Objective:To construct a training program for nurses in shared-decision making of breast cancer surgery based on core competence, and to provide reference for clinical training.Methods:From February to May 2023, through literature review, qualitative interview, group discussion, Delphi and analytic hierarchy process, the training program were determined.Results:Among 18 experts, there were 3 males and 15 females, aged (44.67±9.24) years old. The final training program included 6 first-level indicators(admission criteria, training content (theory + practice), training format, training hours, training instructors, training evaluation), 17 second-level indicators, and 57 third-level indicators. The effective response rates of 2 rounds of expert consultations were both 18/18, and the expert authority coefficients were both 0.933. The Kendall coordination coefficients of the first and second round were 0.160, 0.213 (both P<0.05). Conclusions:The training program of decision aid nurses in breast cancer surgery is scientific, practical and clinically valuable, and can provide reference for the development of standardized training for nurses.

Objective To explore the thoughts and experiences of exercise adherence in breast cancer patients undergoing endocrine therapy,aims to provide reference for targeted intervention.Methods Employing purposive sampling,a descriptive qualitative study was conducted from Octomber 2023 to November 2024,and 24 breast cancer patients receiving endocrine therapy who visited a tertiary-level hospital in Tianjin,China,were selected for semi-structured in-depth interviews.The data was analyzed through traditional content analysis to extract themes.Results 3 primary themes and 6 sub-themes were identified,including sense of benefits from exercise(including physical benefits and psychological well-being),factors influencing exercise adherence(barriers and facilitators),and supportive needs for exercise adherence(including professional support and guidance,as well as emotional support and companionship).Conclusion Healthcare providers should consider the influencing factors,supportive needs of behavior change,and exercise experiences of breast cancer patients receiving endocrine therapy.Developing targeted exercise rehabilitation programs to address these needs could enhance exercise adherence.

Objective To explore the thoughts and experiences of exercise adherence in breast cancer patients undergoing endocrine therapy,aims to provide reference for targeted intervention.Methods Employing purposive sampling,a descriptive qualitative study was conducted from Octomber 2023 to November 2024,and 24 breast cancer patients receiving endocrine therapy who visited a tertiary-level hospital in Tianjin,China,were selected for semi-structured in-depth interviews.The data was analyzed through traditional content analysis to extract themes.Results 3 primary themes and 6 sub-themes were identified,including sense of benefits from exercise(including physical benefits and psychological well-being),factors influencing exercise adherence(barriers and facilitators),and supportive needs for exercise adherence(including professional support and guidance,as well as emotional support and companionship).Conclusion Healthcare providers should consider the influencing factors,supportive needs of behavior change,and exercise experiences of breast cancer patients receiving endocrine therapy.Developing targeted exercise rehabilitation programs to address these needs could enhance exercise adherence.

Objective:To construct a training program for nurses in shared-decision making of breast cancer surgery based on core competence, and to provide reference for clinical training.Methods:From February to May 2023, through literature review, qualitative interview, group discussion, Delphi and analytic hierarchy process, the training program were determined.Results:Among 18 experts, there were 3 males and 15 females, aged (44.67±9.24) years old. The final training program included 6 first-level indicators(admission criteria, training content (theory + practice), training format, training hours, training instructors, training evaluation), 17 second-level indicators, and 57 third-level indicators. The effective response rates of 2 rounds of expert consultations were both 18/18, and the expert authority coefficients were both 0.933. The Kendall coordination coefficients of the first and second round were 0.160, 0.213 (both P<0.05). Conclusions:The training program of decision aid nurses in breast cancer surgery is scientific, practical and clinically valuable, and can provide reference for the development of standardized training for nurses.

