Qualitative exploration of home life experiences and care needs among elderly patients with temporary intestinal stomas

BACKGROUND This study employed a phenomenological research approach within qualitative research to explore the challenges encountered by elderly individuals with temporary colostomies in managing their daily lives and care needs.Protecting the anus surgery combined with temporary colostomy has emerged as a prevalent treatment modality for low rectal cancer.However,the ileostomy is susceptible to peri-stoma skin complications,as well as fluid,electrolyte,and nutritional imbalances,posing challenges to effective management.The successful selfmanagement of patients is intricately linked to their adjustment to temporary colostomy;nonetheless,there remains a dearth of research examining the factors influencing self-care among temporary colostomy patients and the obstacles they confront.AIM To investigate the lived experiences,perceptions,and care requirements of temporary colostomy patients within their home environment,with the ultimate goal of formulating a standardized management protocol.METHODS Over the period of June to August 2023,a purposive sampling technique was utilized to select 12 patients with temporary intestinal stomas from a tertiary hospital in Shanghai,China.Employing a phenomenological research approach,a semi-structured interview guide was developed,and qualitative interviews were conducted using in-depth interview techniques.The acquired data underwent coding,analysis,organization,and summarization following Colaizzi’s seven-step method.RESULTS The findings of this study revealed that the experiences and needs of patients with temporary intestinal stomas can be delineated into four principal themes:Firstly,Temporary colostomy patients bear various burdens and concerns about the uncertainty of disease progression;secondly,patients exhibit limited self-care capabilities and face information deficits,resulting in heightened reliance on healthcare professionals;thirdly,patients demonstrate the potential for internal motivation through proactive self-adjustment;and finally,patients express a significant need for emotional and social support.CONCLUSION Home-living patients with temporary intestinal stomas confront multifaceted challenges encompassing burdens,inadequate self-care abilities,informational deficits,and emotional needs.Identifying factors influencing patients’self-care at home and proposing strategies to mitigate barriers can serve as a foundational framework for developing and implementing nursing interventions tailored to the needs of patients with temporary intestinal stomas.

Perceptions and factors influencing exercise interventions in elderly patients with debilitating spinal surgery and healthcare professionals:A qualitative study

BACKGROUND Older spine surgery patients have a high incidence of debilitation,which can be managed with certain exercises.AIM To investigate the current status and influencing factors related to the knowledge of exercise intervention among patients and professionals.METHODS Descriptive research methods were used to classify and summarize patients and professionals’perceptions and factors affecting exercise interventions.Data were analysed using the Colaizzi seven-step analysis method to distill and refine themes.RESULTS A total of 7 themes were identified:(1)The current status of patients'exercise is unsatisfactory;(2)patients'health literacy is low,coupled with a lack of social and family support;(3)there are numerous challenges with systematic exercise interventions;(4)healthcare professionals acknowledge the importance and need for exercise interventions;(5)there's a pronounced willingness among patients to participate in exercise intervention programs;(6)healthcare professionals believe that exercise interventions are beneficial;and(7)participants offered invaluable insights and suggestions on perioperative exercise during spinal surgery.CONCLUSION To investigate the current status and influencing factors related to the knowledge of exercise intervention among patients and the related healthcare professionals to provide a reference for the construction of exercise management programs for these patients.

Qualitative analysis of aromatic compounds via 1D TOCSY techniques

The aromatic compounds,including o-xylene,m-xylene,p-xylene,and ethylbenzene,primarily originate from the catalytic reforming of crude oil,and have a wide variety of applications.However,because of similar physical and chemical properties,these compounds are difficult to be identified by gas chromatography(GC)without standard samples.With the development of modern nuclear magnetic resonance(NMR)techniques,NMR has emerged as a powerful and efficient tool for the rapid analysis of complex and crude mixtures without purification.In this study,the parameters of one-dimensional(1D)total correlation spectroscopy(TOCSY)NMR techniques,including 1D selective gradient TOCSY and 1D chemicalshift-selective filtration(CSSF)with TOCSY,were optimized to obtain comprehensive molecular structure information.The results indicate that the overlapped signals in NMR spectra of nonpolar aromatic compounds(including o-xylene,m-xylene,p-xylene and ethylbenzene),polar aromatic compounds(benzyl alcohol,benzaldehyde,benzoic acid),and aromatic compounds with additional conjugated bonds(styrene)can be resolved in 1D TOCSY.More importantly,full molecular structures can be clearly distinguished by setting appropriate mixing time in 1D TOCSY.This approach simplifies the NMR spectra,provides structural information of entire molecules,and can be applied for the analysis of other structural isomers.

