Background:Breast cancer-related lymphedema is the most prevalent postoperative complication among breast cancer survivors. Although mobile health tools are increasingly used for patient education, evidence supporting their efficacy in lymphedema prevention remains limited. Objective:This study aimed to evaluate the effectiveness of a WeChat-based intervention grounded in the common-sense model (CSM) in improving preventive behaviors, modifying illness perceptions, and reducing lymphedema incidence among breast cancer survivors and to validate the targets of the intervention. Methods:This study used a quasi-experimental design. Participants (N=192) were recruited from the breast cancer department of a cancer hospital in Guangzhou, China. The control group (n=98) received routine care. The intervention group (n=94) participated in a 3-month CSM-guided WeChat mini-program ("Nantian e-Care") delivering tailored educational articles, exercise tutorials, arm circumference monitoring, and real-time nurse consultations. Outcomes, including preventive behaviors, illness perceptions, and lymphedema incidence, were assessed 1, 3, and 6 months post surgery. Generalized estimating equations were used for the analysis. Results:The intervention group exhibited significant improvements in lifestyle adjustments (Wald χ22=6.9, P=.03) and physical exercise adherence (Wald χ22=6.9, P=.03) compared with the control group. Illness perception, including identity (Wald χ23=8.1, P=.04), timeline cyclical (Wald χ23=8.5, P=.04), personal control (Wald χ23=9.3, P=.03), illness coherence (Wald χ23=29.8, P<.001), and behavioral (Wald χ23=19.5, P<.001) and physical factors (Wald χ23=24.1, P<.001) were markedly enhanced. Mechanistically, skin care improvements were driven by intervention effects, personal control, illness coherence, and behavioral attribution. Lifestyle changes were correlated with intervention and illness coherence. Adherence to physical exercise was not statistically significantly affected by the intervention, although a trend was observed. Critically, the intervention group demonstrated a lower incidence of lymphedema at 6 months (7.50% vs 16.48%, χ21=3.9, P=.048). Conclusions:The CSM-guided WeChat intervention effectively promoted preventive behaviors, optimized illness perceptions, and reduced lymphedema risk. These findings underscore the value of integrating theory-driven mobile health tools into postoperative care and highlight scalable strategies for chronic disease management in resource-limited settings.

Purpose To describe the illness perception, dyadic coping, and marital quality of cervical cancer patient-husband dyads. In addition, we explore the direct effects of illness perception on marital quality, and whether dyadic coping acts as a mediator in this process. Methods A cross-sectional design was employed. The Revised Illness Perception Questionnaire for Cervical Cancer, the Dyadic Coping Inventory, and the Marital Adjustment Test were used to assess illness perception, dyadic coping, and marital quality. Dyadic analysis was conducted by constructing the actor‒partner interdependence mediation model. Results A total of 175 dyads of postoperative cervical cancer patients and their husbands completed the questionnaires. The dyads reported suboptimal scores for both marital quality and dyadic coping. For direct effects of illness perception on marital quality, our model indicated that the positive illness perception of patients and negative illness perception of husbands can negatively impact their own marital quality. With respect to the indirect effects of dyadic coping acting as a mediator, both positive illness perception and negative illness perception of husbands can impact their own marital quality through their own dyadic coping and can also impact patients' marital quality through patients’ dyadic coping. Conclusions This study highlights that the level of marital quality and dyadic coping in dyads need to be improved, demonstrates the significance of illness perception for influencing dyads’ marital quality and reveals the underlying mediating mechanism of dyadic coping. This study provides guidance for illness perception-based dyadic interventions to improve marital quality among cervical cancer patients and husbands.

