Discussing the cognition, attitude and influencing factors of the family members of organ donors towards advance care planning (ACP) to provide a basis for the further promotion of ACP in the field of organ donation. Using qualitative research methods, 8 family members of organ donors were selected purposefully for semi-structured interviews, and the 7-step of Colaizzi was used to analyze and summarize the themes of the interview data. The results showed that the cognition status of the family members of organ donors of ACP could be summarized into 3 themes: problems faced by ACP implementation, positive recognition of the implementation of ACP, factors affecting the promotion of ACP. Organ donors’ family members are unfamiliar with the concept of ACP and have unclear cognition, but think that the implementation of ACP is of positive significance. It is suggested to further strengthen the publicity of ACP, medical autonomy, death education, so as to promote the development of ACP and improve the willing to donate organ.

Objective:To investigate the incidence and influencing factors of olfactory dysfunction in postoperative laryngeal cancer patients.Methods:From November 2022 to August 2023, totally 76 postoperative laryngeal cancer patients admitted to the Department of Head and Neck Surgery at Zhejiang Cancer Hospital were selected by convenience sampling. General information questionnaire and the T&T olfactometer were used for assessment. Multiple linear regression analysis was conducted to explore the influencing factors of olfactory dysfunction in postoperative laryngeal cancer patients.Results:The T&T olfactometer score for the 76 postoperative laryngeal cancer patients at two weeks post-surgery was (4.74±0.93). Olfactory dysfunction occurred in 76 patients, with 25 cases of anosmia, 33 cases of severe hyposmia, 17 cases of moderate hyposmia, and one case of mild hyposmia. Multiple linear regression analysis revealed that age, educational level, surgical method, and smoking history were influencing factors for olfactory dysfunction in these postoperative laryngeal cancer patients.Conclusions:Postoperative laryngeal cancer patients experience varying degrees of olfactory dysfunction. Healthcare providers should pay special attention to older patients, those with lower educational levels, those undergoing total laryngectomy, and those with a history of smoking. Designing practical olfactory rehabilitation programs and implementing early olfactory training methods can help reduce the incidence of olfactory dysfunction.

Discussing the cognition, attitude and influencing factors of the family members of organ donors towards advance care planning (ACP) to provide a basis for the further promotion of ACP in the field of organ donation. Using qualitative research methods, 8 family members of organ donors were selected purposefully for semi-structured interviews, and the 7-step of Colaizzi was used to analyze and summarize the themes of the interview data. The results showed that the cognition status of the family members of organ donors of ACP could be summarized into 3 themes: problems faced by ACP implementation, positive recognition of the implementation of ACP, factors affecting the promotion of ACP. Organ donors’ family members are unfamiliar with the concept of ACP and have unclear cognition, but think that the implementation of ACP is of positive significance. It is suggested to further strengthen the publicity of ACP, medical autonomy, death education, so as to promote the development of ACP and improve the willing to donate organ.

Objective:To construct a risk assessment scale for flap necrosis after flap transplantation in patients with head and neck tumors, so as to provide an effective reference for clinical implementation of flap necrosis risk screening.Methods:The overall study period was from December 2020 to June 2021. Based on evidence, the item pool of the risk assessment scale for flap necrosis after flap transplantation in patients with head and neck tumors was preliminarily established. Using the Delphi method, 16 experts engaged in flap transplantation were selected for three rounds of consultation, and the risk assessment scale for flap necrosis after flap transplantation in patients with head and neck tumors was initially established. The weights were given to all indicators through the paired comparison.Results:In the first round, 16 questionnaires were distributed, and 15 valid questionnaires were recovered. In the second and third rounds, 15 questionnaires were distributed, and 15 valid questionnaires were recovered. Expert authority coefficients of the three rounds of expert consultation were 0.851, 0.853 and 0.853, respectively. The Kendall coordination coefficients of the three rounds of expert consultation were 0.377, 0.302 and 0.302 ( P<0.05) . The final constructed risk assessment scale for flap necrosis after flap transplantation in patients with head and neck tumors included 3 first-level indicators, 8 second-level indicators, and 32 third-level indicators. The weights were assigned to each indicator by paired comparison, and the weights of the first-level indicator patient factor, treatment factor, and nursing factor were 0.36, 0.38, and 0.26, respectively. Conclusions:The risk assessment scale for flap necrosis after flap transplantation in patients with head and neck tumors constructed by combining evidence-based and Delphi method is highly scientific and reliable. Its clinical applicability and effectiveness can be further verified in the future clinical flap evaluation process.