Facilitating and hindering factors of community nurses'emergency and critical care treatment abilities:A qualitative study

BACKGROUND This study adopts a descriptive phenomenological approach to investigate the facilitators and barriers of community nurses'abilities in managing critical and emergency conditions.With the transition of healthcare systems to the community,the evolution of nursing practices,and the attention from policies and practices,community nurses play a crucial role in the management of critical and emergency conditions.However,there is still a lack of comprehensive understanding regarding the factors that promote or hinder their capabilities in this area.AIM To understand the facilitators and barriers of community nurses in managing critical and emergency conditions,exploring the fundamental reasons and driving forces influencing their treatment capabilities.METHODS This study utilized the destination sampling method between May 2023 and July 2023.It employed a descriptive phenomenological approach within qualitative research methodologies.Through objective sampling,17 community nurses from 7 communities in Changning District,Shanghai,were selected as the study subjects.Semi-structured interviews were conducted to gather data,which were subsequently organized and analyzed using Colaizzi's seven-step analysis method,leading to the extraction of final themes.RESULTS The barrier factors identified from the interviews encompassed three topics:resource allocation,professional factors,and personal literacy.The facilitators comprised three themes:professionalism,management attention,and training and continuing education.We identified that the root causes of the barriers included the lack of practical treatment experience among community nurses,insufficient awareness of self-directed learning,and limited knowledge and technical proficiency.The professional quality of community nurses and management attention serve as motivation for them to enhance their treatment abilities.CONCLUSION To enhance the capability of community nurses in treating acute and critical patients,it is recommended to bolster training specifically tailored to acute and critical care,raise awareness of first aid practices,and elevate knowledge and skill levels.

Nurse anesthetists’perceptions and experiences of managing emergence delirium:A qualitative study

BACKGROUND This study employs a descriptive phenomenological approach to investigate the challenges anesthesia nurses face in managing emergence delirium(ED),a common and complex postoperative complication in the post-anesthesia care unit.The role of nurses in managing ED is critical,yet research on their understanding and management strategies for ED is lacking.AIM To investigate anesthetic nurses’cognition and management experiences of ED in hopes of developing a standardized management protocol.METHODS This study employed a descriptive phenomenological approach from qualitative research methodologies.Purposeful sampling was utilized to select 12 anesthetic nurses from a tertiary hospital in Shanghai as research subjects.Semi-structured interviews were conducted,and the data were organized and analyzed using Colaizzi’s seven-step analysis method,from which the final themes were extracted.RESULTS After analyzing the interview content,four main themes and eight subthemes were distilled:Inefficient cognition hinders the identification of ED(conceptual ambiguity,empirical identification),managing diversity and challenges(patientcentered safe care,low level of medical-nursing collaboration),work responsibilities and pressure coexist(heavy work responsibilities,occupational risks and stress),demand for high-quality management(expecting the construction of predictive assessment tools and prevention strategies,and pursuing standardized management processes to enhance management effectiveness).CONCLUSION Nursing managers should prioritize the needs and suggestions of nurses in order to enhance their nursing capabilities and provide guidance for standardized management processes.

