Information Needs of Breast Cancer Patients at Cancer Diseases Hospital, Lusaka, Zambia

Background: Breast cancer is the second most common cancer worldwide and the second most common among Zambian women. Breast cancer diagnosis being a stressful experience, causes psychological and emotional disruption that can be abated by meeting information needs of the affected patients. In light of the escalating cases of Breast cancer among the Zambian women, the study examined a special aspect of cancer management which is usually neglected in most cases. Aim: The main objective of the study was to assess information needs of breast cancer patients at the Cancer Diseases Hospital in Lusaka, Zambia using a modified structured interview schedule adopted from the Toronto Information Needs Questionnaire-Breast Cancer (TINQ-BC). Methods: A descriptive cross-sectional design was used to elicit the information needs of breast cancer patients. One hundred and ten (97% response rate) participants were selected using simple random sampling method and data was collected using a modified structured interview schedule adopted from the Toronto Information Needs Questionnaire-Breast Cancer (TINQ-BC). Stata 10.0 (StataCorp, 2008) was employed for all quantitative data analysis and graphical presentation of data. Results: The overall score for information needs was obtained by adding the scores across all the five information needs categories which were further divided into three categories namely: low important scores, of less than 50%, moderately important scores of 50% - 70% and highly important scores ranged above 70% of the 200 total scores. Out of the 110 participants recruited, 88 (80%) indicated that the information across the five categories was moderately important. Logistic regression of information needs and posited determinants revealed that anxiety levels;education level;presence of co-morbidity;and being on treatment were significant determinants of patients’ informational needs (Effect’s p ≤ 0.05). Conclusion: The findings of this study support the idea that breast cancer patients are seeking more information on their illness, hence information provision is one of the most important factors for providing high quality cancer care across the whole cancer continuum. Therefore, appreciating the information needs of breast cancer patients is substantial in improving care.

Increased Mortality Risk among Early Stage Hormone Receptor Positive Breast Cancer Patients Who Did Not Receive Adjuvant or Neoadjuvant Therapy

Background: Hormone receptor positive (HR+), human epidermal growth factor receptor 2 negative (HER2-) is the most common biologic subtype of breast cancer. Although adjuvant therapy has demonstrated a survival benefit in clinical trials, its use is poorly understood in the real-world among elderly breast cancer patients since age is a barrier to receiving adjuvant therapy. An examination of treatment patterns and outcomes associated with receipt of adjuvant/neoadjuvant therapy among elderly HR + HER2-breast cancer patients was undertaken. Methods: There were 18,470 HR + HER2-breast cancer patients from the linked SEER-Medicare database. Patients were diagnosed with stage I-III disease between 1/1/2007-12/31/2011, ≥66 years, enrolled in Medicare Parts A, B and D, and underwent breast cancer surgery after diagnosis. Time-varying Cox proportional hazards regression assessed overall survival. Results: There were 13,670 (74%) patients treated with adjuvant/neoadjuvant therapy and 4800 (26%) untreated. Compared to treated patients, untreated patients were older, had earlier stage, lower grade, smaller tumors, poorer performance, higher comorbidity score, and less use of a 21-gene recurrence score (RS) assay (p < 0.0001). In the survival model, increasing age, stage, tumor size, tumor grade, comorbidity score and poor performance were significantly associated with higher mortality risks, while use of an RS assay was associated with lower risks. The Cox model showed a 48% higher risk of death in untreated compared to treated patients. In a subset of 8967 patients with stage I disease, tumor size < 2.0 cm and grade 1/2;untreated patients had a 22% higher risk of death compared to treated patients. Conclusions: Older patients with favorable clinical characteristics (earlier stage, smaller tumor, lower grade) are less likely to be treated and have a higher risk of death compared to adjuvant/neoadjuvant treated patients. An unmet need among older breast cancer patients persists.

