Scopus and Google Scholar were undertaken from 2010 until February 2020 using defined criteria. Methodological quality and data extraction were undertaken using JBI‐SUMARI. Results: Eight studies were included in the review. A total of 39 findings were extracted and aggregated into eight categories based on similarity of meaning. Three synthesised themes were generated: (i) misconceptions and lack of education or information regarding sexual activity exists for patients with cancer, (ii) concerns for overall health and well‐being as well as physical and psychological changes can alter sexual desire and behaviours in patients with cancer and (iii) lack of sexual activity and intimacy can create relationship problems. Conclusions: Sexual relationships are intimate, personal and private in Chinese culture and beliefs. Chinese adults living with cancer report many neglected issues on sexual well‐being in various domains. Adequate and consistent education about sexual intimacy issues from health care providers was identified as an important need. Unaddressed needs might affect adults' coping strategies in managing their sexual relations during various stages of cancer treatment and beyond. It must be noted that there are many Chinese ethnic minorities living with cancer outside the Greater China region. The evidence provides valuable recommendations to health care providers globally to consider the specific sexual needs and initiate culturally sensitive sexuality education and care support for Chinese adults living with cancer. [ABSTRACT FROM AUTHOR]

Background: Studies in the West have demonstrated that appropriate informational support is a vital component of cancer care, with positive effects on both patients and their informal caregivers. Since little is known about the information needs of advanced cancer patients and informal caregivers in China, where 'silence as virtue' is much more valued and the communication style is less open, this study was therefore conducted to elaborate the information needs of advanced cancer patients and informal caregivers as well as to explore their perceptions and experiences regarding their unmet information needs in the Chinese context. Methods: This sub-study of a previous cross-sectional survey utilized a qualitative descriptive study design. The approach involved semi-structured interviews that followed an interview guide to collect data. Eligible participants were the advanced cancer patients and informal caregivers who had participated in the previous cross-sectional survey and reported unmet information needs. Each interview was audio-recorded and transcribed verbatim. Descriptive content analysis was used to analyze the data. Results: Seventeen advanced cancer patients and 15 informal caregivers with unmet information needs participated in the semi-structured interviews, with ages ranging from 32 to 63 years old for patients and from 32 to 70 for informal caregivers. Four categories were extracted from the interviews with the patients and caregivers: (1) types of unmet information needs; (2) reasons for information needs not being met; (3) preferences for the provision of information; and (4) meaning and role of information. Each category had two to four sub-categories for both the patients and the caregivers, which were similar but not completely the same. Conclusion: The findings indicated that the provision of appropriate information could promote informed decision-making and greater satisfaction with treatment options, reductions in psychological disturbances, and enhanced confidence and ability in self-management and capacity in caregiving. Moreover, information on Traditional Chinese Medicine and food therapy should be increased, particularly for patients at the follow-up stage, while the amount of information on prognosis should be flexible as it could increase patients' and caregivers' psychological burden. Healthcare professionals were the most preferred information provider, although their heavy workload resulted in time constraints. In this case, they should provide information to patients and caregivers together as a 'whole unit.' At the same time, the value of separate conversations should also be recognized as some caregivers preferred to conceal unpleasant information from the patient. [ABSTRACT FROM AUTHOR]

Objectives: To explore the correlations among social isolation and symptoms of anxiety and depression among patients with breast cancer in China and to further verify the mediating role of social support in social isolation and symptoms of depression or anxiety. Design: A cross‐sectional survey. Settings: The cluster sampling method was conducted for 456 female inpatients diagnosed with breast cancer at the Tumor Hospital Affiliated of Harbin Medical University from April 2019–September 2019. Methods: Pearson correlation analysis was used for identifying correlations among all the variables. Mediation effect analysis was used to examine the role of social support in social isolation and symptoms of depression or anxiety. Results: The results showed a prevalence of 73.26% and 70.44% for anxiety and depression symptoms in patients with breast cancer, respectively. Anxiety was significantly negatively correlated with social support (r = −.334, p <.01) and significantly positively correlated with social isolation (r =.369, p <.01). Similarly, depression was significantly negatively correlated with social support (r = −.289, p <.01) and significantly positively correlated with social isolation (r =.466, p <.01). Social support played a mediating role in social isolation and f symptoms of anxiety or depression among these patients. Conclusions: Social isolation was positively correlated with symptoms of anxiety and depression in patients with breast cancer, respectively. Social support for patients with breast cancer has a mediating effect on the patients' social isolation and symptoms of anxiety and depression. Therefore, the support of family, friends, hospitals, and organizations plays a positive role in reducing social isolation as well as symptoms of depression and anxiety in these patients. [ABSTRACT FROM AUTHOR]

