Perioperative Comprehensive Supportive Care Interventions for Chinese Patients with Esophageal Carcinoma: a Prospective Study

Objective: To assess the effects of perioperative comprehensive supportive care interventions on outcomeof Chinese esophageal cancer patients in a prospective study. Methods: 60 patients with primary esophagealcarcinoma were randomized into an intervention group (IG, n=31) and a control group (CG, n=29). The Chineseversion of symptom checklist-90 (SCL-90) was adopted to assess their psychological status. The interventions,including health education, psychological support, stress management, coping strategies and behavior training,were carried out in 3 phases (preoperative, postoperative Ⅰ and postoperative Ⅱ), and psychological effects werethereafter evaluated accordingly before surgery, and 1 week, 4 weeks and 24 weeks post-surgery. Medical costswere estimated at discharge. Survival of patients was estimated each year post-surgery. General health statusand satisfaction-with-hospital were surveyed by a follow-up questionnaire 4 years post-surgery. Results: All thesubjects demonstrated higher scores in the preoperative phase than the normal range of Chinese populationconcerning 7 psychological domains including somatization, obsessive-compulsive, depression, anxiety, hostility,phobic anxiety and paranoid ideation. Although no significant difference was observed between the two groupsat admission, the scores of IG, which tended to decrease at a faster rate, were generally lower than those of CGat weeks 1, 4 and 24 post-surgery. The length of hospital stay and medical costs of IG were significantly less thanthose of CG and satisfaction-with-hospital was better. However, there was no significant difference in 4-yearsurvival or health status between two groups. Conclusions: Appropriate perioperative comprehensive supportivecare interventions help to improve the psychological state of Chinese patients with esophageal carcinoma, toreduce health care costs and to promote satisfaction of patients and their families with hospital.     

胃癌患者个案护理管理模式的临床应用

目的探讨胃癌患者个案护理管理模式的临床应用效果。方法 300例胃癌住院患者根据入住病床的单双号分为治疗组和对照组,每组150例。对照组患者在化疗期间采用常规护理,治疗组患者采用积极的个案护理管理模式,两组的干预周期均为12周。结果治疗组和对照组,干预前的焦虑自评量表(SAS)和抑郁自评量表(SDS)评分差异无统计学意义,干预后两组的评分显著下降,组间差异有统计学意义(P<0.05)。干预后,治疗组患者的躯体功能、角色功能、认知功能、情绪功能和社会功能评分以及自我管理生活行为、自我处置药物行为、自我监控症状行为和心理自我调整行为评分均显著高于对照组(P<0.05)。结论胃癌个案护理管理模式的临床应用可有效缓解患者的焦虑抑郁情况,提高患者的自我管理能力,从而提高生活质量。     

心灵关怀及音乐治疗对肿瘤患者应对方式影响

目的:观察音乐治疗及临床心灵关怀对肿瘤患者希望水平、应对方式的影响.方法:将肿瘤患者随机进入研究组与对照组.研究组予以音乐治疗配合临床心灵关怀服务,对照组予以单纯临床心灵关怀干预,调查干预前后两组患者的希望水平和应对方式的变化情况.结果:研究组干预前医学应对问卷"面对"分量表得分为15.71±2.932,干预后得分为20.427±2.610;研究组干预前医学应对问卷"回避"分量表得分为14.57±2.115,干预后得分为16.800±1.970;研究组干预前Herth希望调查表得分为29.54±3.052,干预后得分为34.434±2.137.对照组干预前医学应对问卷"面对"分量表得分为17.11±2.941,干预后得分为21.747±2.507;研究组干预前医学应对问卷"回避"分量表得分为15.82±1.933,干预后得分为16.720±2.095;研究组干预前Herth希望调查表得分为30.29±2.753,干预后得分为34.500±2.430.两组治疗干预前后医学应对问卷"面对"、"回避"量表总分、Herth希望调查表总分的主效应有差异(P<0.001).研究组与对照组相比,两组的"面对"、"回避"总分的主效应有差异(P<0.05).结论:音乐治疗配合临床心灵关怀干预较单纯心灵关怀,提高患者使用面对、回避应对方式可能性的效果更佳.     

