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Advanced cancer not only affects the physical, psychological, and social functions of patients, but it also impacts their adolescent children. There is a dearth of information regarding the understanding of family functioning and specific needs of patients with advanced cancer and their adolescent children.
This qualitative study aimed to explore the experience and needs regarding family functioning of patients with advanced cancer and their adolescent children, as well as understanding potential approaches for maintaining positive family functioning.
A descriptive qualitative study was employed.
This study was conducted at three tertiary hospitals in Changsha, China, from January to September 2023. Purposive sampling was adopted to recruit participants. 17 stage III and IV patients with cancer and 11 adolescent children were interviewed.
Face-to-face individual interviews were conducted among patients with advanced cancer and their adolescent children. The data analysis employed Braun and Clarke's thematic analysis method. The McMaster family functional model theoretical framework was utilised to facilitate the identification and organisation of topics, ensuring a comprehensive analysis of the data.
Six themes were identified: communication challenges; impaired family role functioning; positive/negative feelings; over-involvement; change of behaviour control pattern; Needs for medical and psychological support. Both patients with advanced cancer and their adolescent children expressed collective views and needs regarding family functioning.
The findings of this study reveal an understanding of family functioning and needs among patients with advanced cancer and their adolescent children. The identified themes provide valuable insights for designing and implementing targeted intervention strategies.
Nursing interventions should focus on helping patients with advanced cancer and their adolescent children improve family functioning and communication skills. The findings indicate that communication challenges are a significant aspect of impaired family functioning, necessitating targeted interventions to enhance communication. Healthcare providers should be trained to recognise the diverse communication needs of families, which include providing resources for age-appropriate communication, counselling, and guidance on maintaining family routines. Enhancing the communication skills of patients and their children is crucial for addressing problem-solving needs and mitigating negative feelings, thereby fostering a more supportive family environment.
This study aimed to investigate the incidence and identify risk factors of stress hyperglycaemia among patients who received enteral nutrition (EN) in the intensive care unit (ICU).
Stress hyperglycaemia is common among ICU patients receiving EN and is related to worse outcomes. However, the factors associated with stress hyperglycaemia during EN remain unclear, especially among patients who are not diagnosed with diabetes.
A retrospective cohort study.
Electronic medical records of 614 non-diabetic patients receiving EN at two ICUs in Guizhou Provincial People's Hospital were reviewed. Patients were classified into hyperglycemic and non-hyperglycemic groups. Social demographics, clinical characteristics, treatment regimens, nutrition therapy, and point-of-care blood glucose values were collected. Univariate and multivariable analyses identified risk factors for stress hyperglycaemia. This study followed the STROBE guideline.
The incidence of stress hyperglycaemia among ICU patients without diabetes receiving EN was 35.50%. Multivariable analysis revealed that obesity (BMI ≥ 28 kg/m2), high carbohydrate intake (> 5.0 g/kg/day), and the use of semi-elemental EN solutions were independent risk factors for stress hyperglycaemia. In contrast, a moderate carbohydrate intake (3.0–3.9 g/kg/day) was associated with a significantly lower risk of stress hyperglycaemia.
The 35.50% of ICU patients without diabetes experienced stress hyperglycaemia during EN. Potential risk factors included BMI ≥ 28 kg/m2, high carbohydrate intake (> 5.0 g/kg/day), and the use of semi-elemental EN solutions. A moderate carbohydrate intake (3.0–3.9 g/kg/day) was protective. Future research should explore optimal carbohydrate intake ranges and personalised nutrition protocols to reduce stress hyperglycaemia in critically ill patients.
Reducing stress hyperglycaemia in ICU patients without diabetes receiving EN is crucial. Recommendations include monitoring patients with BMI ≥ 28 kg/m2 and considering moderate carbohydrate intake (3.0–3.9 g/kg/day), and reasonably selecting the type of enteral nutrition solution based on the patient's individual condition.
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