以质量求发展，以服务铸品牌

Journal of Nursing ›› 2025, Vol. 32 ›› Issue (6): 27-31.doi: 10.16460/j.issn1008-9969.2025.06.027

Previous Articles     Next Articles

Development of a public education manual for evidence-based decision support tools in symptom communication for cancer patients

Guo Zihan1,2, Deng Shisi1,2, Zhang Yujie1,2, Wu Yanni1   

  1. 1. Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong 510515, China;
    2. School of Nursing, Southern Medical University, Guangzhou, Guangdong 510515, China
  • Received:2024-12-20 Online:2025-03-25 Published:2025-05-06

PDF (PC)

0

Like

Abstract: Objective To develop a patient-friendly educational manual on the use of decision aids for symptom communication in cancer patients, grounded in evidence-based practices. Methods Guided by evidence-based nursing principles, a systematic literature review, quality appraisal, evidence extraction, and evidence grading were conducted to establish best practices and define the manual’s framework. Semi-structured interviews with 12 cancer patients were performed to refine the content themes, followed by iterative revisions to draft the preliminary version. External validation was obtained through reviews by 10 multidisciplinary experts. Results The finalized manual comprehensively addresses the benefits, accessibility, application scenarios, operational guidelines, core components, and precautions for using decision aids in symptom communication. In the second round of expert validation, satisfaction scores ranged from 81% to 100%, with coefficients of variation (CV) between 0 and 0.104, indicating high consensus. Conclusion The manual was developed through a methodologically rigorous process, emphasizing patient-centered design and broad applicability. This work provides a practical reference for creating future health education materials tailored to cancer patients’ needs, ensuring both scientific validity and usability in clinical and community settings.

Key words: cancer, symptom communication, public education manual, evidence-based nursing, decision aids

CLC Number: 

