PURPOSE:Chemotherapy-related cognitive impairment (CRCI) is a prevalent neurotoxicity in patients with breast cancer (BC), leading to cognitive decline and reduced quality of life. Exercise is recommended as a potential strategy to mitigate CRCI; however, optimal exercise modalities and protocols remain unclear. Moreover, implementing exercise during chemotherapy presents practical and adherence challenges, highlighting the need for feasible, targeted exercise interventions. This study aimed to evaluate the effects of an aerobic exercise programme delivered throughout chemotherapy on cognitive function in patients with BC. METHODS:A non-randomized controlled clinical trial was conducted in patients aged 18-65 years with stage I-III breast cancer undergoing chemotherapy. Participants received either usual care or an aerobic exercise-based programme delivered throughout chemotherapy, incorporating behavioural and social support components. Subjective and objective cognitive function, fatigue, quality of life, and physical fitness were assessed at baseline, mid-chemotherapy, and post-intervention. RESULTS:Fifty-nine patients (intervention group, n = 28 vs. control group, n = 31) were enrolled into the study, and 48 (24 per group) completed all tests at final-chemotherapy. Compared with the control group, significant improvements were observed in all measurements of cognitive function, fatigue, quality of life, and grip strength (healthy) after the intervention (p < .05). CONCLUSION:The aerobic exercise-based program had beneficial effects on cognitive function, fatigue, quality of life, and grip strength.

Fear of cancer recurrence (FCR) is a prevalent psychological concern among breast cancer survivors, and identifying influencing factors is crucial for designing effective interventions. We aimed to investigate the relationship of FCR with sociodemographic characteristics, clinical features, physical and psychological symptoms, and social support among survivors of breast cancer. A cross-sectional study performed between November 2024, and January 2025. 387 potential participants were screened using convenience sampling. Fear of cancer recurrence, symptoms, and social support were assessed using the FCR Inventory-Short Form (FCRI-SF), the Memorial Symptom Assessment Scale (MSAS), and the Social Support Rating Scale (SSRS), respectively. Factors influencing FCR in survivors of breast cancer were determined using multiple linear regression. The findings revealed that age < 40 years (B = 3.505, p = 0.012), severe medical burden (B = 5.079, p < 0.001), tumor stage III (B = 4.309, p = 0.018), cancer diagnosis time of 6–12 months (B = 2.174, p = 0.014), and chemotherapy (B = 2.077, p = 0.031) were significantly associated with higher FCR. Endocrine therapy was positively associated with FCR scores, although this association did not reach statistical significance (B = 2.300, p = 0.054). Among the psychological factors, worrying (B = 2.213, p < 0.001) and feeling nervous (B = 0.880, p = 0.006) were significantly associated with higher FCR. Among the physical factors, “I do not look like myself” (B = 0.796, p = 0.010) and lack of energy (B = 0.662, p = 0.018) were also significantly associated with higher FCR. FCR in this population is influenced by age, medical burden, cancer stage, duration of cancer diagnosis, treatment methods, and physical and psychological symptoms. Although social support was not significant in this study, its potential role, as reported in previous literature, warrants further attention.

Fear of cancer recurrence (FCR) is one of the most common psychological challenges faced by breast cancer survivors. However, limited qualitative research has examined survivors’ lived experiences, personal interpretations, and support needs related to FCR. This study aimed to explore the experiences, perceptions, and support needs of breast cancer survivors and to identify existing gaps and preferences in the available support systems. A qualitative photo-elicitation study was conducted between January and March 2025 with 15 breast cancer survivors at two large tertiary hospitals in Beijing, China. Participants submitted 76 photographs, and thematic analysis of the photographs and interviews identified six themes: experiencing and understanding fear of cancer recurrence; experiencing and understanding co-occurring symptoms; impact of co-occurring symptoms; coping strategies for fear of cancer recurrence and co-occurring symptoms; advice to fellow patients for coping with fear of cancer recurrence; and suggestions to healthcare workers for improved support and communication. The themes reflected symptom-related triggers, coping practices including physical activity, and needs for information, peer, and healthcare support. These findings highlight the need for routine screening for fear of cancer recurrence and associated co-occurring symptoms, as well as the provision of clear informational support and psychoeducation. They also suggest the importance of integrating psychological, rehabilitative, and peer-related support into survivorship care. Based on these findings, a conceptual framework was developed to inform future survivorship care and support strategies for breast cancer survivors.

