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Tian Y, Wang YL. Resilience provides mediating effect of resilience between fear of progression and sleep quality in patients with hematological malignancies. World J Psychiatry 2024; 14:541-552. [PMID: 38659599 PMCID: PMC11036458 DOI: 10.5498/wjp.v14.i4.541] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Revised: 02/19/2024] [Accepted: 03/28/2024] [Indexed: 04/17/2024] Open
Abstract
BACKGROUND Hematological tumors are common malignant tumors, with high morbidity and mortality rates. Most patients with hematological malignancies develop sleep disorders that seriously affect their life and health because of acute onset of disease, rapid progression, high recurrence rates, complex treatment methods, and treatment costs. AIM To explore the mediating effect of resilience on fear of disease progression and sleep quality in patients with hematological malignancies. METHODS A cross-sectional analysis of 100 patients with hematological malignancies, treated in the First Affiliated Hospital of Jinzhou Medical University between August 2022 and August 2023, was conducted. Patients were assessed using a general data survey, a simplified scale for the fear of progression (FoP) of disease, a resilience scale, and the Pittsburgh Sleep Quality Index. Statistical analysis was conducted to determine the relationship between various patient characteristics and FoP, resilience, and sleep quality. Spearman's correlation analysis was used to examine the correlations between mental resilience, FoP, and sleep quality. RESULTS The total FoP score mean value in patients with hematological malignancies was 38.09 ± 5.16; the total resilience score mean value was 40.73 ± 7.04; and the Pittsburgh Sleep Quality Index score mean value was 10.72 ± 1.90. FoP, resilience, and sleep quality of the patients were associated with family per capita monthly income and patient education level (P < 0.05). Spearman correlation analysis revealed that FoP was negatively correlated with resilience and sleep quality scores (r = -0.560, -0.537, P < 0.01), respectively, and resilience was significantly associated with sleep quality scores (r = 0.688, P < 0.01). Mediation analysis showed that the mediating effect of resilience between FoP and sleep quality in patients with hematological malignancies was -0.100 and accounted for 50.51% of the total effect. This indicated that FoP directly and indirectly affected sleep quality through the mesomeric effect of resilience. CONCLUSION Resilience is an intermediary variable between FoP and sleep quality in patients with hematological malignancies. Medical staff should evaluate and follow-up FoP and resilience to implement measures to improve sleep quality.
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Affiliation(s)
- Yuan Tian
- Department of Hematology, The First Affiliated Hospital of Jinzhou Medical University, Jinzhou 121000, Liaoning Province, China
| | - Ying-Li Wang
- Department of Cardiology, The First Affiliated Hospital of Jinzhou Medical University, Jinzhou 121000, Liaoning Province, China
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Melhem SJ, Nabhani-Gebara S, Kayyali R. Evaluating online health information utilisation and its psychosocial implications among breast cancer survivors: Qualitative explorations. Health Promot Perspect 2024; 14:61-69. [PMID: 38623349 PMCID: PMC11016143 DOI: 10.34172/hpp.42682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2023] [Accepted: 12/26/2023] [Indexed: 04/17/2024] Open
Abstract
Background This study investigated the online information-seeking behaviours of breast cancer patients at Jordan University Hospital, focusing on their dissatisfaction with available online health resources and its impact on their well-being and anxiety levels. Methods Employing descriptive phenomenology and convenience sampling, we conducted five Skype-based focus groups with 4-6 breast cancer survivors each, from March to July 2020. Data analysis was performed using NVivo, following Braun and Clark's inductive thematic analysis framework. Results The thematic analysis revealed critical insights into survivors' interactions with online cancer resources, identifying key subthemes such as the quality of online information, cyberchondriasis, health literacy and search strategies, the distress caused by counterproductive searches, and the tendency to avoid internet searches. Conclusion The study underscores the challenges breast cancer survivors face in accessing online health information, especially in Arabic. It highlights the need to improve the quality and accessibility of these resources. Enhancing the cultural relevance of online materials and educating patients on effective information evaluation are crucial. These measures can significantly boost health literacy, mitigate anxiety, and provide better support for breast cancer survivors.
