Asia-Pacific Journal of Oncology Nursing最新文献

{"title":"Corrigendum to “A nature-immersive virtual reality intervention to support hospice family caregivers: Qualitative findings from a pilot study” [Asia-Pacific J Oncol Nursing 11 (2024) 100616]","authors":"Arienne Patano , Mohammed Alanazi , Rebecca Lehto , Dawn Goldstein , Gwen Wyatt","doi":"10.1016/j.apjon.2025.100721","DOIUrl":"10.1016/j.apjon.2025.100721","url":null,"abstract":"","PeriodicalId":8569,"journal":{"name":"Asia-Pacific Journal of Oncology Nursing","volume":"12 ","pages":"Article 100721"},"PeriodicalIF":2.4,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144253505","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Facilitators and barriers associated with returning to work for cancer survivors: A systematic review","authors":"Jiayi Liu ,&nbsp;Jinnan Xiao ,&nbsp;Suqi Ou ,&nbsp;Jiarui Chen ,&nbsp;Siyuan Tang","doi":"10.1016/j.apjon.2025.100734","DOIUrl":"10.1016/j.apjon.2025.100734","url":null,"abstract":"<div><h3>Objective</h3><div>To analyze facilitators and barriers affecting cancer survivors' return to work based on the views of survivors and various stakeholders, using the social ecological model.</div></div><div><h3>Methods</h3><div>Five electronic databases were searched in April 2025. Relevant studies and extracted data were selected by two researchers independently. Qualitative synthesis followed the Joanna Briggs Institute three-step process and drew on the five interrelated layers of the social ecological model.</div></div><div><h3>Results</h3><div>Of 5535 initial studies, 13 qualitative studies were included. Intrapersonal factors consisted of personal characteristics, disease diagnosis, post-treatment physical symptoms, post-treatment emotional states, the perceived impacts of the disease and treatments on work, understanding of and attitudes toward work, and strategies for coping with return-to-work issues. Interpersonal factors included the opinions of employers and interpersonal relations at work, as well as interpersonal support. Organizational factors consisted of occupational return-to-work arrangements and occupational support. Community factors included community support and public cognition and atmosphere. Public policy factors included the dissemination of related policies, the deficiency of related legislation, and the impacts and implementation criteria of welfare policies. The differences between cancer survivors' and stakeholders' perspectives were compared.</div></div><div><h3>Conclusions</h3><div>Multiple factors directly or indirectly influence cancer survivors' return-to-work decisions and experience. Cancer survivors should develop their awareness and learn more strategies in dealing with return-to-work problems. Stakeholders should care about the health status of cancer survivors, offering increased understanding and collaboration. Further studies should explore the relationships among the factors. Multi-component interventions are recommended to address return-to-work issues.</div></div><div><h3>Systematic review registration</h3><div>PROSPERO CRD42024555929.</div></div>","PeriodicalId":8569,"journal":{"name":"Asia-Pacific Journal of Oncology Nursing","volume":"12 ","pages":"Article 100734"},"PeriodicalIF":2.4,"publicationDate":"2025-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144288772","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Frailty level, cancer history and healthcare utilization among older adults: Results from the US National Health Interview Survey","authors":"Siqi Liu ,&nbsp;Mingzhu Su ,&nbsp;Li Liu ,&nbsp;Quan Wang ,&nbsp;Tingting Qin ,&nbsp;Fang Wang","doi":"10.1016/j.apjon.2025.100736","DOIUrl":"10.1016/j.apjon.2025.100736","url":null,"abstract":"<div><h3>Objective</h3><div>Limited information exists on the association among frailty, cancer history, and health care utilization in older adults, particularly cancer survivors. This study aimed to examine the relationship between frailty level, cancer history, and health care utilization among older adults.</div></div><div><h3>Methods</h3><div>A total of 14,562 older adults were identified from the 2019 and 2020 National Health Interview Survey, including cancer survivors (<em>n</em> = 3944) and those without a cancer history (<em>n</em> = 10,618). Frailty was assessed using a modified FRAIL Scale (Fatigue, Resistance, Ambulation, Illness, and Low body mass index). Health care utilization outcomes included urgent care, emergency care, hospitalization, delayed care, and needed but did not get care due to cost. Multivariate logistic regressions examined the association between cancer-frailty characteristics and health care utilization.