Objective:To explore the status quo of symptom management self-efficacy based on patient reported outcomes of nasopharyngeal carcinoma patients and analyze its related factors.Methods:From January to April 2021, 230 patients with nasopharyngeal carcinoma who were treated in Zhejiang Cancer Hospital were selected as the study subject by convenient sampling. The General Information Questionnaire and Patient-Reported Outcome Measurement Information System-Self-Efficacy for Managing Symptoms (PROMIS-SEMSX) were used to investigate. Single factor analysis and multiple linear regression analysis were used to explore the influencing factors of symptom management self-efficacy in patients with nasopharyngeal carcinoma.Results:A total of 230 questionnaires were distributed, 220 were recovered, and 205 were valid. The score of symptom management self-efficacy of patients with nasopharyngeal carcinoma was (97.74±20.00) , which was above the middle level, and the lowest score dimension was confidence, which was (23.52±5.91) . Multiple linear regression showed that gender, education level, medical expense payment method, economic level, tumor stage, course of disease, tumor recurrence and metastasis were the influencing factors of symptom management self-efficacy of nasopharyngeal carcinoma patients ( P<0.05) . A total of 41.5% of the total variation was explained. Conclusions:The self-efficacy of symptom management in patients with nasopharyngeal carcinoma needs to be improved. The medical and nursing staff should focus on the patients with low educational level, heavy economic burden, late tumor, recurrence and metastasis, and focus on providing specific health guidance to alleviate their discomfort symptoms during treatment, and improve their self-efficacy of symptom management.

Stigma is common in patients with head and neck cancer, which greatly affects their physical and mental health and the quality of life. This article summarizes the research progress of stigma in patients with head and neck cancer from the aspects of research status, measurement tools, influencing factors and intervention strategies, in order to provide a reference for carrying out the research on stigma in patients with head and neck cancer in China.

Objective:To investigate the value of nomogram predictive model established by the risk factors of upper extremity venous thrombosis risk associated with peripherally venous inserted central catheter (PICC) in cancer patients.Methods:A total of 1 032 patients who underwent PICC insertion between January 2016 and March 2017 in Zhejiang Cancer Hospital were selected by using prospective cohort study and convenience sampling. Risk factors of upper extremity venous thrombosis risk associated with PICC in cancer patients were evaluated by using Cox regression model. The nomogram predictive model of upper extremity venous thrombosis risk associated with PICC insertion was constructed. Bootstrap method was used to complete the inside check, and figure calibration was used to verify the nomogram.Results:A multivariate Cox regression analysis showed that trombosis history ( HR = 27.82, 95% CI 8.17-94.88, P < 0.01) and hyperlipidemia ( HR = 3.01, 95% CI 1.31-6.93, P = 0.009) were independent risk factors for upper extremity venous thrombosis associated with PICC. The nomogram model C-index was 0.71 (95% CI 0.63-0.80) based on the above risk factors, which indicated that the nomogram had a good differentiation. The calibration curve for predicting the probability of upper extremity venous thrombosis risk associated with PICC within one week, two weeks and one month deviated slightly from the standard curve, suggesting that the model might overestimate the risk of upper extremity venous thrombosis associated with PICC in cancer patients. Conclusions:The nomogram model has a good predictive value and strong operability, which can be used to predict the probability of upper extremity venous thrombosis associated with PICC in cancer patients after PICC insertion. It can provide a reference for identifying the high-risk cancer patients and formulating proper therapeutic strategies.

