Background:With the development of digital health platforms, patients with breast cancer are increasingly relying on web-based resources to search for disease-related information. Proper usage of web-based health information by patients with breast cancer is crucial for understanding disease information and participating in treatment decisions. However, in the face of the large amount and complexity of information, it is still unclear how patients can make psychological adjustments and behavioral responses. Problems such as variable information quality and conflicting information are also affecting the cognitive and treatment decision-making process of patients with breast cancer. Objective:This study aims to explore the real experiences of Chinese patients with breast cancer in their search for web-based health information from a phenomenological perspective, providing insights for optimizing future web-based health information support for patients. Methods:This qualitative study used semistructured, in-depth face-to-face interviews to collect data. Through purposive and convenience sampling, 18 female patients with breast cancer were recruited from a tertiary cancer hospital in China. The data saturation principle was observed to determine the endpoint of data collection. The collected data were analyzed using thematic analysis. Results:From 18 original interview documents, three themes and 11 subthemes were categorized as follows: (1) driving force of information search (emotion-based information search, problem-solving-oriented information search), (2) cognitive judgments amidst the information fog (interweaving of multichannel information, judgment of information authenticity, information applicability assessment, cognitive confusion in the context of information conflict, and construction of information meaning), and (3) adaptation under the pressure of web-based information (transform information into action, emotional regulatory coping, build a support network, and acceptance and adjustment of expectations). Conclusions:This study reveals that the experiences of patients with breast cancer within web-based health information environments resemble an information navigation journey. Patients continuously search, evaluate, and adjust within the sea of information to maintain cognitive clarity and emotional equilibrium. The findings offer valuable insights for clinical health care providers, health information platform developers, and policymakers. They can help optimize digital health services and design personalized information support that better meets patients' needs.

BACKGROUND:Accurate estimation of prognosis can help provide early palliative care to patients. However, few studies have developed nomograms that are totally based on objective blood test parameters. The current study constructed a simple and objective prognostic nomogram and validated the model using advanced cancer patients. METHODS:A total of 245 patients were retrospectively analyzed (training sample, n=162; validation sample, n=54), from January 2020 to December 2021. Blood test and demographic data were collated. Cox proportional hazard regression was performed to identify the independent factors, which were built into a nomogram to visualize the probability of patient survival within 30 days. Calibration and discrimination of the model was assessed. The decision curve analysis (DCA) was developed to summarize the performance of the model in supporting decision making. RESULTS:The median survival was 17.0 [8, 37] days and 21.0 [10, 46] days for the training set and the validation set, respectively. Serum calcium (>2.65 mmol/L), neutrophil count (<2 mmol/L and >7 mmol/L), urea (>7.6 nmol/L), and glutamic oxalacetic transaminase (>40 U/L) were identified and an easily obtained nomogram predicting the 30-day probability of mortality was developed. The nomogram model had adequate discrimination and calibration. The Harrell's concordance index (C-index) of the training set and validation set was 0.69 and 0.71, respectively, while the values of the area under the curve (AUC) of the receiver operating characteristic (ROC) curve were 0.76 and 0.70, respectively. CONCLUSIONS:A simple and objective prognostic nomogram model for predicting the 30-day survival of patients with advanced cancer was developed and validated, with adequate calibration and discrimination. It is expected to guide practical prognosis evaluation in the clinical setting. Further validation is still required in a prospective, multicenter, and large sample study.

目的:深入分析医院护士对护理质量督查的态度与建议,为临床制定合理的护理督查方式,构建科学的护理质量评价体系提供参考和依据.方法:应用现象学研究方法,于2021年3月—5月对长沙市某三级甲等医院的14名临床在职护士进行半结构化深度访谈,运用Colaizzi 7步分析法分析资料.结果:护士对护理质量督查的态度与看法可归纳为2个主题:认可质量督查的重要性、认为督查标准过于理想化.护士对护理质量督查的建议可提炼为4个主题:督查者应专业、客观、公平;督查方式应多元化;督查结果应及时反馈并指导改进;督查过程应融入人文关怀理念.结论:护士普遍认可护理质量督查的重要性,不过同时也提出有些督查标准过于理想化.这提示督查者在进行质量督查时应提高自身能力、及时反馈督查结果并提供人文化的督查,同时护理管理者应制定符合临床实际情况的督查评价指标.