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Affiliation(s)
- Samar J Melhem
- Department of Biopharmaceutics and Clinical Pharmacy, School of Pharmacy, The University of Jordan. Amman-Jordan
- Department of Pharmacy, School of Life Sciences, Pharmacy and Chemistry, Kingston University London, Kingston upon Thames, Surrey KT1 1LQ, UK
| | - Shereen Nabhani-Gebara
- Department of Pharmacy, School of Life Sciences, Pharmacy and Chemistry, Kingston University London, Kingston upon Thames, Surrey KT1 1LQ, UK
| | - Reem Kayyali
- Department of Pharmacy, School of Life Sciences, Pharmacy and Chemistry, Kingston University London, Kingston upon Thames, Surrey KT1 1LQ, UK
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Melhem SJ, Kayyali R. Multilayer framework for digital multicomponent platform design for colorectal survivors and carers: a qualitative study. Front Public Health 2023; 11:1272344. [PMID: 38115846 PMCID: PMC10728820 DOI: 10.3389/fpubh.2023.1272344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 11/08/2023] [Indexed: 12/21/2023] Open
Abstract
Background The advent of eHealth services offers the potential to support colorectal cancer (CRC) survivors and their informal caregivers (ICs), yet research into user needs and design requirements remains scant. This exploratory qualitative study addresses this knowledge gap by focusing on the development of a Digital Multicomponent Platform (DMP) designed to provide comprehensive support to these populations. Aims The objective of this research is to use qualitative methodologies to identify key user needs and design requirements for eHealth services. It seeks to propose and apply a multi-tiered framework for creating a DMP that encapsulates the needs of CRC survivors and their ICs. Methods Skype-based focus groups (FGs) were utilized to gather qualitative data from CRC survivors and ICs. This approach served to elicit crucial themes integral to the design of the DMP. A multi-tiered framework was subsequently developed to integrate user-centered design (UCD) principles and requirements with predetermined outcomes, eHealth services, and IT infrastructure. Results The first stage of the analysis identified five crucial themes: (1) the importance of healthcare system interaction via eHealth, (2) interaction between healthcare providers and peers, (3) lifestyle and wellness considerations, (4) platform content and user interface requirements, (5) caregiver support. The second stage analysis applied the multi-tiered framework, to determine the DMP that was conceptualized from these themes, underscores the significance of personalized content, caregiver involvement, and integration with electronic health records (EHRs). Conclusion The study offers novel insights into the design and development of digital supportive care interventions for CRC survivors and their caregivers. The results highlight the utility of user-centered design principles, the significance of personalized content and caregiver involvement, and the need for a unified health data platform that promotes communication among patients, healthcare providers, and peers. This multi-tiered framework could serve as a prototype for future eHealth service designs.
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Affiliation(s)
- Samar J. Melhem
- Department of Pharmacy, School of Life Sciences, Pharmacy and Chemistry, Kingston University London, Kingston upon Thames, Surrey, United Kingdom
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Tang H, Wang R, Yan P, Zhang W, Yang F, Guo S, Li T, Yi L, Bai X, Lin S, Zhang Y, Shang L. Dietary Behavior and Its Association with Nutrition Literacy and Dietary Attitude Among Breast Cancer Patients Treated with Chemotherapy: A Multicenter Survey of Hospitals in China. Patient Prefer Adherence 2023; 17:1407-1419. [PMID: 37325586 PMCID: PMC10263021 DOI: 10.2147/ppa.s413542] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Accepted: 06/06/2023] [Indexed: 06/17/2023] Open
Abstract
Background Chemotherapy often negatively impacts the nutritional status of breast cancer patients, and healthy dietary behaviors are important for patient wellbeing. With the guidance of the "Knowledge, Attitude and Practice model" (KAP model), the objective of this survey was to determine the frequency with which patients engage in healthy dietary behaviors and to explore the association between healthy dietary behaviors and nutrition literacy and dietary attitudes. Methods This study included a total of 284 breast cancer patients undergoing chemotherapy from three hospitals spanning three cities in China. Face-to-face interviews were conducted to collect demographic and clinical characteristics as well as the Dietary Nutritional Knowledge, Attitude and Practice Questionnaire (DNKAPQ) and the Nutrition Literacy Measurement Scale for Chinese Adult (NLMS-CA). Results Participants exhibited medium to high scores for nutrition literacy, dietary attitude and dietary behavior. Nutrition literacy (r = 0.505, p < 0.001) and dietary attitude (r= 0.326, p < 0.001) scores were both positively correlated with the total dietary behavior score. The total nutrition literacy score was positively correlated with the total dietary behavior score (r = 0.286, p < 0.001). In the univariate analysis, age, body mass index, living environment, education level, monthly family income, work status, menopausal status, number of comorbidities, relapse and endocrine therapy were significantly associated with dietary behavior (p < 0.05). In the multiple linear regression analysis, patients' dietary behavior was significantly associated with nutrition literacy (β = 0.449, p < 0.001) and dietary attitude (β = 0.198, p < 0.001). These two factors accounted for 28.6% of the variation in the patients' dietary behavior scores. Conclusion There is an important need for targeted dietary and nutritional interventions designed and implemented by health professionals to improve dietary behaviors. Intervention design and content should take the patients' nutrition literacy and dietary attitudes into consideration. In particular, women who are older, overweight, unemployed, and postmenopausal and live in rural areas, exhibit fewer comorbidities, have a lower family income and education level, have not relapsed and are currently receiving endocrine therapy are in urgent need of diet-specific intervention.
