PURPOSE:The level of nutritional literacy reflects the self-management ability of individuals for a healthy diet and serves as a foundation for effective nutritional interventions. This qualitative study aimed to gain a comprehensive insight into the nutritional literacy levels of patients with esophageal cancer who underwent surgery, obtaining information from both patients and medical staff through interviews. METHODS:Based on Nutbeam's health literacy model, 27 participants were selected from December 2023 to February 2024. We used semi-structured interviews and directed content analysis. RESULTS:Sixteen patients who underwent surgery for esophageal cancer and 11 medical staff from the Department of Esophageal Cancer completed the interviews. There were five themes, including attitude and cognition, functional nutrition literacy, interactive nutrition literacy, critical nutrition literacy, and ways to improve patients' nutritional literacy. CONCLUSION:This study investigated the nutritional literacy levels of patients after esophageal cancer surgery from the perspectives of both patients and medical staff, offering comprehensive insights into the assessment of patients' nutritional literacy and the corresponding strategies for improvement. It emphasizes the hierarchical nature of nutritional literacy among patients after surgery and systematically outlines the different levels of nutritional literacy in this population. The results indicated that the level of nutrient literacy was low and exhibited marked differences. This finding suggests that future studies should be individualized, continuous, and comprehensive, following the Nutbeam's health literacy model, to improve patients' nutritional literacy levels.

OBJECTIVE:We aimed to construct and internally validate a frailty risk prediction model in older adults with lung cancer. METHOD:In total, 538 patients were recruited in a grade A tertiary cancer hospital in Tianjin, and patients were randomly divided into the training group (n = 377) and the testing group (n = 166) at a ratio of 7:3. The Frailty Phenotype scale was used to identify frailty and logistic regression analysis was used to identify the risk factors and establish a frailty risk prediction model. RESULTS:In the training group, logistic regression showed that age, fatigue-related symptom cluster, depression, nutritional status, D-dimer level, albumin level, presence of comorbidities, and disease course were independent risk factors for frailty. The areas under the curve (AUCs) of the training and testing groups were 0.921 and 0.872, respectively. A calibration curve of P = 0.447 validated model calibration. The decision curve analysis demonstrated greater clinical benefit when the threshold probability was >20%. CONCLUSION:The prediction model had a favorable prediction power for determining the risk of frailty, contributing to the prevention and screening of frailty. Patients with a frailty risk score of more than 0.374 should be regularly monitored for frailty and receive personalized preventive interventions.

Objective To preliminarily construct the functional modules of the "Internet+" information platform for pain management and continuous nursing care in cancer patients. Methods The function module of the information platform was preliminarily drawn up through literature retrieval.A total of 20 cancer and pain-related clinical management experts were selected by purpose sampling method, and 2 rounds of expert letter consultation were conducted on information platform function modules by Delphi method. Results The index of the functional module of the patient pain management and continuous nursing information platform was finally established, including 3 first-level indicators（system management terminal, patient-side APP, and medical-care terminal APP）, 14 second-level indicators, and 40 third-level indicators. Among them, the index importance score of indicators was 4.60-4.95, the coefficient of variation was 0.04-0.20, the Kendall harmony coefficient was 0.105, and the expert authority coefficient was 0.870. Conclusion The functional modules of the "Internet+" information platform for pain management and continuation of nursing care for cancer patients constructed in this study are scientific, reliable, and important, which provide evidence support for the optimal management of pain information and the practice of remote home care services for cancer patients.

