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The aim of the study was to identify, summarize and critically appraise studies that have investigated the effects of exercise and psychosocial interventions on body image of breast cancer survivors.A critical review.A comprehensive search was conducted to identify relevant articles published in MEDLINE, PsycINFO, CINAHL and British Nursing Index between 2011 and 2021. Included studies' methodological quality was assessed using the critical appraisal checklists of the Center for Evidence-Based Management.A total of eight studies were included. Breast cancer survivors who received exercise or psychosocial interventions had an improved body image compared with baseline, which enhanced their quality of life. Compared with psychosocial interventions, exercise demonstrated more positive effects as they enhanced both mental and physical well-being. Breast cancer survivors expressed that they preferred to have a knowledgeable mentor to guide and empower them throughout the exercise intervention. Psychosocial interventions showed varying effectiveness, with self-compassion-focused writing activity being most effective.

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

This study assessed the psychological wellbeing and its associated factors amongst ethnic minorities during the coronavirus disease 2019 (COVID-19) pandemic. A total of 310 Hong Kong South Asians aged 41.3 (SD 13.7) years completed an anonymous online survey between July 2020 and February 2021. The results showed an overall moderate level of stress and high levels of depression, anxiety and post-traumatic stress disorder (PTSD) symptoms amongst South Asian minorities. Multivariable regression analyses suggested that being single/divorced, following Hinduism or other non-Muslim religions, having lower perceived knowledge of COVID-19 and having worried about losing job were significant predictors of higher levels of depression, anxiety and/or stress; additionally, being male, having a low monthly household income, having worried about losing job and healthcare collapse were significant predictors of a higher level of PTSD symptoms. The findings suggest an urgent need to alleviate the psychological impacts of the COVID-19 pandemic on ethnic minorities, specifically for those most vulnerable to these impacts.

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

This study aimed to examine the fidelity of intervention delivery and identify precursory factors contributing to the successful delivery and beneficial effects of family-oriented dignity therapy.This was a process evaluation with quantitative and qualitative methods alongside a randomized controlled trial from March to May 2019. Nonparametric statistics were used to analyze how participants' demographics (The fidelity was achieved with minor deviations from the protocol. Higher educational level and higher income were significantly correlated with lower levels of existential distress (H ​= ​12.20,Fidelity and precursory factors that enhance the beneficial effects of family-oriented dignity therapy were identified. Reinforcement strategies, such as using supplementary video, audio, and reading materials; developing a flexible approach to expressing feelings; and exploring lessons and achievements from various perspectives, are recommended for future research to enhance intervention effects.The study was registered in the Chinese Clinical Trial Registry (registration number: ChiCTR1900020806).

BackgroundAppropriate breastfeeding training for midwives is necessary to enhance their knowledge, attitude, and practice (KAP). However, evidence surrounding the effects of midwife breastfeeding training programmes is insufficient to draw a conclusion.ObjectiveThis systematic review aims to identify, summarise, and critically analyse the available literature to evaluate the effects of midwife breastfeeding training programmes on the midwives’ KAP towards breastfeeding and breastfeeding initiation, duration and rates among postnatal mothers.MethodsNine English and six Chinese databases were searched with relevant key words. The methodological quality of the included studies was assessed by two reviewers independently using the Joanna Briggs Institute critical appraisal checklists.ResultsNine English and one Chinese articles were included in this review. Five articles investigating midwives’ KAP towards breastfeeding reported positive results (p

Background: Appropriate breastfeeding training for midwives is necessary to enhance their knowledge, attitude, and practice (KAP). However, evidence surrounding the effects of midwife breastfeeding training programmes is insufficient to draw a conclusion. Objective: This systematic review aims to identify, summarise, and critically analyse the available literature to evaluate the effects of midwife breastfeeding training programmes on the midwives' KAP towards breastfeeding and breastfeeding initiation, duration and rates among postnatal mothers. Methods: Nine English and six Chinese databases were searched with relevant key words. The methodological quality of the included studies was assessed by two reviewers independently using the Joanna Briggs Institute critical appraisal checklists.