Psycho-Education on Knowledge of Oral Hygiene and Psychological Distress to the Parents with Leukemia Children

Objective: To analyze the effect of psycho-educational intervention on knowledge of oral hygiene and psychological distress to the parents of children suffering from leukemia. Methods: Design of this study was a quasi-experimental pre-posttest control group design. The sample were 70 mothers who had children with leukemia (intervention group = 35 mothers; control group = 35 mothers). The independent variable was psycho-educational, while the dependent variables were oral hygiene knowledge and psychological distress. The instruments used were the knowledge questionnaire and the Depression-Anxiety-Stress Scale (DASS-21). Data were analyzed using the Wilcoxon signed rank test and the Mann Whitney U-test with the significance α =0.05. Results: The knowledge most widely known by parents was about how to perform of oral care (37.3%). All parameters of knowledge about oral hygiene have increased after being given a psycho-educational intervention. Psycho-educational interventions had an effect on reducing psychological distress; depression (p=0.000), anxiety (p=0.001) and stress (p=0.000). Conclusion: Most parents whose children suffer from cancer experience psychological distress in the form of depression, anxiety and stress with a range of symptoms ranging from mild to moderate. Psycho-educational interventions can increase knowledge about oral hygiene and decrease psychological distress in parents.     

中西医结合护理对消化道肿瘤患者化疗不良反应的干预效果

目的探讨中西医结合护理对消化道肿瘤化疗不良反应的干预效果。方法将89例患者随机分为中西医结合护理的观察组（45例）和常规护理的对照组（44例）,护理结束后观察评价两组患者的不良反应、焦虑情绪及生活质量评定。结果观察组患者的不良反应低于对照组,差异有统计学意义（P〈0．05）。干预前,两组患者汉密尔顿焦虑量表（HAMA）评分比较差异无统计学意义（P〉0．05）;干预后HAMA评分比较,观察组患者总分和精神性焦虑、躯体性焦虑因子得分下降程度均高于对照组,差异有统计学意义（P〈0．05）。随访6个月期间,观察组患者各项生活质量指标均优于对照组,差异有统计学意义（P〈0．05）。结论中西医结合护理措施不仅可降低患者化疗后的不良反应,而且可缓解患者的焦虑情绪,提高生活质量。     

The Effect of Family-Centered Education on the Care Burden of Family Caregivers of the Elderly with Cancer: A Quasi-experimental Study

Introduction: Given the role of the family in decisions related to the patient’s health, their role in educating the patient should be considered in the health care program. Therefore, the present study was conducted to determine the effect of family-centered education on the care burden of family caregivers of the elderly with cancer. Methods: In this quasi-experimental study, 30 elderly caregivers with cancer were selected and randomly divided into two groups of 15 intervention and 15 control from 1 March 2020 to 1 July 2021. Data collection tools were demographic characteristics questionnaire and care burden questionnaire. The intervention was performed as individual training to caregivers in two one-hour sessions. 6 weeks after the intervention, care burden was measured in both groups. Data were collected and analyzed using PSSS software version 23. Results: According to the independent t-test, before the intervention, there was no significant difference between the mean score of care burden in the intervention and control groups, but after the intervention, the mean score of care burden in the intervention group decreased from 56.93 ±11.08 to 42.93 ± 9.78 and in the control group It changed from 54.27 ± 11.38 to 56.80 ± 11.43 and there was a statistically significant difference in the mean scores of the two groups (P <0.001). Conclusion: Based on the findings of the present study, family-centered education intervention can be effective in reducing the care burden of caregivers of the elderly with cancer in a sample of Iranian society. Therefore, it is predicted that providing such educational services in the health care delivery system is absolutely necessary and effective, and the use of this type of training in nursing activities is recommended.     

手术室个性化舒适护理在甲状腺癌手术患者中的应用

目的：了解甲状腺癌患者的焦虑、抑郁现况,探讨手术室个性化舒适护理在甲状腺癌手术患者中的应用效果。方法：选择接受甲状腺癌手术的患者326例,将其随机分为干预组和对照组,对照组采用常规护理,干预组患者实施手术室个性化舒适护理。在入院时、术前一天、术后一天对患者的焦虑、抑郁情况进行调查,同时监测患者的血压、心率、睡眠情况。结果：甲状腺癌患者入院时存在明显的焦虑抑郁情况,81.9%的甲状腺癌患者存在焦虑情绪,71.8%的患者存在抑郁情绪,以轻度焦虑抑郁为主。与入院时相比,术前一天患者的焦虑抑郁得分明显升高（P<0.001）,但干预组焦虑得分低于对照组（t =-4.643, P<0.001）,术后一天患者的焦虑得分较术前一天明显下降（P<0.001）。干预组患者术前、术后血压、心率均低于对照组（P<0.001）。手术当日干预组和对照组均出现不同程度的血压升高、心率加快,干预组变化比例明显低于对照组（血压升高：47.9% vs. 76.7%;心率加快：22.1% vs. 33.7%）。干预组和对照组在术前一天、术后当晚均存在不同程度的睡眠障碍,其中对照组失眠比例大于干预组（P<0.05）。结论：手术室个性化舒适护理可明显改善患者的焦虑、抑郁情绪,提高治疗效果。     