This study aimed to conduct a retrospective cross-sectional study to investigate the prevalence of symptoms and symptom clusters on sociodemographic and disease characteristics, as well as factors associated with Do-Not-Resuscitate (DNR) consent. Advanced cancer patients were enrolled between 2018 and 2020 with available data. Demographic and clinical data were obtained for analysis from Hospital Information System (HIS) in China. Symptom clusters were extracted by hierarchical cluster analysis. Chi-square test and multiple logistic regression were conducted to investigate the prevalence characteristics of symptoms and influencing factors of DNR consent, respectively. 798 advanced cancer patients were enrolled. The most prevalent symptoms were pain (93%), anorexia (36.5%), and sleep disorders (34.2%). High heart rate was associated with poor performance status and more symptoms. Three clusters were extracted: fatigue-related, respiratory-circulatory system, and digestive system symptom clusters. The incidence of symptoms was statistically significant in age, gender, education level, residence, BMI, performance status, distress score, ADL, and primary pain level. The DNR signature rate was 15.5%. Female, distant metastasis, in-ward rescue, and appearance of dyspnea were independent influencing factors of DNR signature.Chinese hospitalized cancer patients had more symptoms burden that were influenced by various demographic characteristics, especially pain and fatigue-related symptoms. Concerning the trajectory of vital signs is important among advanced cancer patients. The DNR signature rate was lower and our finding indicating an urgency to accurately assess the prognosis and give more palliative care education to enhance DNR rates and early signing in Chinese context.

Objective. This study aimed to conduct a retrospective observational study to understand the status of characteristics of pain and identify potential variables influencing the clinical presentation of breakthrough cancer pain (BTP) in advanced cancer patients. Methods. Advanced cancer patients over 18 years of age; diagnosed with cancer of any type and stage III or IV in the palliative care ward with available data were enrolled between 2018 and 2020. Demographic data and pain-related information were collected by using structured electronic extraction form from Hospital Information System (HIS). Patients who had well-controlled background pain with an intensity ≤4 on a 0–10 numerical scale for >12 hours/day, the presence of transient exacerbations of pain with moderate-severe intensity (≧5), and clearly distinguish from background pain were regarded to have suffered BTP. Spearman correlation was conducted to explore the relationship between pain score and demographics characteristics. Factors significant in univariate analysis were included in the multiple regression model to explore independent predictive factors associated with the BTP. Results. Of 798 advanced cancer patients, the mean age was 56.7 (SD = 11.84) years. Lung cancer (29.95%) was the most common cancer, and pain (93%) was the most common symptom. More than half (n = 428, 53.6%) of the patients experienced BTP. The median number of BTP episodes was 4 (IQR = 2, 7, range: 1–42). The median intensity of BTP was 6 (IQR = 6, 7, range 5–10). Patients with severe background pain or BTP had longer hospital stay and more symptoms. Besides, more severe background pain was related to higher activity of daily living. Intramuscular injection of hydromorphone hydrochloride was the main medication for BTP onset. Younger age, background pain, anorexia, and constipation were independently associated with the presentation of BTP. BTP pain intensity was independently associated with bloating. Symptom numbers were an independent factor and positively associated with BTP episodes. Conclusions. BTP resulted in poor prognosis, which has a variable presentation depending on interdependent relationships among different characteristics. Good controlling of background pain and assessment of pain-related symptoms are essential for BTP management. BTP should be managed individually, especially the invisible pain among aged patients. Furthermore, BTP-related education and training were still needed.

