Aim
To describe partners' experiences of living with men with a screening‐detected abdominal aortic aneurysm (AAA).
Background
Diagnosis of a chronic life‐threatening disease affects the patients' as ...well as their partners' lives in different aspects. AAA, with rupture as the major consequence, is a life‐threatening disease that can affect the whole family. Screening programmes for AAA have been introduced in several countries to reduce the mortality rate. Although the awareness of having an AAA influences the individuals' quality of life and well‐being, it is still unclear how it affects their partners.
Design
Qualitative descriptive design.
Methods
Twenty‐one partners of men with AAA were purposely selected to participate in individual semi‐structured interviews between August 2017–February 2018 in Sweden. Data were transcribed and imported into NVivo‐12®. The data were analysed using qualitative content analysis. The study conforms to the COREQ checklist.
Results
Three categories were identified: (a) experiencing the unexpected; (b) being reminded of fragility; and (c) balancing a changing relationship. The partners had a positive attitude towards the screening process and were pleased that their husbands were under surveillance. Nevertheless, at the same time, the diagnosis caused worries and questions. The AAA diagnosis was constantly in the minds of the partners, which sometimes affected and limited daily activities. Furthermore, ambivalent feelings towards surgical treatment were described. The partners tried to support their men and encouraged them to achieve a healthy lifestyle.
Conclusion
The partners' well‐being and daily lives were impacted by the awareness of the screening‐detected AAA. Different degrees of worry were the most common reaction and were pervasive in all three categories.
Relevance for clinical practice
The result highlights the need to review routines or develop new strategies to include the partners in the process of screening and offer supplementary support and information.
The aim of this study was to explore the stressors and coping of nursing students with differing levels of resilience and burnout during clinical placement. A qualitative descriptive study was ...conducted with twenty-four final-year baccalaureate nursing students, who were identified in the quantitative phase of the study as having scores indicating either: a) low resilience and high burnout; or b) high resilience and low burnout. Ten focus group interviews were conducted using a semi-structured interview guide. A thematic analysis of the data identified two main themes: a) stressors arising from the students aligning their expectations with the demands of the clinical placement (i.e., practice demands in busy wards, striving for learning opportunities, and discovering the social rules), and b) coping as a process of fitting into the ward culture. Those students with high resilience and low burnout scores had self-directed goals and coped by using self-regulation strategies. Those with low resilience and high burnout adopted external orientation and self-blame strategies. As suggested by the findings, the following approaches are recommended: offering interventions to enable students to fit actively into the clinical environment; encouraging engagement in reflection to facilitate self-awareness; and encouraging flexible use of personal and external resources.
•Stressors arose from the students' expectations of the clinical placement.•Students' coping was a process of fitting into the ward culture.•While the students reported similar stressors, the coping strategies that they used to deal with those stressors differed.•Students with high resilience scores and low resilience scores demonstrated self-awareness and self-blame respectively.
We aimed to test a model in which hope and spiritual well-being acted as protective factors against anxiety and depressive symptoms in childhood cancer patients (CCPs). We hypothesized that hope and ...spiritual well-being were mutually reinforcing factors that would both reduce anxiety and depressive symptoms.
Using path analysis, the hypothetical model was tested on a cross-sectional sample of 412 Chinese CCPs aged 8-17 years. Self-reported measures were used to obtain data on participants' social and clinical characteristics, spiritual well-being, hope, anxiety and depressive symptoms.
The hypothetical model was supported. Results suggested that sex, treatment type and diagnosis predicted spiritual well-being; diagnosis and time since diagnosis predicted hope. Spiritual well-being and hope were mutually predictive and mutually reinforcing, and were both negatively associated with anxiety and depressive symptoms. This model predicted 40% of the variance in spiritual well-being, 37% in hope, 39% in depressive symptoms, and 28% in anxiety.
Spiritual well-being and hope were mutually reinforcing and served as protective factors against anxiety and depressive symptoms. These support the value for integrating spiritual and hope elements in developing interventions for CCPs to improve their spiritual and psychological well-being along the disease trajectory.
Spiritual well-being is the fourth dimension of health, as equally important as physical, mental, and social well-being. The shadow of death associated with cancer triggers children to explore their ...personal values, meanings, and life goals throughout the illness trajectory, enabling them to identify their unique spiritual needs. Chinese children are generally non-religious, unlike Western children, which affects their spiritual needs. To address the literature gaps, we applied a qualitative, descriptive, phenomenological approach for exploring the spiritual needs of Chinese children hospitalized with cancer. Purposive sampling was conducted in two public hospitals with special wards for pediatric oncology patients in Hunan Province, China. Consequently, 22 children, hospitalized with cancer, were recruited and individually interviewed using a semi-structured interview format. We conducted a thematic analysis of the interview transcripts. Four important themes were identified: the need for self-exploration, inner needs, need for a connection with others, and need for a connection with gods, supernatural powers, and fictional characters. We found that culture significantly influenced the spiritual needs of Chinese children with cancer. Hope was a key factor motivating the children to continue cancer treatment. To address their unique spiritual needs, culturally specific interventions should be developed and incorporated into their care to enhance their spiritual well-being.
