Financial toxicity and its risk factors among patients with cancer in China: A nationwide multisite study.

Objective: We assessed financial toxicity (FT) among Chinese patients with cancer and investigated associated risk factors guided by a multilevel conceptual framework. Methods: Applying multistage stratified sampling, we selected six tertiary and six secondary hospitals across three economically diverse provinces in China. From February to October 2022, 1208 patients with cancer participated. FT was measured using the COmprehensive Score for financial Toxicity (COST), with 28 potential risk factors identified at multilevel. Multiple regression analysis was used for risk factor identification. Results: FT prevalence was 82.6% (95% confidence interval [CI]: 80.5%, 84.8%), with high FT (COST score ≤ 18.5) observed in 40.9% of participants (95% CI: 38.1%, 43.7%). Significant risk factors included younger age at cancer diagnosis, unmarried status, low annual household income, negative impact of cancer on participants' or family caregiver's work, advanced cancer stage, longer hospital stay for cancer treatment or treatment-related side effects, high perceived stress, poor emotional/informational support, lack of social medical insurance or having urban and rural resident basic medical insurance, lack of commercial medical insurance, tertiary hospital treatment, and inadequate cost discussions with healthcare providers (all P < 0.05). Conclusions: Cancer-related FT is prevalent in China, contributing to disparities in cancer care access and health-related outcomes. The risk factors associated with cancer-related FT encompasses multilevel, including patient/family, provider/practice, and payer/policy levels. There is an urgent need for collective efforts by patients, healthcare providers, policymakers, and insurers to safeguard the financial security and well-being of individuals affected by cancer, promoting health equities in the realm of cancer care.

Corrigendum to "Feasibility and acceptability of motivational interviewing to promote colorectal cancer screening among average risk Chinese older adults" [Asia-Pacific J Oncol Nurs 10 (2023) 100315].

[This corrects the article DOI: 10.1016/j.apjon.2023.100315.].

Effects of immersive virtual reality for alleviating anxiety, nausea and vomiting among patients with paediatric cancer receiving their first chemotherapy: protocol for a randomised controlled trial.

INTRODUCTION: Anxiety, nausea and vomiting are common side effects suffered by paediatric patients receiving chemotherapy. Emerging evidence supports the efficacy of immersive virtual reality (IVR) on improving anxiety and distress symptoms including nausea and vomiting in this vulnerable group. This trial aims to evaluate the effects of IVR intervention on anxiety, chemotherapy-induced nausea and vomiting and anticipatory nausea and vomiting in patients with paediatric cancer receiving first chemotherapy. METHOD AND ANALYSIS: An assessor-blinded, randomised controlled trial with a mixed methods evaluation approach. On the basis of our pilot results, 128 chemotherapy-naive patients with paediatric cancer scheduled to receive their first intravenous chemotherapy will be recruited from a public hospital and randomly allocated to intervention (n=64) or control groups (n=64). The intervention group will receive the IVR intervention for three sessions: 2 hours before the first chemotherapy, 5 min before and during their first chemotherapy and 5 min before and during their second chemotherapy, respectively. The control group will receive standard care only. A subsample of 30 participants in the intervention group will be invited for a qualitative interview. Study instruments are: (1) short form of the Chinese version of the State Anxiety Scale for Children, (2) visual analogue scale for anticipatory nausea and vomiting, (3) Chinese version of the Multinational Association of Supportive Care in Cancer Antiemesis Tool and (4) individual face-to-face semistructured interviews to explore intervention participants' perceptions of the IVR intervention. ETHICS AND DISSEMINATION: This study has been approved by the Hong Kong Children's Hospital Research Ethics Committee (HKCH-REC-2021-009). The findings will be disseminated in peer-reviewed journals and through local or interventional conference presentations. TRIAL REGISTRATION NUMBER: ChiCTR2100048732.

A Mobile Instant Messaging-Delivered Psychoeducational Intervention for Cancer Caregivers: A Randomized Clinical Trial.