Bowel preparation experiences and needs before follow-up colonoscopy in older adult postoperative colorectal cancer patients: A qualitative study

BACKGROUND The bowel preparation process prior to colonoscopy determines the quality of the bowel preparation,which in turn affects the quality of the colonoscopy.Colono-scopy is an essential procedure for postoperative follow-up monitoring of colorec-tal cancer(CRC)patients.Previous studies have shown that advanced age and a history of colorectal resection are both risk factors for inadequate bowel prepara-tion.However,little attention has been paid to the bowel preparation experiences and needs of predominantly older adult postoperative CRC patients.AIM To explore the experiences and needs of older adult postoperative CRC patients during bowel preparation for follow-up colonoscopy.METHODS Fifteen older adult postoperative CRC patients who underwent follow-up colonoscopy at a tertiary hospital in Shanghai were selected using purposive sampling from August 2023 to November 2023.The phenomenological method in qualitative research was employed to construct an interview outline and conduct semi-structured interviews with the patients.Colaizzi's seven-step analysis was utilized to organize,code,categorize,summarize,and verify the interview data.RESULTS The results of this study were summarized into four themes and eight sub-themes:(1)Inadequate knowledge about bowel preparation;(2)Decreased physiological comfort during bowel preparation(gastrointestinal discomfort and sleep deprivation caused by bowel cleansing agents,and hunger caused by dietary restrictions);(3)Psychological changes during different stages of bowel preparation(pre-preparation:Fear and resistance due to previous experiences;during preparation:Irritation and helplessness caused by taking bowel cleansing agents,and post-preparation:Anxiety and worry while waiting for the colonoscopy);and(4)Needs related to bowel preparation(detailed instructions from healthcare professionals;more ideal bowel cleansing agents;and shortened waiting times for colonoscopy).CONCLUSION Older adult postoperative CRC patients'knowledge of bowel preparation is not adequate,and they may encounter numerous difficulties and challenges during the process.Healthcare professionals should place great emphasis on providing instruction for their bowel preparation.

Surgeon Perspectives on Anastomotic Leaks and FluidAI’s StreamTM Platform: Integrating Qualitative Insights for Technological Innovation

Purpose: This article investigates the critical importance of integrating surgeons’ direct input into the development of innovative technologies that address gaps in surgical care, including those aimed at reducing anastomotic leaks (AL), a major complication in gastrointestinal surgery. While traditional quantitative research methods are prevalent, they often overlook the invaluable insights of the surgeons who manage these complications firsthand. Subjects and Methods: This study employs a qualitative approach, utilizing semi-structured interviews with 40 surgeons from various specialties, including general, bariatric, colorectal, trauma, hepato-biliary, and thoracic surgery. The interviews were designed to probe the needs of surgeons, challenges currently faced, and gaps in clinical practice, research, and technology for detection and/or management of AL. The data were analyzed using thematic analysis, which revealed significant gaps in current technologies for early detection and prevention of leaks. Results: Surgeons expressed strong interest in FluidAI’s Stream™ Platform, a non-invasive medical device designed to monitor postoperative drainage fluid in real-time, providing continuous data on AL risk. The ability of this platform to offer early prediction through pH and electrical conductivity analysis was particularly appealing to participants, who emphasized the importance of timely interventions in improving patient outcomes. The study’s findings highlight not only the clinical challenges but also the emotional toll that AL takes on surgeons, underlining the need for innovations that are both data-driven and humanistic. Conclusion: By centering surgeons’ perspectives, this research advocates for a human-centered approach to technological advancement, ensuring that new tools are both clinically effective and aligned with the real-world needs of surgical practitioners.

Generation Mechanism and Social Impact of Knowledge in the Era of"New Quality Productivity"

The changes in knowledge forms in the era of"new quality productivity"are closely related to the development of society.With the rise of the Internet,"the world of dataism is coming".The traditional knowledge production model is undergoing fundamental changes in structure and nature.The most prominent change is that knowledge is becoming increasingly inseparable from data networks.The collaborative production of knowledge based on the Internet is becoming increasingly common,and Wikipedia is a prominent example of this.Wikipedia makes the networked production of knowledge possible by utilizing collective intelligence and data connectivity.Wiki users are commonly referred to as"wiki".This paper conducted interviews with 30 Wiki users and used content analysis to statistically analyze the interview records,in order to study the significance and value of the Wiki knowledge production model for online users,and to glimpse the impact of the knowledge structure changes in the era of"dataism"on social change.