PURPOSE:Breast cancer patients and their spouses often encounter emotional and physical challenges after surgery that shape how they perceive and manage the illness. Guided by the Self-Regulation Model, this study examined whether discrepancies in illness perceptions between partners predict their respective illness management behaviors three months after surgery. METHODS:The descriptive longitudinal study was conducted with 295 breast cancer patient-spouse dyads recruited by convenience sampling between August 2021 and April 2023. Illness perceptions were assessed during hospitalization by using the Chinese version of the Revised Illness Perception Questionnaire for Breast Cancer (CIPQ-R-BC) (patient/spouse version), and illness management behaviors were measured three months later using the Cancer Self-Management Assessment Scale (CSMAS) for patients and the Caregiver Contribution to Cancer Patient Self-Management Scale (CC-CPSMS) for spouses. Paired t-tests were used to examine perception differences, and pathway analyses explored how these discrepancies predicted illness management behaviors. RESULTS:Patients reported more negative emotions, less overall illness understanding, and confidence in their own efforts on the prognosis than their spouses. Discrepancies within patient-spouse dyads regarding timeline acute/chronic, treatment control, illness coherence, and timeline cyclical negatively predicted patients' illness management behaviors. Conversely, differences in perceived causes (metabolic comprehensive, environmental/immune, and uncontrolled factors) were the positive predictors of dyads' illness management behaviors. Additionally, greater dissimilarities in emotional representations were associated with poorer behavioral outcomes within dyads. CONCLUSION:Perceptual discrepancies significantly influence illness management behaviors among breast cancer patient-spouse dyads. Dyadic interventions should target these gaps to improve outcomes. Targeting the perceptual gaps through dyadic, theory-based interventions may enhance the behavioral outcomes for both members of the breast cancer patient-spouse dyad during the oncology clinical settings.

Objectives: This study aimed to investigate the associations between inner strength (IS), illness perception (IP) and self-management (SM) in older adults with advanced lung cancer. Methods: A cross-sectional survey was conducted with 222 patients recruited via convenience sampling between December 2021 and February 2023. SM, IP, and IS were measured using the Cancer Self-Management Assessment Scale, the Revised Illness Perception Questionnaire for lung cancer patients, and the Inner Strength Scale. Data were analyzed using descriptive statistics, Pearson correlation analysis, and structural equation modeling (SEM). Results: Participants exhibited moderate levels of SM, with the lowest scores observed for the symptom management dimension. Both SM and IS were negatively associated with negative illness perception (NIP) (rSM: -0.500, -0.149, p < 0.05; rIS: -0.519, -0.250, p < 0.001), and positively associated with positive illness perception (PIP) (rSM: 0.360, 0.565, p < 0.001; rIS: 0.233, 0.467, p < 0.001). Among the various dimensions of IP, personal control (representing PIP) and emotional representations (representing NIP) exhibited the strongest associations with SM (rPIP = 0.565, p < 0.001; rNIP = -0.500, p < 0.001). A positive relationship was observed between SM and IS (r = 0.427, p < 0.001). SEM indicated that IS partially mediated the associations between SM and both NIP and PIP (βNIP = -0.120, 95%CINIP: -0.234, -0.013, p = 0.032; βPIP = 0.132, 95%CIPIP: 0.011, 0.246, p = 0.028). Conclusions: The SM of older adults with advanced lung cancer remains suboptimal. IS may play an important mediating role in the association of both NIP and PIP with SM. These findings highlight that both IP and IS are key factors associated with SM in older adults with advanced lung cancer. Therefore, future research and clinical interventions should target these factors to improve SM in this population.