Background: Appropriate breastfeeding training for midwives is necessary to enhance their knowledge, attitude, and practice (KAP). However, evidence surrounding the effects of midwife breastfeeding training programmes is insufficient to draw a conclusion. Objective: This systematic review aims to identify, summarise, and critically analyse the available literature to evaluate the effects of midwife breastfeeding training programmes on the midwives' KAP towards breastfeeding and breastfeeding initiation, duration and rates among postnatal mothers. Methods: Nine English and six Chinese databases were searched with relevant key words. The methodological quality of the included studies was assessed by two reviewers independently using the Joanna Briggs Institute critical appraisal checklists.

Background: Appropriate breastfeeding training for midwives is necessary to enhance their knowledge, attitude, and practice (KAP). However, evidence surrounding the effects of midwife breastfeeding training programmes is insufficient to draw a conclusion. Objective: This systematic review aims to identify, summarise, and critically analyse the available literature to evaluate the effects of midwife breastfeeding training programmes on the midwives' KAP towards breastfeeding and breastfeeding initiation, duration and rates among postnatal mothers. Methods: Nine English and six Chinese databases were searched with relevant key words. The methodological quality of the included studies was assessed by two reviewers independently using the Joanna Briggs Institute critical appraisal checklists.

Background Adjuvant endocrine therapies are known to induce undesirable adverse effects such as vasomotor, vaginal and musculoskeletal symptoms among breast cancer patients. Drugs used in these therapies are often metabolised by cytochrome P450 (CYP) enzymes, in which their metabolising activities can be modified by single nucleotide polymorphisms (SNP) in CYP genes and CYP genotypes. This review aims to explore whether SNPs or genotypes of CYP are associated with the occurrence, frequency and severity of vasomotor, vaginal and musculoskeletal symptoms in breast cancer patients on adjuvant endocrine therapies. Methods A literature review was conducted using five electronic databases, resulting in the inclusion of 14 eligible studies, and their findings were presented narratively. Selected items from the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist were used for critical appraisal of the reporting quality of the included studies. Results Most of the included studies showed that SNPs or genotypes of CYP that modify its metabolising activity have no effect on the occurrence, frequency or severity of vasomotor symptoms, including hot flashes. One study showed no correlation of these genetic variations in CYP with musculoskeletal symptoms, and no data were available on the association between such genetic variations and vaginal symptoms. Conclusions Overall, genetic variations in CYP have no effect on the experience of hot flashes among breast cancer patients. We recommend exploration of the link between the active metabolites of chemotherapeutic drugs and the molecules shown to affect the occurrence or severity of hot flashes, and the establishment of the relationship between such genetic variations and patients’ experience of musculoskeletal and vaginal symptoms. Subgroup analyses based on patients’ duration of adjuvant endocrine therapies in such studies are recommended.

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.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.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.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, ImHealth 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.CRD42021224307.

Childhood eczema is common but its prevalence is variable in different regions of the world. In this study, we explore the associations of various risk factors such as the microbiome, environment, lifestyle, diet and maternal stress with the development of eczema among infants in Hong Kong. Upon enrolment in the study, the infants' parents provided demographic data by self-reporting. At enrolment and 1 year after birth, the infants' allergic conditions, lifestyles and dietary factors and the degree of maternal stress were assessed using various questionnaires. The infants' gut microbiomes were analysed by 16S RNA sequencing, and the longitudinal changes in various bacterial strains were compared between control and eczema-affected groups. Multivariate analyses (after adjustment for other significant factors) revealed that the changes in the abundance of Hungatella hathewayi in the gut were significantly associated with the development of eczema (p = 0.005). In conclusion, the increased abundance of Hungatella hathewayi was associated with an increased risk of developing eczema by 1 year of age. This study thus explored the potential risk factors for the development of eczema in Hong Kong infants, and sheds light on the possible association between early-life gut microbiome and other environmental factors.

