Experiences of patients with advanced cancer coping with chronic pain: a qualitative analysis.

OBJECTIVES: To gain insight into the perceptions, and beliefs of patients with advanced cancer coping with chronic pain and to identify their attitudes and demands on pain management. METHODS: From July to September 2022, 17 patients with advanced cancer living with chronic pain were recruited from a tertiary cancer hospital in Hunan Province, China. Qualitative and semi-structured interviews were conducted individually, with 30-45 minutes for each. The Colaizzi 7-step analysis method in phenomenological research was used for data analysis. RESULTS: The experience of pain acceptance by advanced cancer patients with chronic pain was summarized into four themes: pain catastrophizing (unable to ignore the pain, try various methods to relieve the pain, exaggerating pain perception, and lack of knowledge about proper pain management), rumination (compulsive rumination and worrying rumination), avoidance coping (situational avoidance and repressive avoidance) and constructive action (setting clear value goal and taking reciprocal action). CONCLUSION: Most patients with advanced cancer had low pain acceptance and negative attitudes. Feeling helpless in the face of pain and suffering alone were their norm. Long-term negative emotions could lead to gradual depression and loss of hope for treatment, resulting in pain catastrophizing and persistent rumination. Nevertheless, a few patients accepted pain with positive attitudes. Medical professionals should pay more attention to the psychological status of advanced cancer patients with chronic pain, and employ alternative therapies, for example, cognitive behavioral therapy. More efforts are needed to reduce patients' pain catastrophizing, and promote their pain acceptance by a better understanding of pain through health education.

Psychological adjustment to death anxiety: a qualitative study of Chinese patients with advanced cancer.

OBJECTIVES: Death anxiety (DA) refers to the negative emotions experienced when a person reflects on the inevitability of their own death, which is common among patients with cancer. It is crucial to understand the causes, coping styles and adjustment processes related to DA. The purpose of this qualitative study is to explore the adaptation process and outcome of patients with advanced cancer with DA and to provide evidence-based support for the development of targeted intervention measures to improve the mental health of such patients. DESIGN: This cross-sectional qualitative study sampled patients with advanced cancer (n=20). Grounded theory procedures were used to analyse transcripts and a theoretical model generated. SETTING: All interviewees in this study were from a tertiary oncology hospital in Hunan Province, China. The data analysis followed the constructive grounded theory method, involving constant comparison and memo writing. PARTICIPANTS: A purposive and theoretical sampling approach was used to recruit 20 patients with advanced cancer with diverse characteristics. RESULTS: A total of 20 participants were included in the study. Four stages of DA in patients with advanced cancer were extracted from the interview data: (1) death reminder and prominence; (2) perception and association; (3) defence and control; (4) transformation and Acceptance. CONCLUSIONS: This study highlights the psychological status and coping strategies of dynamic nature of patients with advanced cancer when confronted with negative emotions associated with death. It emphasises the importance of timely identification of DA in psychological nursing for patients with advanced cancer and the need for targeted psychological interventions based on their specific psychological processes. IMPLICATIONS: Knowing interventions that aim to promote the integration of internal and external resources, enhance self-esteem and facilitate a calm and accepting attitude towards death could ultimately reduce the overall DA of patients with advanced cancer.

Iron diselenide/carbon black loaded mushroom-shaped evaporator for efficiently continuous solar-driven desalination.

