Journal of Advanced Nursing

The Impact of Gestational Trophoblastic Neoplasia Following the Completion of Treatment: A Descriptive Exploratory Qualitative Study

ABSTRACT Aims To explore women's experience of the period after completion of cancer treatment for gestational trophoblastic neoplasia (GTN): a descriptive exploratory study. Design A descriptive exploratory qualitative study. Methods Women diagnosed with the rare pregnancy‐related cancer GTN who had completed their treatment participated in semi‐structured telephone interviews. Twenty‐two interviews were conducted in June 2024 and digitally recorded and transcribed verbatim. The analysis used reflective thematic analysis. Results Complex responses to treatment completion were revealed, described by some as a ‘double‐edged sword’. The end of treatment routine, coupled with recovery from physical effects, left space for the impact of all they had experienced to ‘hit home’. Multiple concerns and losses were described, including issues relating to pregnancy, self‐identity, confidence, fear of recurrence, work and relationships. Gaps in immediate post‐treatment support services created challenges for recovery. Conclusion The study provides valuable insight into the physical, emotional and social impact of GTN experienced by patients following treatment. The findings highlight the importance of continuing support in the immediate post‐treatment period. This study has identified ways in which services can be improved, recognising the need for an individual‐tailored approach to reflect the complex responses of patients to treatment completion. Impact The findings reveal that many women begin to process the implications of their diagnosis and treatment following the completion of their treatment. The end of treatment can be a time when support from healthcare staff is reduced due to fewer routine contacts with healthcare staff. However, these findings suggest the need for nurses to ensure services continue to provide support during the post‐treatment recovery phase. Patient or Public Contribution The interview schedule was reviewed by women previously treated for GTN.

Women's behaviours towards cervical cancer screening in the COVID ‐19 pandemic: A moderated‐mediation‐model based on Information‐Motivation‐Behavioural Skills

Abstract Aims (1) To establish a predictive model based on the Information‐Motivation‐Behavioural Skills model, which can analyse the factors affecting the behaviours of women towards cervical cancer screening in the COVID‐19 pandemic, and (2) to test the mediating effects of behavioural skills in the model, and (3) to test the moderated mediation effect of age. Design A cross‐sectional study was conducted among 354 women aged 30–65 between May and August 2021 in Turkey. Methods Data were collected by using an online survey. The direct and indirect effects were tested in the structural equation model and the moderated‐mediation effect was tested in the PROCESS macro. Results Behavioural skills mediate the effect of motivation on cervical cancer screening behaviours. In addition, age has a moderated mediation effect on this mediation effect. Conclusion Our study revealed that as women's motivation for cervical cancer screening increased, their behavioural skills also increased. It can be stated that middle‐aged and older women with higher behavioural skills are more likely to have screening during the pandemic and to comply with national recommendations. Impact This study is the first quantitative study to test the impact of the components of the Information‐Motivation‐Behavioural Skills model on cervical cancer screening during the COVID‐19 pandemic. In addition, the results reveal the mediating effect of behavioural skills in the relationship between motivation and cervical cancer scanning behaviour and the moderated mediation effect of age. Our results can provide insight for nurses into how to triage women with delayed cervical cancer screening, how to build screening capacity, and how intervention strategies should be developed to improve compliance with cervical cancer screening and follow‐up recommendations in women at risk during and after the pandemic.

Multiprofessional Family Care for Women With Gynaecological Cancer

ABSTRACT Aim The aim of this study was to determine how family care is implemented in the care of women with gynaecological cancer from the perspective of health professionals in Finland. Design Multiphase convergent mixed‐methods research. Methods This study is based on two datasets collected from one Finnish university hospital. The first dataset was collected from health professionals ( n  = 20) in one Finnish university hospital inpatient unit in 2023. The second dataset is based on non‐participant observational cases ( n  = 137) of health professionals in the spring of 2024. The quantitative data were analysed using both parametric and non‐parametric tests. The qualitative data were analysed using thematic analysis. Results The quantitative results of the first and second phases together confirm the gap between the lack of competence and the attitudes of health professionals towards their own communication skills. The qualitative results revealed two main themes: (1) increasing competence towards a more comprehensive patient care process and (2) increasing the sense of safety by sharing timely information between professionals, patients, and relatives. Conclusion Family‐oriented working and communication between professionals is incidental and individual‐dependent. Increased competence and more effective sharing and exchange of care information between professionals can improve the quality of care. Implications for the Profession and/or Patient Care The study was able to identify important areas of family care for professionals to improve their clinical practice. Impact This study addressed clinical competence, as demonstrated by the family care perspective. Family care is recognised as an important part of the care of gynaecological cancer patients and requires increased competence. This study aims to raise awareness among health professionals and policymakers about the current state of family care in Finland. Reporting Method This study was prepared and reported according to the STROBE checklist. Patient or Public Contribution No patient or public contribution.

Development and Psychometric Testing of a Low Extremity Lymphedema Risk Management Behaviours Questionnaire for Patients With Gynecologic Cancer

ABSTRACT Background Lower extremity lymphedema (LEL) is a debilitating complication for patients with gynecologic cancer. A series of strategies have been recommended to mitigate the risk of LEL and improve patient outcomes; however, investigation into LEL risk management behaviours in this population is limited, and the absence of reliable and valid tools is an important reason. Aims To develop and evaluate the psychometric properties of the lower extremity lymphedema risk management behaviours questionnaire (LELRMBQ) for Chinese patients with gynaecologic cancer. Design This was a methodological study. Methods Initial items were generated using a literature review. The initial LELRMBQ was refined, and its content validity was evaluated by conducting two rounds of expert consultation and a pilot study. Psychometric testing of 389 participants recruited by convenience sampling was conducted from December 2022 to June 2023. Exploratory factor analysis (EFA; subsample 1, N  = 158) and confirmatory factor analysis (CFA; subsample 2, N  = 231) were performed separately to determine the multi‐dimensional structure of the questionnaire. Known‐group validity, internal consistency reliability, and test–retest reliability were also evaluated. Results A total of 25 items with satisfactory content validity were included in psychometric testing. The EFA identified a four‐factor structure, comprising 18 items, which explained 74.49% of the total variance. The CFA supported this structure with acceptable fit indices. Known‐group validity was partially supported by significant differences in total LELRMBQ scores among groups with different education levels, residence, cancer type, and LEL awareness. Internal consistency and temporal stability were acceptable. Conclusions The 18‐item LELRMBQ demonstrated sufficient reliability and validity as a tool for measuring LEL risk management behaviours in patients with gynaecologic cancer. Implications for the Profession and/or Patient Care The LELRMBQ has potential applicability in assessing LEL risk management behaviours, identifying gaps in educational practices, tailoring effective interventions, and evaluating intervention effectiveness. Reporting Method This manuscript followed the STROBE guidelines. Patient or Public Contribution Patients with gynecologic cancer participated in this study and provided the data through the survey.