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Affiliation(s)
- Han Tang
- Department of Health Statistics, School of Public Health, The Fourth Military Medical University, Xi’an, Shaanxi, 710032, People’s Republic of China
- Department of Clinical Nursing, School of Nursing, The Fourth Military Medical University, Xi’an, Shaanxi, 710032, People’s Republic of China
| | - Ruibo Wang
- School of Nursing and Health, Zhengzhou University, Zhengzhou, Henan, 450001, People’s Republic of China
| | - Pei Yan
- Department of Health Statistics, School of Public Health, The Fourth Military Medical University, Xi’an, Shaanxi, 710032, People’s Republic of China
- Department of Operation Room, Xijing Hospital, The Fourth Military Medical University, Xi’an, Shaanxi, 710032, People’s Republic of China
| | - Wei Zhang
- Department of Health Statistics, School of Public Health, The Fourth Military Medical University, Xi’an, Shaanxi, 710032, People’s Republic of China
| | - Feng Yang
- Department of Health Statistics, School of Public Health, The Fourth Military Medical University, Xi’an, Shaanxi, 710032, People’s Republic of China
| | - Shengjie Guo
- School of Nursing and Health, Zhengzhou University, Zhengzhou, Henan, 450001, People’s Republic of China
| | - Ting Li
- School of Nursing and Health, Zhengzhou University, Zhengzhou, Henan, 450001, People’s Republic of China
| | - Luanxing Yi
- School of Nursing, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, 350122, People’s Republic of China
| | - Xue Bai
- Puyang Oilfield General Hospital, Puyang, Henan, 457001, People’s Republic of China
| | - Shan Lin
- Department of Neurology, The 900th Hospital of Joint Logistic Support Force, PLA, Fuzhou, Fujian, 350025, People’s Republic of China
| | - Yuhai Zhang
- Department of Health Statistics, School of Public Health, The Fourth Military Medical University, Xi’an, Shaanxi, 710032, People’s Republic of China
| | - Lei Shang
- Department of Health Statistics, School of Public Health, The Fourth Military Medical University, Xi’an, Shaanxi, 710032, People’s Republic of China
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Boran O, Kose G. A Turkish Study to Identify the Discharge Learning Needs of Spinal Surgery Patients. J Neurosci Nurs 2023; 55:86-90. [PMID: 36917823 DOI: 10.1097/jnn.0000000000000702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/15/2023]
Abstract
ABSTRACT PURPOSE: The aim of this study was to identify the learning needs of spinal surgery patients before hospital discharge. METHODS: This cross-sectional study consisted of 117 spinal surgery patients admitted to the neurosurgery department between October 2019 and March 2020. Data were collected using a descriptive information form, visual analog scale, and the Patient Learning Needs Scale. Data were analyzed using descriptive statistics, Mann-Whitney U and Kruskal-Wallis tests, and Spearman correlation analysis. RESULTS: The mean age of the participants was 54 years, 54.7% were male, and 59% underwent surgery because of spinal disc herniation. The mean Patient Learning Needs Scale score was 188.74. The primary learning needs of the patients were related to the dimensions of activities of living, medication, treatment, and complications, whereas the feelings related to condition were the least-demanded dimension of learning needs. Sex and occupation were the primary factors influencing learning needs. CONCLUSION: The level of learning needs in spinal surgery patients was relatively high. Therefore, discharge education may be planned in line with the learning needs and priorities of these patients, and sex and occupation may be considered while planning discharge education.
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Tang H, Wang R, Liu W, Xiao H, Jing H, Song F, Guo S, Li T, Yi L, Zhang Y, Bai X, Shang L. The influence of nutrition literacy, self-care self-efficacy and social support on the dietary practices of breast cancer patients undergoing chemotherapy: A multicentre study. Eur J Oncol Nurs 2023; 64:102344. [PMID: 37290159 DOI: 10.1016/j.ejon.2023.102344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 03/27/2023] [Accepted: 04/29/2023] [Indexed: 06/10/2023]
Abstract
PURPOSE Breast cancer patients undergoing chemotherapy experience adverse reactions, which lead to poor nutritional status. The objective of this study was to explore the dietary practice of Chinese breast cancer patients undergoing chemotherapy and to analyse the influence of nutrition literacy, self-care self-efficacy and perceived social support on dietary practice. METHOD A total of 295 participants from three hospitals in China were enrolled. The Dietary Nutritional Knowledge, Attitude and Practice Questionnaire; Nutrition Literacy Measurement Scale for Chinese Adults; Strategies Used by People to Promote Health and Perceived Social Support Scale were administered. Multiple linear regressions were used to identify influencing factors. RESULTS The dietary practice of patients were generally satisfactory. Nutrition literacy (r = 0.460, p < 0.001), self-care self-efficacy (r = 0.513, p < 0.001) and perceived social support (r = 0.703, p < 0.001) were positively correlated with dietary practice. The main factors influencing participants' dietary practice were nutrition literacy, self-care self-efficacy, perceived social support, living environment, cancer stage, body mass index, chemotherapy cycle and average monthly household income (all p < 0.05). The model explained 59.0% of the variance in dietary practice. CONCLUSIONS Health professionals should emphasize breast cancer patients' dietary practice throughout the entire chemotherapy course, and dietary interventions should be designed by oncology nurses based on patients' nutrition literacy, self-care self-efficacy and perceived social support. Female patients who have a higher body mass index and income, live in rural areas, have a lower education level, have stage I cancer and have undergone numerous chemotherapy cycles are the focus population of intervention.