Objective: This article aimed to report the experience of developing a complex nurse-led, theory-driven, and evidence-based educational intervention program intended to manage the nutrition impact symptom cluster experienced by patients with nasopharyngeal carcinoma (NPC) during radiotherapy, based on the Medical Research Council (MRC) framework. Methods: The “development” and “feasibility and piloting” phases of the MRC framework were used to guide the intervention development. The development phase included identifying the evidence base through a systematic review, exploring the relevant and guiding theory to enhance the effectiveness of the intervention and conducting a qualitative study to identify the intervention modelling. For the feasibility and piloting phase, we conducted a pilot study to examine the feasibility and estimate the effectiveness of the intervention. Results: The systematic review revealed that nurse-led educational interventions were used commonly for symptom cluster management, with promising effectiveness. The theoretical foundation was provided by the Theory of Unpleasant Symptoms, which indicates that an educational intervention can help patients to manage symptom cluster by influencing psychological, situational, and physiological factors. The qualitative study further provided contents of the intervention based on the perspectives of NPC patients and health professionals. The resulting program involves a nurse-led, family caregiver involvement, educational intervention with two sessions that uses a booklet as a medium. The pilot study found that conducting the educational intervention program was feasible and it also had some favorable effects on managing the nutrition impact symptom cluster in NPC patients. Conclusions: The MRC framework provided a strong structure with which to develop a complex intervention for nutrition impact symptom cluster management through a theory-driven and evidence-based approach. The evaluation of the intervention, the delivery process and the mediation mechanism of change using a rigorous randomized controlled trial design is recommended.

Background The breast-conserving surgery and reconstruction rate in China is relatively low when compared with those in Western countries. Moreover, predictors of surgical choices for women with breast cancer in China have not yet been explored. This study aims to explore differences in the surgical choices of women with different demographic and clinical characteristics and the predictors that influence surgical choices of women with early-stage breast cancer. Methods This retrospective study included women with early-stage (0-II) breast cancer who underwent surgeries at one of two Xiamen University-affiliated hospitals between 2009 and 2017. Using medical records, eleven variables were collected: the woman's age, year of diagnosis, hospital, marital status, payment method, cancer stage, presence of positive axillary lymph node, histology, neoadjuvant chemotherapy, radiotherapy, and the type(s) of surgery they chose. Binary logistic regression was used to analyse predictors of surgical choice. Results A total of 1,787 cases were included in this study. Of the total number of women with breast cancer, 61.3% underwent mastectomy without breast reconstruction, 26.4% underwent mastectomy with breast reconstruction, and the remaining 12.2% chose breast-conserving surgery. Women with different demographic and clinical characteristics underwent different types of surgery. Cancer stage, neoadjuvant chemotherapy, radiotherapy, and the choice of hospital were found to be predictors of breast-conserving surgery. Meanwhile, age, year of diagnosis, payment method, neoadjuvant chemotherapy, and the choice of hospital were found to be predictors of reconstruction after mastectomy in women with early-stage breast cancer. Conclusions In China, surgical choices for women with breast cancer have diversified. Healthcare workers should understand the surgical preferences of women of different ages. For early detection of breast cancer, knowledge of breast self-examination and breast cancer screening should be provided. Adequate information about the safety of reconstruction and advocacy for medical insurance coverage of reconstruction should be offer. Breast surgeons need specialised training and standardising protocols towards different types of breast surgery. These actions will help women make better, well-informed decisions about their breast surgeries.

