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Awareness and associated factors of venous thromboembolism in breast cancer surgical patients: a cross-sectional study



Venous thromboembolism (VTE) is a major complication of breast cancer surgical patients. Assessing VTE awareness enables medical staff to tailor educational programs that improve patient self-management and reduce VTE risk. Therefore, this study aimed to assess VTE awareness among breast cancer surgical patients and identify factors influencing their awareness level.


A multicenter cross-sectional study was conducted on breast cancer patients scheduled for surgery from May 2023 to November 2023. Data were collected using a general information form and a validated self-assessment questionnaire on VTE awareness for breast cancer surgical patients. Univariate analysis and multiple linear regression analysis were used to analyze the data.


Of 1969 patients included, the term awareness rates for deep vein thrombosis and pulmonary embolism were 42.5% and 26.1%, respectively. Information about VTE was primarily obtained from doctors (30.4%), nurses (24.0%), and social media (23.3%). The overall average VTE awareness score was 1.55 ± 0.53, with the dimension of VTE preventive measures scoring highest, and VTE clinical symptoms/signs scoring lowest. Multivariate analysis identified education level, personal VTE history, chemotherapy and surgical history, and the hospital’s regional location as significant factors associated with VTE awareness level (p < 0.05).


This study highlights a critical need for improved VTE awareness among breast cancer surgical patients, particularly regarding clinical symptoms/signs. Health education programs are recommended especially tailored for patients with lower education levels, no history of VTE, or without prior surgery or chemotherapy, to improve their understanding of VTE.

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Venous thromboembolism (VTE), encompassing deep vein thrombosis (DVT) and pulmonary embolism (PE), significantly contributes to the global disease burden [1]. VTE related to hospitalization is a major cause of mortality and morbidity across both developed and developing nations [2]. Given its high morbidity, mortality, and associated healthcare costs, numerous international, national, and regional organizations have implemented various measures, such as setting up World Thrombosis Day by the International Society on Thrombosis and Haemostasis, publishing the Call to Action to Prevent DVT and PE by the United States Surgeon General, and established the National Program for Prevention and Management of PE and DVT by Chinese government, to raise the awareness of thrombosis disease among medical professions and the public [3,4,5].

Breast cancer, which has the highest prevalence worldwide, also sees a significant number of patients developing VTE, accounting for 17% of all cancer patients receiving anticoagulation therapy [6]. Previous studies have indicated that VTE could disrupt the course of anticancer treatment, extend the hospitalization days by about a week, increase by 2919 ~ 3611€ treatment cost per patient, and even increase the risk of death of breast cancer patients [7,8,9,10,11]. Surgery, a principal treatment modality for breast cancer, is also widely acknowledged as a significant risk factor for VTE. The incidence of VTE in breast cancer patients after surgery has been reported as high as 31.4% [12], with the majority of cases occurring within one month postoperatively [13,14,15]. Therefore, breast cancer patients undergoing surgery constitute a key group for the prevention and control of VTE.

Although the clinical features [16], risk factors [17,18,19,20,21], and prophylactic measures [22,23,24,25,26] of VTE in breast cancer patients undergoing surgery have been studied, no research was found which reported the awareness level of VTE and the knowledge level related to VTE clinical manifestation, key risk factors, prophylactic measures, etc. in patients with breast cancer. Assessing patients’ awareness of VTE can assist healthcare providers in developing more targeted and precise health education programs, to attract patients to actively participate in VTE prevention. Consequently, this study aims to (1) investigate the awareness level of VTE among breast cancer patients undergoing surgery, and (2) identify factors associated with their level of awareness.


Study design and setting

This was a multi-center cross-sectional study conducted in 20 provinces, involving 47 hospitals. This study received approval from the Ethics Committee of West China Hospital,Sichuan University (Approval No. 2023 − 1276) and adhered to the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines.


Inpatients with breast cancer planning to receive a mastectomy from May 2023 to November 2023 were eligible for this survey. The inclusion criteria were as follows: 1) a pathological diagnosis of breast cancer; (2) age ≥ 18 years; 3) consciousness and ability to complete the questionnaire independently or with investigator assistance; and 4) voluntary participation in the survey. Patients who could not fill out the questionnaire with the assistance of the investigator were excluded. All participants signed the electronic or paper informed consent form.

Sample size calculation

The sample size of this study was calculated based on the calculation method used for the cross-sectional study, i.e. \( N=\frac{{Z}_{1-\alpha /2}^{2}\left(1-p\right)}{{\epsilon }^{2}p}\). Considering that there is no research reported on the awareness rate of VTE in breast cancer patients, we referred to the results of a survey conducted on cancer patients in internal medicine, which reported the awareness rate of DVT was 28.8% [27]. Therefore, we took 28% as the value of proportion (p) in this study. Additionally, the value of confidence level (1-α) and admissible error (δ) were taken to the generally accepted value of 95% and 10%, respectively. In summary, at least 988 patients were needed\( (N=\frac{{1.96}^{2}\times \left(1-0.28\right)}{{0.1}^{2}\times 0.28}=988\)).


