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Chen C, Cheng G, Chen X, Yu L. Information disclosure to cancer patients in Mainland China: A meta-analysis. Psychooncology 2023; 32:342-355. [PMID: 36582008 DOI: 10.1002/pon.6085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 12/10/2022] [Accepted: 12/25/2022] [Indexed: 12/31/2022]
Abstract
OBJECTIVE This study aims to systematically examine Chinese cancer patients' and families' preferences for information disclosure to the patient, patient awareness, and predictors of patient awareness. METHODS The Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines were followed. Web of Science, Scopus, Proquest, Taylor & Francis Online, and China National Knowledge Infrastructure were searched in April 2022 and Chinese Biomedical Literature Database in July 2022 for quantitative studies. The Mixed Methods Appraisal Tool was used for quality assessment. RESULTS A total of 22 studies were included, and the average quality score was 0.65/1. Meta-analyses showed that 89.6% and 81.8% of cancer patients wanted to know their diagnosis and prognosis, respectively. Meanwhile, 50.0% and 32.4% of families prefer diagnosis disclosure and prognosis disclosure to the patient, respectively. Significantly more patients than families favored disclosure to the patient. In reality, only 59.3% of cancer patients know their diagnosis, and 19.9% know their prognosis. For predictors, while patients' gender, cancer type (breast cancer or not), treatment method (operation or other), or complications (yes or no) do not influence diagnosis awareness, being younger, being married, having higher educational attainment, having early-stage rather than late-stage cancer, and being in a higher-grade hospital all predict better chances of knowing a diagnosis. No study explored predictors of patients' prognosis awareness. The findings did not vary according to publication time or sample size. CONCLUSIONS Chinese cancer patients are eager to know their diagnosis and prognosis, but families are hesitant about disclosure to the patient, and patients' awareness is low. While cultural, legal, and medical backgrounds lay the foundation for information disclosure in Mainland China, case-by-case practical factors also make a difference.
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Affiliation(s)
- Chuqian Chen
- Department of Medical Humanities, School of Humanities, Southeast University, Nanjing, China
| | - Guobin Cheng
- Department of Medical Humanities, School of Humanities, Southeast University, Nanjing, China
| | - Xiaoying Chen
- Department of Philosophy and Science, School of Humanities, Southeast University, Nanjing, China
| | - Lingling Yu
- Department of Philosophy and Science, School of Humanities, Southeast University, Nanjing, China
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He D, Yang Y, Yang Y, Tang X, Huang K. Prognostic significance of preoperative C-reactive protein to albumin ratio in non-small cell lung cancer patients: A meta-analysis. Front Surg 2023; 9:1056795. [PMID: 36684183 PMCID: PMC9852518 DOI: 10.3389/fsurg.2022.1056795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Accepted: 11/09/2022] [Indexed: 01/09/2023] Open
Abstract
Objective We aimed to assess whether C-reactive protein to albumin ratio (CAR) is associated with the clinicopathology and prognosis of patients with non-small cell lung cancer (NSCLC) after surgery. Methods Several literature databases were searched for eligible studies in English and Chinese published before September 1, 2022, according to the inclusion and exclusion criteria. The pooled odds ratios (ORs) with 95% confidence interval (CI) were calculated to assess the association of CAR in lung cancer with clinicopathological characteristics including age, sex, smoking status, lymph node metastasis, and American Association of Cancer (AJCC) stage. The pooled hazard ratios (HRs) with 95% CI were calculated to assess the association of CAR with prognosis in lung cancer. Publication bias was assessed using Egger's test. Results Overall, 9 studies involving 3,359 NSCLC patients were included in this meta-analysis. The CAR was observed to be higher in males, smokers, and patients with lymph node metastasis and correlated with advanced AJCC stage but not with age. Moreover, a high CAR correlated with poor survival. No publication bias was observed in this meta-analysis. Conclusions CAR was observed to be a significant biomarker for prognosis and associated with clinicopathological characteristics in patients with NSCLC after surgery.
