Influencing factors of self-management behavior in cancer patients based on a theoretical domain framework. / åŸºäºŽç†è®ºåŸŸæ¡†æž¶çš„ç™Œç—‡æ‚£è€ è‡ªæˆ‘ç®¡ç†è¡Œä¸ºå½±å“å› ç´ åˆ†æž.

OBJECTIVES: To explore the factors that influence self-management behavior in cancer patients based on the theoretical domain framework. METHODS: Studies in Chinese and English about factors influencing self-management behavior in cancer patients were searched from Wanfang database, CNKI, VIP, SinoMed, PubMed, Embase, CINAHL, Web of Science Core Collection, Cochrane library and Medline from inception to June 2022. Two investigators independently identified, extracted data, and collected characteristics and methodology of the studies. Factors were analyzed with Nvivo12, and the theoretical domain framework was mapped to the theoretical domain. Then the secondary node was generalized by theme analysis. Finally, the specific influencing factors were summarized and analyzed. RESULTS: Thirty-four studies were included for analysis. A total of 194 factors were mapped to 13 theoretical domains, and 31 secondary nodes were summarized. Theoretical domains environmental context and resources, social/professional role and identity, and beliefs about consequences were the most common factors. Knowledge, age, self-efficacy, disease stage, social support, gender, economic status and physical status were the most influential factors for self-management in cancer patients. CONCLUSIONS: The influencing factors of self-management of cancer patients involve most of the theoretical domains, are intersectional, multi-source and complex.

Construction and Application of Chain Management Information System for Cancer Pain.

BACKGROUND: With the rapid development of information technology, hospital information systems (HISs) have been deeply applied in the medical field and have shown broad application prospects. There are still some noninteroperable clinical information systems that pose an obstacle to the effective coordination of care, such as cancer pain management. AIM: To construct a chain management information system for cancer pain and explore its clinical application effect. METHODS: A quasiexperimental study was conducted in the inpatient department of Sir Run Run Shaw Hospital, Zhejiang University School of Medicine. A total of 259 patients were nonrandomly divided into two groups: the experimental group (after the system was applied, n = 123) and the control group (before the system was applied, n = 136). The cancer pain management evaluation form score, patient satisfaction with pain control, pain score at admission and discharge, and the worst pain score during hospitalization were compared between the two groups. RESULTS: Compared with the control group, the score of the cancer pain management evaluation form was significantly higher (p < .05). There were no statistically significant differences in worst pain intensity, pain score at admission and discharge, and patients' satisfaction with pain control between the two groups. CONCLUSIONS: The cancer pain chain management information system can enable nurses to evaluate and record pain in a more standardized way, but it has no significant effect on the pain intensity of cancer patients.

Implementing the Hospice Shared Care Model to Support a Patient with Advanced Colon Cancer: A Case Report.

Background: Compared to Western countries, palliative and hospice care services are used less often in Asian countries. While both types have been implemented in mainland China in recent years, their utilization rates have not increased satisfactorily. Moreover, few hospitals in mainland China implement hospice care using the hospice shared care model. Objective: This study investigated a case in which the hospice shared care model was implemented for one patient with advanced colon cancer who had received treatment at a general tertiary hospital in mainland China. Methods: Critical points of care included pain symptom management, nutritional support, application of the SHARE model for disease notification, family meetings to assist medical decision-making, relaxation therapy to relieve depressive symptoms, provisions to address end-of-life wishes, and support for primary caregivers. Results: The patient's basic pain was controlled (Numeric Rating Scale, NRS2-3), and the score of the Depression Screening Scale (PHQ-9) decreased from 15 to 10 after intervention during hospitalization. In the end, the patient died comfortably and peacefully at home. Conclusion: The hospice shared care team helped the patient with her physical and psychological pain, met her end-of-life wishes, and provided support for the families.

Factors affecting sufentanil consumption for intravenous controlled analgesia after hepatectomy: retrospective analysis.

BACKGROUND: Pain control after hepatectomy is usually achieved by opioids. There are significant individual differences in the amount of opioids used after hepatectomy, and the metabolism of opioids is liver-dependent. The purpose of our study was to explore the possible risk factors for opioid consumption during the first 48 h after surgery. METHODS: In a retrospective study design involving 562 patients undergoing open or laparoscopic hepatectomy, all patients were treated with intravenous patient-controlled analgesia (IV-PCA) along with continuous and bolus doses of sufentanil for a duration of 48 h after surgery during the time period of August 2015 and February 2019. The primary endpoint was high sufentanil consumption 48 h after hepatectomy, and patients were divided into two groups: those with or without a high PCA sufentanil dosage depending on the third quartile (Q3). The secondary endpoint was the effect of a high PCA sufentanil dosage on various possible clinical risk factors. The relevant parameters were collected, and correlation and multivariate regression analyses were performed. RESULTS: The median operation time was 185 min (range, 115-250 min), and the median consumption of sufentanil 48 h after the operation was 91 µg (IQR, 64.00, 133.00). Factors related to the consumption of sufentanil at 48 h after hepatectomy included age, operation time, blood loss, intraoperative infusion (red blood cells and fresh-frozen plasma), pain during movement after surgery (day 1 and day 2), preoperative albumin, and postoperative blood urea nitrogen. Age (≤ 60 and > 60 years), extent of resection (minor hepatic resection and major hepatic resection), surgical approach (laparoscope and open) and operation time (min) were independent risk factors for sufentanil consumption at 48 h postoperatively. CONCLUSION: Age younger than 60 years, major hepatic resection, an open approach and a longer operation are factors more likely to cause patients to require higher doses of sufentanil after hepatectomy, and the early identification of such patients can increase the efficacy of perioperative pain management.