Solar-driven desalination is an environmentally sustainable method to alleviate the problems of freshwater scarcity and the energy crisis. However, how to improve the synergy between the photothermal material and the evaporator to achieve high photothermal conversion efficiency simultaneously, excellent thermal management system and good salt resistance remains a challenge. Here, a mushroom-shaped solar evaporation device is designed and fabricated with iron diselenide/carbon black (FeSe2/CB) coated cellulose acetate (CA) film as mushroom surface and cotton swab as mushroom handle, which presented high solar-driven evaporation and excellent salt resistance. Thanks to the unique photothermal effect and the synergistic effect, the FeSe2/CB composites enabled a promising photothermal conversion efficiency of up to 65.8 °C after 180 s. The mushroom-shaped evaporation device effectively overcomes water transport and steam spillage channel blockage caused by salt crystallization through its unique vertical transport water channels and conical air-water interface. When exposed to real sunlight, the solar evaporation rate of the steam generation structure reached as high as 2.03 kg m-2 h-1, which is more than 13 times higher than natural evaporation. This study offered new insights into the higher solar-driven evaporation rate and salt-blocking resistance of the FeSe2/CB mushroom-shaped solar evaporation device for solar-powered water production.

Psychometric validation of the modified Chinese version of the personalized psychological flexibility index in patients with cancer.

Objective: The aim of this study was to perform across-cultural adaptation of the English version of the personalized psychological flexibility index (PPFI) into Chinese, and to evaluate its psychometric properties in patients with cancer. Methods: This study was conducted in two phases. In phase 1, we followed Beaton's guidelines for cross-cultural adaptation of PPFI. In phase 2, we conducted a cross-sectional study to assess the validity and reliability of the PPFI among a total of 455 patients with cancer in Hunan Province of China. Item analysis was used to evaluate and screen items, while content validity, construct validity, convergent validity, and concurrent validity were used to evaluate the validity. Reliability was assessed using Cronbach's ɑ coefficient, retest reliability, and composite reliability. Results: The item-level content validity index of the modified Chinese version of PPFI (PPFI-C) ranged from 0.89 to 1.00, the scale-level CVI/universal agreement was 0.87, and the S-CVI/average was 0.99. Exploratory factor analysis identified a 14-item, three-factor structure of PPFI (item 11 deleted). Confirmatory factor analysis showed χ2/df â€‹= â€‹2.42, RMSEA â€‹= â€‹0.07, GFI â€‹= â€‹0.92, NFI â€‹= â€‹0.91, TLI â€‹= â€‹0.93, CFI â€‹= â€‹0.95, and IFI â€‹= â€‹0.95. PPFI-C demonstrated positive correlations with the 8-item Commitment Action Questionnaire, and negative correlations with Acceptance and Action Questionnaire-II, Hospital Anxiety and Depression Scale, and Short Form Quality Life Scale. The Cronbach's ɑ coefficient of modified PPFI-C stood at 0.84. Conclusions: The results suggest that the 14-item PPFI-C is a reliable and valid tool for measuring PF in Chinese patients with cancer. However, additional studies are needed to validate the psychometric properties of PPFI-C in other populations.

Effectiveness of virtual reality technology in symptom management of end-of-life patients: protocol of a systematic review and meta-analysis.

INTRODUCTION: With the worsening of population ageing globally, the number of the elderly with chronic and incurable diseases such as malignant tumours is gradually increasing, and the need for palliative care is growing. As a primary task in the end-of-life phase, symptom management is an essential aspect of palliative care, which aims to alleviate distressing symptoms of terminally ill patients and improve their quality of life. Virtual reality (VR) technology, which allows the creation of simulated environments in which a three-dimensional experience is generated, has been increasingly used in palliative care for symptom management. Therefore, we aim to conduct a systematic review to investigate the effects of VR-based interventions on end-of-life patients. METHODS AND ANALYSIS: This protocol for conducting a systematic review and meta-analysis will be prepared following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 statement. We will conduct a series of searches from inception to 31 July 2022 in the following databases: PubMed, Embase, Web of Science, the Cochrane Library, JBI, EBSCO, CNKI, Wanfang and SinoMed. The key concepts of 'virtual reality' and 'end-of-life' will be combined in each database using both free-text terms and controlled vocabulary terms (eg, MeSH/Emtree terms), if available. Two independent reviewers will use raw data to explore the effectiveness of VR for symptom management in end-of-life patients. The Cochrane Risk-of-Bias tool will be used to assess the risk of bias of included studies. Disagreements will be resolved by a third independent reviewer to reach a consensus. For the included articles, Review Manager software will be used for data synthesis and I2 statistics will be used to measure the heterogeneity. Subgroup analyses and sensitivity analyses will be used to identify the source of heterogeneity. ETHICS AND DISSEMINATION: As this is a protocol for a systematic review and meta-analysis, patients will not be included in this study. For this reason, ethical approval is not required. In order to disseminate the research findings, the results and conclusions of this review will be submitted to a worldwide journal. PROSPERO REGISTRATION NUMBER: CRD42022344679.