Aim: To investigate the effect of social support on psychological distress among Chinese lung cancer patients and clarify the mediating role of self‐esteem. Design: A cross‐sectional descriptive correlational survey of 441 Chinese lung cancer patients was designed. Methods: Self‐esteem was supposed to play a mediating role in the association between social support and psychological distress. We collected demographic information, the Distress Thermometer, Multidimensional Scale of Perceived Social Support and Rosenberg Self‐Esteem Scale. Results: Our revised model demonstrated an acceptable fit to the data (χ2 = 37.489, comparative fit index (CFI) = 0.965, Tucker‐Lewis index (TLI) = 0.926, root mean square error of approximation [RMSEA] = 0.099). Social support had a direct effect on self‐esteem and psychological distress, and self‐esteem had also a direct effect on psychological distress. Meanwhile, self‐esteem also partially mediated the relationship between social support and psychological distress among Chinese lung cancer patients. [ABSTRACT FROM AUTHOR]

The need to make sense of one's mortality is of central concern for death studies. We aimed to explore the meaning of aftermath concerns in the process of preparing for death. Using a qualitative approach, we explored aftermath concerns among 25 participants with terminal cancer in China. Three aftermath concern themes were developed from the participants' narratives: mental concerns about parents, material concerns about children, and spiritual concerns about the self. Aftermath concerns are relational because they are not about what happens within an individual, but between individuals which are manifested within the broader cultural, social, economic, and political contexts. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the effect of art therapy on cancer patients' quality of life and physical and psychological symptoms. Methods: The databases PubMed, Embase, Web of Science, The Cochrane Library, Clinical Trial.gov, the China National Knowledge Infrastructure (CNKI), Wanfang and the Chinese Biomedical Literature Database (CBM) were searched from their inception up to 20 August 2019. Trials examining the effects of art therapy on physical and psychological symptoms and quality of life versus a control group were included. The methodological quality of the included randomised controlled trials was assessed using the risk of bias tool of Cochrane Handbook. Meanwhile, the Newcastle‐Ottawa Quality Assessment Scale (NOS) was used to evaluate the methodological quality of the non‐randomised studies. Results: Twelve studies involving 587 cancer patients were included. The results revealed that art therapy significantly reduced anxiety symptoms (standard mean difference [SMD] = −0.46, 95% confidence interval [CI] [−0.90, 0.02], p =.04), depression symptoms (SMD = −0.47, 95% CI [−0.72, 0.21], p <.01), and fatigue (SMD = −0.38, 95% CI [−0.68, −0.09], p =.01) in cancer patients. Art therapy also significantly improved the quality of life of cancer patients (SMD = 0.43, 95% CI [0.18, 0.68], p <.01). Conclusions: Art therapy had a positive effect on quality of life and symptoms in cancer patients and can be used as a complementary treatment for cancer patients. [ABSTRACT FROM AUTHOR]

Purpose. To assess the quality of life (QoL) and the long-term psychosocial outcomes in adult survivors of unilateral retinoblastoma (RB). Methods. This is a cross-sectional study. Enrolment was offered to all adult survivors of unilateral RB who were treated by enucleation and were followed up in the Ninth People's Hospital of Shanghai Jiao Tong University School of Medicine; noncancer healthy adults served as a control group. All participants completed a series of questionnaires consisting of two aspects, QoL and psychosocial status. The psychosocial outcomes included anxiety, depression, fear of cancer, and satisfaction with facial appearance. Results. A total of 66 RB survivors (43.0% male) and 66 healthy adults (33.3% male) were aged 27.94 ± 7.63 and 29.18 ± 8.37 at the time of the study, respectively. Adult RB survivors did not have significantly higher rates of depression and anxiety compared with the control group, and they experienced a relatively good QoL. RB survivors were more likely to worry about their facial appearance (median, 1.59 [inter-quartile range, IQR, 1.27 to 2.16] v median, 0.36 [IQR, 0.09 to 1.18]; p < 0.001). Radiotherapy was not the factor affecting satisfaction with facial appearance (β, −0.27 [confidence interval, CI, −0.69 to 0.16]; p = 0.214). Females were more likely to be influenced by the disease (mean, 29.59 ± 8.89 v mean, 24.37 ± 6.92; p = 0.031) and worry about their appearance (mean, 1.88 ± 0.84 v mean, 1.46 ± 0.77; p = 0.041). Conclusions. Unilateral RB survivors are a fairly healthy and resilient group. Most unilateral RB survivors experience a relatively good QoL, and they do not have poorer psychosocial functioning compared with a noncancer sample. Females may need more specific psychosocial care. [ABSTRACT FROM AUTHOR]