Background and Purpose:
Qigong is used by cancer patients, but its effect is not adequately evaluated to date. The aim of this study was to investigate the effects of Qigong for the management of a ...symptom cluster comprising fatigue, dyspnea, and anxiety in patients with lung cancer.
Methodology:
A total of 156 lung cancer patients participated in this trial, and they were randomized to a Qigong group (6 weeks of intervention) or a waitlist control group receiving usual care. The symptom cluster was assessed at baseline, at the end of treatment (primary outcome), and at 12 weeks, alongside measures of cough and quality of life (QOL).
Results:
There was no significant interaction effect between group and time for the symptom cluster overall and for fatigue and anxiety. However, a significant trend towards improvement was observed on fatigue (P = .004), dyspnea (P = .002), and anxiety (P = .049) in the Qigong group from baseline assessment to the end of intervention at the 6th week (within-group changes). Improvements in dyspnea and in the secondary outcomes of cough, global health status, functional well-being and QOL symptom scales were statistically significant between the 2 groups (P = .001, .014, .021, .001, and .002, respectively).
Conclusion:
Qigong did not alleviate the symptom cluster experience. Nevertheless, this intervention was effective in reducing dyspnea and cough, and improving QOL. More than 6 weeks were needed, however, for detecting the effect of Qigong on improving dyspnea. Furthermore, men benefited more than women. It may not be beneficial to use Qigong to manage the symptom cluster consisting of fatigue, dyspnea, and anxiety, but it may be effective in managing respiratory symptoms (secondary outcomes needing further verification in future research). Future studies targeting symptom clusters should ensure the appropriateness of the combination of symptoms.
Trial registration:
ClinicalTrials.gov Identifier: NCT02977845. Registered November 30, 2016. https://clinicaltrials.gov/ct2/show/NCT02977845?term=Qigong&cond=Lung+Cancer&draw=2&rank=1
IntroductionCancer and its treatment affect children’s physical, psychological and social well-being throughout the disease trajectory. Spiritual well-being is a fundamental dimension of people’s ...overall health and is considered a source of strength to motivate patients to cope with and adapt to their disease. Appropriate spiritual interventions are important to mitigate the psychological impact of cancer on children, with an ultimate goal of improving their quality of life (QoL) throughout the treatment course. However, the overall effectiveness of spiritual interventions for paediatric patients with cancer remains unclear. This paper describes a protocol to systematically summarise the characteristics of studies related to existing spiritual interventions and synthesise their effectiveness on psychological outcomes and QoL among children with cancer.Methods and analysisTen databases will be searched to identify appropriate literature: MEDLINE, the Cochrane Central Register of Controlled Trials, EMBASE, CINAHL, PsycINFO, LILACS, OpenSIGLE, the Chinese Biomedical Literature Database, the Chinese Medical Current Contents and the Chinese National Knowledge Infrastructure. All randomised controlled trials that meet our inclusion criteria will be included. The primary outcome will be QoL as evaluated by self-reported measures. The secondary outcomes will be self-reported or objectively measured psychological outcomes, including anxiety and depression. Review Manager V.5.3 will be used to synthesise the data, calculate treatment effects, perform any subgroup analyses and assess the risk of bias in included studies.Ethical and disseminationThe results will be presented at international conferences and published in peer-reviewed journals. As no individual data will be involved in this review, ethical approval is not required.
Hope plays an extremely important role in protecting childhood cancer patients from psychological distress caused by cancer. The availability of a valid and reliable instrument that can accurately ...assess hope is crucial for the development of interventions to enhance hope among childhood cancer patients. This study aimed to examine the psychometric properties of the Chinese version of the Herth Hope Index (HHI). Chinese childhood cancer patients aged 8-17 years (n = 412) were invited to participate in this cross-sectional study. Participants completed the Chinese translated version of the HHI, the Center for Epidemiology Studies Depression Scale for Children and the Paediatric Quality of Life Inventory 3.0 Cancer Module. Exploratory factor analysis and confirmatory factor analysis were conducted to assess the structural validity of the HHI. Content validity, convergent validity, internal consistency, and test-retest reliability at 2 weeks were also examined. The content validity index for items ranged from 0.8 to 1.0, and that for the scale was 0.9, demonstrating appropriate content validity. There was a positive correlation between HHI and Center for Epidemiology Studies Depression Scale for Children scores and a negative correlation between HHI and Paediatric Quality of Life Inventory 3.0 Cancer Module scores. The results indicated that the Chinese version of the HHI showed reasonable convergent validity and discriminant validity. Exploratory factor analysis yielded a three-factor model, which could explain 82.74% of the total variance. The confirmatory factor analysis results showed that χ
/df was 2.20, comparative fit index was 0.98, goodness of fit index was 0.94, and root-mean-square error of approximation was 0.07. Cronbach's alpha was 0.78, indicating good internal consistency. The findings of the study showed that the Chinese version of the HHI (11-item) is a reliable and valid instrument for assessing hope among Chinese childhood cancer patients. Evidence-based interventions can be provided to enhance hope in this population.