General information form

A general information form was pre-designed to collect patients’ sociodemographic information (i.e. age, education level, and marital status), medical history (including personal VTE history, family history of VTE, surgical history, chemotherapy history, and central venous catheterization history), whether heard of the term or diseases of hypertension, hyperlipidemia, stroke, coronary heart disease, DVT, PE, and ways to learn about VTE.

VTE awareness level self-evaluation questionnaire

Based on the questionnaire developed by Wendelboe [28] and Aggarwal [29], a VTE awareness level self-evaluation questionnaire specialized for breast cancer patients was designed after a comprehensive literature review. Five clinical medical and nursing experts from the vascular or oncology department were invited to modify and test the content validity of this questionnaire. Then, a pilot survey was conducted on 40 breast cancer patients to check whether the descriptions of items were unclear or ambiguous. Finally, the questionnaire contained four dimensions, i.e., basic knowledge (13 items), clinical symptoms/signs (11 items), risk factors (17 items), and preventive measures of VTE (6 items), with a total of 47 items. Each item was rated on a 3-point Likert scale, where 1 point indicated ‘completely unknown’ and 3 points indicated ‘very known’. To compare these four dimensions easily, the scores of each dimension were standardized, that is, the score of each dimension was equal to the total score of each dimension divided by the number of items in each dimension. The higher the score, the higher the awareness level of patients. The scale of content validity of this questionnaire was 0.97. The Cronbach’s α coefficient for the total questionnaire was 0.97, and for four dimensions were 0.90, 0.95, 0.95, and 0.87, respectively.

Data collection

Data were collected by an investigator using an electronic questionnaire on the day of admission. After the patient submitted the questionnaire, the investigator checked the completeness of the questionnaire on the same day and asked the patient to fill in the missing items in time to ensure the integrity of the data. An invalid questionnaire is defined as an answer with obvious logical errors or inconsistent answers. A total of 2005 patients were investigated in this study, of which 36 questionnaires were eliminated because of inconsistent answers, and 1969 valid questionnaires were finally recovered, with a recovery rate of 98.2%.

Statistical analysis

Data analysis was performed using SPSS (version 26.0). Participants’ characteristics were presented as frequencies and proportions, and the awareness level of VTE of participants was presented as x ± SD. Univariate analyses (t-test or ANOVA) and multiple linear stepwise regression analyses were used to analyze the factors influencing participants’ awareness level of VTE. Variables with a p-value < 0.05 from the univariate analysis were included in the multivariate analysis. Two side p < 0.05 was considered statistically significant.


Characteristics of participants

The analysis included 1969 hospitalized breast cancer surgery patients with a mean age of 49.7 ± 11.5 years; 83.7% were under the age of 60. The majority of participants had an educational level of junior/senior high school or above; 4.2% of participants had a history of VTE and 26.5% had a history of surgery. Detailed demographic information is presented in Table 1.

Among the participants, a majority were familiar with the terms ‘hypertension’ (88.6%), ‘stroke’ (77.4%), and ‘coronary heart disease’ (64.0%). However, only 42.5% and 26.1% of them have heard the terms DVT and PE respectively (Fig. 1). Participants learned about VTE mainly through surgeons (n = 598), followed by nurses (n = 473), online social applications (n = 459), books or health brochures (n = 362), fellow patients or friends (n = 231), and other ways (n = 125).

Table 1 The VTE awareness level of participants with different characteristics and the univariate analysis results for the VTE awareness level
Fig. 1
figure 1

Terminology awareness related the cardiovascular diseases

The VTE awareness level of participants

Table 1  summarizes the total score and scores for 4-dimension scores of VTE awareness level under different characteristics of participants. The total score of all participants after standardization was 1.55 ± 0.53. The scores of four dimensions from high to low were: preventive measures of VTE (1.76 ± 0.66), basic knowledge (1.58 ± 0.53), risk factors (1.50 ± 0.55), and clinical symptoms/signs (1.48 ± 0.60). Table 2 presents the items with the highest and lowest scores within each dimension.

Table 2 Details of the scores of each item in each dimension

Factors associated with VTE awareness level

In the univariate analysis (Table 1), all variables were associated with participants’ VTE awareness level (p < 0.05) and were subsequently included in the multiple linear stepwise regression analysis.

The results of multivariate analysis are presented in Table 3. Patients with higher education levels (Junior/senior high school: β = 0.09, p = 0.014; College graduated or above: β = 0.28, p < 0.001) and patients with a personal history of VTE (β = 0.20, p < 0.001), family history of VTE (β = 0.10, p = 0.014), history of chemotherapy (β = 0.10, p < 0.001), surgery (β = 0.11, p < 0.001), had higher levels of awareness of VTE. Patients admitted to hospitals in Western China exhibited a lower awareness level of VTE (β = -0.19, p < 0.001).