Background: To conduct an indirect treatment comparison of patients with high-volume mHSPC and a cost analysis between Abi-ADT and Doc-ADT therapies in China. Methods: The Bucher technique for indirect treatment comparison was used. A cost analysis was conducted from both healthcare and patient perspectives. Results: The indirect treatment comparison demonstrated no significant difference in PFS for Abi-ADT versus Doc-ADT (HR: 0.84, 95% CI 0.66–1.07). Doc-ADT therapy costs less than Abi-ADT, with potential savings of up to RMB 887,057 per patient from the healthcare perspective and RMB 226,210 per patient from the patient perspective. Conclusions: No significant differences in PFS between Doc-ADT and Abi-ADT therapy for patients with high-volume mHSPC. Doc-ADT therapy is a cost-saving alternative to Abi-ADT in China. [ABSTRACT FROM AUTHOR]

Purpose. Studies on genetic alterations of the heterogenous small cell lung cancer (SCLC) are rare. We carried out the present study to clarify the genomic alterations and TMB levels of Chinese SCLC patients by whole-exome sequencing. Materials and Methods. Whole-exome sequencing by next-generation sequencing technique was implemented on twenty SCLC samples. Significant somatic mutations and copy number variations were screened, followed by comparison with the data extracted from COSMIC. Besides, altered signaling pathways were examined in order to figure out actionable targets. Results. A total of 8,062 nonsynonymous mutations were defined. The number of mutations for each case ranged from 98 to 864. As for base substitutions, a total of 15,817 substitutions were detected with C > A conversion which was correlated to smoking occupying 25.57%. The TMB values ranged from 2.51/Mb to 22.1/Mb with a median value of 9.95/Mb. RB1 was the most frequently mutated gene altered in 18 (90%) cases, followed by TP53 altered in 17 (85%) cases. Other commonly changed genes were PTEN, and RBL1, with frequencies of 55% and 50%, respectively. SOX2 significantly amplified in 6 (30%) cases and MYCN amplified in 1 (5%) patient. Notch signaling pathway and PI3K/AKT/mTOR signaling pathway were universally and significantly changed. Major genomic alterations were in consistency with data from COSMIC, but frequencies of less common mutations were different. Conclusion. TP53 and RB1 inactivations were universally detected in SCLC. The Notch and PI3K/AKT/mTOR signaling pathways were both significantly altered, implying potential actionable targets. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Advanced Nursing (John Wiley & Sons, Inc.) is the property of John Wiley & Sons, Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Aims and objectives: To compare the differences in psychosocial behaviour reactions, psychosocial needs, anxiety and depression before and after colostomy surgery and to explore the predictors of psychosocial behaviour reactions. Background: Colorectal cancer is increasing worldwide. Abdominoperineal resection accompanied by permanent colostomy can cause complicated psychosocial reactions and needs. However, colostomy patients' trajectories of psychosocial adjustment at different time points must be discussed. Design: A longitudinal study. Methods: Using a convenience sampling method, 67 patients planning to undergo colostomy surgery were recruited from a tertiary cancer centre in southern China from January 2013–January 2014. Data collection consisted of two phases, conducted 1–2 days before surgery and 1–2 days prior to discharge. The Ostomy Psychosocial Behaviour Reaction Questionnaire, the Ostomy Psychosocial Needs Questionnaire, the Hospital Anxiety and Depression Scale and a self‐designed demographic questionnaire were used to collect data. STROBE guidelines were followed. Results: The participants had a moderate level of psychosocial behaviour reactions, a deep and wide range of psychosocial needs and a high incidence of anxiety and depression before and after surgery. Anxiety before surgery was significantly higher than that after surgery. Psychosocial needs and anxiety were significant predictors of psychosocial behaviour reactions. Conclusions: Patients' anxiety was alleviated after surgery. The combination of ascertaining and meeting various psychosocial needs and managing negative emotions was helpful in alleviating patients' stress responses before and after surgery. Relevance to clinical practice: An increased focus on the relationships among psychosocial behaviour reactions, psychosocial needs, anxiety and depression at different time points in colostomy patients is necessary for future research and practice. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Background. Evidence regarding the relationship between synthetic house-tree-person (S-HTP) drawing test and depression in cancer patients is limited. The aim of this study was to explore the applicability and validity of S-HTP drawing test in cancer patients suffering from depression. Methods. As a population based cross-sectional study, 167 patients with cancer were enrolled in a hospital in China from December 2015 to December 2017. Self-edited general information questionnaire, self-rating depression scale (SDS), and the S-HTP drawing test were completed by all participants. Results. The average age of 167 selected participants was 52.92 ± 10.43 years old, and about 58.7% (98/167) of them were male. On SDS, depression rate was found in 34.1% (27/167) cancer patients. The logistic regression equation was established by using the depression drawing characteristics as the independent variables and the evaluation results from SDS as the dependent variable and 9 drawing characteristics employed in the regression equation (χ2 = 68.657, P < 0.001. Nagelkerke R2 = 0.466). Correlation analysis revealed a positive correlation between S-HTP drawing test and SDS for depression state of cancer patients (p < 0.01). Conclusions. There are interrater reliability and test-retest reliability between S-HTP drawing test and SDS. The S-HTP drawing test could help in screening depression in cancer patients. [ABSTRACT FROM AUTHOR]

