Symptom experience in endocrine therapy for breast cancer patients: A qualitative systematic review and meta-synthesis.

Objective: The purpose of this study was to systematically integrate the experience of symptoms of breast cancer patients receiving endocrine therapy, analyze the patients' understanding and coping status of symptoms, and provide information for the development of targeted symptom management measures. Methods: We searched databases including PubMed/MEDLINE, MEDLINE (Ovid), Web of Science, EMBASE (Ovid), CINAHL (EBSCO), and ProQuest from inception to September 25, 2023. Literature was screened and analyzed using Endnote software, evaluated using the Joanna Briggs Institute Critical Appraisal Tool for Qualitative Research, and the results were integrated using JBI's Pooled Integration Methodology. Results: Three composite findings were derived from 10 studies: symptom distress during endocrine therapy; coping in symptom experience; and support needs. Conclusions: Emphasis should be placed on the symptomatic experience of breast cancer patients undergoing endocrine therapy, and effective interventions should be developed to improve patients' medication compliance and quality of life. Finally, the long-term survival rate of patients is improved. Systematic review registration: CRD42023466073.

The contribution of perceived death competence in determining the professional quality of life of novice oncology nurses: A multicentre study.

PURPOSE: Novice nurses find it challenging to cope with patient dying and death, especially in a death taboo cultural context, such as mainland China. By taking the example of Chinese novice oncology nurses, this study aimed to explore the contribution of their perceived death competence in determining their professional quality of life. METHOD: A multicentre, cross-sectional study was conducted in six tertiary cancer hospitals in mainland China involving 506 novice oncology nurses. Measurements were the Coping with Death Scale-Chinese version, the Professional Quality of Life Questionnaire, and the Coping Style Questionnaire. Hierarchical multiple regression analyses were used to analyse the data. RESULTS: Death competence was significantly associated with compassion satisfaction (r = 0.509, P < 0.001), burnout (r = -0.441, P < 0.001) and secondary traumatic stress (r = -0.154, P < 0.001) which are the three dimensions of professional quality of life. The results of hierarchical multiple regression analyses demonstrated that death competence positively predicted compassion satisfaction and negatively predicted burnout (P < 0.01), but had no significant impact on secondary traumatic stress after coping style was entered into the model (P > 0.05). CONCLUSIONS: Novice oncology nurses who perceive themselves to be incompetent in dealing with patient dying and death are more likely to experience poor professional quality of life in the death taboo cultural context. Cultural-sensitive interventions and a supportive work environment are important to enhance these nurses' death competence, increasing their professional quality of life and ultimately contributing to better end-of-life cancer care management.

Effect of evidence-based nursing management of protocol compliance in anticancer drug clinical trial.

Objective: This study aimed to construct evidence-based anticancer drug clinical trial nursing management norms to ensure the safety and quality of clinical trial nursing. Methods: This before-after study was carried out to complete the evidence implementation in a cancer hospital in Shanghai, China. Seven review indicators were developed and reviewed in one phase I clinical trial center and two oncology wards. The corresponding evidence-based intervention program was formulated, and the completion rate of good clinical practice certification, protocol training, delegation of duties, qualification rate of administration, sampling and document recording in anticancer drug clinical trials before and after implementation were compared. Results: After implementation, the completion rate of protocol training, delegation of duties, and the qualification rate of document recording were significantly higher than those of the baseline review, whereas the completion rate of good clinical practice certification and the qualification rate of sampling did not significantly differ from those observed at the baseline review. There was no administration or infusion device-related protocol deviation during the baseline and post reviews. Conclusions: Anticancer drug clinical trial nursing management norms and relevant standard operating procedures were constructed. The results showed that the implementation of this intervention improved the standardization of nurse qualification procedures and the nursing original document recording in anticancer drug clinical trials, and nursing-related protocol deviation could be reduced to a certain extent.

Psychometric properties of the Chinese version of female self-advocacy in cancer survivorship scale.