Importance: Psychoeducational interventions (PEIs), which provide both information and emotional and psychosocial support, may address the unmet needs of the caregivers of adolescent and young adult patients with cancer. Objective: To explore the effects of an instant messaging-delivered PEI on anxiety, depression, quality of life (QOL), and coping and determine whether the intervention reduces caregivers' unmet needs. Design, Setting, and Participants: This randomized clinical trial using an intention-to-treat protocol was conducted from April 1 to September 14, 2022, in a tertiary cancer hospital in China and included caregivers of patients diagnosed with cancer at age 15 to 39 years recruited using convenience sampling. Intervention: Caregivers were allocated 1:1 using a randomized block scheme to the intervention or control group. The intervention group received a 5-week PEI and usual care, whereas the control group received only usual care. The PEI was delivered through articles and calls through an instant messaging application. Main Outcomes and Measures: The primary outcomes were changes in the levels of caregivers' anxiety and depression, measured using the 7-Item Generalized Anxiety Disorder Scale and the Patient Health Questionnaire 9, respectively. The secondary outcomes were changes in the levels of caregivers' QOL, coping, and unmet needs. Results: Of the 160 participants, 92 (57.5%) were male; mean (SD) age was 40.27 (8.33) years. Compared with the control group, the intervention group had significantly greater reduction in severity of anxiety (B = -3.231; 95% CI, -4.746 to -1.716; P < .001) and depression (B = -3.253; 95% CI, -5.052 to -1.454; P < .001), smaller reduction in QOL (B = 13.574; 95% CI, 0.488-26.661; P = .04), and greater reduction in unmet needs (B = -12.136; 95% CI, -18.307 to -5.965; P < .001) after the intervention. Twelve weeks after baseline, the intervention group demonstrated a significantly greater reduction only in severity of anxiety (B = -1.890; 95% CI, -3.382 to -0.397; P = .01). Conclusions and Relevance: In this randomized clinical trial of a mobile instant messaging-delivered PEI, caregivers' unmet needs, anxiety, and depression decreased significantly and QOL declined at a significantly slower rate immediately after the intervention in the intervention group compared with the control group. A sustained effect on anxiety was observed 12 weeks after baseline. Trial Registration: Chinese Clinical Trial Registry identifier: ChiCTR2200055951.

Determination of a cut-off COmprehensive Score for financial Toxicity (COST) for identifying cost-related treatment nonadherence and impaired health-related quality of life among Chinese patients with cancer.

PURPOSE: This study aimed to determine a cut-off for the simplified Chinese version of the COmprehensive Score for financial Toxicity (COST) that could identify cost-related treatment nonadherence among Chinese patients with cancer. The study also sought to validate this cut-off score by using it to assess impaired health-related quality of life (HRQoL) in the same population. METHODS: A secondary analysis was conducted using data from a cross-sectional survey of 1208 Chinese patients with cancer who were recruited from 12 hospitals in six cities across three provinces of the Chinese mainland. Sociodemographic information and data on financial toxicity (FT), cost-related treatment nonadherence, and HRQoL were used in the analysis. Receiver operating characteristic (ROC) analysis was used to determine the optimal cut-off for the simplified Chinese version of the COST. RESULTS: The ROC analysis identified a COST cut-off of 18.5 for identifying cost-related treatment nonadherence, yielding a sensitivity of 76.5% and specificity of 71.4%. In the validation study, this cut-off score yielded a sensitivity of 64.2% and a specificity of 67.1% for identifying impaired HRQoL. CONCLUSION: Early and dynamic assessment of cancer-related FT in routine clinical practice may play a crucial role in the early identification and management of FT. Accordingly, a COST cut-off of 18.5 was identified to indicate cost-related treatment nonadherence and impaired HRQoL in a population of patients with cancer from the Chinese mainland. This finding may facilitate the implementation of universal FT screening among patients with cancer in specific settings such as the Chinese mainland.

Feasibility and acceptability of motivational interviewing to promote colorectal cancer screening among average risk Chinese older adults.