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Affiliation(s)
- Han Tang
- Department of Health Statistics, School of Public Health, The Fourth Military Medical University, 710032, Xi'an, China; Department of Clinical Nursing, School of Nursing, The Fourth Military Medical University, 710032, Xi'an, China
| | - Ruibo Wang
- School of Nursing and Health, Zhengzhou University, 450001, Zhengzhou, China
| | - Wei Liu
- Department of Breast Surgery 2 (Area 1), The First Affiliated Hospital of Zhengzhou University, 450052, Zhengzhou, China
| | - Han Xiao
- Department of Breast Surgery 2 (Area 1), The First Affiliated Hospital of Zhengzhou University, 450052, Zhengzhou, China
| | - Haihong Jing
- Department of Breast Surgery 2 (Area 1), The First Affiliated Hospital of Zhengzhou University, 450052, Zhengzhou, China
| | - Fangxia Song
- Department of Breast Surgery 2 (Area 1), The First Affiliated Hospital of Zhengzhou University, 450052, Zhengzhou, China
| | - Shengjie Guo
- School of Nursing and Health, Zhengzhou University, 450001, Zhengzhou, China
| | - Ting Li
- School of Nursing and Health, Zhengzhou University, 450001, Zhengzhou, China
| | - Luanxing Yi
- School of Nursing, Fujian University of Traditional Chinese Medicine, 350025, Fuzhou, China
| | - Yuhai Zhang
- Department of Health Statistics, School of Public Health, The Fourth Military Medical University, 710032, Xi'an, China
| | - Xue Bai
- Puyang Oilfield General Hospital, 457001, Puyang, China
| | - Lei Shang
- Department of Health Statistics, School of Public Health, The Fourth Military Medical University, 710032, Xi'an, China.
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Melhem SJ, Nabhani-Gebara S, Kayyali R. Digital Trends, Digital Literacy, and E-Health Engagement Predictors of Breast and Colorectal Cancer Survivors: A Population-Based Cross-Sectional Survey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1472. [PMID: 36674237 PMCID: PMC9860554 DOI: 10.3390/ijerph20021472] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 12/30/2022] [Accepted: 01/06/2023] [Indexed: 06/17/2023]
Abstract
Introduction: Advances in information and communication technology (ICT) and post-COVID-19 tectonic changes in healthcare delivery have made it possible for cancer survivors to obtain disease-related information for remote management online rather than through healthcare providers. To comprehend and evaluate health information, digital literacy is crucial. Objectives: This study examined cancer survivors’ information-seeking behaviour, information sources, digital health literacy, and digital trends, as well as potential determinants of e-health information receptivity and online resource use. Methods: A national 30-item cross-sectional survey using a representative random sample of cancer survivors from Jordan’s cancer registry was conducted. Chi-square tests established categorical variable relationships. Using the mean and standard deviation, we calculated the Likert scale’s ordinal data average. A p-value < 0.05 was statistically significant. Logistic regression identified predictors of interest in late-trajectory information acquisition and use of e-health platforms (apps, portals) for cancer self-management. Results: Lower digital literacy and electronic searching were associated with older age and lower income, education, and employment status (p ≤ 0.001). Digital literacy independently predicted m-health app use for remote management and interest in cancer supportive care information. Digitally literate survivors preferred the use of digital platforms (p ≤ 0.001). Information acquisition barriers included “reliability” (26%, n = 25) and “health information trustworthiness” (16.2%, n = 25). Following treatment completion, Internet-seeking behaviour decreased significantly when compared to the early cancer trajectory. Conclusion: Our findings imply that Jordanian cancer survivors’ low digital literacy may hinder information acquisition and technology-enabled cancer care. Digital interventions for cancer survivors should be adaptable to varying levels of digital health literacy. Healthcare policymakers should recognise digital inequities and devise focused initiatives to bridge the digital divide while responding to the urgent need to digitalise cancer care delivery.
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Affiliation(s)
- Samar J. Melhem
- Department of Pharmacy, School of Life Sciences, Pharmacy and Chemistry, Kingston University London, Kingston upon Thames, Surrey KT1 1LQ, UK
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