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Aim: To establish a supportive care framework for addressing unmet needs among breast cancer survivors, providing practical guidance for healthcare providers to assess and manage these needs, ultimately enhancing the health outcomes and quality of life of breast cancer survivors. Design: We conducted a two‐round Delphi survey to gather expert opinions regarding the unmet needs supportive care framework for breast cancer survivors. Methods: Initial framework identification and inquiry questionnaire creation was achieved via literature search and expert group discussions, which included 15 experts from nursing practice, clinical medicine, nursing management and nursing education was conducted using a Delphi survey. To establish consensus, a two‐round Delphi poll was done, using criteria based on the mean (≥4.0), coefficient of variation (CV < 0.25) and percentage for entire score (≥20%). Results: Experts reached a consensus, leading to six care modules, and 28 care entries: Tumour Detection Support (three care entries), Management of Complications of Antitumor Therapy (seven care entries), Healthy Lifestyle Management (five care entries), Sexual and Fertility Support (four care entries), Psychosocial Support (four care entries) and Resource and Linkage Support (five care entries). Conclusion: To address breast cancer survivors' unmet needs, a supportive framework was developed to actively enhance their health outcomes. However, further refinement and feasibility testing using mobile devices or artificial intelligence are required. Implications for the Profession and Patient Care: This pioneering framework prioritises addressing unmet needs and equips healthcare providers to assess and manage these needs effectively, facilitating the implementation of programs aimed at improving the well‐being of breast cancer survivors. Reporting Method: This study was guided by a modified guideline for the Conducting and Reporting of Delphi Studies (CREDES) (Palliative Medicine, 31(8), 684, 2017). Patient or Public Contribution: No Patient or Public Contribution. Trial and protocol registration: The Delphi study methodology does not require registration. [ABSTRACT FROM AUTHOR]

Background: More than 80% of adolescent and young adult cancer patients (AYACPs) experienced psychological distress. Physical activity and behavioral activation are effective to relieve the psychological distress in AYACPs. Methods: Participants aged 15–39 years diagnosed with malignant tumors were included. A total of 143 eligible AYACPs were randomly assigned to three groups. The treatment‐as‐usual group (N = 48) received routine care, the physical activity group (N = 47) received 8 weeks of physical activity program based on intelligent wearable devices, and the behavioral activation group (N = 48) received an internet‐based modified behavioral activation program for 8 weeks. Objective outcome measures included salivary cortisol and testosterone. Results: Linear mixed‐model analyses showed significant differences between treatment‐as‐usual, physical activity and behavioral activation in salivary cortisol, as well as total scores on depression and anxiety, physical activity, self‐efficacy, and social support. Significantly stronger effect sizes for physical activity group compared with behavioral activation group were found on physical activity (d = 0.53) (1 week after intervention), moderate activity (d = 0.61), and walking activity (d = 0.57) (3‐month follow‐up). Conclusions: Intelligent, wearable, device‐based physical activity program is more effective in alleviating anxiety and depression, reducing saliva cortisol, and improving physical activity in AYACPs than internet‐based modified behavioral activation program. Intelligent, wearable, device‐based physical activity program can reduce the time cost of AYACPs to ensure that the intervention is carried out. [ABSTRACT FROM AUTHOR]

Radiation therapy is used for breast cancer treatments to improve local control and overall survival but may also lead to unwanted complications such as cardiac toxicity and pneumonitis. Deep inspirational breath hold (DIBH) has been used to reduce doses to the heart and other organs near the treatment target to lower the risk of radiation-induced complications. In this study, we present our experience on the clinical implementation and application of DIBH for breast cancer patients, its dosimetric benefits in heart and other organ sparing based on comparisons with free breathing plans, effects on the treatment efficiency as represented by treatment imaging, and beam delivery times, as well as challenges during implementation and clinical application at our center. [ABSTRACT FROM AUTHOR]

Fertility is a significant concern among adolescent and young adult (AYA) cancer survivors and their caregivers, especially after their completion of cancer treatment programs. Concerns about fertility affect not only cancer patients' psychological well‐being, but also all aspects of their medical treatments, including treatment protocol, decision‐making, and treatment adherence. In this scoping review, the PubMed, CINAHL, Web of Science, Embase, CNKI, and Wanfang electronic databases were searched according to the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta‐Analysis Extension for Scoping Reviews. The searches identified 669 articles, 54 of which met the inclusion criteria. Reviewers extracted the data on the study characteristics, measurements, positive factors, negative factors, and additional themes. This scoping review included studies from 10 countries. Most studies were quantitative using a cross‐sectional design. The prevalence of reproductive concerns among AYA cancer survivors ranged from 44% to 86%, and 28% to 44% of the survivors experienced moderate to severe concerns. The specific implementation of fertility consultation, including timing, consult frequency, and content, deserves ongoing exploration. [ABSTRACT FROM AUTHOR]