Objective: This study aims to evaluate the feasibility and acceptability of motivational interviewing to promote fecal immunochemical test (FIT) uptake among average-risk Chinese older adults and to preliminarily examine its effects on the knowledge level, perceived barriers to and benefits of the FIT, self-efficacy in screening, screening intention and FIT uptake. Methods: A one-group pre-test and post-test study design was adopted. A motivational interviewing intervention using face-to-face and telephone approaches was delivered to average-risk Chinese older adults aged 50-75 years. The number of participants approached, the number eligible for participation and intervention completion, and study retention rates were recorded. The knowledge, perceived benefits of, barriers to, self-efficacy in and intention to participate in colorectal cancer (CRC) screening were assessed before and after the intervention. FIT uptake was recorded 3 months after the intervention. Interviews were conducted to record the participants' experiences of participating in the intervention. Results: Twenty Chinese older adults completed the study. The motivational interviewing intervention improved the screening intention, knowledge of CRC and its screening, the perceived benefits of and self-efficacy in screening and perceived barriers to screening. Twelve participants (60%) had undergone FIT screening. Nineteen participants attended the interviews. They were all satisfied with the intervention. Three categories were generated regarding their experience in participating in the intervention, namely, (1) enhanced motivation and self-efficacy in screening, (2) enhanced understanding of the CRC screening program, and (3) areas for intervention improvement. Conclusions: The implementation of a motivational interviewing intervention was feasible and was acceptable to average-risk Chinese older adults. A full-scale study should be conducted in the future. Trial registration: ISRCTN39658070.

A multi-modal intervention for managing the fatigue-sleep disturbance-depressed mood symptom cluster in breast cancer patients undergoing chemotherapy: A pilot study.

Objective: To examine the feasibility and acceptability of a multi-modal intervention for managing the cancer-related fatigue-sleep disturbance-depressed mood (F-S-D) symptom cluster in patients with breast cancer (BC) and receiving chemotherapy in Hong Kong, and the preliminary effects of such intervention on the occurrence of the F-S-D symptom cluster in these patients. Methods: This study was a single-blind randomized controlled trial. Patients with BC scheduled for chemotherapy were recruited. Intervention participants received a weekly nurse-led multi-modal intervention lasting 7 weeks. The feasibility parameters and adverse events were assessed using logbook records. Acceptability was evaluated using a program evaluation questionnaire. F-S-D symptoms and quality of life (QOL) were measured at baseline (T0), upon intervention completion (T1), and 3 months after intervention completion (T2). Generalized estimating equation analyses were used. Results: Fifty participants were enrolled. The eligibility and enrollment rates were 11% and 87.7%, respectively. The rate of adherence to the intervention was 96%. No adverse events were reported. All participants were satisfied with the intervention, which had significant effects in terms of reducing the occurrence of the F-S-D symptom cluster at T2 (P â€‹= â€‹0.035) and improving QOL at T1 and T2 (T1: P â€‹= â€‹0.035; T2: P â€‹= â€‹0.012). Conclusions: The multi-modal intervention is a feasible, acceptable, and safe intervention that demonstrated preliminary positive effects in managing the F-S-D symptom cluster and improving QOL in patients with BC and receiving chemotherapy in Hong Kong. This study provides key insights into F-S-D symptom cluster management in patients with BC. Trial registration: ChiCTR2100047819 (Chinese Clinical Trial Register).

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

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

Financial well-being as a mediator of the relationship between multimorbidity and health-related quality of life in people with cancer.

BACKGROUND: It is unknown whether financial well-being mediates the impact of multimorbidity on the health-related quality of life (HRQoL) of cancer patients. METHODS: Participants were recruited from three outpatient oncology clinics of Hong Kong public hospitals. Multimorbidity was assessed using the Charlson Comorbidity Index. Financial well-being, the mediator of the association between multimorbidity and HRQoL outcomes, was assessed using the Comprehensive Score for Financial Toxicity Functional Assessment of Chronic Illness Therapy. The HRQoL outcomes were assessed using the Functional Assessment of Cancer Therapy - General (FACT-G) and its four sub-dimensions. Mediation analyses were conducted using SPSS PROCESS v4.1. RESULTS: Six-hundred and forty cancer patients participated in the study. Multimorbidity had a direct effect on FACT-G scores independent of financial well-being (ß for path c' = -0.752, p < 0.001). In addition, multimorbidity had an indirect effect on FACT-G scores through its effect on financial well-being (ß for path a = -0.517, p < 0.05; ß for path b = 0.785, p < 0.001). Even after adjustments were made for the covariates, the indirect effect of multimorbidity on FACT-G via financial well-being remained significant, accounting for 38.0% of the overall effect, indicating partial mediation. Although there were no statistically significant associations between multimorbidity, social well-being, and emotional well-being, the indirect effects of multimorbidity on physical and functional well-being through financial well-being remained significant. CONCLUSIONS: Poor financial well-being attributable to multimorbidity partially mediates the direct impact of chronic conditions on HRQoL in Chinese cancer patients, particularly their physical and functional well-being.