Details of Particulars of Benefit Finding through the Experiences of Breast Cancer Patients Analysis on Breast Cancer Journals Written by Patients

This study aims to analyze the descriptions in breast cancer journals written by patients and to understand the experience of benefit finding among patients with breast cancer. We selected 22 such breast cancer journals written by patients published after 2000 in Japan. The extracted statements related to benefit finding of patients experiencing breast cancer from the 22 journals were subjected to a qualitative analysis, and the following seven benefit finding elements were extracted: “Gratitude toward others”, “Benefits due to cancer”, “Happiness at living a normal life”, “Realization of and satisfaction with my growth”, “Awareness of the meaning of my existence”, “Hopes for life”, and “Willingness to contribute to others”. These benefit findings suggest that these particulars fulfill cultural, practical, spiritual, and social meanings, and lead to self-revaluation in daily life.

Cancer risk in relatives of BRCA1/2 pathogenic variant carriers in a large series of unselected patients with breast cancer

Objective:The spectrum and risk of cancer in relatives of BRCA1/2 pathogenic variant carriers in the Chinese population have not been established.Methods:A family history of cancer in 9903 unselected breast cancer patients was retrospectively analyzed.BRCA1/2 status was determined for all patients and relative risks(RRs)were calculated to evaluate cancer risk in relatives of the patients.Results:The incidences of breast cancer in female relatives of BRCA1 carriers,BRCA2 carriers,and non-carriers were 33.0%,32.2%,and 7.7%,respectively.The corresponding incidences of ovarian cancer were 11.5%,2.4%,and 0.5%,respectively.The incidences of pancreatic cancer in male relatives of BRCA1 carriers,BRCA2 carriers,and non-carriers were 1.4%,2.7%,and 0.6%,respectively.The corresponding incidences of prostate cancer were 1.0%,2.1%,and 0.4%,respectively.The risks of breast and ovarian cancers in female relatives of BRCA1 and BRCA2 carriers were significantly higher than female relatives of non-carriers(BRCA1:RR=4.29,P<0.001 and RR=21.95,P<0.001;BRCA2:RR=4.19,P<0.001 and RR=4.65,P<0.001,respectively).Additionally,higher risks of pancreatic and prostate cancers were noted in male relatives of BRCA2 carriers than non-carriers(RR=4.34,P=0.001 and RR=4.86,P=0.001,respectively).Conclusions:Female relatives of BRCA1 and BRCA2 carriers are at increased risk for breast and ovarian cancers,and male relatives of BRCA2 carriers are at increased risk for pancreatic and prostate cancers.

HER2-positive circulating tumor cells indicate poor clinical outcome in stageⅠto Ⅲ breast cancer patients

Metastases may occur in node-negative breast cancer patients. It indicates that breast cancer cells can bypass regional lymph nodes and hematogenously disseminate to distant organs. In a recent paper (Clin Cancer Res 2006, 12:1715-1720) , Wulfing et al. evaluated the prognostic value of blood-borne, HER2-positive circulating tumor cells (CTC) in the peripheral blood from 42 breast cancer patients with a median follow-up of 95 months. HER2-

Clinicopathological Data of Breast Cancer in Diabetic Patients

Background: Diabetes mellitus and breast cancer are both chronic diseases. Breast cancer in patients with diabetes is often diagnosed at an advanced stage and has worse prognosis. Aim of work: To investigate the clinicopathological factors, hormonal receptor status and molecular subtypes of breast cancer in diabetic breast cancer patients. Patients and methods: Records of patients presenting to the radiotherapy committee of the breast cancer clinic of Ain Shams University Hospital in the period between January 2017 and January 2018 were revised regarding age, presence of diabetes, presence of comorbidities, and type of the surgery performed. Pathological data such as: Tumor size (T), LN staging (LN), ER, PR, Her2/neu and Ki67 status were also recorded. Patients were divided into 2 groups: Group (I): those with diabetes and Group (II): those without diabetes. Inclusion criteria were Breast cancer cases with proven pathological diagnosis, available IHC studies, clear record of comorbidity status, age > 18 years, cases who underwent upfront surgery. Exclusion criteria were metastatic cases, bilateral cases, cases with double primary, male breast cancer cases, and those with missing data for ER, PR and Her2/neu. Results: Retrieving data from the files of the patients that met the inclusion criteria in the allocated period revealed that 117 patients had diabetes (Group I) and 199 didn’t have the disease (Group II), There was a highly significant difference between both groups regarding the age as most of the patients with diabetes were above fifty years of age (84.6%) compared to only 44.7% of the patients without diabetes also the mean age of patients with diabetes was significantly higher (59 years) compared to 48 years of age for those without diabetes. Diabetes was associated with hypertension in most of the cases (69%). Comorbidities other than hypertension were recorded in 39 diabetic patients (33.3%) and 21 (10.6%) nondiabetic patients and the difference was statistically highly significant. In the diabetic group, the most encountered comorbidity was cardiac disease in 14.5% of patients. In the diabetic group, most of the patients underwent modified radical mastectomy (MRM) with a percentage of about 54.7% compared to 48.2% of patients for both groups respectively. Regarding pathological data apart from the finding that presence of diabetes was associated with more multiple tumors (p value: 0.013), no other statistically significant differences between both groups were found. Hormonal receptor status and molecular subtypes were also not affected by presence of diabetes in the studied breast cancer patients.