Measures of Variability for Qualitative Variables Using the R Software

Although there are many measures of variability for qualitative variables, they are little used in social research, nor are they included in statistical software. The aim of this article is to present six measures of variation for qualitative variables of simple calculation, as well as to facilitate their use by means of the R software. The measures considered are, on the one hand, Freemans variation ratio, Morals universal variation ratio, Kvalseths standard deviation from the mode, and Wilcoxs variation ratio which are most affected by proximity to a constant random variable, where the measures of variability for qualitative variables reach their minimum value of 0. On the other hand, the Gibbs-Poston index of qualitative variation and Shannons relative entropy are included, which are more affected by the proximity to a uniform distribution, where the measures of variability for qualitative variables reach their maximum value of 1. Point and interval estimation are addressed. Bootstrap by the percentile and bias-corrected and accelerated percentile methods are used to obtain confidence intervals. Two calculation situations are presented: with a sample mode and with two or more modes. The standard deviation from the mode among the six considered measures, and the universal variation ratio among the three variation ratios, are particularly recommended for use.

Core competencies and perceived training needs of nurses in the background of Internet plus nursing service:a qualitative descriptive study

Background:The Internet plus nursing service program is being piloted in China,which has become a new home nursing service model led by nurses.To enable safe and effective homecare service delivery,nurses working in the program need a high level of competency.However,the content of these core competencies and the training needs of nurses for Internet plus nursing services are still unknown.Aim:To describe nurses’perceptions of core competencies and training needs to work in the Internet plus nursing service program,thereby providing a reference for the development of training programs.Methods:A qualitative descriptive study using semi-structured interviews was conducted on 15 nurses with experience of working in the Internet plus nursing service program.Interviews were audio-recorded and transcribed verbatim,and the data were analyzed using thematic analysis.Results:Core competencies involved comprehensive assessment competence,direct care practice competence,health education and consulting competence,risk estimation and response competence,and communication competence.Training needs involved complex operational items,knowledge of chronic disease management,professional communication,risk identification and response,nursing standards,norms,and procedures,and utilization of information technology.Conclusions:The training system may be developed based on nurses’core competencies and their training needs to promote professional development of the Internet plus nursing service.

Research on the High-Quality Development Path of Listed Private Education Groups

The rapid growth of the education industry and private education groups has brought the high-quality development of listed private education companies into focus for both the educational sector and the capital market.This study employs the fuzzy-set qualitative comparative analysis(fsQCA)method to explore pathways to high-quality development for these companies.Necessity analysis confirms that no single factor guarantees a company’s success,highlighting the importance of multi-factor interactions.Three main paths to high-quality development are identified:human resource optimization,precise market positioning,and comprehensive advantage.Conversely,four development paths for non-high-level companies are identified:dual insufficiency in resources and market,high turnover and over-investment,scale expansion with resource mismatch,and inadequate human resource development.The findings indicate that optimal allocation of educational resources,precise market positioning,rational resource allocation,and staff training are crucial for achieving high-quality development.Robustness tests,which raise the consistency threshold,verify the reliability and stability of the results.These findings provide a reference for policymakers,investors,and managers in the education industry.

Raman spectroscopy in crop quality assessment: focusing on sensing secondary metabolites: a review

As a crop quality sensor,Raman spectroscopy has been consistently proposed as one of the most promising and non-destructive methods for qualitative and quantitative analysis of plant substances,because it can measure molecular structures in a short time without requiring pretreatment along with simple usage.The sensitivity of the Raman spectrum to target chemicals depends largely on the wavelength,intensity of the laser power,and exposure time.Especially for plant samples,it is very likely that the peak of the target material is covered by strong fluorescence effects.Therefore,methods using lasers with low energy causing less fluorescence,such as 785 nm or near-infrared,are vigorously discussed.Furthermore,advanced techniques for obtaining more sensitive and clear spectra,like surface-enhanced Raman spectroscopy,time-gated Raman spectroscopy or combination with thin-layer chromatography,are being investigated.Numerous interpretations of plant quality can be represented not only by the measurement conditions but also by the spectral analysis methods.Up to date,there have been attempted to optimize and generalize analysis methods.This review summarizes the state of the art of micro-Raman spectroscopy in crop quality assessment focusing on secondary metabolites,from in vitro to in vivo and even in situ,and suggests future research to achieve universal application.