CONTEXT:Improving illness management among postoperative breast cancer patient-spouse dyads is important for prognosis, and dyadic coping is a key influencing factor. However, current evidence has primarily focused on psychological outcomes, while the dyadic roles of dyadic coping in behavioral process remain underexplored, particularly from a dimensional perspective. OBJECTIVES:To examine and compare illness management and dyadic coping among postoperative breast cancer patients and their spouses, and investigate the dyadic effects of dyadic coping on illness management. METHODS:A total of 232 dyads of breast cancer patients and their spouses were recruited in China between December 2023 and September 2024. At three months postsurgery, patients and spouses completed the Cancer Self-Management Assessment Scale and the Caregiver's Contribution to Cancer Patient's Self-Management Scale, respectively, to assess illness management. Dyadic coping was measured using the Chinese version of the Dyadic Coping Inventory, including stress communication, supportive dyadic coping, delegated dyadic coping, common dyadic coping, and negative dyadic coping. The Actor-Partner Interdependence Model was used to examine dyadic effects between dyadic coping dimensions and illness management. RESULTS:Dyadic model results indicated that patients' or spouses' stress communication, supportive dyadic coping and common dyadic coping showed positive actor effects on their own illness management. Patients' stress communication and delegated dyadic coping had positive partner effects on spouses' illness management, while spouses' negative dyadic coping exhibited both negative actor and partner effects on their own and patients' illness management. CONCLUSIONS:This study demonstrated the important roles of dyadic coping in illness management, offering guidance for developing dyadic coping-targeted dyadic interventions to optimize dyads' behavioral outcomes.

Objective:Readiness for return to work (RRTW) is a critical stage in the return-to-work process and deserves significant attention. Researchers have found that RRTW is related to symptom burden and fear of cancer recurrence (FCR). This study aimed to (1) describe RRTW among lung cancer patients, (2) examine the relationships among symptom burden, FCR, and RRTW, and (3) explore the mediating role of FCR between symptom burden and RRTW. Methods:A cross-sectional survey was conducted among 208 lung cancer patients from February 2023 to May 2025 at a tertiary hospital in China. The RRTW Scale, the Fear of Progression Questionnaire-Short Form (FoP-Q-SF), M.D. Anderson Symptom Inventory-Chinese Version (MDASI-C) and the MDASI Lung Cancer-Specific Module (MDAS-LC) were used. Results:The contemplation dimension scored highest (3.36 ​± ​1.09) in RRTW, and the actions-evaluation dimension scored lowest (2.57 ​± ​0.97). Symptom burden was significantly positively associated with the actions-behavior dimension of RRTW (r ​= ​0.183, P ​< ​0.01). FCR showed positive correlations with all four RRTW dimensions (r ​= ​0.147-0.272, P ​< ​0.05). The structural equation model showed that FCR significantly mediated the relationship between symptom burden and RRTW. Conclusions:FCR had a significant mediating effect on symptom burden and RRTW. These findings highlight the importance of assessing symptom burden and FCR in postoperative lung cancer care and provide a basis for future research to explore strategies that may enhance RRTW.

Mobile health applications have been widely adopted among breast cancer survivors for disease management; however, their use specifically for the prevention of breast cancer-related lymphedema (BCRL) remains sparse. This study is aimed at developing a WeChat-based intervention program for the prevention of BCRL based on the common-sense model (CSM). This study was designed based on intervention mapping. First, a longitudinal investigation was conducted to determine the predictive effect of illness perception on BCRL prevention behaviors among breast cancer survivors. An intervention program was then constructed based on the CSM and longitudinal results. Finally, a WeChat mini-program was developed, and 15 patients were recruited to test its usability and user satisfaction through usability tests based on typical tasks and the Post-Study System Usability Questionnaire (PSSUQ), respectively. The longitudinal study revealed that identity, personal control, illness coherence, and behavioral and physical factors in the causes dimension could positively predict prevention behaviors, whereas treatment control and uncontrollable factors exhibited negative predictive effects. This study then developed an individualized intervention program and a WeChat mini-program (named “Nantian e-Care”) consisting of five modules: “resources,” “questionnaires,” “homepage,” “consultation,” and “personal center.” Patients could read BCRL-related educational content, watch functional exercise videos, self-measure arm circumference, and consult questions. The five-task completion rates were 80.00 100.00 https://www.chictr.org.cn/ , ChiCTR2100048798.

