This study aimed to explore an evidence-based nursing practice model of CRF management\nin hospitalized adult patients using the PARIHS evidence-implementation framework\nas the theoretical structure to provide guidance for similar nursing practices. The implementation\nof guideline evidence into clinical practice was conducted on the oncology and radiotherapy\nwards of a university-affiliated hospital. The process of integrating the guideline into\nthe symptom management system of cancer patients was described. The impact of the evidence\nimplementation was evaluated from three aspects: organizational innovations and\noutcome measures associated with nurses and with patients pre- and post-evidence implementation.\nDuring the implementation of evidence into practice on the wards, a nursing process,\nhealth education, a quality control sheet and CRF training courses were established.\nThrough this implementation, compliance with evidence related to CRF increased significantly\non the two wards, with that of ward B being higher than that of ward A. Regarding\nnursing outcomes, nursing knowledge, attitude and behavior scores with respect to CRF\nnursing care increased substantially after its application on the two wards, and the ward B\nnurses� scoring was higher than that of the ward A nurses. Qualitative analysis concerning\nthe nurses suggested that leadership, patient concern about CRF management, and the\nneed for professional development were the main motivators of the application, whereas the\nshortage and mobility of nursing human resources and insufficient communication between\ndoctors and nurses were the main barriers. Additionally, most nurses felt more professional\nand confident about their work. Regarding patient outcomes, patient knowledge, attitude\nand behavior scores regarding CRF self-management increased significantly. Patients�\npost-implementation CRF was alleviated compared with the pre-implementation treatment\ncycle. The PARIHS framework may provide instructive guidance for the incorporation of evidence\ninto practice, and the process-oriented framework might provide greater operational\nutility of the application.
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