Objective To develop a evidence-based and local decision supporting tool for breast reconstruction for breast cancer surgery based on Ottawa decision support framework to guide clinical decision-making and promote the implementation of shared decision-making.Methods Based on Ottawa decision support framework and International Patient Decision Aid Standards 4.0(IPDAS4.0),the initial version of breast reconstructive surgery decision support tool was proposed through a literature review.Eighteen clinical and nursing experts specialised in breast cancer and breast reconstruction were invited to participate in 2 rounds of Delphi consultations and resulted in a revised version of the tool.Following a pilot test involving 5 patients and 5 family members in clinical settings,their feedback was integrated into the revised version to create a final version of the tool.Results The initial version of the tool were developed based on the literature review and evidence synthesis,comprising 7 primary indicators,14 secondary indicators and 49 tertiary indicators.In the first round of consultation on the 3-tier indicators,the average importance scores ranged from 4.06 to 4.94,with coefficients of variation were 0.05-0.22,and proportions of full marks ranged from 0.53 to 0.88.In the second round of consultation on the 3-tier indicators,the average importance scores ranged from 4.71 to 4.94,with coefficients of variation were 0.05-0.15,and proportions of full marks ranged from 0.72 to 1.00.Kendall's W coefficients for the primary,secondary and tertiary indicators in the second round were 0.509,0.437,and 0.425,respectively.The finalised decision support tool for breast cancer and breast reconstruction included 7 primary indicators covering decision evaluation,disease information support,risk and benefit analysis,decision support system,balance value and preference,promotion of decision making,evaluation of decision quality,alongside 14 secondary indicators and 50 tertiary indicators.Clinical trials confirmed the finalised effectiveness of the tool.Conclusion The decision support tool for breast cancer and breast reconstruction which developed on the basis of Ottawa decision support framework demonstrates scientific rigor and clinical value.It provides solutions for breast cancer patients when facing difficulties in making a decision for breast reconstruction surgery.

Objective To explore the risk factors and awareness level of deep vein thrombosis(DVT)in elderly outpatients in Shanghai community hospitals.Methods A total of 710 elderly outpatients were subjected with random sampling from 10 community hospitals in Shanghai.Au-tar deep vein thrombosis risk assessment scale and venous thromboembolism(VTE)self-manage-ment ability related knowledge scale were used to conduct questionnaire investigation.The influ-encing factors for risk level of DVT and for VTE self-management ability score were analyzed in these patients.Results The high-risk DVT group had significantly larger proportions of aged 65 years,primary school education or below,chronic diseases,BMI≥28 kg/m2,and suburban resi-dents than the low-risk DVT patients(88.0％vs 50.9％,65.5％vs 26.5％,94.8％vs 86.2％,12.9％vs 5.2％,58.2％vs 43.9％,P＜0.01).Multivariate logistic regression analysis showed that age,education level,chronic disease,multimorbidity,BMI and residential area were independent risk factors for risk level of DVT in the elderly outpatients in community hospitals(P＜0.05,P＜0.01).Hypertension,cerebral infarction,cerebral hemorrhage and malignant tumors were inde-pendent risk diseases of DVT in the patients with multimorbidity(P＜0.01).Age,education lev-el,chronic diseases,BMI,smoking,residential area and other factors were related to the score of VTE self-management(P＜0.05,P＜0.01).Conclusion General practitioners should pay close attention to the elderly outpatients in community hospitals,with characteristics of advanced age,obesity,lower education level,chronic disease,multimorbidity and living in suburban area,espe-cially those with multiple diseases.What's more,awareness of risk for DVT and self-management ability should be improved simultaneously.

Objective:To establish the fingerprints of Plantaginis Herba.Methods:The fingerprints were determined by UPLC. The peak areas of fingerprints of different parts and origins were analyzed by variance analysis and independent sample t-test. PCA, HCA, PLS-DA and other chemical patterns were analyzed by Simca14.1. The index weight was calculated by CRITIC, and the quality of plantain evaluation was combined with grey correlation degree.Results:The fingerprints of grass, stem, leaf and spike of Plantago depressa Willd. calibrated for 24, 16, 23 and 22 common peaks. The fingerprints of grass, stem, leaf and spike of Plantaginis Herba calibrated for 22, 10, 16 and 22 common peaks, and the fingerprints of commercial mixed plantain calibrated for 23 common peaks. 10 peaks were identified. The analysis of variance showed that there were differences in chromatographic peak areas between different parts of Plantago asiatica L. and Plantago depressa Willd.. And combinedede with PLS-DA, it showed that there were 16 important characteristic indexes in the classification, and the importance ranking was peak 3, 8, 28, 12, 14, 7, 5, 17, 6, 19, 23, 11, 22, 27, 9, 16. The quality evaluation results of critical method combined with grey correlation degree showed that among Plantago depressa Willd., Plantago asiatica L. and commercial mixed plantain herbs, the quality of Plantago asiatica L. was the best. Conclusion:The mixture of plantain exists in the market. The fingerprints established in this study can be used for the identification and quality evaluation of Plantaginis Herba from different sources.