Objective: To translate Female Self-Advocacy in Cancer Survivorship (FSACS) scale and evaluate the psychometric properties of Chinese version of FSACS scale among female cancer survivors in China. Methods: This study employed a cross-sectional design. FSACS scale was forward-backward translated and cognitive interviews were conducted for cultural adaptation. The newly translated tool was distributed to female cancer survivors to test psychometric properties, including item analysis, content validity, construct validity, criterion validity, internal consistency, and test-retest reliability. Results: A total of 436 female cancer survivors were recruited in a Chinese tertiary cancer center from May to August in 2021. Item analysis showed statistical significance (P < 0.05) for each one and no ceiling or floor effect. The item-level content validity index ranged from 0.86 to 1.00 and the scale-level content validity index was 0.98. Three factors were extracted based on parallel analysis, and confirmatory factor analysis proved a good model fit with the original 3-factor structure. Pearson's correlation coefficient showed acceptable criterion validity. The Cronbach's α of 0.880 demonstrated the scale's internal consistency reliability, and the Alpha coefficients were 0.826, 0.763, and 0.859 for its three dimensions, respectively. The interclass correlation coefficients for test-retest reliability was 0.904 (0.870-0.891, P < 0.01) which confirmed the external reliability of the scale. Conclusions: The Chinese version of FSACS scale proved to be a valid and reliable instrument that can be applied among Chinese female cancer survivors. Further research could be conducted in larger populations or people in different cancer stages.

Risk Factors for Pulmonary Metastasis in Differentiated Thyroid Carcinoma Patients and the Significance of Changes in Matrix Metalloproteinase 13 and microRNA-142 Levels.

This work aims to explore the risk factors of lung metastasis (LM) in differentiated thyroid cancer (DTC) (LM-DTC) and the effect of treatment and to detect the relationship between LM-DTC and the levels of matrix metalloproteinase-13 (MMP-13) and micro ribonucleic acid (RNA)-142 (miR-142) in peripheral blood. The data of 420 patients with DTC who are admitted from March 2020 to December 2021 are collected and divided into a non-metastasis group (non-LM group) of 400 cases and metastasis group (LM group) of 20 cases according whether the mung metastasis is found. In addition, risk factors of LM-DTC are analysed and compared. The results of multivariate logistic analysis show that age, disease course, and imaging timing are independent influencing factors of the radionuclide treatment effect. Follicular carcinoma, abnormal expressions of MMP-13, and miR-142 can increase the risk of LM-DTC. MMP-13 and miR-142 can be undertaken as auxiliary diagnostic biological indicators.

Distress management in cancer patients：Guideline implementation based on CAN-IMPLEMENT.

Objective: To standardize the distress management of gastric cancer patients receiving chemotherapy, the adapted Cancer-related Distress Management Guidelines were implemented in nursing practice among gastric cancer patients receiving chemotherapy based on A Guideline Adaptation and Implementation Planning Resource (CAN-IMPLEMENT). Methods: Based on the theoretical framework of CAN-IMPLEMENT, A multidisciplinary team was established, barriers and facilitators obstacles of guidelines implementation in medical oncology units were assessed, corresponding solutions were formulated, the guidelines implementation process was monitored, and implementation results were evaluated. Results: The multidisciplinary team developed review criteria, standardized work paths, assessment tools, training manuals for healthcare professionals, education manuals for patients and their caregivers. After guidelines implementation, the completion rate of the distress management record came up to 97.9% (189/193). From September 2017 to December 2018, the compliance of medical staff on most items in the audit checklist was improved, ranging from 57.1% (100/175) to 100.0% (193/193). The positive distress rate of gastric cancer patients receiving chemotherapy was decreased from 22.7% (32/141) to 9.3% (18/193) (P < 0.05), and the Median (range) of the distress score declined from 2 (0-9) to 0 (0-7) (P < 0.001). Conclusions: The implementation of guidelines based on CAN-IMPLEMENT promotes the establishment of a distress management system in the medical oncology units. The review standards, standardized work paths, and evaluation tools for distress in cancer patients formulated by the multidisciplinary team had clinical applicability and effectiveness. Quality control in the practice of distress management was effective. The compliance of healthcare professionals with distress management was improved. The distress of gastric cancer patients receiving chemotherapy was alleviated effectively.