Effect of Breast Conserving Sentinel Lymph Node Biopsy(SLNB)and Modified Radical Mastectomy on Patients with Early Breast Cancer

Objective:To study the clinical effect of breast conserving combined with sentinel lymph node biopsy and modified radical mastectomy in patients with early breast cancer.Methods:Female patients with early breast cancer in clinical stage I and II were selected as the main objects of this study,the study period started from July 2017 to July 2020.In the breast conserving and sentinel lymph node biopsy patients,50 cases were randomly selected as the experimental group;50 cases in the modified radical mastectomy patients were randomly selected as the control group.The clinical intervention effect of the two groups was analyzed.Results:the perioperative indexes of the experimental group were shorter than those of the control group,the patients recovered faster,the incidence of complications in the experimental group was lower,and the quality of life scores of the experimental group were significantly higher than those of the control group,and the difference was statistically significant,the intervention effect of the experimental group was also better.Conclusion:The application of breast conserving and sentinel lymph node biopsy in the treatment of early breast cancer can promote the recovery of patients,shorten the operation time and reduce the rate of complications,which has significant clinical significance.

Perceived health-related stigma among patients with breast cancer

Breast cancer survivors face many challenges(particularly changes in body image) on their road to restoring physical and psychosocial health following diagnosis. Perceived health-related stigma(PHS)refers to the attachment of negative connotations to some types of disease diagnoses. PHS is common among patients with breast cancer and is associated with adverse emotions, attitudes and behaviors. This article summarizes the latest advances and new perspectives on PHS of breast cancer patients and approaches to block this deleterious process. Effects of PHS on patients with breast cancer, in this paper,and measures, predictors and interventions of PHS have been discussed in depth. Future studies should continue to develop more effective instruments that are specialized for measuring PHS of breast cancer patients, explore the predictors of PHS, and discuss effective interventions on the basis of the predictors.

Correlation between Subliminal Depression and the Quality of Life in Patients Preliminarily Diagnosed with Breast Cancer

Objective: To investigate the subthreshold depression and the quality of life in patients preliminarily diagnosed with breast cancer, and to explore their relationship. Methods: A total of 210 patients preliminarily diagnosed breast cancer were recruited by convenience sampling method to complete the self-made general questionnaire, Center for Epidemiological Studies Depression Scale (CES-D), Hamilton Rating Scale for Depression and Functional Assessment of Cancer Therapy-Breast (FACT-B). Results: The incidence rates of subthreshold depression was 48.6% in patients preliminarily diagnosed breast cancer, the total score of FACT-B in patients with subthreshold depression and non-subthreshold depression was (73.92 &plusmn;17.62) and (86.74 &plusmn;16.15). The total score of CES-D was significantly negatively correlated to the total score and factor scores of FACT-B (p Conclusion: The incidence rate of subthreshold depression in preliminarily diagnosed breast cancer patients is high, and it is closely related to the quality of life, so we should pay attention to the psychological status of preliminarily diagnosed breast cancer patients, to increase the psychological intervention, than improve their quality of life.