System barriers to the provision of quality maternal health care in two regional teaching and referral hospitals in Kenya:a qualitative study

Objective:Sub-Saharan Africa accounts for 66%of global maternal deaths.In Kenya,362 maternal deaths occur in every 100000 live births.Most of these deaths occur as a result of suboptimal quality care of mothers during labor,delivery,or within 24h of delivery.This study explored barriers that nurse-midwives encounter in trying to provide high-quality obstetric care during these periods.Methods:A qualitative research design utilizing focus group discussion as part of a mixed method study was used to find out the participants'experiences.Data were collected between February and March 2022 in the maternity units of two regional teaching and referral hospitals in Kenya.Eligible participants were nurse-midwives in charge of the maternity unit.The discussion was conducted in English,tape-recorded,and transcribed verbatim,Data were analyzed thematically,following Braun and Clarke 6-step framework.Nvivo version 7.0 computer software was used to facilitate this process.Results:Two focused group discussions each involving seven participants were conducted.The participants agreed that maternal mortality due to postpartum hemorrhage and pregnancy-induced hypertension is a major health concern.Further,maternal care in the two hospitals was substandard.Themes that emerged as barriers were:inadequate supplies;inadequate obstetric knowledge and skills;shortage of nurse-midwives,and inadequate support supervision.The underlying factors include inadequate funding by the county government and high staff turnover.Conclusion:This study showed that nurse-midwives are working under very difficult circumstances which are hindering the provision of quality maternal care.This is mainly due to system failures and inadequate nursemidwife numbers.Targeted strategies need to be urgently implemented to mitigate these challenges to improve the quality of maternal health care.

Experiences of Counselors Who Provided Psychological Support during COVID-19 Disaster: A Qualitative Study

Background:In crisis intervention sites such as infectious disease disasters,counselors are repeatedly exposed,directly or indirectly,to the traumatic experiences of victims.Disaster counseling has a negative effect on coun-selors,which can eventually interfere with the counseling process for disaster victims.Therefore,exploring and understanding the experiences of counselors is necessary to ensure that qualitative counseling for disaster victims can be continuously and efficiently conducted.Objectives:This study investigated the experiences of counselors who participated in mental health counseling as psychological support for victims of the COVID-19 disaster in Korea.Design:This is a qualitative study.Participants:The study participants comprised 18 counselors who had mental health professional qualifications of level 2 or higher and who had provided mental health counseling for COVID-19 confirmed cases and quarantined persons.Methods:Data were collected using focus group interviews from February 21 to May 29,2021.The duration of each interview was 60–90 min,and the data were analyzed using content analysis.Results:Thefinal theme was“Continuing to walk this road anytime,anywhere.”The par-ticipants’experiences were identified in four sub-themes:“being deployed to unprepared counseling,”“encoun-tering various difficulties,”“feeling full of meaning and value,”and“hoping to become a better counselor.”Conclusions:In order to continuously provide qualitative counseling in case of an infectious disease disaster such as COVID-19,it is important to develop a qualification and competency strengthening program through educa-tion and training to secure the crisis intervention expertise of counselors according to the characteristics of the disaster.In addition,a psychological support manual for each disaster should be prepared at the national level according to the type of disaster.

Role of intelligent/interactive qualitative and quantitative analysisthree-dimensional estimated model in donor-recipient size mismatch following deceased donor liver transplantation