Objective:To investigate the present situation of lymphedema clinics in 60 hospitals and provide reference for the management and development of lymphedema nursing clinic.Methods:Convenience sampling method was used to select 60 hospitals that had set up lymphedema nursing outpatient service. A self-designed questionnaire was conducted for the heads of lymphedema nursing clinics from June 10th 2021 to August 15th, 2021 using electronic questionnaires.Results:Lymphedema clinics had been opened since 2015 and developed rapidly in recent years. The outpatient service mainly took the form of specialized outpatient service for lymphedema, accounted for 61.67%(37/60), and also existed in the form of combined breast rehabilitation, ostomy, catheter maintenance, etc. There was a great difference in the frequency of outpatient service in hospitals, 46.67%(28/60) had outpatient service every day, 36.67% (22/60) had outpatient service only half a day every week. The number of outpatient patients was relatively low, 61.67%(37/60) of the hospitals had no more than 10 patients per week, and only 8.33% (5/60) had more than 50 patients per week. There were only 26 full-time nurses accounted for 14.94%(26/174), and the international lymphedema therapist certification rate was 36.21% (63/174). Training institutions included foreign introduced training programs, domestic and foreign cooperation programs, overseas training and local training, etc. 100.00% (60/60) of the hospitals participating in the survey adopted comprehensive detumescence therapy, combined with auxiliary motor muscle energy binding technology 51.67% (31/60), air wave pressure therapy 48.33% (29/60), traditional Chinese medicine therapy 16.67% (10/60), etc. According to the survey of charging situation, only 14 hospitals accounted for 23.33%(14/60) had special charging, among which 12 hospitals accounted for 20.00%(12/60) had official charging approval.Conclusions:Lymphedema clinics have been developed and the ranks of lymphedema therapists are growing. The relevant departments should strengthen the standard management of lymphedema clinic, clarify the qualifications of visiting personnel, establish the standard of outpatient fees, promote the sustainable development of lymphedema clinic, and finally improve the quality of life of patients with lymphedema.

Objective:To investigate the status quo and influencing factors of unsatisfied needs of patients after radical gastrectomy for gastric cancer through quantitative and qualitative mixed research methods, and to provide reference for the development of effective health management programs in the future.Methods:A total of 297 patients who were hospitalized in Tianjin Medical University Cancer Hospital from January to December 2021 after radical gastretomy were selected as subjects by convenient sampling method. The general data questionnaire and Short-Form Survivor Unmet Needs Survey (SF-SUNS) were used to investigate. Selected 12 patients with gastric cancer by objective sampling method for semi-structured in-depth interview and collate data by Colaizzi 7-step analysis method.Results:The total average score of 297 subjects who did not meet the requirements was (60.91 ± 16.00), which was in the middle level. The average score of each dimension from high to low was: continuous care unmet needs (2.37 ± 0.75) points, work economy unmet needs (2.22 ± 0.65) points, information unmet needs (2.20 ± 0.92) points, emotion unmet needs (1.72 ± 0.60) points. Educational background, main economic source of family and working state were the influencing factors of unmet demand ( t=5.32, -3.59, -3.28, all P<0.05). Qualitative research had extracted four themes: unmet needs for symptom network recognition and accurate symptom management, unmet needs for shared decision participation and disease perception trajectory, unmet needs for dignity maintenance and reconstruction of psychological stress mechanism, and unmet needs for "Internet plus" mobile medical continuous care. Conclusions:The problem of unmet needs of patients after radical gastritis is still prevalent and affected by a variety of factors. It is suggested that medical workers build an effective supportive care system based on the status quo of unmet needs of patients, promote the whole process of multidimensional health management services for patients with gastric cancer, and improve the quality of life.

Objective:To systematically evaluate the effect of couple-centered psychological intervention on breast cancer patients.Methods:Randomized controlled trials published in PubMed, Embase, Web of Science, Scopus, CINAHL, Cochrane Library, JBI, CNKI, Wanfang, Vip and CBM database on the effect of psychological intervention on breast cancer patients with husband and wife as the center were searched by computer. The retrieval time was from the establishment of the database to September 2020. Two reviewer independently conducted literature screening, data extraction and literature quality evaluation according to the inclusion and exclusion criteria, and Meta analysis was carried out using RevMan 5.3 software.Results:A total of 879 patients were included in 11 articles. Meta analysis results showed that the couple-centered psychological intervention not only improved the quality of life, but also improved the anxiety of breast cancer patients ( SMD=1.54, 95% CI 0.22-2.86, P=0.02) and depression ( SMD=1.22, 95% CI 0.12-2.33, P=0.03). Conclusions:After psychological intervention, the anxiety and depression of breast cancer patients were improved and the quality of life was also improved. Due to the inconsistency in the mode, frequency and evaluation index of psychological intervention, more large samples and high-quality studies are needed to further verify the effect of couple-centered psychological intervention on breast cancer patients and spouses centered on husband and wife.