Treatment Patterns and Mortality Risk among Elderly Patients with Metastatic Triple Negative Breast Cancer in the United States: An Observational Cohort Study Using SEER-Medicare Data

Purpose: Triple negative breast cancer is more aggressive than other breast cancer subtypes and accounts for up to 20% of all breast cancers. Despite the poorer prognosis, there are no approved targeted treatments available and chemotherapy remains the only choice. We examined treatment patterns and outcomes among elderly metastatic triple-negative breast cancer (mTNBC) patients in routine clinical practice. Methods: Patients were identified from the linked SEER-Medicare database between 1/1/2001 and 12/31/2013 and included de novo Stage IV (n = 776) and patients with distant metastasis followed an initial diagnosis of Stage I - III disease (n = 1851). Kaplan-Meier analyses and time-varying Cox proportional hazards regression were used to assess overall survival (OS). Results: The mean age at metastatic diagnosis was 77.6 years and 1259 (48%) patients received chemotherapy. Compared to <70 year olds, ≥70 year olds had worse performance status, higher comorbidity burden, and were less likely to receive chemotherapy (45% vs. 66%). Patients treated with chemotherapy had increased OS compared to untreated patients, and the survival advantage was more pronounced in the -month longer unadjusted OS compared to the ≥70 cohort (log rank p < 0.0001). This finding was supported in the adjusted multivariate model which showed a 46% increased risk of death for untreated patients in the <70 year olds and a 17% increased risk of death for untreated patients in the ≥70 year olds (vs. treated). Conclusions: In this real-world analysis, 48% of elderly mTNBC patients did not receive chemotherapy and a greater proportion were untreated in the ≥70 year old cohort (55%). Although the survival benefits of chemotherapy were greater in the younger cohort, the benefits of treatment persisted in ≥70 year olds. These findings suggest opportunities exist to improve the clinical treatment of elderly mTNBC patients.

COMBINED EFFECTS OF SELECTIVE PHOTOTHERMAL THERAPY AND IMMUNOADJUVANT AGAINST STAGE IV BREAST CANCER

Metastasis to distant sites is a severe treatment challenge and a major cause of death for breast cancer patients.Laser immunotherapy(LIT)is a novel technique,combining a selective photothermal therapy with local application of glycated chitosan,a potent immunoadjuvant.The pre-clinical studies of LIT have shown its unique characteristics in generating specific antitumor immunity.The clinical application of LIT in the treatment of melanoma patients has achieved preliminary success.Recently,LIT has been used to treat late-stage breast cancer patients.Here we report for the first time the clinical results of this combination therapy in breast cancer patients.The LIT treatment procedures are presented and the medical history of two stage Ⅳ breast cancer patients is reviewed.Most of the breast cancer lesions and the metastasis of lung and brain disappeared after repeated treatments of LIT.One patient achieved complete response;the other achieved partial response at the time of this report.Although there is still a long way for LIT to become a standard modality for breast cancer treatment,the results of this study indicated its promising future.

Twenty-five years of research on the effects of exercise training in breast cancer survivors:A systematic review of the literature

AIM:To investigate the role of exercise training the past 25 years on major physiological-psychological outcomes studied thus far in this patient population.METHODS:Pub Med, Medline Plus, the Cochrane Library, Web of Science, SportD iscus, Embase, Scorpus, and Google Scholar were searched from September to November 2013 to identify exercise training studies that used objective measurements of fitness and/or patient reported outcomes assessed pre and post-exercise training with statistical analyses performed in at least one of the following outcome measurements:Cardiorespiratory function, body composition, muscular strength, fatigue, depression, and overall quality of life. Five reviewers independently identified the studies that met the criteria for the review and discrepancies were resolved by consensus among all authors.RESULTS:Fifty-one studies were included in this review with 5 from the period between 1989-1999, 11 from 2000-2006, and 35 from 2007-2013. The evolution of study designs changed from aerobic only exercise training interventions(1989-1999), to a combination of aerobic and resistance training(2000-2006), to studies including an arm of resistance training or examining the effects of resistance training as the main mode of exercise(2007-2013). Overall, the benefits of exercise showed improvements in cardiorespiratory function, body composition, strength, and patient reported outcomes including fatigue, depression, and quality of life.CONCLUSION:Exercise training appears to be safe for most breast cancer patients and improvements in physiological, psychological, and functional parameters can be attained with regular participation in moderate intensity exercise.