  • R473.73
[1] Han B, Zheng R, Zeng H, et al.Cancer incidence and mortality in China, 2022[J]. J Natl Cancer Ctr, 2024, 4(1): 47-53. DOI: 10.1016/j.jncc.2024.01.001.
[2] 佟丹阳, 王晨霞, 白雪红, 等. 癌症患者自我报告的症状负担及影响因素分析[J]. 西部中医药, 2024, 37(5): 79-85. DOI: 10.12174/j.issn.2096-9600.2024.05.15.
[3] Pollak KI, Arnold RM, Jeffreys AS, et al.Oncologist communication about emotion during visits with patients with advanced cancer[J]. J Clin Oncol, 2007, 25(36): 5748-5752. DOI: 10.1200/JCO.2007.12.4180.
[4] Lu Q, Man J, You J, et al.The link between ambivalence over emotional expression and depressive symptoms among Chinese breast cancer survivors[J]. J Psychosom Res, 2015, 79(2): 153-158. DOI: 10.1016/j.jpsychores.2015.05.007.
[5] Back AL.Patient-Clinician communication issues in palliative care for patients with advanced cancer[J]. JCO, 2020, 38(9): 866-876. DOI: 10.1200/JCO.19.00128.
[6] Bower JE, Bak K, Berger A, et al.Screening, assessment, and management of fatigue in adult survivors of cancer: an American Society of Clinical oncology clinical practice guideline adaptation[J]. J Clin Oncol, 2014, 32(17): 1840-1850. DOI: 10.1200/JCO.2013.53.4495.
[7] Mc Darby M, Silverstein HI, Carpenter BD.Effects of a patient question prompt list on question asking and self-efficacy during outpatient palliative care appointments[J]. J Pain Symptom Manag, 2023, 65(4): 285-295. DOI:10.1016/j.jpainsymman.2022.12.010.
[8] Wang SJ, Hu WY, Chang YC.Question prompt list intervention for patients with advanced cancer: a systematic review and Meta-analysis[J]. Support Care Cancer, 2024, 32(4): 231. DOI: 10.1007/s00520-023-08432-3.
[9] Joshi S, Ramarajan L, Ramarajan N, et al.Effectiveness of a decision aid plus standard care in surgical management among patients with early breast cancer: a randomized clinical trial[J]. JAMA Netw Open, 2023, 6(10): e2335941. DOI: 10.1001/jamanetworkopen.2023.35941.
[10] Arthur J, Pawate V, Lu Z, et al.Helpfulness of question prompt sheet for patient-physician communication among patients with advanced cancer: a randomized clinical trial[J]. JAMA Netw Open, 2023, 6(5):e2311189. DOI: 10.1001/jamanetworkopen.2023.11189.
[11] 王奕, 葛静玲, 王娟. 问题提示列表在肿瘤医患沟通中应用的范围综述[J]. 护理学报, 2023, 30(16): 57-62. DOI:10.16460/j.issn1008-9969.2023.16.057.
[12] 张青月, 王燕, 王小媛, 等. 问题提示清单在肿瘤患者决策沟通中的应用进展[J]. 中国护理管理, 2022, 22(6): 943-946. DOI:10.3969/j.issn.1672-1756.2022.06.028.
[13] Dicenso A, Bayley L, Haynes RB.Accessing pre-appraised evidence: fine-tuning the 5S model into a 6S model[J]. Evid Based Nurs, 2009, 12(4): 99-101. DOI: 10.1136/ebn.12.4.99-b.
[14] Brouwers MC, Kho ME, Browman GP, et al.AGREE II: advancing guideline development, reporting and evaluation in health care[J]. CMAJ, 2010, 182(18): E839-E842. DOI: 10.1503/cmaj.090449.
[15] McArthur A, Klugarova J, YanH, Florescu S. Chapter 4: Systematic reviews of text and opinion. In: Aromataris E, Munn Z (Editors)[M/OL]. JBI Manual for Evidence Synthesis. JBI, 2020. DOI:10.46658/JBIMES-20-05.
[16] Aromataris E, Fernandez R, Godfrey CM, et al.Summarizing systematic reviews: methodological development, conduct and reporting of an umbrella review approach[J]. Int J Evid Based Healthc, 2015, 13(3):132-140. DOI:10.1097/XEB.0000000000000055.
[17] 王春青, 胡雁. JBI证据预分级及证据推荐级别系统(2014版)[J]. 护士进修杂志, 2015, 30(11): 964-967. DOI: 10.16821/j.cnki.hsjx.2015.11.002.
[18] 刘明. Colaizzi七个步骤在现象学研究资料分析中的应用[J]. 护理学杂志, 2022, 34(11): 90-92. DOI:10.3870/j.issn.1001-4152.2019.11.090.
[19] 中国健康科普联盟. 中国健康科普作品创作与传播专家(2018)[EB/OL].[2022-01-10].https://cmhadb.cma-cmc.com.cn/.
[20] Barnett N, Edwards A, Erez G, et al.Shared decision making[EB/OL].[2021-05-17].https://www.nice.org.uk/guidance/ng197.
[21] Adams J, Carr E, Dodwell M, et al.Patient experience in adult NHS services: improving the experience of care for people using adult NHS services[EB/OL].[2021-08-17].https://www.nice.org.uk/guidance/cg138.
[22] Ferrell BR, Temel JS, Temin S, et al.Integration of palliative care into standard oncology care: American society of clinical oncology clinical practice guideline update[J].J Clin Oncol, 2017, 35(1): 96-112. DOI: 10.1200/JCO.2016.70.1474.
[23] Paice JA, Portenoy R, Lacchetti C, et al.Management of chronic pain in survivors of adult cancers: American society of clinical oncology clinical practice guideline[J]. J Clin Oncol, 2016,34(27):3325-3345. DOI: 10.1200/JCO.2016.68.5206.
[24] Rodin G, Zimmermann C, Mayer C, et al.Clinician-patient communication: evidence-based recommendations to guide practice in cancer[J]. Curr Oncol, 2009,16(6):42-49. DOI: 10.3747/co.v16i6.432.
[25] 盛婉婷, 杨小惠, 陈家欣, 等. 决策辅助工具在癌症患者治疗决策中应用效果的系统评价再评价[J]. 中国循证医学杂志, 2024, 24(6):708-714. DOI:10.7507/1672-2531.202401080.
[26] Thode M, Pasman HRW, van Vliet LM, et al. Feasibility and effectiveness of tools that support communication and decision making in life-prolonging treatments for patients in hospital:a systematic review[J].BMJ Support Palliat Care, 2022,12(3):262-269.DOI:10.1136/bmjspcare-2020-002284.
[27] Spiegle G, Al-Sukhni E, Schmocker S, et al.Patient decision aids for cancer treatment: Are there any alternatives?[J]. Cancer, 2013, 119(1): 189-200. DOI: 10.1002/cncr.27641.