BACKGROUND:Lower extremity lymphedema (LEL) is a debilitating complication for patients with gynecologic cancer. A series of strategies have been recommended to mitigate the risk of LEL and improve patient outcomes; however, investigation into LEL risk management behaviours in this population is limited, and the absence of reliable and valid tools is an important reason. AIMS:To develop and evaluate the psychometric properties of the lower extremity lymphedema risk management behaviours questionnaire (LELRMBQ) for Chinese patients with gynaecologic cancer. DESIGN:This was a methodological study. METHODS:Initial items were generated using a literature review. The initial LELRMBQ was refined, and its content validity was evaluated by conducting two rounds of expert consultation and a pilot study. Psychometric testing of 389 participants recruited by convenience sampling was conducted from December 2022 to June 2023. Exploratory factor analysis (EFA; subsample 1, N = 158) and confirmatory factor analysis (CFA; subsample 2, N = 231) were performed separately to determine the multi-dimensional structure of the questionnaire. Known-group validity, internal consistency reliability, and test-retest reliability were also evaluated. RESULTS:A total of 25 items with satisfactory content validity were included in psychometric testing. The EFA identified a four-factor structure, comprising 18 items, which explained 74.49% of the total variance. The CFA supported this structure with acceptable fit indices. Known-group validity was partially supported by significant differences in total LELRMBQ scores among groups with different education levels, residence, cancer type, and LEL awareness. Internal consistency and temporal stability were acceptable. CONCLUSIONS:The 18-item LELRMBQ demonstrated sufficient reliability and validity as a tool for measuring LEL risk management behaviours in patients with gynaecologic cancer. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE:The LELRMBQ has potential applicability in assessing LEL risk management behaviours, identifying gaps in educational practices, tailoring effective interventions, and evaluating intervention effectiveness. REPORTING METHOD:This manuscript followed the STROBE guidelines. PATIENT OR PUBLIC CONTRIBUTION:Patients with gynecologic cancer participated in this study and provided the data through the survey.

BackgroundIn breast cancer patients, alexithymia has been found to correlate with poorer quality of life. While previous research has established a connection between alexithymia and various outcomes, the mediating effect of social support and self-compassion—promoting quality of life—remains largely unexplored, underscoring the need for further investigation in this area.ObjectiveTo examine the mediating role of social support and self-compassion in the association between alexithymia and quality of life in postoperative breast cancer patients.MethodsA cross-sectional correlational study was conducted among 324 postoperative breast cancer patients from a tertiary Grade A hospital in Guangzhou, China. Variables were measured using the Functional Assessment of Cancer Therapy-Breast version 4.0 (FACT-Bv4.0), Toronto Alexithymia Scale (TAS-20), Social Support Rating Scale (SSRS), and Self-Compassion Scale (SCS). Data analyses were performed using descriptive analysis, independent sample t-tests, one-way ANOVA, Pearson correlation analysis, and mediation analyses performed with Hayes’ PROCESS macro for SPSS.ResultsThe study identified alexithymia was negatively associated with quality of life. Additionally, social support and self-compassion mediated the relationship between alexithymia and quality of life in postoperative breast cancer patients.ConclusionThe study highlights the complex interplay between alexithymia, quality of life, social support and self-compassion, emphasizing the significant mediating effects of social support and self-compassion among breast cancer patients. Additionally, the findings imply that interventions targeted at enhancing social support and self-compassion could manage the consequences of alexithymia, and ultimately improve their quality of life.

