BACKGROUND: Global Cancer Statistics 2020 reported that breast cancer had exceeded lung cancer as the most frequently diagnosed cancer. Surgery is the primary treatment modality for breast cancer, but postoperative upper limb dysfunction often occurs; functional exercise can alleviate this and restore upper limb function. However, exercise compliance is low in postoperative breast cancer patients; thus, many studies have been conducted in recent years to improve patient compliance with exercise. OBJECTIVE: The aim of this study was to compare the effectiveness of different interventions to improve exercise adherence in postoperative breast cancer patients. METHODS: We searched PubMed, Cochrane Library, Web of Science, EMBASE, Wan Fang, CNKI, VIP, and CBM databases for eligible studies. Exercise adherence rate and quality-of-life difference were assessed as outcomes. Sensitivity analysis and inconsistency detection were performed to evaluate whether the exclusion of high-risk studies affected the validity. Risk of bias was assessed using the risk-of-bias table in RevMan 5.4. Surface under the cumulative ranking was used to estimate the rankings among different interventions. RESULTS: Twenty-five randomized controlled trials involving 9 interventions were included, and the network meta-analysis results showed that patients in the pedometer + counseling group had the best exercise adherence. CONCLUSION: Pedometer + counseling care measures are recommended to improve exercise adherence in postoperative breast cancer patients. IMPLICATIONS FOR PRACTICE: Oncology nurses can improve patients' exercise compliance through counseling and by giving them pedometers to wear.
PROBLEM: There have been some studies on the needs of women experiencing perinatal loss in various socio-cultural contexts, but there is no research that systematically and comprehensively synthesizes these needs. BACKGROUND: Perinatal loss has profound psychosocial effects. The misconceptions and prejudices existing in the public, the lack of satisfactory clinical care, and the available social support may all increase the negative impact. AIM: To synthesize evidence for the needs of women experiencing perinatal loss, attempt to explain the findings, and provide insights into the application of evidence. METHODS: Published papers were searched in seven electronic databases until 26 March 2022. The Joanna Briggs Institute Critical Appraisal Checklist for Qualitative Research was used to assess the methodological quality of the included studies. Through meta-aggregation, the data was extracted, rated, and synthesized, resulting in new categories and findings. The credibility and dependability of the synthesized evidence were evaluated by ConQual. FINDINGS: Thirteen studies that fulfilled the inclusion criteria and quality assessment were included in the meta-synthesis. Five synthesized findings were identified, covering information needs, emotional needs, social needs, clinical care needs, as well as spiritual and religious needs. CONCLUSION: Women's perinatal bereavement needs were individualized and diverse. There is a necessity to understand, identify, and respond to their needs in a sensitive and personalized way. Families, communities, healthcare institutions, and society form a coordinated whole and provide accessible resources to improve recovery from perinatal loss and a satisfactory outcome in the subsequent pregnancy.
Delivery of Health Care , Pregnancy , Female , Humans , Qualitative Research
PURPOSE: This study aimed to evaluate and analyze the methodological quality of the published clinical practice guidelines (CPGs) for perinatal bereavement care and provide a reference for implementing best clinical practices. METHODS: We performed a systematic and comprehensive search in five electronic databases (PubMed, The Cochrane Library, Web of Science, CNKI, Wan Fang Database), eight guideline databases, and six websites of professional organizations from March 2021 to June 2021. Four researchers used the Appraisal of Guidelines for Research and Evaluation (AGREE II) instrument to appraise the selected CPGs independently. The inter-rater reliability of AGREE II domains was calculated using the intraclass correlation coefficient with 95% CI. RESULTS: We included a total of 8 CPGs. The mean scores of six domains ranged from the lowest score of 46.61% (editorial independence) to the highest score of 87.85% (clarity of presentation). Subgroup analysis showed no statistical difference. Each domain achieved "good" and "very good" intraclass reliability. Two CPGs were deemed as grade A (strongly recommended), five were rated as grade B (recommended with modifications), and one was evaluated as grade C (not recommended). CONCLUSIONS: Healthcare professionals in obstetrics and neonatology play an important role in helping bereaved parents and families to cope with perinatal loss. High-quality CPGs for perinatal bereavement care can serve as useful resources to improve the quality and outcomes of clinical practice. More efforts should be made to disseminate the best practices for perinatal bereavement care. When implementing GCPs in countries or regions with different backgrounds, professional translations, strict validations, and cultural adaptations should be taken into account.
Hospice Care , Databases, Factual , Humans , Reproducibility of Results