Spiritual well-being is a strength for childhood cancer patients to cope with cancer. The availability of a valid and reliable instrument for assessing spiritual well-being is crucial. This study ...translated and adapted the Functional Assessment of Chronic Illness Therapy Spiritual Well-being scale (FACIT-Sp) for Chinese childhood cancer patients and examined the psychometric properties and factor structure in this population.
This was a methodological study. The FACIT-Sp was translated into Chinese. Adaptation was based on our qualitative study. For psychometric evaluation, a convenience sample of 412 were recruited based on the suggested sample size for the exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). Childhood cancer patients were included if they aged 8-17 years, with parental consent to participate, able to communicate that they were being treated for cancer, and able to communicate and read Chinese. Participants answered the Chinese version of the adapted FACIT-Sp, the Center for Epidemiology Studies Depression Scale for Children (CES-DC), and the Pediatric Quality of Life Inventory 3.0 Cancer Module (PedsQL). Content validity, convergent validity, internal consistency and test-retest reliability were examined. Both EFA and CFA assessed the structural validity of the adapted FACIT-Sp.
The content validity index values for items ranged 0.8-1.0 and that for the scale was 0.84, indicating appropriate content validity. The scale had good internal consistency, with a Cronbach's alpha of 0.815. The FACIT-Sp scores positively correlated with the CES-DC scores, and negatively correlated with PedsQL scores, suggesting that the Chinese version of the adapted FACIT-Sp had reasonable convergent validity. EFA yielded a four-factor (meaning, peace, faith, and connection with others) model. The CFA results revealed that the four-factor model achieved a better fit than the original three-factor model (Chi-Square Mean/Degree of Freedom = 2.240 vs. 3.557, Comparative Fit Index = 0.953 vs. 0.916, Goodness of Fit Index = 0.909 vs. 0.884, Root Mean Square Error of Approximation = 0.078 vs. 0.112).
The Chinese version of the adapted FACIT-Sp is a reliable and valid instrument for assessing spiritual well-being among Chinese childhood cancer patients. This instrument can be applied in clinical settings for routine assessment.
Despite an increase in emphasis on psychosocial care in cancer nursing, time constraints and nurses' lack of knowledge in skilled communication continue to be challenges.
To examine how cancer care ...nurses view their communication with patients and how they deal with the psychosocial needs of patients in busy wards.
A qualitative interview study.
Focus groups and individual interviews were conducted with eleven hospital-based cancer nurses in Hong Kong from July 2, 2017 to January 2, 2018.
A qualitative thematic analysis of the data identified three themes: 1. Intentional and unintentional psychosocial care that is secondary in focus; 2. Managing an emotionally challenged environment; 3. Mentoring and learning.
Oncology settings are time-constrained, emotionally charged environments for nurses, and providing psychosocial care for patients is a secondary concern. While proactive strategies can be used to avert patient complaints, being open and attending to the individual needs of patients is equally important to avoid blocking in nurse-patient communication. Despite emotional entanglement and tensions, the positive follow-up strategies used by nurses to manage the patients' emotions and provide psychosocial care reflect good practices. Leadership and support are needed to deal with the nurses' perception that their communication training has been ineffective and their ability to manage strong emotions deficient. Communication skills, honed by making continuous opportunities to communicate available, as well as an understanding of emotional labour, need to be integrated with mindfulness in the nurses' care of themselves and their patients. Notwithstanding the importance of experience in oncology care for junior nurses, it is necessary for both junior and senior nurses to learn about and reflect upon the different forms of emotional labour if value-based care is to be provided. In addition, it is essential for junior nurses to receive continuous coaching and mentoring, and to engage in reflective learning from each clinical encounter with oncology patients.
Limited research has been conducted on community college (CC) transfer students' (TS) experiences in four-year universities, particularly in Asian contexts. To fill this research gap, in this ...qualitative study, 124 TS from various disciplines in a Hong Kong university participated in 39 focus groups and seven individual interviews. Unlike their Western counterparts, our TS were relatively better prepared and more academically adaptive. Nevertheless, their social integration was restricted by a lack of time for extra-curricular activities, a sense of inferiority and incompetence, and restricted social circles that did not enable interaction with non-TS. These challenges and their implications are discussed. In particular, this study has highlighted differences between the special education systems for CC transfer in Hong Kong and those in Western CC models. The study has also highlighted the study-induced stress, and poor self-perceptions that TS experience, despite their academic abilities.
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