To identify symptom phenotypes among breast cancer survivors using latent profile analysis (LPA) and examine differences in fear of cancer recurrence (FCR) and social support levels across phenotypes. A multicenter cross-sectional study recruited 357 breast cancer survivors through convenience sampling from three university-affiliated tertiary hospitals in Beijing between November 2024 and January 2025. Symptoms were assessed using the Memorial Symptom Assessment Scale (MSAS), while the Fear of Cancer Recurrence Inventory-Short Form and Social Support Rating Scale measured FCR severity and perceived social support. LPA was performed using severity scores of nine MSAS symptoms to determine the optimal symptom profile model. Three symptom phenotypes were identified: Emotion-reactive (33.9%), Somatic-burden fatigue-pain (13.2%), and Regulated low-symptom (52.9%). Significant differences among these phenotypes were observed in medical burden, treatment method, activities of daily living, and illness cognition (P < 0.05). FCR levels were significantly higher in the Emotion-reactive and Somatic-burden phenotypes compared with the Regulated low-symptom phenotype (p < 0.001, η2p = 0.199), with no difference between the two high-symptom phenotypes. After adjusting for covariates, differences in perceived social support across symptom phenotypes were not significant (p = 0.119, η2p = 0.012). Breast cancer survivors exhibit substantial heterogeneity in symptom phenotypes: those with Emotion-reactive and Somatic-burden fatigue-pain phenotypes experience higher FCR levels, whereas individuals with the Regulated low-symptom phenotype show better symptom control and comparatively lower FCR levels. Integrating symptom phenotypes with FCR may aid rapid identification of high-risk subgroups and support precision nursing in survivorship care.

Purpose: Psychosomatic symptoms are frequently observed side effects in breast cancer (BC) patients and significantly influence cognitive function. However, limited research has addressed the role of psychosomatic symptoms in the relationship between physical activity and cognitive function. This study aimed to examine the mediating effect of psychosomatic symptoms on the relationship between physical activity and cognitive function in BC patients. Methods: A cross-sectional study was conducted across 10 hospitals in China from April 2022 to February 2023. Cognitive function was assessed using the Functional Assessment of Cancer Therapy-Cognitive Function scale. Exercise frequency, sleep quality, fatigue, anxiety, and depression were measured using the Pittsburgh Sleep Quality Index questionnaire, Cancer Fatigue Scale, Generalized Anxiety Disorder Questionnaire-7, and Patient Health Questionnaire-9, respectively, among 741 BC patients. Correlation analysis and path analysis were performed to explore associations between variables. Results: The prevalence of cognitive impairment in BC patients was found to be 9.58%. The path model demonstrated the best fit when age was included as a moderating variable, and the association between age and sleep disorders was controlled. Physical activity showed a negative correlation with both psychosomatic symptoms and cognitive impairment (p < 0.05). It exerted a direct impact on cognitive impairment (20.3%, p < 0.001) and an indirect impact mediated through anxiety and depression (6.3%, p < 0.001). The total effect in the model was 38.6% (p < 0.001). Conclusion: Physical activity has a pivotal role in improving cognitive function in BC patients, both through direct mechanisms and indirectly by reducing anxiety and depression. While enhancements in sleep quality and fatigue levels were observed, their influence on cognitive function did not reach statistical significance, indicating the need for further research. These findings underscore the importance of incorporating psychological symptom management into supportive care plans to aid cognitive recovery. A combination of physical activity and psychological interventions could provide synergistic benefits, potentially boosting cognitive improvement and enhancing the overall quality of life in BC patients.