Breast Reconstruction: Does It Worth to Start If the Patient Is Not Sure to Take All the Process Along?

Introduction: Breast cancer is the most common cancer in women worldwide, representing a major public health problem. There is still little information comparing the satisfaction of the patients who finished their process against the ones who start it but did not finish it. The aim of our retrospective study was to analyze the results in terms of satisfaction after one year of undergoing to complete breast reconstruction (CBR) vs incomplete breast reconstruction (IBR). Materials and Methods: Retrospective study of patients that underwent breast reconstruction (BR) surgery after mastectomy for breast cancer treatment. Performed at Hospital Central Sur de Alta Especialidad PEMEX in Mexico City, including patients from January 1, 2015 to January 01, 2020. Demographic baseline variables were included. BREAST-Q satisfaction questionnaires one year after the last reconstructive procedure were analyzed. Results: A total of 44 patients fulfilled the inclusion criteria. Of these 44 patients, 11 were included in the IBR group, and 33 patients in the CBR group. There were no statistically significant differences between the two groups in terms of age (IBR 56.09 vs CBR 53.06 years, p = 0.321);BMI (IBR 27.94 vs CBR 26.40, p = 0.253), time from mastectomy to first reconstructive procedure (IBR 22.8 vs CBR 31 months, p = 0.957), history of chemotherapy (IBR 27.3% vs CBR 33.3%, p = 0.709) and radiotherapy (IBR 54.5% vs CBR 42.4%, p = 0.484), additionally type of reconstruction, affected side or complication rate were not significantly different. Regarding postoperative satisfaction, only the second module of satisfaction with breasts displayed statistically significant differences, with a higher score in the CBR group (46.27 vs 52.27, p = 0.019). Other items explored didn’t show significant differences. Discussion: The data reported in this study suggest that regardless of whether the last stage of a BR is reached, the results in these settings can be very similar in terms of psychosocial well-being, sexual well-being, physical well-being regarding the chest area, with some degree of better perception of her breasts. Conclusion: This study suggests that the results in terms of satisfaction in BR after mastectomy for breast cancer are quite similar for patients who decide to take only the first reconstructive stage, compared with those that finished all the process along, this may be a valuable tool for decision making.

保乳术联合前哨淋巴结活检术对乳腺癌患者生活质量、应激水平及血清肿瘤标志物的影响

目的:探究保乳术联合前哨淋巴结活检术对乳腺癌患者生活质量、应激水平及血清肿瘤标志物的影响。方法:回顾性研究常熟市第五人民医院2017年2月—2021年12月收治的102例乳腺癌患者的病例资料。根据治疗方案将其分为对照组和观察组,其中对照组51例接受保乳术治疗,观察组51例接受保乳术联合前哨淋巴结活检术治疗。比较两组手术指标,生活质量的情况、应激水平血管紧张素Ⅱ(AngⅡ)、肾上腺素(AD)、检测血清肿瘤标志物水平。结果:观察组手术时间短于对照组,术后引流量少于对照组(P<0.05)。两组1年后生活质量评分(总体健康、生理职能、生理功能、活力、躯体疼痛、社会功能、情感职能、精神健康)比较,差异均有统计学意义(P<0.05)。术前0.5 h,两组应激反应相关指标对比,差异均无统计学意义(P>0.05);术后1 d,两组AD、AngⅡ水平均升高(P>0.05),观察组AD、AngⅡ水平均低于对照组(P<0.05)。术前0.5 h,两组血清癌胚抗原(CEA)和糖类抗原153(CA153)水平比较,差异均无统计学意义(P>0.05);术后1 d,两组血清CA153、CEA水平均低于术前0.5 h(P<0.05),观察组CA153、CEA水平均低于对照组(P<0.05)。结论:保乳术联合前哨淋巴结活检术应用于乳腺癌患者治疗中,更有助于缩短手术时间等手术指标,提高患者的生活质量,调节应激反应,且术后短期肿瘤标志物调节水平较低。