Due to successful public health campaigns, breast cancer has successfully transformed from a highly stigmatized illness to a philanthropically supported disease in the United States. However, Chinese American breast cancer survivors continue to experience high levels of self-stigma and associated negative mental health outcomes. In the present study, we examined the relations between self-stigma and depressive symptoms, and further tested individual difference variables such as ambivalence over emotional expression and intrusive thoughts that may exacerbate the harmful effects of self-stigma among this population. One hundred and twelve foreign-born Chinese breast cancer survivors living in the United States completed questionnaires measuring self-stigma, depressive symptoms, AEE, and intrusive thoughts. We found significant AEE × self-stigma and intrusive-thought × self-stigma interaction effects in predicting depressive symptoms. Specifically, the relationships between self-stigma and depressive symptoms were exacerbated among individuals with high levels of AEE and intrusive thoughts. Self-stigma represents a significant predictor of depressive symptoms among Chinese breast cancer survivors, and particularly so for individuals with higher levels of AEE and intrusive thoughts. The findings suggest that for interventions designed to reduce the negative mental health outcomes associated with self-stigma, targeting risk factors such as AEE and intrusive thoughts might be promising. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Advanced Nursing (John Wiley & Sons, Inc.) is the property of John Wiley & Sons, Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The aim of investigation is to explore the relationship between demands for lung cancer screening (LCS) and the constructs derived from the health belief model (HBM) in Hefei. The study collected data about socio-demographics, health beliefs in and demands for LCS during early June to later July 2015. By constructing a LCS demands HBM constructs, it calculated indices of demands for LCS (DSI) and HBM constructs, which include perceived risk (PR) and seriousness (PS) of the cancers; and perceived effectiveness (PE), benefits (PB) and difficulties (PD) of the screening. It also performed descriptive and multivariate regression analysis of the demands and the HBM constructs. The amount of 823 respondents participated and completed the survey. 6.4% of them had ever undertaken LCS, whereas 60.1% of them expressed willingness to accept the service of LCS if it is free. In multiple regression analysis which used weights in calculating the HBM construct indices, education displayed significant positive associations with DSI (p = .044), and most of HBM constructs indices (PSI, PRI, PBI, and PDI) were statistically significant with DSI (p < .05). HBM-based constructs regarding LCS have important effects on demands for the service, and may provide effective paths to cancer screening promotion. [ABSTRACT FROM AUTHOR]