Objective:To explore the incidence and risk factors of peripherally inserted central catheter (PICC) related upper extremity venous thrombosis (UEVT) in patients with head and neck neoplasm so as to provide a basis for preventing thrombosis.Methods:This study used the design of prospective cohort study. From January 2016 to March 2018, UEVT follow-up examination by B ultrasound was carried out for 1 137 head and neck neoplasm patients with PICC selected by convenience sampling. Single factor and multivariate Cox regression were used to determine the risk factors of PICC related UEVT.Results:There were 3.6% (41/1 137) of patients with PICC related UEVT. Multivariate Cox regression showed that the independent risk factors of PICC related UEVT included the older patients ( RR=1.04, 95% CI: 1.01-1.07, P=0.013) , being with a history of PICC catheterization ( RR=3.22, 95% CI: 1.53-6.77, P=0.002) and high frequency of catheter delivery ( RR=1.98, 95% CI: 1.30-3.00, P=0.001) . Conclusions:Patients with head and neck neoplasm have the low incidence of PICC related UEVT. The independent risk factors of PICC related UEVT in patients with head and neck neoplasm include the older ages, history of PICC catheterization and high frequency of catheter delivery. Positive intervention should be carried out for those patients which may reduce the incidence of PICC related thrombosis.

Objective? To construct the objective, scientific and practicable self-management assessment indicators for cancer patients with oral chemotherapy at home so as to provide a basis for medical staff to pertinently carry out self-management education and guarantee safety of patients with oral chemotherapy agents well. Methods? From July 2017 to June 2018, we preliminarily drew up the assessment indicators based on self-management theory by document analysis, semi-structured interviews and expert group discussion. And then, we determined the self-management assessment indicators for cancer patients with oral chemotherapy at home by two rounds of 18 experts enquiry with the method of Delphi. Results? Among two rounds of enquiry, the questionnaire recovery rate was 100% with high expert initiative. The expert authority coefficient and the coordination coefficient were 0.83 and 0.192 respectively (P＜ 0.05). Finally, a total of 5 primary indicators and 38 secondary indicators were determined. Conclusions? The self-management assessment indicators for cancer patients with oral chemotherapy at home are scientific and reliable which are convenient for medical staff to understand patients' self-management and to provide high quality of nursing for cancer patients with oral chemotherapy at home.

Objective? To compare the effect of European Nutritional Risk Screening (NRS 2002) and Patient General Subjective Score (PG-SGA) in perioperative patients with head and neck squamous cell carcinoma, and to provide evidence for clinical nutritional screening in perioperative patients with head and neck squamous cell carcinoma. Methods? Using convenience sampling method, 82 patients with head and neck squamous cell carcinoma who were admitted to the Department of Head and Neck Surgery of Zhejiang Cancer Hospital from October 2015 to December 2017 during perioperative period were selected as the study subjects. NRS 2002 and PG-SGA were used to longitudinally evaluate their nutritional status at admission, 1 day before operation, 2 days after operation, 1 week after operation and at discharge, respectively. The differences of nutritional status between the two assessment tools during perioperative period were compared. Results? The trend of malnutrition risk in NRS 2002 was similar to that in PG-SAG dynamic assessment from admission to discharge, all of which were in the form of "V". The positive rate of malnutrition in PG-SAG assessment was higher than that in NRS 2002, and the difference was statistically significant (P＜ 0.01). Conclusions? NRS 2002 and PG-SGA are both suitable for nutritional risk screening of head and neck squamous cell carcinoma patients, but the positive rate of PG-SGA is higher, which can effectively screen and evaluate the nutritional status of head and neck squamous cell carcinoma patients, and is conducive to timely providing nutritional intervention and treatment for patients.