BackgroundA range of psychological issues often accompany breast cancer chemotherapy. Owing to their ubiquity, mobile phones have been used to deliver supportive interventions that address these issues. However, we currently lack sufficient evidence to guide the design of such interventions.AimTo 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.MethodsA 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.ResultsThe review included ten published studies which covered 1,548 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 = 0.96, 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 =.27), symptom distress (p = .004, d = .004), symptom interference (p = .02, d = .51), supportive care needs (p < .05, d = 2.43); improved self-efficacy (p = .03, d = 0.53), self-esteem (p d = 0.87) and emotional functioning (p = .008, d = .30). The methodological quality ranged from low to moderate.ConclusionmHealth interventions might be helpful in addressing certain psychological issues experienced by this population, although the evidence is still being gathered and not yet conclusive. More rigorous trials are hereby warranted to confirm the suitable duration while addressing the methodological flaws found in previous studiesPROSPERO registration numberCRD42021224307

Background Women diagnosed with BC receiving chemotherapy have reported various side effects, which adversely affect their psychological state. Evidence suggests that psychoeducational interventions (PEIs) delivered through mobile phones might effectively provide psychosocial support for this population. However, there is a lack of evidence on Nigerian women's perception of mHealth PEI, which prompted this study.MethodA multi-centre exploratory qualitative study was conducted among women with BC who had completed chemotherapy at two tertiary hospitals in Nigeria. Face-to-face focus group interviews were conducted at the oncology clinics. Data were collected using a semi-structured interview guide until data saturation was reached. Data were analysed using thematic analysis. Results Thirty-two women were recruited, with seven focus group interviews conducted. The participants were between 22 and 75 years old and mostly diagnosed with Stage III BC. Four main themes emerged from the data analysis, including experiences of BC diagnosis and treatment phase, patients’ needs during chemotherapy, coping with chemotherapy and perception of mHealth intervention for psychoeducational support. The participants found that mHealth intervention is acceptable, and the suggested contents include information on chemotherapy, how to deal with the fear of chemotherapy, nutritious diet locally available and information on exercise.Conclusion BC diagnosis was devastating, and psychological disturbances were experienced while receiving chemotherapy, but the participants perceived that mHealth intervention could provide psychological and informational support. This study will help design a culturally appropriate mHealth PEI for this population.

It is well-documented in the literature that dignity therapy is feasible and effectively improves the end-of-life experience of the terminally ill. In a similar vein, this study aimed to develop and investigate the feasibility of evidence-based and culturally sensitive family-oriented dignity therapy for Chinese patients with lung cancer undergoing chemotherapy.Three phases of the Medical Research Council framework were adopted to guide the development of the novel dignity therapy intervention. It was preliminarily designed based on a qualitative study and a systematic review, Erikson's eighth stage of psychosocial development, and the dignity model. The feasibility and acceptability of the intervention were examined in a pilot randomized controlled trial with 12 recruited dyads of patients and family caregivers.The intervention consists of three face-to-face sessions that facilitate participants' reminiscences and promote their communication. Recruitment and response rates for the feasibility study of the intervention were 92.3% and 75%, respectively. Both patients and family caregivers reported that the intervention alleviated their psychological distress and improved communication.The Medical Research Council framework serves as a useful scientific basis for modifying dignity therapy with a culturally sensitive approach. The results of the feasibility study suggest that the family-oriented dignity therapy intervention is feasible, acceptable and has the potential to enhance the effects of dignity therapy.

Women diagnosed with breast cancer (BC) receiving chemotherapy have reported various side effects, which adversely affect their psychological state. Evidence suggests that psychoeducational interventions (PEIs) delivered through mobile phones might effectively provide psychoeducational support for this population. However, there is a lack of evidence on Nigerian women's perception of mobile health (mHealth) PEI, which prompted this study.A qualitative study was conducted among women with BC who had completed chemotherapy at two tertiary hospitals in Nigeria. Face-to-face focus group discussions were conducted at the oncology clinics. Data were collected using focus groups until data saturation was reached. Data were analyzed using thematic analysis.In total, 32 women were recruited, with seven focus group discussions conducted. The participants were between 22 and 75 years old and mostly diagnosed with Stage III BC. Four main themes emerged from the data analysis, including experiences of BC diagnosis and treatment phase, patients' needs during chemotherapy, coping with chemotherapy, and perception of mHealth intervention for psychoeducational support. BC diagnosis was devastating, and psychological disturbances were experienced while receiving chemotherapy, but the participants indicated that mHealth intervention was acceptable as it could provide psychological and informational support. The suggested contents include information on chemotherapy, how to deal with the fear of chemotherapy, nutritious diet locally available, and information on exercise.This study has shown that the participants perceived a mHealth PEI is feasible and acceptable in providing psychoeducational support for Nigerian women diagnosed with BC receiving chemotherapy. It is hoped that the unmet needs of this population will be addressed while receiving chemotherapy.