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Affiliation(s)
- Dingxiu He
- Department of Emergency, Deyang People's Hospital, Sichuan, China
| | - Yong Yang
- Department of Emergency, Deyang People's Hospital, Sichuan, China
| | - Yi Yang
- Department of Emergency, Deyang People's Hospital, Sichuan, China
| | - Xiaoqu Tang
- Department of Emergency, Deyang People's Hospital, Sichuan, China
| | - Kaisen Huang
- Department of Cardiology, Deyang People's Hospital, Sichuan, China,Correspondence: Kaisen Huang
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Song X, Jiang N, Ding N, Li H, Xin C, Qu R, Wen D. "It really puts me in a bind", professionalism dilemmas reported by Chinese residents. ADVANCES IN HEALTH SCIENCES EDUCATION : THEORY AND PRACTICE 2023:10.1007/s10459-022-10198-4. [PMID: 36595184 DOI: 10.1007/s10459-022-10198-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 12/11/2022] [Indexed: 06/17/2023]
Abstract
Residents play a pivotal role in the healthcare system. However, few tools have systematically revealed the dilemmas and challenges faced by residents. This study aimed to develop a checklist for professionalism dilemmas based on a behavior-based professionalism framework and to examine the range and proportion of professionalism dilemmas heard of, witnessed, or experienced by Chinese residents. Mixed methods were used, comprising qualitative (document analysis and focus group interviews) and quantitative (a small-scale questionnaire survey) data. Document analysis summarized professionalism dilemma items from previous publications. For focus group interviews, we used narrative inquiry to explore and make sense of residents' experiences and perceptions of professionalism dilemmas. A small-scale questionnaire survey was conducted during each focus group to investigate the proportion of professionalism dilemma items that residents reported to have heard of, witnessed, or experienced. Through document analysis and focus group interviews, we developed a checklist of professionalism dilemmas based on a behavior-based professionalism framework. The checklist included 58 items over four domains, with 10 sub-domains (compassion, respect, communication, collaboration, integrity, duty, pursuit of excellence, fair stewardship of health care resources, patient confidentiality, and informed consent). We also sought a preliminarily subjective impression by exploring the proportion of residents who have heard of, witnessed, and experienced each of the professionalism dilemma items and residents' perspectives when faced with professionalism dilemmas. Residents inevitably encounter or experience a diverse range of professionalism dilemmas. This checklist of professionalism dilemmas that was developed could prove to be a significant reference for targeted professionalism education, both for the resident as well as for faculty. It can also act as a helpful tool for improving hospital management guidelines and patient education.
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Affiliation(s)
- Xinzhi Song
- Institute for International Health Professions Education and Research, China Medical University, No. 77 Puhe Road, Shenyang, 110122, People's Republic of China
| | - Nan Jiang
- Institute for International Health Professions Education and Research, China Medical University, No. 77 Puhe Road, Shenyang, 110122, People's Republic of China
| | - Ning Ding
- Institute for International Health Professions Education and Research, China Medical University, No. 77 Puhe Road, Shenyang, 110122, People's Republic of China
| | - Honghe Li
- Institute for International Health Professions Education and Research, China Medical University, No. 77 Puhe Road, Shenyang, 110122, People's Republic of China
| | - Chunyu Xin
- Institute for International Health Professions Education and Research, China Medical University, No. 77 Puhe Road, Shenyang, 110122, People's Republic of China
| | - Ruoyi Qu
- Institute for International Health Professions Education and Research, China Medical University, No. 77 Puhe Road, Shenyang, 110122, People's Republic of China
| | - Deliang Wen
- Institute for International Health Professions Education and Research, China Medical University, No. 77 Puhe Road, Shenyang, 110122, People's Republic of China.
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Ng SS, Lee HL, Pandian BR, Doong RA. Recent developments on nanomaterial-based optical biosensor as potential Point-of-Care Testing (PoCT) probe in carcinoembryonic antigen detection: A review. Chem Asian J 2022; 17:e202200287. [PMID: 35471591 DOI: 10.1002/asia.202200287] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 04/25/2022] [Indexed: 11/09/2022]
Abstract
For the past decades, several cancer biomarkers have been exploited for rapid and accurate prognosis or diagnosis purposes. In this review, the optical biosensor is targeted for carcinoembryonic antigen (CEA) detection. The CEA level is a prominent parameter currently used in clinical cases for the prognosis of cancer-related diseases. Many nanomaterial-based biosensors are invented as alternatives for the commonly used enzyme-linked immunosorbent assays (ELISA) immunoassay method in CEA detection as the traditional approach but they possess certain drawbacks such as tedious procedure, high technical demand, and costly. Nevertheless, the effort appears to be wasted as none of them are being actualised. Generally, the sensor function was carried out by converting bio-signals generated upon the interface of the receptor into light signals. These sensors were popular due to specific advantages such as sensitivity, being free from chemical and electromagnetic interferences, wide dynamic range, and being easy to be monitored. The features of PoC diagnostics are discussed and associated with the various applications of colorimetric-based and chemiluminescent-based biosensors. The roles of nanomaterials in each application were also summarised by comparing the modification, incubation period, lowest detection limit (LOD) and linear range of detection amount. The challenges and future perspectives were highlighted at the end of the review.