Association between unmet needs and quality of life in hospitalised cancer patients no longer receiving anti‐cancer treatment

Assessing the quality of life and unmet needs of cancer patients is an integral part of palliative care. This cross‐sectional study sought to determine whether there is an association between quality of life and unmet needs, anxiety and depression in cancer patients who are no longer receiving anti‐cancer treatment. The sample consisted of 93 patients from the oncology department at the University Hospital in Ostrava for whom further cancer treatment had been terminated as ineffective in halting the progression of their cancer. The European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ‐C30), the Patient Needs Assessment in Palliative Care (PNAP) questionnaire, and the Hospital Anxiety and Depression Scale (HADS) were used to collect data. The overall quality of life score was quite low at 46. Most unmet needs were defined in terms of physical, psychological or spiritual needs. Correlations were found between impaired quality of life and lower Karnofsky scores (r = 0.50); increased physical (r = 0.52), psychological (r = 0.44) and spiritual (r = 0.36) needs; and higher levels of anxiety (r = ?0.30) and depression (r = ?0.68). Effective management of patients' physical (pain, fatigue and depression), psychological and spiritual needs may improve their quality of life.     

Effects of a Self-Monitoring Quality of Life Intervention in Outpatients with Breast Cancer: A Preliminary Report of A Randomized Controlled Trial

Objective: This preliminary report used data from a randomized controlled clinical trial to investigate the beneficial effects of a self-monitoring quality of life (SMQOL) intervention on communication, medical care and patient outcomes in Japanese women with breast cancer. Methods: This study compared a SMQOL intervention group with a control group that received usual care after 4 months on self-efficacy aspects of patient–physician communication among outpatients with breast cancer in Japan using the Perceived Efficacy in Patient–Physician Interactions (PEPPI) questionnaire. Patients were randomly assigned to the intervention and control groups using permuted-block randomization. The intervention groups were asked to complete a paper-based quality-of-life (QOL) questionnaire in addition to the usual care provided in the control group. Analysis of covariance was used to assess the difference in PEPPI scores between the intervention and control groups. Additionally, subgroup analyses were performed for outpatients with breast cancer accompanied by depression or anxiety. Results: In total, 232 patients were eligible for this study and randomized. Seven patients did not answer the PEPPI questionnaire at baseline after group allocation, leaving 225 patients for inclusion in the analyses. The modified intention-to-treat ITT analysis showed the SMQOL intervention had no significant effect on PEPPI total score (P = 0.226). We found a significant between-group difference in PEPPI total score in the anxiety group (P = 0.045), namely, the self-efficacy aspects of patient–physician communication of those with anxiety in the intervention group were better than for those in the control group after 4 months. Conclusion: Use of the SMQOL had beneficial effects on communication self-efficacy between patients and physicians for outpatients with breast cancer, those with anxiety.     

Swedish Mothers and Fathers of Children with Cancer: Perceptions of Well-Being,Social Life,and Quality Care

The overall aim was to describe and compare well-being, social life, and quality care among parents of children with cancer with respect to mothers versus fathers and whether the children were on versus. off treatment. The Life Situation Scale for Parents (LSS-P) was answered by 320 parents, comprising 85 mothers and 71 fathers of children on treatment, and 93 mothers and 71 fathers of children off treatment. The results show that the well-being of parents of children with cancer is affected by their child's situation, and that they experience such things as economic strain and a sense of being dependent on the care provided, especially during the child's treatment phase. Mothers whose children are receiving treatment see their life situation as less satisfying, and report being sadder and having lower self-esteem.     