Cultural Adaptation of the Younger Women's Wellness After Cancer Program for Younger Chinese Women With Breast Cancer: A Pilot Randomized Controlled Trial.

BACKGROUND: The incidence of breast cancer in younger women, that is, aged 50 years or younger, in Hong Kong is increasing. The Internet-based Younger Women's Wellness After Cancer Program (YWWACP) is a whole-lifestyle intervention that can help young women to manage their health and risks of chronic diseases. OBJECTIVES: The study aimed to test the acceptability and feasibility of the culturally adapted YWWACP in Hong Kong (YWWACPHK) and to evaluate its preliminary effects in improving health-related quality of life, distress, sexual function, menopausal symptoms, dietary intake, physical activity, and sleep among younger Chinese women with breast cancer. INTERVENTION/METHODS: Women aged 18 to 50 years with breast cancer were recruited from an oncology outpatient department. The participants in the intervention group received the 12-week YWWACPHK, whereas the control group received standard care. RESULTS: Sixty women consented to participate. At 12 weeks after intervention completion, the intervention group showed a significant increase in the pain subscale scores of sexual function and more improvement in the level of physical activity than the control group, with Hedge g effect sizes 0.66 and 0.65, respectively. Nineteen intervention group participants reported that they were satisfied with the program and suggestions for improvement were provided. CONCLUSION: The implementation of YWWACPHK is feasible. The preliminary findings suggest that YWWACPHK could increase the level of physical activity among the participants. IMPLICATIONS FOR PRACTICE: Nurses could utilize YWWACPHK to support younger Chinese patients with breast cancer to maintain a healthy lifestyle, subject to wider confirmation of these results through a larger study.

Translation and evaluation of psychometric properties of the Amharic pediatric quality of life inventory 4.0 generic core scale for children with cancer.

BACKGROUND: Childhood cancer negatively impacts a child's physical, mental, and behavioural health and significantly affects their health-related quality of life. The Pediatric Quality of Life Inventory 4.0 Generic Core Scale (PedsQL™ 4.0 GCS) is one of the most commonly used measures of the quality of life in children. However, the Amharic version of PedsQL™ 4.0 GCS has not been validated in a paediatric oncology population. This study aimed to translate and evaluate the psychometric properties of the Amharic PedsQL™ 4.0 GCS (PedsQL™ 4.0 GCS (A)) for Ethiopian children with cancer. METHODS: A descriptive cross-sectional study was conducted among children aged 8-18 years with any type of cancer across the cancer trajectory. Cronbach's alpha and intraclass correlation coefficient were computed to determine the internal consistency and test-retest reliability of the scale. The convergent validity was established by examining the correlation of the PedsQL™ 4.0 GCS (A) with the Amharic version of the Revised Child Anxiety and Depression Scale (RCADS-25(A)). Factorial validity was evaluated by conducting a confirmatory factor analysis. RESULTS: The study included 142 participants with childhood cancer. PedsQL™ 4.0 GCS (A) had good validity and reliability. It demonstrated high internal consistency with a Cronbach's alpha of 0.96 for the scale and 0.82-0.95 for the subscales. The intraclass correlation coefficient for the scale was 0.9 and that for the subscales was 0.76-0.90. The PedsQL™ 4.0 GCS (A) was highly correlated with RCADS-25 (A) (r = - 0.97, p < 0.001), supporting its convergent validity. The four-factor structure of the model fitted the data satisfactorily (χ2/df = 1.28; CFI = 0.97; TLI = 0.97; RMSEA = 0.05; SRMR = 0.05), supporting the factorial validity of the PedsQL™ 4.0 GCS (A). CONCLUSION: The PedsQL™ 4.0 GCS (A) demonstrates desirable psychometric properties for assessing quality of life among Ethiopian children with cancer. The scale can be used in clinical settings for assessing and evaluating quality of life in children with cancer. The use of parent-report versions and studies in those with different health conditions and healthy populations are necessary to further establish the psychometric properties of the PedsQL™ 4.0 GCS (A).