目的:调查了解PD-1/PDL-1治疗的肺癌患者衰弱现状,并分析其影响因素.方法:采用一般情况调查表、微型营养评定法简版、Barthel指数、中文版格列宁根衰弱指标量表、安德森症状评估量表修订版对天津市某三级甲等肿瘤专科医院接受PD-1/PDL-1治疗的190例肺癌患者进行横断面调查.结果:190例患者中,发生衰弱57例(30.0％),23例(12.1％)患者处于衰弱前期,未发生衰弱者110例(57.9％).Lasso回归结果显示,Barthel指数、营养分数、有睡眠问题、合并症数量、症状分数、疲乏、苦恼、健忘、悲伤、便秘和体质量下降是PD-1/PDL-1治疗的肺癌患者衰弱发生的影响因素.结论:PD-1/PDL-1治疗的肺癌患者衰弱发生率较高,应关注自理能力差、营养不良、有睡眠问题、合并症数量≥2以及症状分数高的患者,采取有针对性的干预措施来积极应对,预防或是延缓PD-1/PDL-1治疗的肺癌患者衰弱的发生与发展.

PurposesIn patients with advanced lung cancer, immune checkpoint inhibitors (ICIs) dramatically extended survival. We aimed to investigate the experiences of patients with advanced lung cancer who are receiving ICIs, with a focus on perceptions and sentiments on ICIs, to inform future research and clinical care.MethodsPatients were recruited from January to July 2022 at Tianjin Medical University Hospital Cancer Institute & Hospital. The method of purposive sampling was used. Patients with stage IV lung cancer who were taking ICIs as a single therapy were recruited. Data were gathered using semi-structured and face-to-face interview. An inductive approach to analysis was used.ResultsOf the 42 eligible patients, 27 were invited, 20 agreed to participate, and ultimately 17 patients completed the interview. A total of 5 themes were extracted: suffered from adverse effects but generally tolerable; focus on survival, hope, and expectation; uncertainty about durability of response and the future; poor knowledge and attitude of ICIs; and financial stress and guilt over family.ConclusionThese findings make an important contribution to healthcare professionals' understanding of what it is like to be a patient with advanced lung cancer who is receiving ICIs. In general, the experience of immunotherapy is different from that of chemotherapy; financial and family pressures and uncertainty issues are likely to be heavier in this population. Oncology specialist nurses should provide tailored education to improve the patient's knowledge of immunotherapy, especially to improve risk awareness of immune-related adverse events and objective prognosis expectations.

目的 系统整合癌症患者生育力保存决策体验的质性研究,为辅助癌症患者做决策及改进现有决策支持体系提供循证依据.方法 计算机检索PubMed、EMbase、The Cochrane Library、CINAHL、Web of Science、PsycINFO、Scopus、中国知网、万方数据库、维普数据库关于癌症患者生育力保存决策的质性研究,检索时限为建库至 2022 年 8 月.采用JBI循证卫生保健中心质性研究质量评价标准对文献进行质量评价,采用 Meta整合中汇集性整合方法对结果进行整合.结果 共纳入 18 篇文献,提炼出 67 个研究结果,将相似结果归纳成 7 个新的类别,并综合成 3 个整合结果:对生育力保存风险-收益的艰难权衡,紧迫决策下复杂的心理变化过程,决策过程的干扰.结论 医护人员及相关卫生机构应重视癌症患者生育力保存决策的心理体验和信息需求,优化决策程序、开发决策辅助方案,促进患者尽快完成决策.

Objective To develop a self-management scale for gastroesophageal reflux in patients after surgery for esophageal cancer, and to test its reliability and validity. Methods Literature review, qualitative interview, and expert consultation were used to construct the draft of the scale guiding by the theory of self-management. A total of 463 patients were selected by convenience sampling for item screening and reliability and validity testing. Results The scale consisted of 4 dimensions of disease knowledge management, mood and attitude management, diet management and life behavior management and 31 items. The cumulative rate of total explained variance was 68.3%; the Cronbach’s α coefficient 0.946; the split-half reliability 0.614 and the test-retest reliability 0.931. Conclusion The self-management scale of gastroesophageal reflux in patients after surgery for esophageal cancer presents good reliability and validity, and it can be used to evaluate the self-management of gastroesophageal reflux in patients after esophageal cancer surgery.