</div></div><div><h3>Results</h3><div>Participants with cancer were more likely to be older, with a higher proportion aged 75–84 (37.1% vs. 27.4%) and 85+ (12.6% vs. 9.4%) years, compared to those without a cancer history. Cancer survivors also showed higher rates of frailty (23.8% vs. 14.5%) and pre-frailty (36.0% vs. 33.7%). In adjusted analyses, both higher frailty severity and cancer history were independently associated with increased odds of emergency care and hospitalization. Frail older cancer survivors had the highest likelihood of these outcomes, with odds ratios of 4.738 for emergency care and 5.643 for hospitalization. Sensitivity analyses confirmed the robustness of these findings.</div></div><div><h3>Conclusions</h3><div>Using nationally representative data, this study demonstrates that frailty and cancer history are independently associated with increased emergency care and hospitalization among older adults.</div></div>","PeriodicalId":8569,"journal":{"name":"Asia-Pacific Journal of Oncology Nursing","volume":"12 ","pages":"Article 100736"},"PeriodicalIF":2.4,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144290679","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors facilitating effective collaboration between labor and social security attorneys and medical professionals in supporting cancer survivors balancing treatment and work","authors":"Sono Sugitani ,&nbsp;Shinobu Yamada","doi":"10.1016/j.apjon.2025.100732","DOIUrl":"10.1016/j.apjon.2025.100732","url":null,"abstract":"<div><h3>Objective</h3><div>This study aims to identify the key factors that enable effective collaboration between labor and social security attorneys and health care professionals in supporting cancer survivors who are balancing treatment and work. By understanding what attorneys consider essential for successful collaboration with health care professionals, this research seeks to improve the interprofessional support system for cancer survivors managing both their health and work.</div></div><div><h3>Methods</h3><div>A questionnaire survey was conducted among labor and Social Security Attorneys in two prefectures in Japan's Kansai region. Qualitative text analysis and hierarchical cluster analysis were used to identify essential factors for smooth coordination between these professionals and medical practitioners.</div></div><div><h3>Results</h3><div>Twelve key factors were identified, including the need for clear medical information without reliance on internet searches, prognosis-based employment considerations, improved understanding of employment regulations by medical professionals, and enhanced information-sharing practices. Additionally, issues such as differences in perception between medical professionals and cancer survivors, the necessity of specifying work restrictions based on treatment policies, and the importance of estimated return-to-work timelines were highlighted.</div></div><div><h3>Conclusions</h3><div>Effective collaboration between Labor and Social Security Attorneys and medical professionals requires clear, structured communication of medical information tailored to individual work conditions. Medical professionals should ensure that their recommendations regarding employment are specific, practical, and easily interpretable by non-medical professionals. Strengthening multidisciplinary cooperation will contribute to better support systems for cancer survivors in maintaining their employment while undergoing treatment.</div></div>","PeriodicalId":8569,"journal":{"name":"Asia-Pacific Journal of Oncology Nursing","volume":"12 ","pages":"Article 100732"},"PeriodicalIF":2.4,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144288771","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perioperative respiratory physiotherapy in patients with thoracic tumors: Summary of best evidence and recommendations","authors":"Shaofei Liu ,&nbsp;Yangyang Liao ,&nbsp;Dandan Liu,&nbsp;Ziya Xin,&nbsp;Jiudi Zhong,&nbsp;Juan Yuan ,&nbsp;Lu Kang","doi":"10.1016/j.apjon.2025.100730","DOIUrl":"10.1016/j.apjon.2025.100730","url":null,"abstract":"<div><h3>Objective</h3><div>To summarize the best evidence-based perioperative respiratory physiotherapy strategies for patients with thoracic tumors and to provide a reference for clinical practice.</div></div><div><h3>Methods</h3><div>The review was conducted following the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. A systematic search of evidence on the perioperative respiratory physiotherapy in patients with thoracic tumors was performed in computerized decision systems, guideline websites, professional association websites, and comprehensive databases from the date of creation to 30 April 2024. The types of evidence included were clinical decisions, guidelines, expert consensuses, evidence summaries, systematic reviews, and meta-analyses. Two independent researchers evaluated the quality of the literature and extracted and summarized the included evidence.