Use of a Linguistically Appropriate Decision Aid for Cervical Cancer Screening of South Asian Ethnic Minority Women in Hong Kong: A Pilot Randomised Controlled Trial.

BACKGROUND: Decision aids have been shown to be effective in assisting the decision-making process in healthcare settings. This study aimed to examine the feasibility and acceptability of a linguistically appropriate printed decision aid for cervical cancer screening in South Asian women and to preliminarily estimate its effects on decisional conflicts, clarity of values, risk perception, the screening decision and screening uptake. METHODS: This was a pilot randomised controlled trial. Forty-eight South Asian women aged 25 to 64 years were recruited and allocated to either the intervention group or control group. The participants in the intervention group read a linguistically appropriate printed decision aid. RESULTS: All of the participants in the intervention group agreed that the decision aid was useful in aiding their decision-making. These participants showed significantly greater improvement in decisional conflicts, clarity of values and risk perceptions than those in the control group (all p < 0.05). The screening uptake rate was significantly higher in the intervention group than in the control group (p < 0.001). CONCLUSIONS: The decision aid was feasible and acceptable among South Asian women, and it resulted in reduced decisional conflict and increased screening uptake compared with usual care. To improve the convenience of using decision aids, they could be developed in various forms, such as printed and mobile application forms, to meet individual requirements. TRIAL REGISTRATION: The trial was registered at the Chinese Clinical Trial Registry on 23 October 2021 (ChiCTR2100052225).

Effects of immersive virtual reality for managing anxiety, nausea and vomiting among paediatric cancer patients receiving their first chemotherapy: An exploratory randomised controlled trial.

PURPOSE: To assess the feasibility and acceptability of immersive virtual reality for managing anxiety, nausea and vomiting amongst paediatric patients with cancer receiving their first chemotherapy. METHODS: An exploratory randomised control trial supplemented with qualitative interviews was conducted to enrol Chinese paediatric patients receiving their first intravenous chemotherapy. Participants were randomly assigned to intervention (three immersive virtual reality sessions) or control (standard care) groups. The main outcome measures included (1) feasibility parameters; (2) anxiety, nausea and vomiting; and (3) satisfaction with the chemotherapy procedures. Qualitative data were collected by semi-structured individual interviews with patients, parents and nurses. RESULTS: A total of 19 patients, 19 accompanying parents and 9 nurses were recruited. Results suggested that the intervention was feasible as evidenced by the high consent rate, low withdrawal rate and attrition rate. The intervention group showed significantly better improvement in anxiety at T2 [Hedges' effect size, ES = 1.25, 95% confidence interval (CI): 0.22-2.17)] and T4 [ES = 1.87, 95% CI: 0.72-2.85], as well as greater reduction in acute nausea at T4 [ES = 0.97, 95% CI: 0.02-1.87] than the control group. Qualitative data yielded three categories including positive experiences and perceived benefits of the intervention, and suggested improvements. CONCLUSIONS: This study demonstrated the potential effectiveness, feasibility and acceptability of immersive virtual reality for managing anxiety and acute nausea amongst paediatric patients with cancer receiving their first chemotherapy.

Unmet needs, anxiety, depression, and quality of life among caregivers of adolescents and young adults with cancer: A cross-sectional study.