[28] Brandes K, Linn AJ, Butow PN, et al.The characteristics and effectiveness of question Prompt List interventions in oncology: a systematic review of the literature[J]. Psycho-oncology, 2015, 24(3): 245-252. DOI: 10.1002/pon.3637.
[29] Stacey D, Légaré F, Lewis K, et al. Decision aids for people facing health treatment or screening decisions[J]. Cochrane Database Syst Rev, 2017, 4(4): CD001431. DOI: 10.1002/14651858.CD001431.pub5.
[30] Wang Y, Anazodo A, Logan S.Systematic review of fertility preservation patient decision aids for cancer patients[J]. Psycho-oncology, 2019,28(3):459-467.DOI:10.1002/pon.4961.
[31] Zhao J, Abdallah M, Sanapala C, et al.A systematic review of decision aids in hematologic malignancies: what are currently available and what are we missing?[J]. Oncologist, 2023, 28(2): 105-115. DOI: 10.1093/oncolo/oyac231.
[32] Cardona-Morrell M, Benfatti-Olivato G, Jansen J, et al.A systematic review of effectiveness of decision aids to assist older patients at the end of life[J]. Patient Educ Couns, 2017, 100(3): 425-435. DOI: 10.1016/j.pec.2016.10.024.
[33] Riganti P, Ruiz Yanzi MV, Escobar Liquitay CM, et al. Shared decision-making for supporting women’s decisions about breast cancer screening[J].Cochrane Database Syst Rev, 2024,5(5):CD013822.DOI:10.1002/14651858.CD013822.pub2.
[34] Sánchez-álvarez N, Extremera N, Fernández-Berrocal P. The relation between emotional intelligence and subjective well-being: a Meta-analytic investigation[J]. The Journal of Positive Psychology, 2016, 11(3):276-285. DOI:10.1080/17439760.2015.1055968.
[1] LIAO Yarou, LIU Jia, SONG Ning, LI Shaofang, WU Xing. Current status and influencing factors of decision fatigue in patients with breast cancer [J]. Journal of Nursing, 2025, 32(6): 6-11.
[2] CHEN Ruiyun, LI Xiaojin, WEI Li, YANG Hui, LIU Saisai, CHEN Jingru. Best evidence summary for physical activity of hospitalized patients with lung transplant [J]. Journal of Nursing, 2025, 32(5): 53-58.
[3] GUO Lin-fang, ZHANG Pei-li, HOU Xiao-ya, LI Ying, CAO Min, GAO Chao-yue. Construction of online and offline nutrition intervention program for liver cancer patients undergoing chemotherapy [J]. Journal of Nursing, 2025, 32(4): 1-5.
[4] CAI Ying-ying, LING Chen, LIU Mian-zhu, ZHOU Jie, ZHANG Jun-feng, CHEN Lian-hua, TIAN Xiao-fei, LUO Bin, CHEN Meng-yun. Methodological quality assessment of guidelines for assessment and management of adult cancer pain [J]. Journal of Nursing, 2025, 32(4): 34-40.
[5] LI Ruo-Yu, LIU Xin, LIN Ping, CHEN Dan, LIN Hua. Best evidence summary for medication safety management for discharged patients [J]. Journal of Nursing, 2025, 32(3): 50-55.
[6] YANG Xiao-juan, MAO Xiao-rong, WANG Jing, JIANG Hua, LI Rong, FAN Yu, WEN Qing, LI Lin-zhang, CHEN Xiao-rong. Best evidence summary for early enteral nutrition management in adults with severe burns [J]. Journal of Nursing, 2025, 32(3): 56-61.
[7] CAO Min, ZHANG Pei-li, HOU Xiao-ya, GAO Chao-yue, GUO Lin-fang, LI Ying. Nutritional care experience of caregivers of colorectal cancer patients undergoing chemotherapy based on ABC-X model: a qualitative study [J]. Journal of Nursing, 2025, 32(2): 13-18.
[8] LIU Shuo-yi, XIONG Li-juan, LI Ling, WANG Yu-mei, HE Jia, LI Xin, YUAN Shi-lei, GUO Xue-qin, WANG Yang-jing, ZHANG Hui-juan. Quality evaluation and content analysis of clinical practice guidelines for prevention and management of frailty in elderly hospitalized patients [J]. Journal of Nursing, 2025, 32(2): 50-55.
[9] CHEN Jie, MENG Qing-tong, LIU Jing-jin, WU Yan-ni. Development of guideline-based exercise rehabilitation handbook for patients with chronic heart failure [J]. Journal of Nursing, 2024, 31(9): 36-41.
[10] FU Lu-lu, XIE Yi-xuan, WANG Yue, WEI Wei, ZHANG Chuan-ying, ZHU Yu. Evidence summary for auditory stimulation intervention for procedural pain in neonates [J]. Journal of Nursing, 2024, 31(9): 42-47.
[11] HUA Jing, ZHANG Qing-yue, WANG Yan, CHENG Chang, ZHANG Xiu-li, ZHANG Ai'ai. Application of question prompt list in patients undergoing breast cancer surgery [J]. Journal of Nursing, 2024, 31(8): 18-22.
[12] CHEN Si-qi, LIU Ning, HOU Xiao-min, LU Shu-ying. Best evidence summary for perioperative nursing management of enhanced recovery after surgery in robotic surgery for gastric cancer [J]. Journal of Nursing, 2024, 31(8): 31-36.
[13] JI Rui-ting, LIN Dan-na, LIU Xiao-cheng, LI Ting-ting, XIE Ying-mei, HU Bing, YING Wen-juan. Best evidence for colostrum as oral immune therapy in premature infants [J]. Journal of Nursing, 2024, 31(8): 37-42.
[14] HUANG Jia-ying, ZHANG Jing, LIANG Li-chan, MENG Jiang-nan, YE Hong-yu, WANG Wei-jie, SHI Lei. Translation of Mini Symptom Screening in pediatrics tool and its validation in cancer children aged 4~7 [J]. Journal of Nursing, 2024, 31(8): 55-59.
[15] CAO Juan, LI Fang, YU Yue, DAI Li, YANG Dan-dan, LI Zhi-hua, XU Xin-yi, DAI Qi, CHEN Ke-yu. Construction and verification of risk prediction model for venous thromboembolism after esophageal cancer surgery [J]. Journal of Nursing, 2024, 31(8): 63-68.
Viewed
Full text


Abstract

Cited
  Shared   
No Suggested Reading articles found!