</div></div><div><h3>Results</h3><div>A total of 24 articles were included for analysis, comprising one clinical decision, three guidelines, four expert consensuses, two evidence summaries, and 14 systematic reviews. The overall quality of the literature was high. Thirty-seven pieces of evidence were summarized, focusing on four areas: assessment, preoperative respiratory physiotherapy strategies, postoperative respiratory physiotherapy strategies, and home-based management.</div></div><div><h3>Conclusions</h3><div>This study synthesizes the best evidence on implementing perioperative respiratory physiotherapy in patients with thoracic tumors, providing a reference for clinical practice. More comprehensive and high-quality guidance documents focused on home-based management of respiratory physiotherapy are needed.</div></div><div><h3>Systematic review registration</h3><div>This study was registered at the Fudan University Centre for Evidence-based Nursing (Registration No. ES20245066).</div></div>","PeriodicalId":8569,"journal":{"name":"Asia-Pacific Journal of Oncology Nursing","volume":"12 ","pages":"Article 100730"},"PeriodicalIF":2.4,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144240981","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of Swanson theory-based auricular acupressure on chemotherapy-induced peripheral neuropathy, and broader health-related outcomes in patients with breast cancer: A randomized controlled trial","authors":"Yuanyuan Mi ,&nbsp;Ying Chen ,&nbsp;Jing Li ,&nbsp;Xinxin Liu ,&nbsp;Zhengrong Li ,&nbsp;Quanlian Ye ,&nbsp;Jinli Guo ,&nbsp;Yuanfei Liu","doi":"10.1016/j.apjon.2025.100729","DOIUrl":"10.1016/j.apjon.2025.100729","url":null,"abstract":"<div><h3>Objective</h3><div>Chemotherapy-induced peripheral neuropathy (CIPN) is common in patients with breast cancer who received taxane-based chemotherapy. While auricular acupressure has shown promise in symptom management, its effects within a caring framework remain underexplored. This study aims to examine the effects of Swanson theory-based auricular acupressure on CIPN and broader health-related outcomes (e.g., sleep and quality of life) and the potential mediating role of inflammatory biomarkers.</div></div><div><h3>Methods</h3><div>Seventy-four participants with breast cancer were recruited with 1:1 random assignment in intervention group and control group. Participants in the intervention group were instructed by nurses to do Swanson theory-based auricular acupressure during the 6 cycles of chemotherapy. Auricular acupressure was applied to10 ear points with each of them evenly for 1–2 minutes at a time and 3–5 times a day according to their feeling of discomfort. CIPN symptoms, sleep quality, inflammatory biomarkers, quality of life and patient-reported nurse-patient relationship were measured. Two-factor repeated measures analysis of variance was used to assess differential change in these outcomes between the two groups over time.</div></div><div><h3>Results</h3><div>The levels of inflammatory biomarkers decreased over time in both groups. Compared to the control group, the intervention group experienced significantly larger reduction in Tumor Abnormal Protein level (<em>P</em> ​&lt; ​0.001), smaller increases in CIPN symptom severity (<em>P</em> ​&lt; ​0.001), improved sleep quality (<em>P</em> ​&lt; ​0.001), and higher levels of trust in nurses (<em>P</em> ​&lt; ​0.001) across chemotherapy cycles.</div></div><div><h3>Conclusions</h3><div>Swanson theory-based auricular acupressure may have a potential benefit to mitigate the worsening of CIPN symptoms, improve sleep and quality of life, reduce inflammatory biomarkers, and enhance the nurse-patient relationship during chemotherapy. These findings support the integration of auricular acupressure within holistic cancer care, highlighting the value of compassionate, theory-driven nursing interventions. Further large-scale studies are recommended to confirm these outcomes and explore underlying mechanisms.</div></div><div><h3>Trial registration</h3><div>This study was registered in the National Health Security Information Platform (Medical Research Registration and Information System, <span><span>https://www.medicalresearch.org.cn/</span><svg><path></path></svg></span>) (MR-14-24-054013).</div></div>","PeriodicalId":8569,"journal":{"name":"Asia-Pacific Journal of Oncology Nursing","volume":"12 ","pages":"Article 100729"},"PeriodicalIF":2.4,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144240980","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Joint developmental trajectories of fear of recurrence and coping behaviors among patients with lung cancer: A parallel process latent class growth analysis","authors":"Yonglin Li ,&nbsp;Yiyang Lin ,&nbsp;Shuting Lin ,&nbsp;Jialing Lin ,&nbsp;Wei-Ti Chen ,&nbsp;Feifei Huang","doi":"10.1016/j.apjon.2025.100728","DOIUrl":"10.1016/j.apjon.2025.100728","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to investigate the joint developmental trajectories of fear of cancer recurrence (FCR) and coping behaviors in patients with lung cancer and analyze the influences of family resilience and quality of life (QOL) on each latent trajectory.