Chemotherapy-induced hand-foot syndrome among Chinese inpatients: a qualitative descriptive study in Shanghai.

Abstract

To explore the symptom experiences and self-management strategies of patients with chemotherapy-induced hand-foot syndrome (HFS), and to identify approaches for improving symptom control and quality of life. A qualitative study using semi-structured interviews and thematic analysis. We conducted this study in the oncology inpatient ward of a tertiary hospital in Shanghai, China. We used a purposive sampling approach to recruit 25 inpatients with chemotherapy-induced HFS from July 2022 to March 2024. The interviews were audio-recorded and transcribed verbatim. We employed an adapted version of Colaizzi's qualitative analysis approach to examine the data. 25 patients (mean age 58 years; 56% male) with grade I-III chemotherapy-induced HFS were interviewed. Four inter-related themes emerged.(1) Symptom experience: pain, numbness and burning sensations disturbed sleep; visible peeling and hyper-pigmentation triggered embarrassment and self-consciousness.(2) Emotional responses: most participants accepted symptoms as 'part of treatment', yet persistent anxiety about progression and guilt over becoming a family burden were common.(3) Social impact: patients avoided outdoor activities, stopped caring for grandchildren and reported lost income because 'hands can't touch cold or rough items'.(4) Future expectations: participants wanted pictorial self-care guides, a nurse hotline after discharge and earlier introduction of pain-relief strategies. All expressed frustration at 'no-one to ask' once home. Chemotherapy-induced HFS imposes a considerable multidimensional burden. Tailored, patient-centred interventions that integrate education, psychological support and family involvement are essential to improve symptom management and overall well-being. Future work should develop and test sustainable, long-term support strategies in broader populations. This study provides the first qualitative evidence base for understanding and managing chemotherapy-induced HFS in Chinese patients, informing nurse-led interventions, patient-reported outcome development and national supportive-care policy.