Effects of a Self-Encouragement Program on Stress of Mothers of Children with Cancer Referred to Imam Ali Hospital,Zahedan, In 2015

Introduction: In addition to the physical problems for the patients themselves, cancer can cause several social and psychological problems to the family, especially the mother in pediatric cases. This study aimed to investigate the effects of a self-encouragement program on stress of mothers of children with cancer referred to Imam Ali Hospital of Zahedan in 2015. Materials and Methods: This case-control study was performed on 44 mothers with children suffering from cancer, referred to the hospital during October and November of 2015. Convenience sampling was used, and the mothers were randomly allocated into two 22-member groups. The Impact of Event Scale – Revised (IES-R) was the data collection instrument. Educational classes were held in the hospital. Confidentiality and mutual respect were observed by each and every member of the group. Data obtained before and after the intervention were analyzed using the independent t-test, paired t-test and ANOVA. The significance level was set at 0.05. Findings: The most frequent diseases were acute lymphoblastic leukemia (47%) and brain tumors (16%). The results indicated that the mean score of stress in the control group did not significantly between the two time points (P=0.106). In the intervention group, however, there was a significant difference in stress mean scores before (54.3±2.0) and after (37.1±1.8) the intervention (P<0.001). Conclusion: Self-encouragement can help mothers dealing with a diseased child to feel less stressed. Therefore, they may be able to act more effectively when faced with problems.     

Spiritual Care Needs of Terminal Ill Cancer Patients

Objective: Terminal ill cancer patients experience spiritual distress and need spiritual care. They are in need of palliative care in the long term to alleviate suffering. The aim of the study was to investigate spiritual needs of terminal ill cancer patients. Methods: This study is a cross-sectional study. The participants were Thai terminal ill cancer patients from seven hospitals in northern, northeast, central, and southern regions of Thailand. Three-hundred-and-twenty-two participants were purposively selected. The instrument used in this study was a spiritual needs scale, consisting of 41 items with 4-point rating scale. Statistical analysis was F-test for one-way analysis of variance. Results: The majority of terminal ill cancer patients aged fifty-one years old. Most of them were females with end stage cancer status that did not respond to treatment. The overall spiritual needs of terminal ill cancer patients were at the moderate level (M = 18.21, SD = 2.56). The highest mean was found in the ‘prepare for death’ dimension, followed by the ‘have meaning, values, and life purposes’ and the ‘have opportunity to pursue most important things in life’ dimensions respectively and had different spiritual needs among status (F(3,318) = 3.66, p < 0.05), number of family members (F(8,313) = 5.07,  p < 0.05), living with family (F(2,319) = 3.91, p < 0.05), and spiritual anchor (F(2,319) = 4.13, p < 0.05). Conclusion: The study results provide insight into spiritual needs of terminal ill cancer patients which assists in improving the provision of holistic care to let the patients be happy at end-of-life phase.     

Psychological Limbo as a Barrier to Spiritual Care for Parents of Children with Cancer: A Qualitative Study

Background: Pediatric cancer causes reduced life quality and psychological problems for parents. It is necessaryto pay attention to spirituality, which plays a significant role in increasing the life quality of these parents and theirpatient children and managing the conditions associated with the disease. This study was performed to determinefactors predisposing to spiritual care in parents of children suffering from cancer. Methods: This qualitative study wasconducted by conventional content analysis. Fifteen parents of children with cancer hospitalized in the oncology andhematology wards of governmental hospitals in Iran were selected using a purposive sampling method and underwentsemi-structured deep interviews from 2015.1.10 until 2017.3.10. Results: On data analysis, 12 subcategories emergedleading to extraction of three : “projection”, “mental concern”, and “psychological pains”. The final result was a focuson the theme “psychological limbo”. Conclusion: Our findings showed that cancer induces psychological problemsin parents, which may serve as factors that drive them towards spiritual affairs. Hence, attention should be paid topredisposing factors of spiritual care to facilitate tranquility and an ability to adapt to their circumstances in affectedparents.     

Home-based Palliative Intervention to Improve Quality of Life in Children with Cancer: A Randomized Controlled Trial