目的 探讨脑肿瘤患者术后发生误吸的影响因素并构建误吸风险预测模型.方法 便利抽样法选取天津市某肿瘤专科医院228例脑肿瘤术后患者为研究对象.根据是否发生误吸分为误吸组与非误吸组.通过单因素和多因素Logistic回归分析筛选脑肿瘤患者术后误吸的影响因素并构建误吸风险预测模型.结果 年龄、手术时间、格拉斯哥评分、洼田饮水实验、误吸史和自主咳嗽是脑肿瘤患者术后误吸的影响因素(均P<0.05).本研究构建的风险模型受试者工作特征曲线下面积为0.9656(95％CI:0.938～0.993),Hosmer-Lemeshow拟合优度检验显示χ2=3.757,P=0.44.结论 本研究构建的风险模型预测效能良好,可为临床医务人员筛查脑肿瘤术后患者中误吸高危患者提供参考.

随着癌症早期筛查的实施和诊疗方案的不断改进,青年女性癌症患者的转归和预后发生较大改善,其对生育问题关注度日益增加.该文对青年女性癌症患者生育信息需求进行综述,介绍以实施多学科合作的生育咨询、开发生育知识手册、提供生育决策辅助工具为主的3种生育信息支持途径的应用情况,并分别从医护人员、患者层面分析阻碍癌症患者生育信息支持的原因,以期为研制癌症患者生育信息需求评估工具、构建以患者需求为导向的生育信息支持方案提供参考.

综述居家癌症病人疼痛发生现状、影响因素、评估方法、现存问题、镇痛方法,提出应提高病人和家庭护理人员对癌症疼痛的认知,结合"互联网+"等信息技术延续居家癌痛护理,为病人居家镇痛管理提供依据.

对移动医疗在癌痛延续护理中的应用现状进行综述,阐述了癌痛延续护理对移动医疗的需求,介绍了移动医疗在癌痛延续护理中的应用领域,并对其可用性和应用效果进行分析与总结,提出有针对性的改进建议及未来发展方向,以期为运用移动医疗技术更好地服务于癌痛患者提供参考.

目的 了解天津市三级医院护士医学叙事能力水平并探讨其影响因素,为实施针对性的培训,提高护士的医学叙事能力提供依据.方法 采用医学叙事能力量表对天津市3所三级医院350名护士进行调查.结果 护士医学叙事能力总分为(154.20±17.07)分,各维度得分从高到低依次为关注倾听、理解回应、反思再现.成长地、职称、对叙事护理的熟悉度、工作年限、对护理工作的满意度可解释医学叙事能力水平27.7％的变异水平(P＜0.05,P＜0.01).结论 护理管理者应尤为关注成长地为城市、职称较低、对叙事护理不了解、工作年限短、对护理工作满意度低的护士,并给予针对性的培训,以提高他们的医学叙事能力水平.

目的 探讨晚期癌症患者预期性悲伤现状及影响因素,为制定针对性的护理措施提供参考.方法 采取便利抽样法,选取2020年6—9月在天津市某肿瘤专科医院住院的225例晚期癌症患者作为研究对象,采用一般资料调查表,预期性悲伤量表、死亡焦虑量表、希望水平量表、社会支持量表进行调查,采用多元线性回归分析研究对象预期性悲伤得分的影响因素.结果 预期性悲伤得分为(45.69±15.73)分,与死亡焦虑呈正相关(P<0.05),与希望水平、社会支持呈负相关(P<0.05).多元线性回归分析显示性别、家庭人均月收入、疼痛反应、死亡焦虑、希望水平、社会支持进入回归方程(P<0.05),共解释晚期癌症患者预期性悲伤总变异的74.5％.结论 本组晚期癌症患者的预期性悲伤呈中等水平,医务人员要关注女性、收入较低、疼痛严重、死亡焦虑大、希望水平低、社会支持低的晚期癌症患者,并给予针对性的干预措施,以降低其预期性悲伤水平.

对远程监护在慢性阻塞性肺疾病患者中应用的相关概念、应用优势、国内外现状、应用建议等进行分析和总结,旨在为远程监护在慢性阻塞性肺疾病中的应用提供依据和参考.