OBJECTIVES:To describe and compare dyads' illness perceptions, dyadic coping and illness management among breast cancer patients and their spouses. In addition, we explore the direct actor and partner effects of illness perception on illness management, and whether this association is mediated by dyadic coping. DESIGN:A descriptive and longitudinal study. METHODS:Baseline illness perceptions and dyadic coping during hospitalization were measured by using the Illness Perception Questionnaire-revised (IPQ-R) and the Dyadic Coping Inventory (DCI). At the 3rd month after discharge, the Cancer Self-Management Assessment Scale (CSMAS) and the Caregiver's Contribution to the Cancer Patient's Self-Management Scale (CC-CPSMS) were used to test the dyads' illness management. Then, the actor-partner interdependence mediation model (APIMeM) was constructed to explore intrapersonal and interpersonal effects. RESULTS:A total of 225 postsurgical breast cancer patients and their spouses completed the questionnaires. It revealed that patients' or spouses' illness perceptions had both positive and negative direct actor effects on their own illness management (positive: personal control and illness coherence dimension; and negative: timeline acute/chronic, consequence, emotional representation and causes-uncontrollable factors dimension). The significant direct partner effects were only displayed in the timeline acute/chronic dimension. Moreover, dyadic coping had mediating effects on these paths, and only the actor-actor and partner-actor indirect effects were statistically significant. CONCLUSIONS:This study demonstrates the significance of illness perceptions in influencing dyads' illness management and reveals the underlying mediating mechanism of dyadic coping. It can provide more specific guidance for dyadic interventions to optimize dyads' behaviour among breast cancer patients and their spouses.

BACKGROUND:Patients with gynecologic cancer who undergo lymphadenectomy are at increased risk of lower extremity lymphedema (LEL). They are encouraged to be alert to the possibility of LEL and take risk-management measures throughout life. However, we know little about the perception for LEL and adherence to risk-management measures of Chinese patients with gynecologic cancer. OBJECTIVE:To assess the illness perception and risk management behaviors of Chinese gynecologic cancer patients and further examine the effect of illness perception on risk management behaviors. METHODS:This was a cross-sectional study. From June to December 2023, gynecologic cancer patients at risk of LEL were surveyed (n = 223). Questionnaires on illness perception and risk management behaviors specifically for LEL were utilized. Descriptive statistics, Pearson correlation analysis, univariate analysis, and multiple linear regression analysis were used for data analysis. RESULTS:The participants exhibited suboptimal LEL risk management behaviors, with the physical activity dimension receiving the lowest score (3.24 ± 1.02). Patients' self-perceived understanding of LEL was relatively low (2.88 ± 0.83). Multiple linear regression analysis revealed that the identity, cause, and control dimensions of illness perception, as well as several demographic and disease variables, were significant predictors of patients' LEL risk management behaviors. CONCLUSIONS:The LEL risk management behaviors of patients with gynecologic cancer need to be improved. Consideration of perceptions of identity, cause, and control is crucial for enhancing LEL risk management behaviors. IMPLICATIONS FOR PRACTICE:Health professionals can implement targeted health education based on an assessment of patients' perceptions of LEL, thereby promoting lymphedema risk management.

Background Intention is an important factor in encouraging patients to receive cardiac rehabilitation. Illness perceptions of patients and individuals around them, such as family caregivers, may influence intention. However, no study has explored how family caregivers’ illness perceptions enhance older coronary heart disease (CHD) patients’ phase II cardiac rehabilitation intentions. Objectives To describe older CHD patients’ phase II cardiac rehabilitation intentions and their relationship with family caregivers’ illness perceptions and to examine the mediating role of patients’ illness perceptions. Methods A descriptive cross-sectional study was conducted among 202 older CHD patient‒family caregiver dyads. The Chinese versions of the Revised Illness Perception Questionnaire, Willingness to Participate in Cardiac Rehabilitation Questionnaire (WPCRQ), and Cardiac Rehabilitation Inventory (CRI) were adopted. Data analysis included descriptive statistics, Pearson correlations, and structural equation modeling. Reporting followed the STROBE checklist. Results Patients were 69.81 years and mostly male (64.85 %); family caregivers were 52.58 years and mostly female (55.94 %). Family caregivers’ personal control had a direct effect on patients’ phase II cardiac rehabilitation intentions (βWPCRQ = -0.217, βCRI = -0.228; P = 0.001). Family caregivers’ personal control, treatment control, and timeline acute/chronic had indirect effects on patients’ cardiac rehabilitation intentions through patients’ corresponding dimensions of illness perceptions (|β|WPCRQ = 0.086∼0.098, |β|CRI = 0.062∼0.097; P < 0.05). Conclusion Family caregivers’ illness perceptions can affect patients’ phase II cardiac rehabilitation intentions directly and indirectly through patients’ illness perceptions. Interventions targeting illness perceptions in both older CHD patients and their family caregivers could be provided to improve patients’ phase II cardiac rehabilitation intentions.