BACKGROUND Donor-recipient size mismatch(DRSM)is considered a crucial factor for poor outcomes in liver transplantation(LT)because of complications,such as massive intraoperative blood loss(IBL)and early allograft dysfunction(EAD).Liver volumetry is performed routinely in living donor LT,but rarely in deceased donor LT(DDLT),which amplifies the adverse effects of DRSM in DDLT.Due to the various shortcomings of traditional manual liver volumetry and formula methods,a feasible model based on intelligent/interactive qualitative and quantitative analysis-three-dimensional(IQQA-3D)for estimating the degree of DRSM is needed.AIM To identify benefits of IQQA-3D liver volumetry in DDLT and establish an estimation model to guide perioperative management.METHODS We retrospectively determined the accuracy of IQQA-3D liver volumetry for standard total liver volume(TLV)(sTLV)and established an estimation TLV(eTLV)index(eTLVi)model.Receiver operating characteristic(ROC)curves were drawn to detect the optimal cut-off values for predicting massive IBL and EAD in DDLT using donor sTLV to recipient sTLV(called sTLVi).The factors influencing the occurrence of massive IBL and EAD were explored through logistic regression analysis.Finally,the eTLVi model was compared with the sTLVi model through the ROC curve for verification.RESULTS A total of 133 patients were included in the analysis.The Changzheng formula was accurate for calculating donor sTLV(P=0.083)but not for recipient sTLV(P=0.036).Recipient eTLV calculated using IQQA-3D highly matched with recipient sTLV(P=0.221).Alcoholic liver disease,gastrointestinal bleeding,and sTLVi>1.24 were independent risk factors for massive IBL,and drug-induced liver failure was an independent protective factor for massive IBL.Male donor-female recipient combination,model for end-stage liver disease score,sTLVi≤0.85,and sTLVi≥1.32 were independent risk factors for EAD,and viral hepatitis was an independent protective factor for EAD.The overall survival of patients in the 0.85<sTLVi<1.32 group was better compared to the sTLVi≤0.85 group and sTLVi≥1.32 group(P<0.001).There was no statistically significant difference in the area under the curve of the sTLVi model and IQQA-3D eTLVi model in the detection of massive IBL and EAD(all P>0.05).CONCLUSION IQQA-3D eTLVi model has high accuracy in predicting massive IBL and EAD in DDLT.We should follow the guidance of the IQQA-3D eTLVi model in perioperative management.

Exploring the Implications of Patient Advocacy Outcomes among Practicing Nurses within the Hospital Context: A Qualitative Research

Background: Nurses are expected by their international code of ethics to advocate for patients to enhance safety and quality care. However, there is a limited understanding regarding the implications of specific patient advocacy outcomes experienced by nurses who advocate for patients in the hospital context. Purpose: This study explored the implications of patient advocacy outcomes experienced among practicing nurses in the hospital context. Methods: A qualitative, descriptive study design was utilized. Data was collected through purposive sampling and an in-depth semi-structured interview of 25 Registered Nurses in an acute care hospital. An inductive qualitative content analysis method was used, and the SRQR guidelines for reporting qualitative studies were followed. Results: This study revealed that nurses who succeeded in advocating for patients experienced feelings of happiness, increased confidence levels, increased work output, and job satisfaction. However, nurses who failed to succeed in advocating for patients experienced physical, emotional, and psychological consequences, which contributed negatively to the quality of patient care. Therapeutic communication and nurses’ commitment to intervene for patients emerged as vital qualities and skills required to succeed in the patient advocacy process. Conclusions: This study showed that patient advocacy has advantages. However, when nurses fail to succeed in their attempt to advocate for patients in clinical practice, the outcomes can negatively affect their own well-being and the quality of patient care delivery. These study results could promote awareness and help nurses to develop strategies for improving patient advocacy activities based on their experiences. Additionally, nurses can seek help, including psychological counseling, when necessary to enhance their optimal well-being as they care for their patients. Nursing educational institutions and hospital managers can support, train, and equip nurses with the required skills for enhancing positive advocacy outcomes. .

Shape Measures for the Distribution of a Qualitative Variable

There are several shape measures for quantitative variables, some of which can also be applied to ordinal variables. In quantitative variables, symmetry, peakedness, and kurtosis are essential properties to evaluate the deviation from assumptions, particularly normality. They aid in selecting the most appropriate method for estimating parameters and testing hypotheses. Initially, these properties serve a descriptive role in qualitative variables. Once defined, they can be considered to check for non-compliance with assumptions and to propose modifications for testing procedures. The objective of this article is to present three measures of the shape of the distribution of a qualitative variable. The concepts of qualitative asymmetry and peakedness are defined. The measurement of the first concept involves calculating the average frequency difference between qualitative categories matched by frequency homogeneity or proximity. For the second concept, the peak-to-shoulder difference and the qualitative percentile kurtosis are taken into consideration. This last measurement is a less effective option than the peak-to-shoulder difference to measure peakedness. A simulated example of the application of these three measures is given and the paper closes with some conclusions and suggestions.