To review recent pharmacogenomics studies on breast cancer patients undergoing tamoxifen therapy, highlighting how our knowledge on cytochrome P450 2D6 (CYP2D6) can help to guide the development of adjuvant therapies for these patients. A comprehensive literature search was conducted. Articles reporting findings pertaining to the effect of CYP2D6 on the therapeutic efficacy of tamoxifen, those reporting how targeting CYP2D6 could inform tamoxifen-based therapy development, and those on the tamoxifen effects on cell lines and animal models were included in the review. With CYP2D6 being the primary enzyme for tamoxifen metabolism, single-nucleotide polymorphisms (SNPs) in this gene were one of the determinants in the rate of tamoxifen metabolism, thereby potentially having an effect on the efficacy of tamoxifen-based therapies. Our review indicates the potential effectiveness of targeting these SNPs, including those for the CYP2D6*10 allele (c. 100C > T), in modifying the level of tamoxifen metabolism. These findings suggest the importance of pharmacogenomics research in our understanding of the efficacy of adjuvant therapies. However, the involvement of multiple enzymes in tamoxifen metabolism, dietary factors, ethnic differences in gene frequencies, and patients’ compliance to tamoxifen therapies in studies do present challenges in pharmacogenomics research. Pharmacogenomics could play important roles in mediating the advancement of tamoxifen-based adjuvant therapies. Research efforts should be directed towards the exploration of further SNPs of CYP2D6 that affect tamoxifen metabolism, as well as epigenetic changes in CYP2D6, enabling the design of precision medicine and confirming clinical validity in the use of pharmacogenomics for tamoxifen.

To identify and evaluate the available evidence on the effectiveness of character strengths-based intervention on the psychological well-being of patients with chronic illnesses.A systematic review with meta-analysis.Six electronic databases, including PubMed, EMBASE, EBSCO (CINAHLThe quality appraisal of evidence and summary of studies were undertaken following Joanna Briggs Institute critical appraisal checklists and the standard guidelines of Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Meta-analysis was conducted according to Cochrane methods using RevMan 5.1.Clinical studies on the character strengths-based intervention for patients with chronic illnesses are limited. Eight studies involving 692 patients were identified and critically appraised in this review. Meta-analysis results for three comparable studies indicated that character strengths-based intervention was effective in improving the self-esteem of patients with chronic illnesses and it significantly enhanced their general self-efficacy and reduced their depression.The findings support the effectiveness of character strengths-based intervention on improving the psychological well-being of patients with chronic illnesses. However, caution is needed in interpreting these results due to limited studies and heterogeneity across studies. Further research is needed to provide strong evidence on the applicability of the intervention in clinical practice.This rigorous review provided current evidence on using character strengths-based intervention to improve the psychological well-being of patients with chronic illnesses. Character strengths-based intervention provides a creative approach for patients because it may help improve their well-being, happiness, self-esteem, and self-efficacy, and reduce depression and mental symptoms. Studies in different groups of patients suffering from chronic illnesses are recommended in the future. The character strengths-based intervention should be replicated in various inpatient facilities and include a larger and a more ethnically and socioeconomically diverse sample.目的: 通过对慢性病患者心理健康状况的调查,确定并评价基于性格优势的介入治疗的效果。 设计: 采用荟萃分析进行系统综述。 数据来源: 搜索包括PubMed因特网生物医学信息检索系统、EMBASE荷兰医学文摘数据、EBSCO文献数据库(CINAHL®护理学数据库和MEDLINE联机医学文献分析和检索系统)、Web of Science科研数据库平台和PsycINFO心理学文摘数据库在内的6个电子数据库从开始到2018年12月的文章。 审查方法: 根据乔安娜布里格斯研究所严格评价检查表和系统综述和荟萃分析优先报告的条目的标准指南,进行证据质量评估和研究总结。根据Cochrane系统评价采用RevMan 5.1进行荟萃分析。 结果: 对慢性病患者进行基于性格优势的介入治疗的临床研究有限。本综述对8个涉及692例患者的研究进行了鉴定和批判性评价。三项比较研究的荟萃分析结果表明,基于性格优势的介入治疗能有效提高慢性病患者的自尊感,显著增强患者的一般自我效能,降低患者的抑郁情绪。 结论: 本研究的发现验证了基于性格优势的介入治疗对改善慢性病患者心理健康的有效性。不过,由于研究的局限性和研究的异质性,应当审慎地阐明这些结果。需要开展进一步的研究为介入治疗在临床实践中的适用性问题提供有力的证据。 影响: 这一严格的综述为使用基于性格优势的介入治疗以改善慢性病患者心理健康提供最新的证据。基于性格优势的介入治疗为患者提供了一种创造性的方法,因为其可以帮助改善患者的健康、幸福感、自尊和自我效能,减少抑郁及精神症状。今后建议对不同慢性病患者群体开展研究。应当在不同医院中复制这项基于性格优势的介入治疗,同时纳入更大范围、更具种族和社会经济多样性的样本。.