BACKGROUND:Illness perception affects lymphedema risk-management behaviors. However, little is known about these behavioral changes within 6 months after surgery and how illness perception predicts behavioral trajectories. OBJECTIVE:The aim of this study was to explore the trajectories of lymphedema risk-management behaviors in breast cancer survivors within 6 months after surgery and the predictive role of illness perception. METHODS:Participants were recruited from a cancer hospital in China and completed a baseline survey (Revised Illness Perception Questionnaire) and follow-up assessments (Lymphedema Risk-Management Behavior Questionnaire and the physical exercise compliance dimension of the Functional Exercise Adherence Scale) at the first, third, and sixth months postoperatively. RESULTS:A total of 251 women were analyzed. Regarding the Lymphedema Risk-Management Behavior Questionnaire, the total scores were stable. The scores of the "lifestyle" and "skin care" dimensions showed upward trends; the scores of the "avoiding compression and injury" and "other matters needing attention" dimensions showed downward trends. For "physical exercise compliance," scores remained stable. Furthermore, key illness perceptions (especially "personal control" and "causes") at baseline could predict the starting levels of and changes in behavioral trajectories. CONCLUSION:Different lymphedema risk-management behaviors exhibited different trajectories and could be predicted by illness perception. IMPLICATIONS FOR PRACTICE:Oncology nurses should focus on the early development of behaviors related to "lifestyle" and "skin care" and the later maintenance of "avoiding compression and injury" and "other matters needing attention" during follow-up, as well as help women strengthen their personal control beliefs and correctly understand the causes of lymphedema during hospitalization.

A good intimate relationship (IR) can relieve the psychological distress of patients with cervical cancer and promote a sense of well-being during stressful times. Researchers have found that IR is related to illness perception (IP) and dyadic coping (DC). Therefore, this study aimed to (1) describe the IR of patients with cervical cancer, (2) identify the relationships and pathways among IP, DC and IR in patients with cervical cancer and (3) explore the mediating role of DC between IP and IR in cervical cancer patients. A total of 175 patients with cervical cancer were recruited at a tertiary hospital in China from September 2021 to January 2023. The data were collected through a general demographic and disease-related information questionnaire, the Locke­Wallace Marriage Adjustment Test, the Revised Illness Perception Questionnaire of Cervical Cancer and the Dyadic Coping Inventory. The mean score for intimate relationships was 107.78 (SD = 23.99, range 30–154). Pearson’s correlation analysis revealed that intimate relationships were positively correlated with IP (personal control) and DC (stress communication, supportive DC, delegated DC and common DC) and were negatively correlated with IP (consequence, timeline acute/chronic, timeline cyclical and emotional representation) and negative DC. As for the results of the structural equation model, DC fully mediated the influencing effects of both positive and negative IP on IR. The level of IR of patients with cervical cancer in China should be improved. DC has a significant mediating effect on the link between the IP and IR.

This longitudinal study aims to examine the present state of perceived control, self-management efficacy, and overall quality of life (QoL) in patients with breast cancer undergoing radiotherapy, and gain insight into the dynamic trends and factors that influence the quality of life experienced by patients during the course of radiotherapy. Participants completed the Cancer Experience and Efficacy Scale (CEES), Strategies Used by People to Promote Health (SUPPH), and Functional Assessment of Cancer Therapy- Breast (FACT-B). The data was analyzed using the software SPSS26.0. Repeated measures analysis of variance (ANOVA) and mixed-effects linear models were used to analyze trends in perceived control, self-management efficacy, and QoL at three-time points, as well as factors affecting QoL during radiotherapy. Perceived control and self-management efficacy were associated with QoL over the course of the radiotherapy. Self-management efficacy (β = 0.30, P < 0.001), presence of chemotherapy (β = 18.33, P = 0.024), and duration of illness (β = 2.25, P = 0.028) had a positive effect on the change in QoL, while time (β = − 2.95, P < 0.001), cancer experience (β = − 0.46, P < 0.001), and type of medical insurance (β = − 2.77, P = 0.021) had the negative effect on the change in QoL. The QoL, perceived control, and self-efficacy of patients with breast cancer show dynamic changes during radiotherapy. The higher the self-efficacy, the better the QoL, and the worse the QoL when the sense of disease control is poor. At the same time, more attention should be paid to the QoL of breast cancer radiotherapy patients with a long course of the disease, receiving chemotherapy, and different medical payment methods.