Distress management in cancer patients: Guideline adaption based on CAN-IMPLEMENT.

OBJECTIVE: This study aimed to adapt relevant clinical practice guidelines for distress management in cancer patients based on A Guideline Adaptation and Implementation Planning Resource (CAN-IMPLEMENT), and develop Cancer-related Distress Management Guidelines in the context of the research site. METHODS: According to CAN-IMPLEMENT, the symptoms of cancer patients in Shanghai were investigated, and a work plan was formulated to adapt cancer-related distress management guidelines. The relevant clinical practice guidelines for distress management in cancer patients were searched, screened and assessed, the contents of the included clinical practice guidelines were screened, extracted and integrated, and the Cancer-related Distress Management Guidelines was developed. After peer review, the Cancer-related Distress Management Guidelines was finally formed. RESULTS: The physical symptom distress score was higher than the psychological symptom distress score among cancer patients in Shanghai. Two clinical practice guidelines related to distress management in cancer patients were included after searching, screening, assessment and selection systematically. The domain scores of the draft Cancer-related Distress Management Guidelines on Appraisal of Guidelines for Research and Evaluation II (AGREE II) were 73.75%-87.50%, respectively. The scores of most recommendations on feasibility, appropriateness, meaningfulness and effectiveness were at least 90%. The final guidelines included 13 recommendations. CONCLUSIONS: The quality of the draft Cancer-related Distress Management Guidelines based on two included guidelines was well-accepted. The final Cancer-related Distress Management Guidelines needs to be further verified in clinical practice for feasibility, suitability and effectiveness.

Symptom Clusters and Quality of Life in Gastric Cancer Patients Receiving Chemotherapy.

CONTEXT: Although gastric cancer is one of the most common tumors worldwide, there is little knowledge about symptom clusters and quality of life (QoL) in this population. OBJECTIVES: The objectives were to identify the symptom clusters in gastric cancer patients receiving chemotherapy, and explore their effects on QoL. METHODS: Gastric cancer patients receiving chemotherapy were recruited. Data were collected using the Memorial Symptom Assessment Scale Short Form, the Functional Assessment of Cancer Therapy-Gastric and the self-designed General Information Evaluation Form. The symptom clusters were extracted through the exploratory factor analysis. The influencing factors of symptom clusters and their effects on QoL were identified using multiple linear regression analysis. RESULTS: A total of 322 participants were enrolled from three medical centers. Five factors were identified in this exploratory factor analysis based on symptom prevalence, namely fatigue related symptom cluster, epithelial symptom cluster, neurologic symptom cluster, malnutrition related symptom cluster and psychological symptom cluster (χ2 = 31.470, P < 0.05). The affecting factors across symptom clusters and QoL subscales were relatively stable, but also different. Generally, fatigue related symptom cluster, malnutrition related symptom cluster and psychological symptom cluster demonstrated significantly negative effects on all aspects of QoL except social well being. CONCLUSION: Five symptom clusters were identified in gastric cancer patients receiving chemotherapy in mainland China. The symptom clusters negatively contributed to the variance in all aspects of QoL except social well being. Further studies should examine interventions for symptom clusters, their influencing factors, and their effects on improving QoL.

The Effect of an Information Support Program on Self-Efficacy of Prostate Cancer Patients during Hormonal Therapy.

OBJECTIVE: This study was conducted to evaluate the effect of an information support program on the self-efficacy (SE) of prostate cancer (PCa) patients receiving hormonal therapy (HT). METHODS: Based on the information support program constructed in a previous study, a randomized controlled trial was conducted in a cancer hospital in Shanghai, China. One hundred subjects were randomly divided into two groups. The control group was provided routine care and communication, and the experimental group participated in an informational support program. Three months later, the following outcomes were compared between the two groups: information acquisition, disease knowledge mastery, SE, healthy behavior adherence, health-related quality of life (HRQoL), and serum prostate-specific antigen (PSA) levels. t-test and Wilcoxon rank-sum test were used to compare the differences between the two groups, and intention-to-treat analysis was used to increase the reliability of the results. RESULTS: After the intervention, information acquisition, disease knowledge mastery, and the SE and healthy behavior adherence of the experimental group were significantly increased compared with the control group, whereas the HRQoL and PSA did not significantly differ from that observed in the control group. CONCLUSIONS: The results showed that information support programs improve information acquisition, disease knowledge mastery, SE, and healthy behavior adherence among PCa patients receiving HT.