This study aims to explore the feasibility of Nurse Employee Assistance Programs (NEAPs) in China and identify associated factors influencing NEAPs implementation from nurse administrators' perceptions. A qualitative approach was undertaken with 21 participants recruited from 7 tertiary hospitals in China that were conducting trials with NEAPs. Semi-structured interviews were carried out, recorded, and transcribed. Thematic analysis was used to identify themes in the data. Two main themes and five sub-themes were formed. Factors associated with NEAPs implementation were identified as individual level (self-stigma and confidentiality), organizational level (NEAPs funds, human resources, and venue setting), national level (national policy, NEAPs certification, and the guidelines of NEAPs implementation). NEAPs are important in solving burnout, compassion fatigue, and moral distress among Chinese nurses. NEAPs in China are still at an exploratory level, and some factors have hindered or promoted this innovation of NEAPs. Therefore, nurse administrators should establish a mutual-help environment and gain support from organizations and nations to foster NEAPs implementation.

Purpose: This study aimed to investigate the factors associated with perceived cognitive function among breast cancer patients treated with chemotherapy in China. Methods: The study was a multicenter cross-sectional design. Data were collected from 10 public hospitals in China between April 2022 and February 2023. A total of 741 participants completed questionnaires assessing sociodemographic and medical characteristics, perceived cognitive function, sleep quality, fatigue, anxiety, and depression. Hierarchical multiple regression analysis was used to assess the determinants of cognitive function. Results: The hierarchical multiple regression model accounted for 31.5% of variation in perceived cognitive function (sociodemographic 4.5%; medical 6.6%; exercise frequency 6.6%; sleep quality 2.1%; fatigue 2.8%; anxiety combined with depression 9.0%). Education level, chemotherapy type, number of chemotherapy cycles, and cyclophosphamide drug use were significant predisposing factors of perceived cognitive function (p < 0.001). Exercising >= 3 times/week (p < 0.001) was a significant factor positively influencing perceived cognitive function, meanwhile, anxiety (p < 0.001) and depression (p < 0 0.001) were negative factors. Conclusion: Our findings suggest that patients with low education levels, postoperative chemotherapy, cyclophosphamide treatment, and a greater number of chemotherapy cycles need more assessment. Sedentary patients, those who have never exercised, and those with anxiety or depression all showed greater cognitive decline. By identifying susceptible populations, encouraging regular exercise, and addressing anxiety and depression, healthcare professionals can contribute significantly to prevent patients' cognitive decline throughout chemotherapy.

Purpose To identify risk factors of chemotherapy-related cognitive impairment (CRCI) and construct and validate a visual prediction model of such for patients with breast cancer. Methods A multicenter, descriptive, and cross-sectional design was adopted. Data were collected from ten public tertiary hospitals in China. Cognitive function was assessed by using Functional Assessment of Cancer Therapy—cognitive function. Socio-demographic, clinical, psychological, and physical indicators were also assessed. The logistic prediction model was constructed by fivefold cross-validation. Then, a nomogram was utilized to visualize the prediction model, which was also evaluated via discrimination, calibration, and decision curve analysis. Results A total of 71 breast cancer patients had CRCI with a prevalence of 9.58%. This visual prediction model was constructed based on education background, exercise frequency, chemotherapy times, and fatigue and demonstrated good discrimination, with an area under the receiver operating characteristic curve of 0.882. The calibration curve indicated good agreement between experimental and projected values, and the decision curve proved good clinical applicability. Conclusion Education background, exercise frequency, chemotherapy times, and fatigue were associated with high incidence of CRCI. The prediction model exhibits superior performance and has promise as a useful instrument for assessing the likelihood of CRCI in breast cancer patients. Implications for cancer survivors Our findings could provide breast cancer survivors with risk screening based on CRCI predictors to implement prevention and early intervention, and help patients integrate into society and achieve comprehensive recovery.