OBJECTIVE This study aims to evaluate the effects of a theory-driven psycho-educational intervention programme on uncertainty in illness, anxiety, and sexual functioning in a cohort of Chinese patients with gynaecological cancer. METHODS Women with newly diagnosed gynaecological cancer (n = 202) received either a four-session, 12-week-long, culturally appropriate psycho-educational intervention programme (n = 102) or attention from intervener (n = 100) in a two-group randomised controlled trial. Patient-reported measures included Chinese version of Mishel's Uncertainty in Illness Scale (C-MUIS), Hospital Anxiety and Depression Scale (HADS)-Anxiety subscale, and Sexual Function-Vaginal Changes Questionnaire (SVQ). Data regarding uncertainty in illness and anxiety were collected at baseline and postintervention, while data on sexual functioning were collected postintervention. RESULTS Patients receiving psycho-educational intervention reported significantly greater reductions in ambiguity, inconsistency, and overall uncertainty in illness, as measured by C-MUIS (P < .01). They were also more likely to be sexually active (P = .037), report their partners having greater sexual interest (P = .008), and perceive a significantly greater level of intimacy (P = .001) in the SVQ. CONCLUSIONS Given the growing population of gynaecological cancer survivors and the universal side effects of the disease and its related treatments, the established design and content of the psycho-educational intervention programme should be incorporated into routine clinical practice.

ObjectiveTo explore the patients’ experiences on character strengths that Chinese patients experience after the diagnosis of breast cancer.DesignA qualitative, exploratory study using semistructured interviews based on the patients’ lived experience after being diagnosed with breast cancer. Ethics approval was granted. Interviews were audiorecorded and transcribed verbatim. Values in Action Classification of Strengths provided conceptual framework for analysing strengths. Directed content analysis based on the classification of strengths and framework analysis were used to analyse transcribed data. The Standards for Reporting Qualitative Research guideline was followed.SettingThe Second Affiliated Hospital of Zhengzhou University and Henan Provincial Cancer Hospital in China.ParticipantsAdult patients over 18 years, diagnosed with breast cancer between October 2019 and December 2020 were recruited. We used purposive sample method to collected data from 24 participants diagnosed with breast cancer.ResultsSix themes (virtues) emerged from our analysis. In addition, two new subthemes (character strengths) emerged in this study, selflessness and pragmatism, respectively. Patients with breast cancer described a large repertoire of character strengths they used or wished for during survivorship, including gratitude, hope, humility, kindness, humour, honesty and forgiveness. Cultural values (eg, collectivism, familyism, Confucianism and Buddhist beliefs) helped structure the experiences of Chinese patients’ character strengths. Patients wanted their character strengths to be more noticed, appreciated and encouraged by others and reported their psychological trajectory of using personal strengths.ConclusionThe findings indicated that patients with breast cancer believing character strengths are important to them. Medical staff should pay more attention to motivating and cultivating character strengths of patients with breast cancer. Attention to make strength-based practices workable in clinical health promotion programmes is necessary. The healthcare system should develop tailored individualised psychological services that specifically address patients' needs for the application of personalised character strengths.Trial registration numberNCT04219267, Pre-results.