Effect of Zhuyun I Recipe Capsule Enema on the Immune Microenvironment of the Endometrium during Implantation Window in Rats.

Background: Preterm birth is the leading cause of neonatal death, and there are no effective clinical means for the prevention and treatment of spontaneous preterm birth, mainly because the mechanism for labor initiation has not been fully elucidated. Objective: The effect of enucleation with Zhuyun I Recipe Capsule enema (ZRC) on the maternal-fetal interface microenvironment in SD rats with kidney deficiency and blood stasis. Methods: In this study, poor endometrial tolerance was induced by hydroxyurea and epinephrine in SD rats with kidney deficiency and blood stasis type of endometrium, and gavage with norethindrone (estradiol) or Bamboo Rhythm No.1 formula. HOXA10 mRNA levels were measured by qPCR. In addition, the expression of IL-6, VEGF, TGF-ß, and IGFBP-1 in the uterus was detected by IHC and ELISA. Results: Hydroxyurea- and epinephrine-induced PER was associated with low levels of HOXA10 in the endometrium and reduced levels of IL-6, TGF-ß, VEGF, and IGFBP-1 in the endometrium. These were abolished by ZRC and Progynova treatment compared to PER rats, resulting in a dramatic increase in the levels of HOXA10 mRNA, IL-6, TGF-ß, VEGF, and IGFBP-1 proteins. Conclusions: ZRC improves metaplasticization of endometrial stromal cells and promotes angiogenesis in rats with kidney deficiency and blood stasis. The moderate dose of kidney tonic to promote blood circulation method is superior in promoting angiogenesis, facilitating the establishment and maintenance of pregnancy, limiting trophoblast invasion of metaplasia, reducing miscarriage, and improving pregnancy rate.

Motherwort injection in preventing post-abortion hemorrhage after induced abortion: A multi-center, prospective, randomized controlled trial.

OBJECTIVE: The aim of this study was to evaluate the efficacy and safety of motherwort injection (MI, Yi mu cao) in preventing post-abortion hemorrhage and promoting uterine retraction after induced abortion surgery. METHODS: In this multi-center randomized controlled trial undertaken between September 2014 and August 2016, 408 child-bearing age women who underwent induced abortion surgery and randomly assigned to two groups: MI group who received intramuscular MI treatment (n = 207) and no-treatment group (n = 201). The volume of vaginal bleeding and its duration were used as primary end points; and uterine size and dimension were measured as secondary end points. Blood coagulation indices, routine blood and adverse events were recorded to evaluate the safety. RESULTS: The efficacy analysis was based on 366 patients. No significant difference were found in baseline characteristics between the two groups (P > 0.05). The amount of vaginal bleeding and duration of bleeding were significantly reduced in MI group compared with on-treatment group in Full Analysis Set (FAS) and Per Protocol Set (PPS) populations (P < 0.001). The volume and perimeter of the uterine dimensions in MI group were smaller than no-treatment group (P < 0.001). No significant abnormal vital signs were observed. Only 1 case of mild, transient erythema was found in MI group. CONCLUSIONS: MI could reduce post-abortion hemorrhage and improve uterine retraction in women undergoing surgical induced abortion, without serious adverse events. It was a safe and effective treatment in preventing post-abortion hemorrhage after induced abortion.