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AnteayerJournal of Clinical Nursing

Symptom Cluster Trajectories Among Patients With Hepatocellular Carcinoma After Partial Hepatectomy: A Longitudinal Study

ABSTRACT

Aims

To investigate types of symptom clusters in patients with hepatocellular carcinoma after partial hepatectomy and explore symptom cluster trajectories over time.

Design

A longitudinal observational study was conducted.

Methods

Symptoms of patients with hepatocellular carcinoma were assessed on the second day, seventh day, third week, fourth week and twelfth week post-operation using the MD Anderson Symptom Assessment Inventory and the Symptom Module for Primary Liver Cancer. Symptom clusters were extracted using exploratory factor analysis, and symptom cluster trajectories were analysed using a latent class growth model.

Results

Two hundred and thirty patients with hepatocellular carcinoma completed the five-point investigation after partial hepatectomy. Three symptom clusters were identified: general somatic, psychological and liver impairment. Each symptom cluster was further categorised into three groups: severe, moderate and low. The severity of the three symptom clusters and subgroups decreased over time.

Conclusion

Three symptom clusters were identified in patients who underwent partial hepatectomy for hepatocellular carcinoma, and symptom cluster trajectories decreased over time during the 12-week postoperative period. These findings will assist healthcare professionals in providing prompt symptom management and improve patient quality of life.

Implications for the Profession and/or Patient Care

Healthcare professionals should evaluate symptom clusters and their trajectories in patients with hepatocellular carcinoma after partial hepatectomy.

Reporting Method

This report was prepared in accordance with the Guidelines for Reporting Cohort Research.

Patient or Public Contribution

Hepatobiliary surgery nurses worked closely with the research team to ensure the questionnaires were fully assessed before being sent to patients. The active participation of patients provided valuable information for the study.

Trial Registration

Chinese Clinical Trial Registry (ChiCTR2400084232)

‘There is always good fortune in misfortune to encourage us in coping with difficulties’—The lived experiences of family caregivers of people with dementia during the COVID‐19 outbreak in China: A phenomenological study

Abstract

Aim

To describe the lived experiences of family caregivers of individuals with dementia during the coronavirus disease (COVID-19) outbreak in China.

Design

This study used a descriptive phenomenological research method.

Methods

Between May and September 2021, semi-structured interviews were conducted with 22 family caregivers of people with dementia. Colaizzi's method was used for manual analysis.

Results

Qualitative data revealed an overarching experience of finding ‘There is always good fortune in misfortune to encourage us in coping with difficulties’. Three themes emerged: family reactions to the COVID-19 outbreak, feeling supported by multiple resources performing respective functions and resilient adaptation to new situations.

Conclusion

During the COVID-19 outbreak, family caregivers of people living with dementia in China looked for positive aspects among difficulties and experienced corresponding reactions, social support resources and resilient adapted coping styles.

Implications for the Profession and/or Patient Care

Nurses in China and other countries facing similar pandemic characteristics, cultures or economic development levels, can guide family caregivers to look at family hardships from a positive perspective, develop interventions to rapidly respond to families' reactions after a disaster and help them identify social support resources and form adapted coping styles.

Impact

We identified the resilience and the positive experiences of Chinese family caregivers of individuals with dementia during the COVID-19 outbreak. The results can inform countries with similar cultures and economic levels, offering measures to support their adaptation to pandemics.

Reporting Method

This study followed the COREQ guidelines.

Patient or Public Contribution

Family caregivers of people with dementia who met the inclusion criteria and who were interested in sharing their understanding of their experiences, participated in the study.

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