PURPOSE:Breast cancer is a major cause of morbidity worldwide and first-degree relatives of breast cancer survivors have a significantly higher risk of breast cancer that can be reduced by altering controllable risk factors. This study examined protective behavioral strategies used to cope with the risk in female first-degree relatives based on descriptions of their experiences, as well as their reason(s) for choosing a particular coping strategy.METHODS:A total of 25 first-degree relatives of breast cancer survivors in 13 families were recruited for this descriptive qualitative study. Data were collected between January and November 2020 through individual interviews, and a thematic analysis was performed using MAXQDA software.RESULTS:Three themes under an overarching theme of 'competition with breast cancer risk' were identified: (1) protective behavioral strategies for coping with breast cancer risk (four coping types); (2) barriers and facilitators for behavior change (five unfavorable and favorable factors related to the type of coping); and (3) significant determinants of coping strategy types. Based on these three themes, we developed a Personal restrictions, Exposure hazards, Adverse circumstances, Coping ability, Endorsement from social network, and Significant determinants ('PEACE-S') scale model of first-degree relatives' strategies for coping with breast cancer risk.CONCLUSIONS:First-degree relatives present different risk coping strategies that are shaped by individual and external factors and specific determinants. Our results provide insights that can help healthcare professionals design targeted interventions based on first-degree relatives' individual circumstances to mitigate breast cancer risk in this group through the adoption of healthy lifestyle choices.

Objective:To explore the effect of hypnotic music therapy in reducing eye pain in patients with diabetic retinopathy undergoing panretinal photocoagulation (PRP) .Methods:From January 2019 to January 2020, 60 diabetic retinopathy patients undergoing PRP admitted to Beijing Tiantan Hospital, Capital Medical University, were selected as the research object. Patients were divided into the control group and intervention group using the random number table method, with 30 cases in each group. Control group carried out routine high-quality nursing, and intervention group implemented hypnotic music therapy on the basis of control group. We observed the pain (Visual Analogue Score, VAS) , pain nursing satisfaction (Patient Satisfaction Scale) , anxiety (Self-rating Anxiety Scale, SAS) and depression (Self-rating Depression Scale, SDS) of the two groups of patients after PRP.Results:The pain scores of the 4 quadrants of the retina after PRP in intervention group were lower than those in control group, and the difference was statistically significant ( P< 0.05) . The SAS score and SDS score of intervention group after intervention were lower than those of control group, the difference was statistically significant ( P<0.05) . The pain nursing satisfaction score of intervention group was higher than that of control group, and the difference was also statistically significant ( P<0.05) . Conclusions:The application of hypnotic music therapy can reduce the degree of pain during the operation of diabetic retinopathy patients undergoing PRP, relieve anxiety and depression, improve nursing satisfaction, and enable patients to cooperate well with treatment.

Purpose Breast cancer affects survivors and their first-degree relatives. They face breast cancer together as a unit. This study aimed to explore the mutual support of breast cancer survivors and their first-degree relatives in their joint coping with breast cancer. Methods A qualitative case study with purposeful sampling was conducted. Ten breast cancer survivors and 21 of their first-degree relatives were recruited for in-depth interviews. Data were analyzed by thematic analysis using MAXQDA software. Results Three themes were extracted under the overarching theme “a shared journey to a better future”: 1. “Mutual support is needed as we are in the same boat,” suggesting mutual support in responding to breast cancer; 2. “We experience stormy and windy weather during our journey,” emphasizing challenges encountered in providing support; and 3. “Sunny and breezy days are a gift for both of us,” indicating they perceived reciprocity during the process of mutual support. Conclusions Mutual support was an important feature of breast cancer survivors and first-degree relatives coping with breast cancer and beneficial to both groups. However, significant challenges in supporting each other were reported, indicating the necessity of external support in coping with breast cancer. Health professionals should not ignore first-degree relatives of breast cancer survivors, and need to support both of these groups.

OBJECTIVE:Due to the coronavirus disease 2019 (COVID-19) pandemic, self-isolation at home was adopted to control the spread of COVID-19 in China for 3 months from 29 January 2020. The psychological status of cancer survivors is affected by their social environment. In this study, we investigated the psychological status and psychological symptoms of Chinese cancer survivors.METHODS:A longitudinal study design was adopted, and an online sample of cancer survivors was successfully recruited via the Internet communities of cancer support groups. From 14 February to 25 May, 111 cancer survivor families completed the symptom checklist 90 (SCL-90) online three times (T1:14 to 24 February; T2: 1 to 10 April; T3: 15 to 25 May).RESULTS:For survivors and their family members, the mean total score of the SCL-90 was 172.05 (13.30) and 142.76 (26.80) at T1, 155.91 (12.18) and 133.42 (15.93) at T2, and 142.75 (11.56) and 130.14 (14.16) at T3, respectively. The SCL-90 scores of cancer survivors were significantly higher than those of family members and Chinese norms at T1, T2, and T3. Nine psychological symptoms of the SCL-90 in cancer survivors significantly declined from T1 to T2 and T3.CONCLUSIONS:The COVID-19 pandemic has had a significant adverse impact on cancer survivors and their families. Psychological assistance should be provided to cancer survivors.