PROBLEM IDENTIFICATION:With poor prognosis and debilitating symptoms, gliomas affect not only patients' physical health, but also their psychological well-being. A systematic review was conducted to explore the experiences, needs, and coping mechanisms of adult patients with gliomas.LITERATURE SEARCH:A literature search was performed in Cochrane Library, PubMed®, Embase®, MEDLINE®, Scopus®, PsycINFO®, CINAHL®, CNKI, and Wan Fang for studies published from January 1999 to December 2019.DATA EVALUATION:The selected studies were assessed by two independent reviewers to determine methodologic quality. Meta-aggregation was used to synthesize the findings.SYNTHESIS:Three overarching themes were developed.IMPLICATIONS FOR PRACTICE:The findings from this systematic review provide data related to the experiences of patients with gliomas, which can inform practice changes and interventions aimed at enhancing patients' quality of life.

目的:调查分析肿瘤科护士职业生活品质现状及其影响因素.方法:采用一般情况调查表、职业生活品质量表(ProQOL)、Connor和Davidson心理弹性量表(CD-RISC)、杰弗逊共情量表(JSPE)、领悟社会支持量表(PSSS)对398名肿瘤科护士进行问卷调查.结果:肿瘤科护士职业生活品质中同情心满足、二次创伤和工作倦怠得分分别为34.15±7.03,26.37±6.09,25.15±6.04;同情心满足与护士心理弹性、共情能力、社会支持总分和各维度得分均呈正相关(r=0.181～0.680,P＜0.01);同情心疲乏与护士心理弹性、共情能力、社会支持总分和各维度得分均呈负相关(r=-0.202～-0.425,P＜0.01);经多元回归分析,坚韧、自强、乐观、重要他人对同情心满足有影响,共解释51.4％的变异量;职称、坚韧、自强、观点采择、换位思考、重要他人对同情心疲乏有影响,共解释32.7％的变异量.结论:肿瘤科护士职业生活品质水平处于中等水平,关注职称较高的肿瘤科护士的同情心疲乏水平;提高护士心理弹性、共情能力、社会支持可有效提升护士职业生活品质,改善护士的心理健康状况.

目的:分析化妆美容对乳腺癌化疗患者的干预效果.方法:采用便利抽样法,选取2017年9月至2018年2月天津市某医院80名女性乳腺癌患者,按入院时间分为干预组和对照组.对照组接受常规照护,干预组在常规照护的基础上,给予化妆美容.比较两组患者的化疗脱发困扰、医学应对方式及生活质量差异.结果:实施化妆美容后干预组在面对应对方式得分及生活质量总分高于对照组,且均有统计学意义(P<0.05);化疗脱发困扰总分及屈服应对方式得分低于对照组,且均有统计学意义(P<0.05);而化疗脱发困扰的生理困扰维度及回避应对方式得分差异无统计学意义(P>0.05).结论:化妆美容能够有效改善患者化疗脱发困扰程度,引导其积极面对形象缺损,缓解屈服应对方式,最终提高生活质量.

目的 评价穴位按摩对化疗相关性恶心呕吐的干预效果.方法 计算机检索Cochrane图书馆、PubMed、Ovid Medline、EMBASE、Web of Science、维普数据库、中国生物医学文献数据库、中国知网及万方数据库中关于穴位按摩对化疗相关性恶心呕吐干预的随机对照试验,纳入文献质量评价依照Cochrane Handbook(5.1.0)质量评价标准,采用RevMan 5.30软件进行分析.结果 共纳入13篇随机对照试验,Meta分析结果显示:穴位按摩可减轻急性恶心呕吐严重程度、延迟性恶心呕吐严重程度、急性恶心呕吐发生率、急性呕吐频率、延迟性恶心频率,但对急性恶心频率、延迟性呕吐发生率和频率的作用效果未显示出优势.结论 在常规止吐药物基础之上,联合按摩内关穴可在一定程度上减轻化疗相关性恶心呕吐,同时穴位按摩是一种非侵入性、简单易操作的辅助药物的补充替代疗法,值得临床中推广使用.