Shape Measures for the Distribution of a Qualitative Variable

There are several shape measures for quantitative variables, some of which can also be applied to ordinal variables. In quantitative variables, symmetry, peakedness, and kurtosis are essential properties to evaluate the deviation from assumptions, particularly normality. They aid in selecting the most appropriate method for estimating parameters and testing hypotheses. Initially, these properties serve a descriptive role in qualitative variables. Once defined, they can be considered to check for non-compliance with assumptions and to propose modifications for testing procedures. The objective of this article is to present three measures of the shape of the distribution of a qualitative variable. The concepts of qualitative asymmetry and peakedness are defined. The measurement of the first concept involves calculating the average frequency difference between qualitative categories matched by frequency homogeneity or proximity. For the second concept, the peak-to-shoulder difference and the qualitative percentile kurtosis are taken into consideration. This last measurement is a less effective option than the peak-to-shoulder difference to measure peakedness. A simulated example of the application of these three measures is given and the paper closes with some conclusions and suggestions.

Needs and Opportunities for Information in Patients with Metastatic Breast Cancer Attending a Tertiary Hospital in Tanzania—A Qualitative Study

Background: The majority of breast cancer patients in Tanzania present with advanced disease, and a significant proportion has metastatic breast cancer (MBC) on presentation or develops it during the course of their follow-up. With few treatment options to choose from, such patients often benefit from empathic support and access to information to help them make treatment decisions based on their individual circumstances and needs. Patients with MBC have been shown to present with unique physical, social and psychological needs that require additional time, counselling and availability of health care providers in addition to the routine options available to other patients. In resource-limited settings, the needs of such patients are often unknown and unaddressed, which adds to the anxiety associated with the diagnosis and its treatment. Materials and methods: This descriptive qualitative study was conducted using 3 focus group discussions with a total of 17 participants with metastatic breast cancer (MBC) attending Ocean Road Cancer Institute in Dar es Salaam, Tanzania. Participants were purposively selected for the study from outpatient clinics and inpatient wards. A semi-structured FGD guide was used to moderate discussions and analysis was done using a thematic approach. Results: The median age of participants was 51 (range 33 - 81 years) with an average of 4 months (range 1 - 12 months) from diagnosis of BC to the interview. 4 (24%) were diagnosed with MBC on first presentation (denovo). Participants spoke about the importance of accurate BC-related information in allowing timely referral and treatment both in the community and within the health system. They recognized the role of mass and social media in increasing awareness about BC and identified myths surrounding cancer treatment especially mastectomy. Correct and timely information at points of care, through media platforms and via ambassadors/patient support groups was perceived as a means to avoiding delays and securing early and effective treatment. Conclusion: Patients with MBC in Tanzania have many unmet informational needs in relation to their disease. Accurate BC-related information is important in allowing early detection and diagnosis. At the community level, provision of information through established media platforms and the use of patient advocates may help to enable early referral and treatment of patients.

A Qualitative Study on the Psychological Experience of Pregnant Women with Abnormal Induced Abortion of Fetuses under 20 Weeks of Pregnancy

Objective: This paper aims to understand the psychological experience and needs of pregnant women who need induction of labor due to fetal abnormalities at less than 20 weeks of gestation through in-depth interviews. Methods: Using the phenomenological research method in qualitative research, 12 pregnant women with fetal abnormalities less than 20 weeks of gestation in the obstetrics department of a hospital from January to April 2023 were selected as the research objects for semi-structured in-depth interviews. After information was collected to saturation, Colaizzi content analysis method was used to sort out, analyze and refine the data. Results: Through the interview results, three themes were refined from the transcript. Those are: 1) the support and assistance needed during the induction of labor;2) inner feelings after labor induction;3) The vision of future life. Conclusion: Abnormal fetal development at <20 weeks of gestation can cause anxiety, depression, guilt, loneliness and other negative emotions for pregnant women, and they need to get corresponding psychological support, especially during the period from fetal abnormality to induction of labor, pregnant women have to experience many physical and mental suffering, and need to get the care of family, relatives, friends, medical staff and society. Medical staff can help them seek multi-directional support, provide professional knowledge, and help them with self-management.