AIMS:The purpose of this study was to investigate the status of self-management behaviour and illness perceptions and to examine illness perceptions in relation to self-management behaviour in elderly patients with chronic obstructive pulmonary disease (COPD). METHODS:A cross-sectional study was conducted, and 152 elderly COPD patients were recruited via the convenience sampling method. The COPD Self-Management Scale and the Revised Illness Perception Questionnaire for COPD patients were used to examine self-management behaviour and illness perceptions. Pearson correlation analysis, univariate analysis and hierarchical linear regression analysis were used to explore illness perceptions in relation to self-management behaviour. RESULTS:The mean overall score for self-management behaviour was 2.90 ± 0.39. Among the subscales of self-management behaviour, information management had the lowest score of 2.20 ± 0.76. Patients' demographic and clinical characteristics, including educational level, smoking status, type of primary caregiver, home oxygen therapy and COPD duration, were found to be significant determinants of self-management behaviour. After controlling for these variables, several illness perception subscales, including treatment control, personal control, coherence, timeline cyclical and identity, were significantly correlated with self-management behaviour. CONCLUSIONS:This study confirmed that elderly COPD patients' self-management behaviour was unsatisfactory and that illness perceptions were significant determinants of self-management behaviour. The findings may contribute to the development of self-management interventions for elderly COPD patients.

Objective: To identify longitudinal trajectories of illness perception (IP) regarding breast cancer-related lym-phedema (BCRL) in the first six months after surgery among women with breast cancer and to explore the predictive effects of demographics and clinical factors on IP trajectories. Methods: From August 2019 to August 2021, a total of 352 patients participated in this study, 328 of whom were included in the data analysis. Demographic and clinical characteristics were collected at baseline (1-3 days after surgery). The BCRL-specific revised illness perception questionnaire was used to measure IP regarding BCRL at baseline and 1 month, 3 months and 6 months post-surgery. A multilevel model was conducted to analyze the data. Results: Over the first six months post-surgery, the "timeline acute/chronic" and "illness coherence" dimensions showed positive growth trajectories; the "personal control" and "treatment control" dimensions presented negative growth trajectories; and the trajectories of identity, consequences, cyclicality and emotional influence perceptions regarding BCRL showed no significant changes. Age, education level, marital status, employment status, family monthly income per person, cancer stage and status of removed lymph nodes were indicated to be predictive factors of IP trajectories. Conclusions: The present study determined significant changes over the first six months post-surgery in four IP dimensions and predictive effects of some demographics and clinical details on IP trajectories. These findings may help healthcare providers know more about the dynamic characteristics of IPs regarding BCRL in patients with breast cancer and assist them in identifying patients with a tendency toward improper IP regarding BCRL.