Purpose: This study aims to develop and validate a stigma scale for Chinese patients with breast cancer. Methods: Patients admitted to the Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, for breast cancer treatment participated in this study. Development of the Breast Cancer Stigma Scale involved the following procedures: literature review, interview, and applying a theoretical model to generate items; the Breast Cancer Stigma Scale's content validity was assessed by a Delphi study (n = 15) and feedback from patients with breast cancer (n = 10); exploratory factor analysis (n = 200) was used to assess the construct validity; convergent validity was assessed with the Social Impact Scale (n = 50); internal consistency Cronbach's α (n = 200), split-half reliability (n = 200), and test–retest reliability (N = 50) were used to identify the reliability of the scale. Results: The final version of the Breast Cancer Stigma Scale consisted of 15 items and showed positive correlations with the Social Impact Scale (ρ = 0.641, P < 0.001). Exploratory factor analysis (EFA) revealed four components of the Breast Cancer Stigma Scale: self-image impairment, social isolation, discrimination, and internalized stigma, which were strongly related to our perceived breast cancer stigma model and accounted for 69.443% of the total variance. Cronbach's α for the total scale was 0.86, and each subscale was 0.75–0.882. The test–retest reliability with intra-class correlation coefficients of the total scale was 0.947 (P < 0.001), and split-half reliability with intra-class correlation coefficients of the total scale was 0.911 (P < 0.001). The content validity index (CVI) was 0.73–1.0. Conclusion: The newly developed Breast Cancer Stigma Scale offers a valid and reliable instrument for assessing the perceived stigma of patients with breast cancer in clinical and research settings. It may be helpful for stigma prevention in China. [ABSTRACT FROM AUTHOR]

Background: Breast cancer survivors (BCSs) often have potential unmet needs. Identification of the specific needs of BCSs is very significant for medical service provision. This study aimed to (1) investigate the unmet needs and quality of life (QoL) of BCSs in China, (2) explore the diverse factors associated with their unmet needs, and (3) assess the association between their unmet needs and QoL.Methods: A multicentre, cross-sectional survey was administered to 1210 Chinese BCSs. The Cancer Survivor Profile-Breast Cancer and the Functional Assessment of Cancer Therapy-Breast scale were administered to survivors who gave informed consent to participate. Data were analysed using t-test, ANOVA, multiple regression analysis, and Pearson correlations.Results: The 1192 participants completed questionnaires (response rate 98.51%). Our study reveals that the most prevalent unmet needs were in the 'symptom burden domain'. The unmet needs of BCSs depend on eleven factors; age, time since diagnosis, education level, occupation, payment, family income status, stage of cancer, treatment, family history of cancer, pain, and physical activities. To ensure the provision of high-quality survivorship care and a high satisfaction level, more attention should be paid to actively identifying and addressing the unmet needs of BCSs. The problem areas identified in the Cancer Survivor Profile for breast cancer were negatively associated with all subscales of QoL except the health behaviour domain, with the correlation coefficient ranging from - 0.815 to - 0.011.Conclusion: Chinese BCSs exhibit a high demand for unmet needs in this study, and the most prevalent unmet needs were in the 'symptom burden domain'. There was a significant association between patients' unmet needs (as defined in the Cancer Survivor Profile for breast cancer) and QoL. Future research should focus on enhancements to survivorship or follow-up care to address unmet needs and further improve QoL. [ABSTRACT FROM AUTHOR]

Objective. To investigate the serum levels of calgizzarin (S100A11) and matrix metalloproteinase-9 (MMP9) in patients with epithelial ovarian cancer (EOC) and determine their clinical significance. Methods. Serum levels of S100A11 and MMP9 were detected in patients with EOC, patients with benign ovarian tumor, and healthy women. The correlation between the two markers and clinicopathological characteristics of ovarian cancer was analysed. Results. The serum levels of S100A11 and MMP-9 in patients with EOC were higher than those in patients with benign ovarian tumor and in healthy women, and the expression levels of S100A11 and MMP-9 were positively correlated. S100A11 and MMP-9 were correlated with tumor staging, postoperative residual foci, ascites volume, serum CA125 level, chemotherapy response, and lymph node metastasis, while S100A11 and MMP-9 were not associated with the bilevel classification, histological type, age, and degree of differentiation. Conclusion. S100A11 and MMP-9 were both highly expressed in the serum of patients with EOC and were associated with cancer development, invasion, and metastasis. Therefore, they can be used as an important reference maker in the diagnosis and treatment of ovarian cancer. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to explore the associated factors of spiritual well-being among cancer patients and the relationship between spiritual well-being (SWB) and quality of life (QOL).Methods: This cross-sectional study was conducted in 200 Chinese cancer patients in a tertiary cancer hospital. Functional Assessment of Cancer Therapy-General (FACT-G) and the Functional Assessment of Chronic Illness Therapy-Spiritual Well-being (FACIT-Sp) were used to measure SWB and QOL levels of participants. Multiple regression analyses were performed to determine the relationship between SWB and QOL.Results: The mean score of QOL was 59.8 (SD 13.1) with a range of 27-106. The mean score of SWB was 24.4 (SD 6.5), with a range of 8-48. Hospitalization frequency was the only variable associated with SWB. In terms of the relationship between SWB and QOL, the meaning and peace subscales were significantly related to overall QOL. It was also observed that the meaning subscale was positively related to social/family well-being, emotional well-being, and functional well-being. The peace subscale was related to the physical well-being, social/family well-being, and functional well-being. Faith was negatively related to physical and emotional well-being, but it had a positive effect on functional well-being.Conclusions: Given that the meaning and peace subscales are related to a higher QOL level, it is important to find ways to improve these dimensions of spiritual well-being among cancer inpatients during treatment. [ABSTRACT FROM AUTHOR]