乳腺癌患者自我倡权体验的质性研究

目的 深入了解乳腺癌患者自我倡权的真实体验。方法 采用现象学研究方法,对20名乳腺癌患者进行半结构式访谈,并采用Colaizzi 7步分析法分析资料。结果 提炼出4个主题和11个亚主题:自我倡权意识薄弱(症状报告不主动和过度依赖医生)、自我倡权积极性受多种因素影响(存在逃避心态、信心不足、病耻感严重和害怕破坏医患关系)、自我倡权过程中面临诸多挑战(医护态度欠缺、家庭成员不支持和害怕增加经济负担)及自我倡权积极体验(增强战胜疾病的信心和提高疾病应对能力)。结论 乳腺癌患者自我倡权意识薄弱、积极性较差,在自我倡权过程中面临各种挑战,部分患者积极体验自我倡权。医务人员应多关注自我倡权意识薄弱和积极性较差的乳腺癌患者,给予其更多的帮助和鼓励,同时也应树立“以病人为中心”的服务理念,营造良好氛围促进患者自我倡权。

基于多量表对乳腺癌患者自体乳房重建与植入物乳房重建术后患者报告结局的量化研究

目的对乳腺癌患者行自体乳房重建与植入物乳房重建术后患者报告结局(patient-reported outcome,PRO)进行评估。方法选取2020年1月至2021年6月在复旦大学附属肿瘤医院乳腺外科行乳房重建手术的患者,其中行自体乳房重建111例,行植入物乳房重建108例。应用中文版Breast-Q 2.0量表、乳腺癌特异性量表QLQ-BR23、EORTC生命质量测定量表QLQ-C30,通过问卷形式调查两组患者术后18个月的PRO。结果自体重建组中Ⅲ期乳腺癌高于植入物重建组(64.9%vs.44.4%,P<0.001),自体重建组在术前行新辅助治疗、术后放疗方面高于植入物重建(P<0.001),自体重建组术后行化疗、内分泌治疗低于植入物重建组(P<0.05)。基于BreastQ 2.0量表的研究显示自体重建组对乳房满意度高于植入物重建组(59.28±17.20 vs.54.94±14.48,P<0.05)。基于QLQ-BR23量表的研究显示在上肢症状领域自体重建组高于植入物重建组(20.02±20.80 vs.12.65±16.18,P<0.05)。基于QLQ-C30量表的研究显示患者在各功能领域及症状领域对比差异均无统计学意义。两组患者在术后社会回归人数与回归时间的差异无统计学意义。结论乳房重建可提高乳腺癌患者PRO,肿瘤学因素会影响乳腺癌重建方式的选择,自体乳房重建患者对乳房外形满意度更高,但是上肢症状(如肿胀、疼痛)较植入物重建组明显,这与自体重建患者行腋窝淋巴结清扫比例较高有关。两组患者在生活质量和社会回归方面差异不明显。

上海市乳腺癌患者诊疗现状研究

目的归纳总结乳腺癌临床专家的访谈材料,探讨乳腺癌患者诊疗现状,为后续的临床科研研究和卫生政策制定提供依据。方法:采用专家深度访谈方法调研上海市具有代表性的医院的乳腺外科医生,应用扎根理论归纳总结乳腺癌患者诊疗现状。结果对4名专家的访谈材料进行三级编码,梳理出15个初始类属,归纳总结为乳腺癌患者发病情况、基本特征、诊疗水平不断提升及诊疗方面面临的挑战4个主要类属,最终形成乳腺癌患者人群特征和乳腺癌患者治疗情况2个核心类属。结论上海市乳腺癌就诊患者呈现年轻化、早期化趋势,诊疗水平不断提升,在创新药发展及保障政策方面仍面临一定挑战。应加强各部门、各环节联动,不断揭示乳腺癌发生发展的机制,坚持乳腺癌早诊早治,加强规范化诊疗工作,不断完善医疗保障制度,最大程度提高患者治愈率和生存率。