AIMS:To evaluate the effects of couple-based dyadic interventions on breast cancer patients and their intimate partners and compare the effects between interventions with different durations (<3 months; =3 months; >3 months). DESIGN:A systematic review and meta-analysis. DATA SOURCES:Six English databases, PubMed, Embase, Web of Science Core Collection, the Cochrane Library, Medline, PsycINFO, and three Chinese databases, China National Knowledge Infrastructure (CNKI), WanFang, and Weipu (VIP), from database inception to 19 February 2022. REVIEW METHODS:The quality of the included RCTs was evaluated using the Cochrane risk-of-bias tool and the data analysis was performed by using RevMan 5.4 and Stata 15. The outcomes were categorized into five aspects: dyadic relationship, overall quality of life (QOL), physical health, psychological health and social adjustment. RESULTS:Nineteen RCTs were included. For patients' overall effects, couple-based dyadic interventions can improve sexual frequency, psychological health (anxiety; depression; well-being; body image) and social adjustment (family function-cohesion; social function-total). In the subgroup analysis, it can adjust patients' relationship satisfaction (>3 months), sexual frequency (>3 months), depression (<3 months and >3 months), well-being (>3 months), and body image (3 months). For intimate partners, no statistically significant overall effects were found, and all results in the subgroup analyses showed no statistical significance. CONCLUSIONS:The results revealed the different effects of couple-based dyadic interventions on dyads. It also suggested that tailored intervention duration should be a focus in future studies to obtain the potential actor-partner benefits. IMPACT:This study revealed that the overall effects of the couple-based dyadic interventions include enhancing patients' sexual frequency, psychological health and social adjustment. Clinical practitioners should consider the intimate partners' outcomes and conduct couple-based dyadic interventions that contain more tailored elements to achieve better effects. NO PATIENT OR PUBLIC CONTRIBUTION:Registration: The systematic review and meta-analysis of RCTs has been registered in PROSPERO (Number: CRD 42021286679).

AIM:The aims of the present study are to describe the status of self-management behaviors and illness perception, and explore the relationship between illness perception and self-management behaviors among Chinese diabetic foot patients.METHODS:A cross-sectional study was conducted at the endocrinology department of a comprehensive tertiary hospital in Guangzhou, China. Data were collected on illness perception, self-management behaviors, and demographic and clinical characteristics over 9 months among 156 subjects. Data were analyzed using Pearson correlation analysis, univariate analysis and multiple linear regression analysis.RESULTS:Only 3.2% of participants maintained excellent self-management behaviors. Additionally, the participants perceived diabetic foot as chronic and could be well controlled through treatment. Multiple linear regression analysis revealed that illness perception was associated with self-management behaviors.CONCLUSIONS:Patient illness perception is an important factor influencing self-management behaviors. It may be helpful to improve self-management behaviors by tailoring the content of the intervention to fit the patients' illness perceptions.

Fluid-control adherence was important for hemodialysis (HD) patients, and while significant correlations between treatment adherence and illness perceptions have been found, there is limited research that explored the relationship between illness perceptions and fluid-control adherence. We sought to assess illness perceptions and fluid-control adherence and to explore the relationship between them among Chinese hemodialysis patients. A cross-sectional study of 253 Chinese HD patients was conducted. We recorded sociodemographic and disease characteristics, Revised Illness Perception Questionnaire (IPQ-R) responses, Fluid Control in Hemodialysis Patients Scale (FCHPS) scores and the interdialytic weight gain (IDWG). The total FCHPS score of hemodialysis patients was of a moderate level, and 45.85% hemodialysis patients' IDWG exceeded 3.0 kg. Regression analysis revealed that sex, academic level, marital status, treatment control dimension and causal (physical) factors of illness perceptions explained 12.7% variance in the total FCHPS score. Age, normalized whole-body urea clearance (Kt/V), dry weight (DW) residual urine volume (mL/24 h) and consequence dimension of illness perceptions explained 29.0% variance in IDWG. About mediating effect analysis, positive indirect effects on IDWG were found for identity, consequences and emotional representations through the attitude dimension of FCHPS, and negative indirect effects on IDWG were found for treatment control and illness coherence through the attitude dimension of FCHPS. The results demonstrated that some sociodemographic and clinical characteristics and illness perceptions were associated with fluid-control adherence, and the patient's attitude toward fluid control is an important mediator between illness perceptions and IDWG, implying that attitude can be a focus of intervention programs based on illness perceptions to improve Chinese HD patients' fluid-control adherence.