Mobile health applications for the care of patients with breast cancer: A scoping review.

OBJECTIVES: In recent years, the use of mobile health applications (mHealth apps) to deliver care for patients with breast cancer has increased exponentially. This study aimed to summarize the available evidence on developing mHealth apps to care for patients with breast cancer and identify the need for systematic efforts. METHODS: A scoping review was performed according to Arksey and O'Malley's framework, aiming to identify eligible research studies in PubMed, CINAHL, and Web of Science between January 2010 and December 2020. All identified studies were screened, extracted, and analyzed independently by two reviewers. RESULTS: A total of 676 studies were retrieved, and eight eligible studies were finally included. Four themes emerged: the involvement of patients and health professionals in the phases of design and development, patients' preferences, the characteristics of patients, and the motivators to use mHealth apps. The results indicated promising prospects for using mHealth apps to care for patients with breast cancer and identified the need for systematic efforts to develop and validate relevant apps. CONCLUSIONS: The attributes of patient characteristics, needs, and patient-reported outcomes data are vital components for developing mHealth apps for patients with breast cancer. Additionally, collaborative efforts, including patients, nurses, and other significant health professionals, should develop mHealth apps for breast cancer care. Additional research focusing on the design and development of mHealth apps for patients with breast cancer is warranted.

Prechemotherapy nursing assessment among adult cancer patients in a university cancer center in Shanghai, China: a best practice implementation project.

OBJECTIVE: The current implementation project aimed to promote evidence-based practice with prechemotherapy nursing assessment among adult cancer patients in a large university cancer center in Shanghai, China, over a 6-month timeframe. INTRODUCTION: Prechemotherapy nursing assessment is an essential element of cancer patient care, aiming to prevent or minimize potential problems from chemotherapy treatment. Regular comprehensive prechemotherapy assessment is not part of routine care currently in many clinical settings within China. METHODS: The project utilized the JBI approach to implementation, incorporating audit and feedback tools. Twelve evidence-based audit criteria were developed for use in the program. A baseline audit was conducted of prechemotherapy nursing assessment among adult cancer patients, with a sample size of 68 patients and 36 nursing staff. Following implementation of systematic strategies based on the analysis of three main barriers, a follow-up audit involving a similar sample as the first audit was conducted using the same audit criteria. RESULTS: The baseline audit indicated that for nursing assessment among adult cancer patients undergoing chemotherapy, the criteria (1, 10, 11 and 12) which related to nurse education, weight measurement, premedication and access device assessment had very high compliance (from 93 to 100%). Compliance for criteria (2, 6, 7, 9) related to medical history, previous exposure to chemotherapy, patients' or caregivers' comprehension of treatment and psychosocial assessment was 0%, while compliance with the other five criteria (3, 4, 5, 8) was low, ranging from 16 to 61%. There was improvement in all 12 criteria in the follow-up audit. Criteria 1, 11 and 12 maintained high compliance (100%). Criterion 2 (patients' medical history), criterion 3 (presence or absence of allergies), criterion 7 (previous exposure to chemotherapy) and criterion 9 (psychosocial elements) demonstrated a significant improvement in compliance. Although progress has been made, there were still some criteria that require further improvement. These included assessment of patients' current diagnosis and cancer status (criterion 4, from 61 to 66%), recent laboratory results (criterion 5, from 31 to 62%), patients' and/or caregivers' comprehension of information regarding the disease and treatment (criterion 6, from 0 to 34%), any previous exposure to chemotherapy agents (criterion 7, from 0 to 57%), and physical assessment of the patient (criterion 8, from 46 to 72%). CONCLUSION: The project achieved increased compliance with evidence-based best practice in all assessed audit criteria improving the practice of prechemotherapy assessment. Involvement of informatics technology is a great strategy to help overcome barriers, simplify the change process and assist in sustaining evidence-based practice change. Future plans and ideas are in place and have been discussed. Further audits will need to be carried out to improve the validity and quality of nursing assessment.