目的:建立安宁疗护专科护士培训基地,探索以库伯学习圈理论为基础的培训模式,培养高知识储备、高技能水平的专科护士,发挥专科辐射带动作用.方法:以学员需求为导向,以库伯学习圈理论为指导,以提升专科护士岗位胜任力为目标,通过多维度教学内容、多样化教学方式、多家机构实践、多手段考核形式、多方向培训平台、理论实践交互的"5多1交互"模式向学员提供全面专科培训.结果:自我院成为安宁疗护实践基地以来,成功举办了2期湖南省安宁疗护专科护士培训班,共培养87名安宁疗护专科护士;连续2届接收中华护理学会安宁疗护专科护士培训班的学员共48名到我院实践;基地教学质量持续改进,培训基地的建设促进了医院安宁疗护专科的发展.结论:安宁疗护专科护士实践培训基地的建立满足了国内护士的继续教育需求,需要继续加强培训基地建设,完善培养体系,培养更多高层次人才.

目的 分析在乳腺癌护理带教中以问题为导向教学方法的应用价值.方法 选取2017年4月-2018年4月期间该院实习护生44名作为研究对象,随机分为对照组和试验组,各22名,对照组选择常规带教方法,试验组开展以问题为导向的教学法,比较两组成绩情况、对教学方法满意度以及学习积极性.结果 带教前,两组比较理论成绩和操作成绩差异无统计学意义(P＞0.05),实施带教后,试验组理论成绩(93.52±5.61)分与操作成绩(91.65±7.02)分高于对照组,差异有统计学意义(P＜0.05),试验组满意度95.45％高于对照组63.64％,差异有统计学意义(P＜0.05),试验组100.00％表现积极高于对照组54.55％,差异有统计学意义(P＜0.05).结论 乳腺癌护理带教中应用以问题为导向教学法可提升护生成绩,提升教学满意度以及学习积极性,值得推广应用.

Objective:To investigate the effects of individualized dietary instruction on patients with esophageal carcinoma.Methods: A total of 106 cases of radical esophagectomy were randomly divided into the intervention group and the control group,53 cases in each group.The control group was given the routine nursing intervention,while the intervention group was given the individualized diet instruction on the basis of the control group,and the nursing effects of the two groups were compared.Results:The nutritional status of the total serum protein,albumin and lymphocyte count in the intervention group were significantly better than those in the control group (P<0.05).The recovery time of gastrointestinal function and the time of hospitalization were significantly shorter than those of the control group (P<0.05).The complication rate was lower than that of the control group.Conclusion:Individualized dietary instruction can effectively improve the diet of patients with esophageal cancer,promote the recovery of gastrointestinal function and reduce complications.

Objective To explore the occurrence rate of the preoperative nutritional risk and the malnutrition rate with the esophagus cancer. Analyze the influence factors of the nutritional risk and to provide basis of clinical nutrition support.Meth-ods Observe the occurrence rate of the nutrition risk and the malnutrition rate, use independent test and χ2 test to analyze the factor that related to nutrition risk, use logistic regression analysis to find the independent factor of the nutrition risk Results In all the 106 patients there are 84 of them NRS2002 rating≥3, and nutritional risk rate was 79.25% (84/106).13 cases were BMI<18.5kg/㎡, malnutrition rate was 12.26% (13/106). Older than65、professional factor、source of drinking water were the domain factors with nutrition risk. The dietary factor of eating dried fruits and vegetables (t value were 2.244) were the domain factor with malnutrition . Logistic regression analysis show the age, Drinking water source is an independent risk factor for the occurrence of nutritional risk.Conclusion High occurrence rate of nutrition risk will appear to patients who underwent esopha-gus cancer surgery, the clinician should take more effective nutrition support to those patients who under nutrition risk.

Objective:To explore the influence on bed occupancy from improving quality of care procedure. Method:Compare the bed occupancy rate and patients satisfaction before and after with improving of bed reservation, admission and discharge managements procedure in breast oncology floor from October 2013 to March 2014. Result:Bed occupancy rate increased from 88.4%to 104.3%with the improving of quality of care procedure. Patient satisfaction rate increased from 67.0%to 88.3%. Conclusion:Improving quality of care procedure can improve the bed occupancy rate and patient satisfaction rate.