目的:调查乳腺癌患者的重返工作现状,并分析其影响因素.方法 :应用方便抽样法,在2018年7月至2019年9月运用一般资料调查表、重返工作准备度量表、一般自我效能感量表、简易应对量表对北京市4家三级甲等医院就诊的306例乳腺癌患者进行调查.结果 :调查对象中有67例患者已重返工作,重返率为21.9％;年龄、自我效能感、病程、腋窝淋巴结是否清扫和每周工作时间是乳腺癌患者重返工作的影响因素.结论 :乳腺癌患者重返工作率有所提高,医护人员应关注患者重返工作的影响因素,开发有针对性的干预方案帮助患者重返工作.

目的 探讨团体认知行为疗法对化疗期乳腺癌失眠患者睡眠质量和焦虑抑郁水平的影响.方法 选择2018年8月—2019年2月在首都医科大学附属北京天坛医院化疗的乳腺癌失眠患者62例,采用随机数字表法分为干预组和对照组,每组31例.对照组实施常规护理,干预组在对照组基础上给予为期6周的团体认知行为疗法干预.比较两组患者在干预前后匹兹堡睡眠质量指数量表(PSQI)及医院焦虑抑郁量表评分.结果 干预后,干预组入睡时间、睡眠效率、睡眠障碍、日间功能障碍及PSQI总分均低于干预前(P<0.05),且睡眠质量、入睡时间、睡眠时间、睡眠效率4个维度及PSQI总分显著低于对照组(P<0.05);医院焦虑抑郁量表各维度评分及总分显著低于干预前,且干预组低于对照组,差异有统计学意义(P<0.05).结论 团体认知行为疗法有助于改善化疗期乳腺癌失眠患者的睡眠质量,同时对降低其焦虑、抑郁情绪有较好的效果.

目的 了解乳腺癌化疗患者的尊严现状,分析其影响因素.方法 采用方便抽样法,2019年4—6月抽取北京市7所三级甲等医院的乳腺癌化疗患者作为研究对象.采用一般资料调查问卷、患者尊严量表、心理痛苦温度计及领悟社会支持量表,对其进行调查.采用多元线性回归分析乳腺癌化疗患者尊严的影响因素.结果 本组乳腺癌化疗患者尊严得分为(38.21±12.98)分;多元线性回归分析结果显示,治疗方案、心理痛苦、社会支持进入回归方程(P<0.01),共解释乳腺癌化疗患者尊严总变异的41.6％.结论 本组乳腺癌化疗患者的尊严处于轻度受损水平,建议医护人员重点关注有乳腺切除术史、心理痛苦评分较高及社会支持得分较低的乳腺癌化疗患者,根据其情况进行个性化指导,鼓励乳腺癌化疗患者之间多交流,鼓励亲友多向患者表达关心和爱,从而提高患者的尊严水平.

Objective:To evaluate the dry eye status of nursing school students and understand their ocular surface health.Methods:Using the convenience sampling method, a total of 90 nursing students studying in the Nursing College of Capital Medical University in March 2018 were selected as the research objects. The OCULUS Jenvis-OSDI dry eye questionnaire and OCULUS ocular surface comprehensive analyzer were used subjectively and objectively to analyze the heath of ocular surface.Results:According to the OSDI dry eye questionnaire, mild dry eyes were 21 cases accounted for 23.3%, moderate dry eyes were 42 cases accounted for 46.7%, and severe dry eyes were 21 cases accounted for 23.3%. The main symptom of dry eye was foreign body sensation, accounting for 53.3%. The secondary symptoms were photophobia and blurred vision, which accounted for 46.7% and 40%, respectively. The OCULUS ocular surface comprehensive analyzer showed that the amount of tear secretion in both eyes was normal. In dry eye grading based on average tear film break-up time, critical dry eye accounted for about 60% and dry eye accounted for about 10%. Eye red analysis showed that 9 patients (10%) with hyperemia score>2.0 were dry eye caused by inflammation.Conclusions:The nursing school students have a high incidence of dry eye and subjective symptoms. It indicates that the students overuse eye and do not pay attention to eye hygiene. It is the responsibility of the nursing teacher to carry out health education for students, popularize scientific and rational use of eye knowledge, and pay attention to eye health.