Validation of the Simplified Chinese Version of the Memorial Symptom Assessment Scale-Short Form Among Cancer Patients.

CONTEXT: Comprehensive symptom assessment is crucial for symptom management. The Memorial Symptom Assessment Scale-Short Form (MSAS-SF) has been validated for symptom assessment in cancer patients, but there is no simplified Chinese version. OBJECTIVES: To present the validation procedures and results for the simplified Chinese version of the Memorial Symptom Assessment Scale-Short Form (MSAS-SF-SC) among cancer patients in mainland China. METHODS: The MSAS-SF was translated and culturally adapted into simplified Chinese. About 359 cancer patients completed the MSAS-SF-SC, the Chinese Functional Assessment of Cancer Therapy-General, the Chinese Brief Fatigue Inventory, the Chinese Hospital Anxiety and Depression Scale, and the Chinese Medical Outcomes Study Social Support Survey. Reliability was assessed by internal consistency and test-retest coefficients. Convergent and divergent validity were analyzed by Pearson's correlation coefficients between MSAS-SF-SC subscales and the other instruments. Known-groups validity used Eastern Cooperative Oncology Group-Performance Status, hemoglobin level, and primary site. RESULTS: The MSAS-SF-SC was reliable with Cronbach's alpha coefficients for subscales ranging from 0.782 to 0.874 and test-retest coefficients ranging from 0.819 to 0.872. MSAS-SF-SC subscales correlated with corresponding Chinese Functional Assessment of Cancer Therapy-General subscales (-0.557 to -0.680; P < 0.001), Chinese Brief Fatigue Inventory (0.620; P < 0.001), and Chinese Hospital Anxiety and Depression Scale (0.663; P < 0.001) indicating convergent validity. MSAS-SF-SC subscales showed low or no correlations with the Chinese Medical Outcomes Study Social Support Survey (-0.146 to -0.165; P < 0.01), indicating divergent validity. MSAS-SF-SC subscales showed appropriate differences by Eastern Cooperative Oncology Group-Performance Status, hemoglobin level, and primary site. CONCLUSION: The MSAS-SF-SC demonstrated good psychometric properties and is culturally adapted. The instrument could be a valuable tool for Chinese health care professionals and researchers.

Management of skin toxicity caused by epidermal growth factor receptor inhibitors: an evidence-based implementation project.

BACKGROUND: Epidermal growth factor receptor inhibitors (EGFRIs) bind to and inhibit epidermal growth factor receptors (EGFRs) in cancer cells, slowing/preventing tumor growth. As a type of "targeted therapy", they have demonstrated therapeutic effects on solid tumors including colorectal, lung, and head and neck cancers. While effective, various skin reactions are associated with EGFRI therapy which can lead to dose modification or discontinuation as well as discomfort, pain and reduced quality of life. With adequate knowledge and skills, EGFRI-induced skin toxicity can be effectively managed collaboratively by clinicians and people affected by cancer. OBJECTIVES: This project aimed to improve management of skin toxicity caused by EGFRIs by implementing evidence-informed practice within a chemotherapy department. METHODS: Evidence-informed recommendations for practice and corresponding audit criteria were developed based on a series of literature reviews. Current practice was reviewed against these criteria with 19 nurses and 21 patients within a chemotherapy department. Barriers to adherence to evidence-informed practice were identified and strategies to improve compliance were implemented with clinicians and patients. A follow-up audit against the criteria was used to measure changes in clinical practice. RESULTS: Multiple strategies for getting research into practice appear to have been successful. The follow-up audit demonstrated large improvements in compliance across all audit criteria in comparison with baseline results with all but one criterion achieving 100% compliance. Low rates of suspected infection meant that clinical practice could not be measured for criterion 7. CONCLUSIONS: Auditing current practice and implementation of strategies to improve compliance with evidence-informed practice were effective. Sustaining these improvements is vital to ensure clinical practice continues to support better patient outcomes.