Objective: To assess unmet needs, anxiety, depression, and quality of life of caregivers of adolescents and young adults with cancer and examine their associations. Methods: A total of 282 caregivers of adolescents and young adults with cancer were recruited by convenience sampling at a tertiary cancer hospital in Chinese Mainland. The participants' unmet needs, anxiety, depression, and quality of life were assessed using self-reported questionnaires. Hierarchical regression analyses were conducted to examine associations between unmet needs and health outcomes. Results: The five most prevalent high unmet needs were related to 'worries about future' and 'information', including dealing with not knowing what lies in the future (n â€‹= â€‹161, 57.1%), dealing with worry about the cancer getting worse (n â€‹= â€‹151, 53.5%), dealing with worry about the cancer coming back (n â€‹= â€‹147, 52.1%), finding information about complementary or alternative therapies (n â€‹= â€‹137, 48.6%), and finding information about the long-term side effects of treatments and medicines (n â€‹= â€‹126, 44.7%). Around 40% of the caregivers reported moderate to severe anxiety and depression. After adjusting for sociodemographic and clinical characteristics, personal and emotional needs, healthcare access and continuity, and financial needs remained significantly associated with anxiety, depression, or quality of life. Conclusions: Nurses need to be aware of the unmet needs of caregivers of adolescents and young adults with cancer. More effort is needed to identify services and interventions that address the unmet needs, particularly personal and emotional, healthcare access and continuity, and financial needs, to improve the caregivers' health outcomes.

Early risk of acute myocardial infarction following hospitalization for severe influenza infection in the middle-aged population of Hong Kong.

INTRODUCTION: Despite evidence suggesting an association between influenza infection and increased risk of acute myocardial infarction (AMI) in the older adult population (aged 65 years or above), little is known about its near-term risks in middle-aged adults (aged 45 to 64 years). This study aims to estimate the risks of and association between severe influenza infection requiring hospitalization and subsequent AMI within 12 months in middle-aged adults. METHOD: This is a retrospective case-control analysis of territorywide registry data of people aged 45 to 64 years admitting from up to 43 public hospitals in Hong Kong during a 20-year period from January 1997 to December 2017. The exposure was defined as severe influenza infection documented as the principal diagnosis using International Classification of Diseases codes and non-exposure as hospitalization for orthopedic surgery. Logistic regression was used to analyze the risk of subsequent hospitalization for AMI within 12 months following the exposure. RESULTS: Among 30,657 middle-aged adults with an indexed hospitalization, 8,840 (28.8%) had an influenza-associated hospitalization. 81 (0.92%) were subsequently rehospitalized with AMI within 12 months after the indexed hospitalization. Compared with the control group, the risk of subsequent hospitalization for AMI was significantly increased (odds ratio [OR]: 2.54, 95% confidence interval [CI]: 1.64-3.92, p<0.001). The association remained significant even after adjusting for potential confounders (adjusted OR: 1.81, 95% CI: 1.11-2.95, p = 0.02). Patients with a history of hypertension, but not those with diabetes mellitus, dyslipidemia or atrial fibrillation/flutter, were at increased risk (adjusted OR: 5.01, 95% CI: 2.93-8.56, p<0.001). CONCLUSION: Subsequent hospitalization for AMI within 12 months following an indexed respiratory hospitalization for severe influenza increased nearly two-fold compared with the non-cardiopulmonary, non-exposure control. Recommendation of influenza vaccination extending to middle-aged adult population may be justified for the small but significant increased near-term risk of AMI.

Effects of a 16-week dance intervention on the symptom cluster of fatigue-sleep disturbance-depression and quality of life among patients with breast cancer undergoing adjuvant chemotherapy: A randomized controlled trial.

