Objective To explore the barriers and facilitators factors of adherence to complete decongestive therapy（CDT） in patients with breast cancer related lymphedema（BCRL）. Methods Based on the Health Action Process Approach theory，from September 2021 to February 2022，12 patients with BCRL undergoing CDT were purposely selected for semi-structured in-depth interviews. Data were collected and analyzed using the Colaizzi seven-step analysis method. Results The extracted barriers of CDT included insufficient risk perception，negative outcome expectation，low self-efficacy，lack of behavioral intention，lack of action and coping plan. The facilitators included perceived benefits of treatment，perceived harm of edema，enhanced self-efficacy，motivation of treatment，and construction of a new normal life. Conclusion The adherence of CDT in patients with BCRL is affected by a series of barriers and facilitators. In the future，targeted intervention strategies can be formulated based on the theory of health action process approach to improve the treatment adherence.
Objective To integrate the best evidence of non-pharmacological interventions for breast cancer-related lymphedema with evidence-based methods，and to provide evidence-based bases for standardized evaluation and management of lymphedema for clinical medical staff. Methods The best evidence about the prevention and management of lymphedema in breast cancer patients were searched systematically，such as relevant guidelines，expert consensuses，systematic reviews and so on. The retrieval period was from January 2016 to January 2022. Results A total of 25 pieces of the literature were included，including 6 guidelines，4 expert consensuses and 15 systematic evaluations，and 33 pieces of best evidences were integrated from 2 aspects，namely the preventive intervention and therapeutic intervention. Conclusion The summarized evidence can be used for the prevention and treatment of breast cancer lymphedema，and medical staff should provide specific health guidance for patients with lymphedema based on cultural background，clinical situation，and patients’ opinions.
Objective A scoping review of unplanned readmission（UR) risk prediction models for cancer patients was conducted to provide a basis for clinical practice and research. Methods The UR risk prediction model of cancer patients was focused,and the Chinese and English databases were searched systematically. The extracted information of the model included applicable population,the incidence of UR,modeling methodology,predictors of the model and their performance. Results 18 studies involving 23 prediction models were included and the population focused on postoperative colorectal cancer patients. The incidence of 30 days UR in cancer patients ranged from 8.2% to 19.0%. The model development methods were various,but the overall prediction performance was poor. Comorbidities,TNM,length of stay,age and postoperative complications were important predictors of UR in cancer patients. Conclusion Clinical staff should pay attention to UR risk factors and choose excellent tools to guide clinical practice. Prediction models with high predictive performance and operability can be developed with artificial intelligence and verified extensively and externally.
Objective To investigate the effect of relaxation training combined with guided imagery on the adverse subjective experience of nausea and vomiting,anxiety levels as well as quality of life in lymphoma patients undergoing chemotherapy. Methods A total of 100 lymphoma patients undergoing initial chemotherapy were divided into an intervention group and a control group using random number table method. Each group contains 50 cases. The intervention group was given relaxation training combined with guided imagery audio based on routine chemotherapy nursing care. The patients in the control group were given routine chemotherapy nursing care,including chemotherapy diet education,accurate implementation of standardized antiemetic programs,and online follow-up during chemotherapy interval. The Index of Nausea and Vomiting and Retching（INVR）,Self-Rating Anxiety Scale（SAS）,and the Functional Assessment of Cancer Therapy-General（FACT-G） were utilized for evaluation. Results At the times of 24 hours before chemotherapy,and 24 hours,7 days,and 14 days after the first,third,and sixth cycle of chemotherapy,the scores of INVR and SAS in the intervention group were lower than those in the control group. The 4 dimensions of physical status,social status,emotional status,and functional status in the FACT-G of cancer patients and the total quality of life score were higher than those in the control group,with statistical significance（P<0.05）. Repeated measures ANOVA results showed that the time effect,the between-group effect and the interaction effect were all statistically significant（P<0.05）. Conclusion Relaxation training combined with guided imagery audio intervention can effectively mitigate the degree of nausea and vomiting,reduce anxiety and improve the quality of life in patients with lymphoma.
Objective To investigate the effects of application of decision aid of breast reconstruction in breast cancer patients after mastectomy. Methods We developed the breast reconstruction decision aid for breast cancer patients based on the literatures at home and abroad,expert meeting and group discussion. A total of 42 patients hospitalized for breast cancer surgery from October to December,2017,were recruited as the control group,and 39 patients admitted from January to March,2018,were enrolled as the intervention group. In addition to routine nursing,the intervention group received the breast reconstruction surgery decision aid,while the control group only received routine nursing. The results of intervention were evaluated by Decision Conflict Scale（DCS）,Preparation Decision Making （PrepDM） and Hospital Anxiety and Depression Scale （HADS） at admission and one day before operation;Decision Regret scale（DRS） and HADS were used at one month,six months and one year after operation. Results The decision preparation score one day before operation in the intervention group was significantly higher than that of the control group（P<0.05）,and the decision conflict score of the intervention group was significantly lower（P<0.05）. There was no significant difference in the anxiety and depression scores between the intervention group and the control group one day before surgery. Anxiety and depression scores in the intervention group were significantly lower than those in the control group one year after surgery（P<0.05）. During postoperative follow-up,the decision regret scores of the intervention group were significantly lower than those of the control group at one month,six months and one year after surgery（P<0.05）. Conclusion The breast reconstruction surgery decision aid can effectively improve patients’ decision preparation,alleviate long-term anxiety and depression,and reduce long-term decision regret.
Objective To establish an intervention program for transferring ICU cancer patients,and to explore its effects on relocation stress of the family members. Methods A total of 52 family members of cancer patients who met the inclusion and exclusion criteria were recruited and divided into the intervention group（26 cases）and the control group（26 cases） randomly. Participants in the intervention group received relocation intervention program in addition to routine nursing,while the control group received routine nursing. Basic information questionnaire,the Family Relocation Stress Scale（FRSS）,the State Anxiety Inventory（SAI） and the Family Caregiver Task Inventory（FCTI） were used to investigate relocation stress,anxiety and care ability of the families before and after the intervention. Results Differences in basic information,relocation stress,anxiety and care ability of patients and their family members were not statistically significant between the intervention group and the control group before intervention（P>0.05）. After the intervention,there were significant differences between two groups in the total score of relocation stress and subscales of relocation stress,the degree of anxiety,the score of family care ability scale and its subscales（P<0.05）. Conclusion The relocation intervention program can effectively prevent the level of relocation stress,reduce anxiety and improve the care ability of family members of cancer patients after ICU transfer.