</div></div><div><h3>Methods</h3><div>Longitudinal observation data from 310 patients with lung cancer were evaluated at 1, 3, 6, and 12 months postdiagnosis (T₁-T₄). The participants completed a comprehensive set of questionnaires. Parallel-process latent class growth analysis was used to delineate the joint developmental trajectories.</div></div><div><h3>Results</h3><div>Three types of joint developmental trajectories were identified: the high FCR-poor coping-sudden change group (28.4%, 88/310), the moderate FCR-medium coping-stable change group (31.9%, 99/310), and the low FCR-good coping-stable change group (39.7%, 123/310). Gender, residential location, educational level, and medical insurance were predictors of trajectory class membership. There were significant differences in family resilience and QOL across the three classes.</div></div><div><h3>Conclusions</h3><div>Targeted interventions should be developed at specific time points to reduce FCR levels and enhance coping behaviors among patients with lung cancer. The importance of addressing and managing the fear of cancer recurrence and coping behaviors among patients with lung cancer to enhance their family resilience and QOL is discussed. Healthcare providers should be particularly attentive to patients with lung cancer who are males, those living in rural areas, those with less than a bachelor's degree, and those without medical insurance.</div></div>","PeriodicalId":8569,"journal":{"name":"Asia-Pacific Journal of Oncology Nursing","volume":"12 ","pages":"Article 100728"},"PeriodicalIF":2.4,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144240979","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"“We hope to, but…”: Chinese frontliners' barriers in providing psychosocial care for cancer survivors","authors":"Ziqi Peng ,&nbsp;Xiaohui Su ,&nbsp;Suet Lin Hung","doi":"10.1016/j.apjon.2025.100725","DOIUrl":"10.1016/j.apjon.2025.100725","url":null,"abstract":"<div><h3>Objective</h3><div>In recent years, there has been an emerging trend of psychosocial oncology caring strategies within the Chinese context. However, many survivors undergoing different stages of the cancer journey continue to report significant life disruptions and unmet psychosocial care needs. While the crucial role frontline professionals play in providing this care, little is known about the critical barriers they encounter. This study aims to provide a comprehensive understanding of the barriers Chinese frontline professionals face in providing psychosocial oncology care.</div></div><div><h3>Methods</h3><div>This study employed a qualitative design with semi-structured interviews. Twenty oncology nurses and social workers with at least one year of experience in relevant specializations were recruited. The interview data were audio-recorded, transcribed, and thematically analyzed to identify themes.</div></div><div><h3>Results</h3><div>Three dominant themes and subthemes were identified: (1) Overburdened clinical work and inadequate training, (2) Emotional and social struggles faced by survivors and their families that hinder the employment of psychosocial care, (3) System failures: social, structural, and policy barriers.</div></div><div><h3>Conclusions</h3><div>The findings shed light on the complexities and barriers among frontline professionals in providing psychosocial oncology care. A central paradox emerged between professionals' desire to offer comprehensive care and the systemic barriers encountered, including limited institutional support and resources, and low public awareness. This study highlighted the need for a context-specific psychosocial oncology framework for research and practice. Interdisciplinary collaboration should be made among research, policy, and social education, which aims to enrich public awareness of psychosocial oncology and provide financial and resource support for practices.</div></div>","PeriodicalId":8569,"journal":{"name":"Asia-Pacific Journal of Oncology Nursing","volume":"12 ","pages":"Article 100725"},"PeriodicalIF":2.4,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144212176","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Knowledge, attitudes, and practices of family members of children undergoing chemoradiotherapy regarding oral mucositis","authors":"Hui Gan ,&nbsp;Kailan Chen ,&nbsp;Li Tao,&nbsp;Qian Hu,&nbsp;Cheng Yang,&nbsp;Xi Xu","doi":"10.1016/j.apjon.2025.100724","DOIUrl":"10.1016/j.apjon.2025.100724","url":null,"abstract":"<div><h3>Objective</h3><div>To explored the knowledge, attitudes, and practices (KAP) of family members of children receiving chemoradiotherapy concerning oral mucositis.