BACKGROUND: Fatigue, sleep disturbance, and depression are frequent concurrent symptoms in patients with breast cancer. Exercise is a promising strategy for symptom management, but the effect of dance as an exercise modality for managing the fatigue-sleep disturbance-depression symptom cluster has not been evaluated yet. OBJECTIVES: This study examined the effects of a 16-week dance program on reducing symptoms and improving the quality of life of patients with breast cancer who underwent adjuvant chemotherapy. METHODS: A prospective, assessor-blinded, two-arm randomized controlled design was used. Adult female patients with breast cancer who were scheduled for adjuvant chemotherapy were recruited from two university-affiliated hospitals in a city in northwest China. Participants in the dance group received six sessions of hospital-based dance instruction and 16 weeks of home-based practice. The dance intervention was culturally adapted for the Chinese population. The control group received general health consultation. Outcomes including fatigue, sleep disturbance, depression, and quality of life were evaluated at baseline and after the third and sixth cycles of chemotherapy. The intention-to-treat principle and a generalized estimating equation were used to analyze data. RESULTS: A total of 279 individuals were assessed for eligibility, and 176 eligible participants were successfully recruited. The majority of the participants (n = 140, 79.6%) were diagnosed with stages I-II breast cancer and had undergone mastectomy (n = 155, 88.1%). The baseline characteristics were similar between the two groups. Participants in the intervention group reported less severe fatigue, sleep disturbance, and depression. In addition, a lower incidence of the symptom cluster (P = 0.003) and an increase in quality of life (P = 0.001) were found in the intervention group compared with the control group at week 17. CONCLUSIONS: A culturally specific dance intervention is a promising method for managing the fatigue-sleep disturbance-depression symptom cluster and promoting the quality of life in Chinese women with breast cancer receiving adjuvant chemotherapy. Given its acceptability and practicality, this program may be incorporated in routine cancer care.

Effectiveness of a tailored communication intervention on colonoscopy uptake for firstdegree relatives of colorectal cancer patients: A randomized controlled trial.

Objective: To evaluate the effect of a WeChat tailored communication intervention on colonoscopy uptake and health beliefs in Chinese first-degree relatives (FDRs) of colorectal cancer patients. Methods: This study employed a single-blinded randomized controlled trial. A total of 188 eligible FDRs were recruited and randomly assigned to the tailored intervention group or control group. Health beliefs were assessed at 1 (T1) and 3 months (T2) postintervention. The colonoscopy uptake was verified by medical records at T2. Data were analyzed using binary logistic regression and generalized estimating equation models. Results: Compared with the participants in the control group, those in the intervention group had a significant improvement in terms of colonoscopy uptake (OR = 2.752, 95% CI: 1.428-5.303, P â€‹< â€‹0.01), perceived susceptibility (T1: ߠ​= â€‹0.298, 95% CI: â€‹0.052-0.402, P â€‹< â€‹0.05; T2: ߠ​= â€‹0.251, 95% CI: â€‹0.078-0.424, P â€‹< â€‹0.001) and cues to action (T1: ߠ​= â€‹0.0.264, 95% CI: â€‹0.138-0.389, P â€‹< â€‹0.001; T2: ߠ​= â€‹0.327, 95% CI: â€‹0.195-0.459, P â€‹< â€‹0.001) and a significant reduction in perceived barriers (T1: ߠ​= â€‹-0.237, 95% CI: â€‹-0.360-0.115, P â€‹< â€‹0.01; T2: ߠ​= â€‹-0.196, 95% CI: â€‹-0.331-0.062, P â€‹< â€‹0.01). Conclusions: This study broadens the application of tailored communication using novel channels in the context of screening in the at-risk Chinese population. The results provide insights on how to improve the intervention by modifying its components and communication channels.

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

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

Participation in a government-subsidised colorectal cancer screening programme for asymptomatic individuals in Hong Kong.

BACKGROUND: A Government-subsidised colorectal cancer screening programme (CRCSP) was launched in Hong Kong. This study aimed to assess the participation rate in CRCSP among Chinese individuals between the ages of 50 and 75 years and to survey individuals' reasons for declining to participate in the CRCSP. METHODS: A cross-sectional study was performed. Asymptomatic Chinese individuals aged 50-75 years in Hong Kong who did not have a history of colorectal cancer were recruited. A survey was used to collect information about individuals' participation in the CRCSP. RESULTS: The survey was completed by 1317 participants. Of these, 432 (32.8%) joined the CRCSP and the remaining 885 participants (67.2%) did not join the CRCSP. The most common reason that participants provided for not joining the CRCSP was thinking that the screening was not necessary because they had no health problems (29.3%). Some (14.4%) of the participants claimed to lack information about the CRCSP and screening procedures. Some (12.5%) of them completed the screening before the CRCSP was launched, and the cost was covered by other sources. CONCLUSION: The participation in CRCSP for a screening among the Hong Kong population has generally increased, but obstacles to participating in screening programme remain.

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

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