Credit transfer information systems in higher education are not well studied. This article demonstrates the prototype development of a cross-institutional credit transfer information system (CICIS) for community college transfer (i.e., vertical transfer) students in an Asian educational context. It exhibits credit transfer guidelines and past credit transfer records to enhance the transparency and sustainability of credit transfer information and to facilitate the transfer process of prospective community college transfer students. It also ensures the sustainability of credit transfer information and its application. The four-phase life cycle of the prototyping model was adopted to guide the study. In this paper, we report the first three phases of this development: (1) Users’ needs assessment and pre-prototyping groundwork, (2) prototype development, and (3) unforeseen circumstances and expert review. Challenges and difficulties throughout the whole process are documented and discussed. Based on this prototype development experience, a solid foundation of strategies for future engineering and enhancement of credit transfer information systems can be developed.

Background Developing students’ generic capabilities is a major goal of university education as it can help to equip students with life-long learning skills and promote holistic personal development. However, traditional didactic teaching has not been very successful in achieving this aim. Kember and Leung’s Teaching and Learning Model suggests an interactive learning environment has a strong impact on developing students’ generic capabilities. Metacognitive awareness is also known to be related to generic capability development. This study aimed to assess changes on the development of generic capabilities and metacognitive awareness after the introduction of active learning strategy among nursing students. Methods This study adopted a quasi-experimental single group, matched pre- and posttest design. It was conducted in a school of nursing at a university in Hong Kong. Active learning approaches included the flipped classroom (an emphasis on pre-reading) and enhanced lectures (the breaking down of a long lecture into several mini-lectures and supplemented by interactive learning activities) were introduced in a foundational nursing course. The Capabilities Subscale of the Student Engagement Questionnaire and the Metacognitive Awareness Inventory were administered to two hundred students at the start (T0) and at the end of the course (T1). A paired t-test was performed to examine the changes in general capabilities and metacognitive awareness between T0 and T1. Results A total of 139 paired pre- and post-study responses (69.5 %) were received. Significant improvements were observed in the critical thinking (p p = 0.03), problem-solving (p p = 0.04) with the implementation of active learning. Significant changes were also observed in knowledge of cognition (p Conclusions Active learning is a novel and effective teaching approach that can be applied in the nursing education field. It has great potential to enhance students’ development of generic capabilities and metacognitive awareness.

Purpose This study aimed to explore the cultural elements of music in relation to pain management among women who have undergone mastectomy. Method: An exploratory qualitative study with in-depth interviews. Using the purposive sampling technique, 20 participants were recruited for the study. The interviews were conducted face to face at the surgical out-patient clinic and female surgical ward. Data collection continued until data saturation was reached. The inductive approach was used to analyse the data, and the concepts were organized into themes. The consolidated criteria for reporting qualitative research guidelines (COREQ) were used to report this study. Results The participants were between 28 and 83 years old and mostly diagnosed with Stage III breast cancer. Three main themes emerged from the data analysis, including pain experienced after mastectomy, culture and music, and the perception of music for postoperative pain management after mastectomy. Conclusion Knowledge and the utilisation of music as a therapy for pain management remains inadequate, but the participants perceived that music could be useful for pain control after mastectomy when the language and religion of the patient and the meaningfulness of the music were considered when introducing and selecting the music. This study will help open and extend the conversation about the utilisation and cultural elements of music that can be used clinically for pain management after mastectomy.