</div></div><div><h3>Methods</h3><div>A cross-sectional study was conducted from August 15, 2023, to May 31, 2024, in the oncology ward of Wuhan Children's Hospital of Tongji Medical College, Huazhong University of Science and Technology, using a custom-designed KAP questionnaire.</div></div><div><h3>Results</h3><div>Of the 364 valid responses, 63.19% were from female family members. Most children (45.33%) received treatment for over six months, and 38.74% were diagnosed with oral mucositis. The participant's median (P25–P75) for knowledge, attitude, and practice scores were 6 (5, 7) (possible range: 0–7), 27 (24, 30) (possible range: 6–30), and 17 (14, 21) (possible range: 5–30), respectively. A significant 36.26% were unsure about the link between radiotherapy and oral mucositis. Only 14.56% were neutral or disagreed on the importance of special oral care. On the practical side, 69.78% of children never used dental floss and 31.59% had never visited the hospital for oral check-ups, though most participants preferred receiving information from medical professionals. Further correlation analysis revealed positive correlations between knowledge scores and attitude scores (<em>r</em> ​= ​0.270, <em>P ​&lt;</em> ​0.001), as well as between knowledge scores and practice scores (<em>r</em> ​= ​0.164, <em>P</em> ​= ​0.002). Additionally, attitude scores were positively correlated with practice scores (<em>r</em> ​= ​0.280, <em>P ​&lt;</em> ​0.001).</div></div><div><h3>Conclusions</h3><div>Family members of children undergoing chemoradiotherapy have adequate knowledge and positive attitudes about oral mucositis, but this does not always lead to proactive practices. Educational interventions should enhance knowledge and encourage its application in daily caregiving to manage oral mucositis effectively.</div></div>","PeriodicalId":8569,"journal":{"name":"Asia-Pacific Journal of Oncology Nursing","volume":"12 ","pages":"Article 100724"},"PeriodicalIF":2.4,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144297047","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the mediating roles of stigma and perceived social support between health literacy and health care decision-making barriers among patients with cervical cancer","authors":"Hanjiao Kong ,&nbsp;Jingzhi Geng ,&nbsp;Qiuhui Wang ,&nbsp;Jie Zhu ,&nbsp;Hong Zhao","doi":"10.1016/j.apjon.2025.100716","DOIUrl":"10.1016/j.apjon.2025.100716","url":null,"abstract":"<div><h3>Objective</h3><div>This study aims to investigate the association between health literacy, stigma, and health care decision-making barriers in patients with cervical cancer and identifies the mediating roles of stigma and perceived social support in this relationship.</div></div><div><h3>Methods</h3><div>A cross-sectional study was conducted using convenience sampling, recruiting 322 hospitalized patients with cervical cancer from three tertiary hospitals in Beijing. The participants completed self-reported questionnaires on health literacy, stigma, perceived social support, and health care decision-making barriers. Chained mediation effects were analyzed using Amos 26.0 software.</div></div><div><h3>Results</h3><div>37.3% of patients with cervical cancer reported delays in seeking medical care. Health literacy was found to have significant negative associations with stigma (<em>P</em> ​&lt; ​0.001) and health care decision-making barriers (<em>P</em> ​&lt; ​0.001) and a positive correlation with perceived social support (<em>P</em> ​&lt; ​0.001). Health literacy indirectly influenced health care decision-making barriers through three mediating pathways: stigma (effect ​= ​−0.073), perceived social support (effect=−0.086), and a combination of stigma and perceived social support (effect ​= ​−0.041), collectively accounting for 27.5%, 32.3%, and 15.4% of the total effect, respectively. The total indirect effect accounted for 75.1% of the total effect.</div></div><div><h3>Conclusions</h3><div>The health literacy levels among patients with cervical cancer in China are moderate. Stigma and perceived social support serve as partial mediators in the relationship between health literacy and health care decision-making barriers. Health care providers can reduce decision-making barriers by improving health literacy and indirectly lessen them by addressing stigma and enhancing social support.</div></div>","PeriodicalId":8569,"journal":{"name":"Asia-Pacific Journal of Oncology Nursing","volume":"12 ","pages":"Article 100716"},"PeriodicalIF":2.4,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144134369","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}