Nurse-led follow-up to outpatients with cancer pain treated with opioids at home-telephone calls plus WeChat versus telephone calls only: a quasi-experimental study.

Background: Recently, cancer pain management has come increasingly to be provided in outpatient settings, requiring health-care providers and outpatients to take on responsibilities. Pain is among the most distressing symptoms of cancer. Objectives: To compare the effectiveness of nurse-led telephone calls plus WeChat versus telephone calls only for the pain management of outpatients with cancer. Methods: 231 outpatients with cancer pain were classified into two groups (group 1, N=125; group 2, N=106). Group 1 was followed up with weekly telephone calls for eight weeks, and group 2 with weekly telephone calls combined with the booklets through WeChat for eight weeks. Differences between groups in pain level, side effects, medication adherence, and satisfaction with pain management were analyzed, and statistical differences were tested usingan independent-sample t-test and a chi-squared test. Results: Group 2 had a significantly lower rest pain (p<0.01), and lower move pain but there was no statistical difference between the two groups. Among patients in group 2, constipation, nausea and vomiting, and dizziness were less (p<0.01), while medication adherence (p<0.05) and pain management satisfaction were higher (p<0.01) than patients in group 1. Conclusion: Nurse-led follow-up telephone calls combined with WeChat significantly reduced opioid-related health problems, such as pain intensity, side effects and medication adherence.

Effect of cultural background and healthcare environment on postoperative opioid requirement.

PURPOSE: The objective of this prospective observational study was to investigate the interactions between cultural background, healthcare environment, and postoperative pain experience. METHODS: We enrolled 128 Chinese patients living in rural mainland China and 134 patients in Hong Kong with a higher level of Western cultural influences (defined by educational attainment, place of residence, and ability to understand English). All patients had major abdominal surgery and received patient-controlled analgesia with intravenous morphine for postoperative pain relief. The primary endpoint was total opioid requirement up to 48 hr after surgery. Other measures included pain intensity, opioid-related side effects, and genetic markers for opioid responsiveness. RESULTS: The mean (95% confidence interval) cumulative opioid requirement, expressed as morphine equivalent, during the first 48 hr after surgery was significantly less in patients from mainland China (18.8 [15.7 to 22] mg) compared with patients from Hong Kong (42.0 [38.3 to 45.6] mg, P < 0.0001). In a multivariable analysis, opioid requirement was influenced by ethnicity, duration of surgery, and severity of pain upon admission to the postanesthetic care unit. CONCLUSIONS: These results suggest that postoperative pain behaviours and opioid requirement may be influenced by cultural background and healthcare environment in two populations of Chinese descent. TRIAL REGISTRATION: Australian and New Zealand Clinical Trials Registry (ACTRN12614000601639); registered 6 May, 2014.

RéSUMé: OBJECTIF: L'objectif de cette étude observationnelle prospective était d'étudier les interactions entre le contexte culturel, l'environnement de soins de santé et l'expérience de la douleur postopératoire. MéTHODES: Nous avons recruté 128 patients chinois vivant en zones rurales en Chine continentale et 134 patients vivant à Hong-Kong avec un haut niveau d'influences culturelles occidentales (définies par le niveau d'éducation atteint, le lieu de résidence et la capacité à comprendre l'anglais). Tous les patients avaient subi une chirurgie abdominale majeure et reçu une analgésie contrôlée par le patient par morphine intraveineuse pour le soulagement de la douleur postopératoire. Le critère d'évaluation principal était la demande totale en opioïdes pendant les 48 premières heures suivant la chirurgie. D'autres mesures ont inclus l'intensité de la douleur, les effets indésirables liés aux opioïdes et des marqueurs génétiques de sensibilité aux opioïdes. RéSULTATS: Le besoin cumulé moyen (intervalle de confiance à 95 %) cumulé en opioïdes, exprimé sous forme d'équivalent-morphine, au cours des 48 premières heures suivant la chirurgie était significativement inférieur pour les patients de Chine continentale (18,8 [15,7 à 22] mg) comparativement aux patients de Hong-Kong (42,0 [38,3 à 45,6] mg, P < 0,0001). Une analyse multifactorielle a montré que la demande en opioïdes était influencée par l'origine ethnique, la durée de l'intervention chirurgicale et l'intensité de la douleur au moment de l'arrivée dans l'unité de soins postanesthésiques. CONCLUSIONS: Ces résultats suggèrent que les comportements postopératoires envers la douleur et le besoin d'opioïdes peuvent être influencés par l'arrière-plan culturel et l'environnement des soins de santé dans deux populations différentes d'origine chinoise. ENREGISTREMENT DE L'ESSAI CLINIQUE: Registre des essais cliniques d'Australie et de Nouvelle-Zélande (ACTRN12614000601639); enregistré le 6 mai 2014.