Objective We investigated the effects of mindfulness-based cognitive therapy on insomnia (MBCT-I) in breast cancer survivors. Methods In total, 136 participants were allocated randomly to a MBCT-I group or a waitlist control (WLC) group. Indicators of insomnia and mindfulness were evaluated using the Insomnia Severity Index, actigraphy and the Five Facet Mindfulness Questionnaire. Data were collected at baseline (T1), post-intervention (T2), 3-month follow-up (T3) and 6-month follow-up (T4) time points. Results Insomnia severity decreased significantly in the MBCT-I group, compared with the WLC group, at T2, T3 and T4 (all p < .001). We found that 59.6% of the MBCT-I group with moderate and severe insomnia improved to no insomnia and subclinical insomnia at T4 relative to T1, accounting for 7.9% and 55.3%, respectively. Compared with the WLC group, the MBCT-I group improved on actigraphy measures of sleep; they exhibited a pattern of decreased sleep onset latency and waking after sleep onset, as well as increased total sleep time and sleep efficiency. Mindfulness also increased more in the MBCT-I group than in the WLC group at T2, T3 and T4 (all p < .001). Conclusions MBCT-I may be an efficacious non-pharmacologic intervention to improve sleep quality in breast cancer survivors.

目的 探讨催眠疗法对乳腺癌患者化疗所致的恶心呕吐的干预效果.方法 选取2017年7月～2018年8月首都医科大学附属北京天坛医院接受化疗的乳腺癌患者1 10例为研究对象,按随机数字表法将其分为试验组(56例)和对照组(54例).对照组采用常规治疗护理,试验组在对照组的基础上实施催眠疗法干预.比较两组干预前后恶心呕吐频率、程度、化疗依从性.结果 两组恶心呕吐发生率比较,差异无统计学意义(P＞0.05);试验组恶心呕吐程度低于对照组,差异有统计学意义(P＜0.05).试验组依从率高于对照组,差异有统计学意义(P＜0.05).结论 催眠疗法可有效降低乳腺癌化疗患者的恶心呕吐程度,提高患者化疗依从性.

Objective:To explore the curative effect of ginger combined with tropisetron on preventing nausea and vomiting caused by chemotherapy in patients with breast cancer.Methods:80 patients with breast cancer who received first chemotherapy from Beijing Tiantan Hospital from April 2019 to December 2019 were selected by the convenient sampling method. According to the random number table method, they were divided into the control group and the intervention group, with 40 cases in each group. The control group received intravenous tropisetron before routine chemotherapy to prevent nausea and vomiting. On this basis, patients in the intervention group took slices of fresh ginger under the tongue 30 min before chemotherapy and applied the slices of fresh ginger to Shenque acupoint and Neiguan acupoint. The degree of nausea and vomiting after chemotherapy and compliance with chemotherapy were compared between the two groups.Results:On 0 to 5 d after chemotherapy, there were 7 patients with nausea of grade Ⅱ and Ⅲ in the intervention group and 18 patients with nausea of grade Ⅱ and Ⅲ in the control group. There were 4 patients with vomiting of grade Ⅱ and Ⅲ in the intervention group and 18 patients with vomiting of gradeⅡ and Ⅲ in the control group. There were statistically significant differences in the degrees of nausea and vomiting between the two groups ( Z=-2.980, -4.151; P<0.05) . There was no statistically significant difference in chemotherapy compliance between the two groups ( P>0.05) . Conclusions:Ginger in mouth and ginger point application combined with tropisetron can effectively alleviate chemotherapy-induced nausea and vomiting symptoms.