心灵关怀对乳腺癌患者术后心理韧性自我效能感和主观幸福感的影响

目的探究基于希望理论的心灵关怀对乳腺癌患者术后心理韧性、自我效能感和主观幸福感的影响。方法将157例乳腺癌患者依据组间基本特征具有可比性的原则分为研究组(n=57)和对照组(n=100)。对照组患者给予常规干预,研究组患者在对照组基础上给予基于希望理论的心灵关怀。干预前后采用灵性需求量表(SNS)、Herth希望量表(HHI)评估两组患者的心灵关怀需求度,采用心理韧性量表(CD-RISC)、一般自我效能感量表(GSES)评估两组患者的心理韧性及自我效能感,采用幸福感指数量表、中文精简版抑郁-焦虑-压力量表(DASS-21)、生存质量测定量表(FACT-B)、症状自评量表(SCL-90)、纽卡斯尔护理满意度量表(NSNS)评估两组患者的主观幸福感、负性情绪、生存质量及护理满意度。结果干预后,两组患者SNS、SCL-90、DASS-21评分均较干预前降低,且研究组低于对照组(P<0.01);两组患者HHI、CD-RISC、GSES、生活满意度、总体情感指数、主观幸福感指数及FACT-B评分均较干预前升高,且研究组高于对照组(P<0.01)。干预后,研究组患者护理满意度高于对照组(P<0.01)。结论给予乳腺癌术后患者基于希望理论的心灵关怀,可改善患者灵性需求、希望水平、心理韧性、自我效能感及主观幸福感,提升其生存质量、护理满意度。

乳腺癌患者治疗间歇期症状群及前哨症状的调查研究

目的:基于自我报告结局调查乳腺癌患者治疗间歇期症状群及前哨症状,分析前哨症状对患者生活质量的影响,为实施精准症状管理、提高患者生活质量提供依据。方法:采用便利抽样法,选取某三级甲等医院281例乳腺癌患者,采用一般资料调查表、欧洲癌症生活质量测定量表(EORTC QLQ-C30)、乳腺癌特定生活质量问卷(QLQ-BR23)进行调查。采用主成分分析法提取患者症状群,基于Apriori算法关联分析结果,判定症状群的前哨症状,采用相关性分析探讨前哨症状与患者生活质量的关系。结果:乳腺癌患者治疗间歇期仍存在多种自我报告症状,可以分为疲乏症状群、消化道症状群、病感症状群、手术创伤相关症状群。Apriori算法关联分析结果显示,疼痛是疲乏症状群的前哨症状,脱发是病感症状群的前哨症状,上肢症状是手术创伤相关症状群的前哨症状。相关性分析显示,除性功能及性欲外3个前哨症状均与患者的生活质量呈负相关(P<0.05)。结论:乳腺癌患者治疗间歇期仍存在多种症状,并以症状群形式存在。乳腺癌患者治疗间歇期存在3个前哨症状,且对患者的生活质量产生影响,建议护理人员可将前哨症状作为症状群管理的切入点,为患者实施精准护理提供依据。

个案管理联合人文关怀干预对老年乳腺癌患者术后康复的影响

目的探讨个案管理联合人文关怀干预对老年乳腺癌患者术后康复的影响。方法根据干预方法的不同将184例老年乳腺癌手术患者分为对照组(n=92,个案管理)和观察组(n=92,个案管理联合人文关怀干预)。比较两组患者的肩关节功能、患侧上肢水肿程度、生活质量[乳腺癌患者生命质量测定量表(FACT-B)]及患肢功能锻炼的依从性。结果术后15天,两组患者Neer肩关节功能评分均高于本组术前,观察组患者Neer肩关节功能评分低于对照组(P<0.05);术后3、6个月,两组患者Neer肩关节功能评分均高于本组术前,观察组患者Neer肩关节功能评分均高于对照组(P<0.05)。术后3个月,两组患者患侧上肢水肿容积均高于本组术前,观察组患者患侧上肢水肿容积低于对照组(P<0.05)。术后6个月,两组患者FACT-B各维度评分均高于本组术前,观察组患者FACT-B各维度评分均高于对照组(P<0.05)。术后6个月,观察组患者患肢功能锻炼的依从率明显高于对照组(P<0.01)。结论个案管理联合人文关怀干预能促进老年乳腺癌患者术后快速康复,提高患者的锻炼依从性和生活质量,值得临床推广。