Objective: Over the past few years, an integrated approach of palliative care (PC) to chronic and/or life-threatening conditions care has been widely used. Home-based PC (HBPC) service is developed to meet the needs of patients at home; however, it has not been used widely. This study is aimed at determining the benefits of integrated HBPC for the quality of life (QoL) and symptoms intensity in Indonesian children with malignancies. Method: A randomized controlled trial was carried out to compare the quality of life between patients who were given PC (a three-month home visit) and those who did not receive PC (control group). Each group was constituted of thirty children with cancer and aged 2-18 years old and were consulted by a palliative team. The participants were randomly allocated to two groups. In the first and twelfth weeks of the intervention, all patients were assessed using the Pediatric Quality of Life Inventory (PedsQLTM) questionnaire cancer module 3.0 (report by proxy or self-report). Symptoms intensity (pain, anorexia, sleep disturbance) were scored by using Edmonton Symptoms Assessment Scale (ESAS). The mean score and each dimension score of both groups were compared and analyzed using bivariate analysis. Results: In total, fifty participants were included in the study. A significant difference was found between the two groups in terms of the mean total score in control group 62.39 and intervention group 81.63 (p<0.001). The QoL was improved in the intervention group, while it was declined in the control group as the disease progressed. The main improvements were in the pain and nausea aspects (p<0.001), followed by procedural anxiety (p=0.002), treatment anxiety (p=0.002), and worry (p=0.014). Palliative intervention significantly reduced sleep disturbances (p=0.003) and anorexia (p<0.001). Conclusion: Home-based PC improved several aspects of QoL and caused better symptom management in children with malignancies. An early intervention concurrent with the underlying treatment can improve QoL in these children.     

护理干预对卵巢癌化疗患者生活质量的影响

目的探讨全程系统化护理干预对卵巢癌化疗患者生活质量的影响。方法将84例卵巢癌术后化疗患者随机分为干预组（41例）和对照组（43例）,对照组行常规护理,干预组实施全程系统化护理干预,化疗前和化疗后3个月使用焦虑自评量表（SAS）、抑郁自评量表（SDS）及生活质量核心量表（EORTCQLQ—c30）评定患者的生活质量。结果干预组的整体生活质量、躯体功能、情绪功能、社会功能得分高于对照组,症状维度和单项问题中疲倦、恶心呕吐、失眠、食欲下降得分低于对照组,两组差异均有统计学意义（P〈0．05）。结论对卵巢癌化疗患者实施全程系统化护理,可改善患者的焦虑、抑郁情绪,提高生活质量。     

妇科恶性肿瘤患者的心理护理效果

目的探讨心理护理在妇科恶性肿瘤护理中的应用效果。方法选取2011年1月至2012年12月间100例妇科肿瘤患者为研究对象,按照随机数字法分为对照组和干预组,对照组给予肿瘤内科的常规护理,而干预组在常规护理基础上实施心理护理干预,观察两组的治疗效果。结果干预组的护理满意度为96.0%,对照组的护理满意度为80.0%,差异有统计学意义(P<0.05)。干预组和对照组护理前的SAS、SDS评分比较,差异无统计学意义(P>0.05);干预组和对照组护理后的SAS和SDS评分较护理前均有明显的改善,差异有统计学意义(P<0.05)。结论对于妇科恶性肿瘤患者实施心理护理干预措施是可行的,能够有效提高患者的临床护理满意度,并且改善患者焦虑和抑郁状况,值得在临床中应用与推广。     

The effectiveness of positive psychology intervention on the well-being,meaning, and life satisfaction of mothers of children with cancer: A brief report

The aim of this study was to promote emotional well-being, hope, life satisfaction, and meaning to mothers of children with cancer utilizing a positive psychology intervention. The study population included 50 mothers who had children with cancer attending an outpatient oncology clinic. The participants (experimental and control groups) completed Ryff's Psychological Well-being Scale (PWBS), Satisfaction with Life Scale (SWLS), Snyder's Hope Scale (HS), and Meaning in Life Questionnaire (MLQ) before and after the intervention and also one month after the end of intervention. Variables of the study significantly increased in the experimental group compared to the control group.     

The Effect of the Family-Centered Empowerment Model (FCEM) on the Care Burden of the Parents of Children Diagnosed with Cancer

Background: Families face multiple problems after their children are diagnosed with cancer. This study aims todetermine the effect of the Family-Centered Empowerment Model (FCEM) on the care burden of the parents of children,diagnosed with cancer. Methods: This quasi-experimental study was conducted with 78 parents, having children withcancer. The FCEM was implemented in the intervention group in four stages, namely perceived a threat, self-efficacy,educational participation, and evaluation during four sessions of 20-40 minutes. The control group only received theusual care. The burden of care of the control and intervention groups were measured one month after filling out theinitial questionnaire, and one month after the end of the intervention, respectively. Results: The two groups weresimilar in terms of demographic variables and level of burden of care. However, a statistically significant differencewas observed between the two groups, in terms of the level of burden (p<0.001). Conclusion: The results of this studyshowed that the empowerment of parents of children with cancer has an impact on reducing their care burden, andusing this empowerment model is recommended to the treatment team, especially nurses.