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Affiliation(s)
- Siew Suan Ng
- National Tsing Hua University, Department of Analytical and Environmental Science, TAIWAN
| | - Hooi Ling Lee
- Universiti Sains Malaysia, School of Chemical Sciences, School of Chemical Sciences,, Universiti Sains Malaysia,, 11800, USM, MALAYSIA
| | | | - Ruey-An Doong
- National Tsing Hua University, Department of Analytical and Environmental Science, TAIWAN
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He C, Zhu WX, Tang Y, Bai Y, Luo Z, Xu J, Wang H, Xu S, Xu J, Xiao L, Zhang R, Wang Y, Du J, Huang Y, Li X, Su T. Knowledge of a cancer diagnosis is a protective factor for the survival of patients with breast cancer: a retrospective cohort study. BMC Cancer 2021; 21:739. [PMID: 34176477 PMCID: PMC8237449 DOI: 10.1186/s12885-021-08512-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Accepted: 06/15/2021] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND The health burden of breast cancer is rising in China. The effect of informed diagnosis on long-term survival is not fully understood. This retrospective cohort study aims to explore the association between early informed diagnosis and survival time in breast cancer patients. METHODS A total of 12,327 breast cancer patients were enrolled between October 2002 and December 2016. Potential factors, including knowing the cancer diagnosis status, sex, age, clinical stage, surgery history, grade of reporting hospital and diagnostic year were, analyzed. We followed up all participants every 6 months until June 2017. Propensity score matching (PSM) was used to balance the clinicopathologic characteristics between patients who knew their diagnosis and those who did not. RESULTS By June 2017, 18.04% of the participants died of breast cancer. Before PSM, both the 3-year and 5-year survival rates of patients who knew their cancer diagnosis were longer (P < 0.001). After PSM, the above conclusion was still established. By stratified analysis, except for the subgroups of male patients and stage III patients, patients who knew their diagnosis showed a better prognosis in all the other subgroups (P < 0.05). Cox regression analysis showed that knowing a cancer diagnosis was an independent risk factor for survival in breast cancer patients (P < 0.001). CONCLUSIONS Being aware of their cancer diagnosis plays a protective role in extending the survival time of breast cancer patients, which suggests that medical staff and patients' families should disclose the cancer diagnosis to patients in a timely manner. Further prospective studies need to be made to validate our findings.
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Affiliation(s)
- Chen He
- Department of Medical Psychology, College of Psychology, Naval Medical University, 800 Xiangyin Rd, Shanghai, 200433, China
| | - Wen Xi Zhu
- School of Nursing and Health Management, Shanghai University of Medicine & Health Sciences, Shanghai, China
| | - Yunxiang Tang
- Department of Medical Psychology, College of Psychology, Naval Medical University, 800 Xiangyin Rd, Shanghai, 200433, China
| | - Yonghai Bai
- Department of Medical Psychology, Changzheng Hospital Affiliated to Naval Medical University, Shanghai, China
| | - Zheng Luo
- Zhoupu Hospital affiliated to Shanghai University of Medicine & Health Sciences, Shanghai, China
| | - Jinfang Xu
- Department of Health Statistics, Naval Medical University, Shanghai, China
| | - Hao Wang
- Department of Medical Psychology, College of Psychology, Naval Medical University, 800 Xiangyin Rd, Shanghai, 200433, China
| | - Shuyu Xu
- Department of Medical Psychology, College of Psychology, Naval Medical University, 800 Xiangyin Rd, Shanghai, 200433, China
| | - Jingzhou Xu
- Department of Medical Psychology, College of Psychology, Naval Medical University, 800 Xiangyin Rd, Shanghai, 200433, China
| | - Lei Xiao
- Department of Medical Psychology, College of Psychology, Naval Medical University, 800 Xiangyin Rd, Shanghai, 200433, China
| | - Ruike Zhang
- Department of Medical Psychology, College of Psychology, Naval Medical University, 800 Xiangyin Rd, Shanghai, 200433, China
| | - Yajing Wang
- Department of Medical Psychology, College of Psychology, Naval Medical University, 800 Xiangyin Rd, Shanghai, 200433, China
| | - Jing Du
- Department of Medical Psychology, College of Psychology, Naval Medical University, 800 Xiangyin Rd, Shanghai, 200433, China
| | - Yujia Huang
- Department of Medical Psychology, College of Psychology, Naval Medical University, 800 Xiangyin Rd, Shanghai, 200433, China
| | - Xiaopan Li
- Department of Cancer Prevention and Vital Statistics, Center for Disease Control and Prevention, Pudong New Area, Shanghai, China.
- Pudong Institute of Preventive Medicine, Fudan University, Shanghai, China.
| | - Tong Su
- Department of Medical Psychology, College of Psychology, Naval Medical University, 800 Xiangyin Rd, Shanghai, 200433, China.
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Mei X, Tu J. Values, skills, and decision-making: A cultural sociological approach to explaining diagnostic disclosure. Soc Sci Med 2021; 279:114034. [PMID: 34020158 DOI: 10.1016/j.socscimed.2021.114034] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 05/03/2021] [Accepted: 05/10/2021] [Indexed: 11/17/2022]
Abstract
This paper provides an analytical framework for explaining the practice of diagnostic disclosure by drawing on theoretical developments regarding the question of "culture in action." Based on ethnographic and interview data collected from fieldwork at a major cancer hospital in China from 2015 to 2019, this paper explains how doctors and family members make decisions about diagnostic disclosure. We argue that it is important to understand the practice of diagnostic disclosure as motivated by the actors' values on the one hand, and constrained and enabled by the actors' skills on the other hand. It is also necessary to distinguish between personal and public values, as well as medical and interpersonal skills. Based on these distinctions, we will be better equipped to explain why diagnostic disclosure has encountered difficulties in family-centered societies, such as China.
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Affiliation(s)
- Xiao Mei
- Institute of Sociology, Chinese Academy of Social Sciences, No. 5 Jianguomennei Street, Beijing, 100732, China
| | - Jiong Tu
- School of Sociology and Anthropology, Sun Yat-sen University, No.135, Xingang Xi Road, Guangzhou, 510275, China.
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