Purpose: Spiritual needs are important for many patients with life-limiting illnesses. Knowledge of spiritual needs is a first step to their fulfillment; however, such knowledge is lacking for patients with cancer in mainland China. This study evaluated spiritual needs among patients with cancer in China and analyzed their associations with demographic and clinical characteristics.Methods: A descriptive, cross-sectional study was performed. A general information questionnaire and a Chinese version of the Spiritual Needs Scale were used to collect information about patients with cancer. A total of 200 participants were recruited, and 182 completed the survey.Results: The overall average spiritual needs score was 3.15. Of five dimensions investigated, the highest and lowest scores were for "hope and peace" (mean = 3.31) and "relationship with transcendence" (mean = 2.96). Of specific needs, "to be accepted," "to take responsibility for my life," and "to alleviate my suffering" (means = 3.36-3.38) were valued as most important by participants. "To talk to someone," "to pray and participate in religious rituals and services," and "to feel God with me during my struggle against disease" (means = 2.71-2.91) were considered least important. Participants' spiritual needs differed significantly according to disease stage (p < 0.001), time since diagnosis (p = 0.002), and hospitalization frequency (p = 0.004).Conclusions: The spiritual needs of patients with cancer should receive more attention in China. Effective assessment tools and procedures should be established to evaluate the spiritual needs of patients and formulate appropriate interventions at an early stage. [ABSTRACT FROM AUTHOR]

Background: Subjective cognitive impairment can be a significant and prevalent problem for gynaecological cancer survivors. The aims of this study were to assess subjective cognitive functioning in gynaecological cancer survivors after primary cancer treatment, and to investigate the impact of cancer treatment on brain structural networks and its association with subjective cognitive impairment.Methods: This was a cross-sectional survey using a self-reported questionnaire by the Functional Assessment of Cancer Therapy-Cognitive Function (FACT-Cog) to assess subjective cognitive functioning, and applying DTI (diffusion tensor imaging) and graph theoretical analyses to investigate brain structural networks after primary cancer treatment.Results: A total of 158 patients with gynaecological cancer (mean age, 45.86 years) and 130 age-matched non-cancer controls (mean age, 44.55 years) were assessed. Patients reported significantly greater subjective cognitive functioning on the FACT-Cog total score and two subscales of perceived cognitive impairment and perceived cognitive ability (all p values <0.001). Compared with patients who had received surgery only and non-cancer controls, patients treated with chemotherapy indicated the most altered global brain structural networks, especially in one of properties of small-worldness (p = 0.004). Reduced small-worldness was significantly associated with a lower FACT-Cog total score (r = 0.412, p = 0.024). Increased characteristic path length was also significantly associated with more subjective cognitive impairment (r = -0.388, p = 0.034).Conclusion: When compared with non-cancer controls, a considerable proportion of gynaecological cancer survivors may exhibit subjective cognitive impairment. This study provides the first evidence of brain structural network alteration in gynaecological cancer patients at post-treatment, and offers novel insights regarding the possible neurobiological mechanism of cancer-related cognitive impairment (CRCI) in gynaecological cancer patients. As primary cancer treatment can result in a more random organisation of structural brain networks, this may reduce brain functional specificity and segregation, and have implications for cognitive impairment. Future prospective and longitudinal studies are needed to build upon the study findings in order to assess potentially relevant clinical and psychosocial variables and brain network measures, so as to more accurately understand the specific risk factors related to subjective cognitive impairment in the gynaecological cancer population. Such knowledge could inform the development of appropriate treatment and rehabilitation efforts to ameliorate cognitive impairment in gynaecological cancer survivors. [ABSTRACT FROM AUTHOR]