Table 3 Multiple linear stepwise regression analysis of participants’ VTE awareness level


This study aimed to assess the awareness level of VTE in breast cancer surgery patients and identify factors that influenced their awareness level of VTE. The findings revealed that (1) the term awareness rates of DVT and PE were low compared with other diseases; (2) medical staff and online social applications were the main sources for participants to learn about VTE; (3) the participants’ overall awareness of VTE related knowledge is at an average level, but the awareness level regarding clinical symptoms/signs and risk factors of VTE is insufficient. (4) several factors associated with participants’ overall VTE awareness level, including education level, personal history of VTE, chemotherapy history, surgical history, and the region where the hospital is located.

In the present survey covering several common cardiovascular diseases, the terminology awareness rates for DVT and PE were the lowest. This is consistent with the findings from Wendelboe et al.‘s [28] 2014 global survey of 7,233 ordinary people, though the terminology awareness rates for DVT and PE in this study (42.5% for DVT and 26.1% for PE) are lower than those reported by Wendelboe et al. (44% for DVT and 54% for PE, respectively). Lavall et al. [30] conducted a survey on 325 members of the general public and the results showed an awareness rate of 42% for both DVT and PE. Aggarwal et al. ‘s [29] survey of 500 cancer patients in the United States indicated an awareness rate of 24% for DVT and 15% for PE. These surveys demonstrated that both cancer patients, who are at a higher risk for VTE, and the general population have low awareness levels of VTE, though increasing measures to improve the public’s awareness of VTE have been implemented at national and international levels. This gap necessitates targeted awareness campaigns and educational interventions, especially for high-risk groups like cancer surgical patients.

In comparison to breast cancer surgical patients’ awareness regarding other postoperative complications, we found limited studies focusing on this topic, only uncovering one study that investigated breast cancer surgical patients’ awareness of lymphedema [31]. This study surveyed 135 breast cancer patients and found that 70.4% of patients were unaware of lymphedema, which was higher than the proportion of patients who were unaware of VTE in this study. What is mentioned above indicates that there may be a general lack of awareness about postoperative complications among breast cancer surgical patients, and there is a deficiency in research exploring patients’ awareness of common postoperative complications. Thus, this study advocates future research to comprehensively investigate the awareness of postoperative complications among breast cancer patients. And, we recommend that medical professionals place greater emphasis on health education regarding postoperative complications to improve breast cancer patients’ awareness, aiming to enhance patients’ awareness, reduce the risk of complications, and assist patients in the early identification of such conditions.

A key finding from this survey is the reliance on healthcare professionals, predominantly physicians, and nurses, as the primary source of knowledge about VTE. This underscores the crucial role of medical professionals in patient education and highlights the need for enhanced educational initiatives, particularly for VTE high-risk groups such as cancer patients receiving surgery. With the rising popularity of social media, it has become an important way for the public to acquire health information alongside hospital medical staff, especially in the setting of community care or home care [32]. Plenty of studies have proved its effectiveness and convenience in patients education and patient education and engagement [33,34,35]. The Baddeley et al. [36] developed a patient health education video, called “Blood Clots, Cancer and You”, which served as a supplement to written and oral health education, and could be watched repeatedly as desired at wards and outpatient clinics. This video has to be proven to significantly shorten the time from VTE symptom onset to diagnosis, reflecting patients’ greater awareness of VTE. Therefore, utilizing crafted videos as an auxiliary tool for medical staff to implement health education may help improve patients’ awareness of VTE, and further dissemination of health education videos through social media may allow patients to continue to improve their awareness of VTE in out-of-hospital settings, tailored to their needs.

The survey results indicated that among the four investigated dimensions, the awareness scores for VTE’s clinical symptoms/signs of VTE (1.48 ± 0.60) and risk factors of VTE (1.50 ± 0.55) were the lowest. Therefore, healthcare professionals need to emphasize education about the clinical symptoms/signs and risk factors of VTE. Although the dimension for VTE preventive measures scored the highest, patients can better effectively understand and adhere to these preventive measures when they fully recognize the clinical symptoms/signs and risk factors of VTE, which will enhance their self-management ability for VTE. With the promotion of the Enhanced Recovery After Surgery (ERAS) medical model, the hospital stay for surgical patients is becoming shorter, which increases the likelihood of VTE occurrences post-discharge [37,38,39]. Furthermore, given that early symptoms of VTE are often atypical, the condition may be underdiagnosed or misdiagnosed after discharge, potentially developing into serious DVT or PE. Thus, enhancing patients’ knowledge of VTE’s clinical symptoms/signs would aid in the timely identification of early VTE symptoms post-discharge, avoiding missing the optimal window for treatment of VTE due to late detection.

The study also identified that patients with a higher level of education, a personal history of VTE, a history of chemotherapy, a history of surgery, and those receiving care in hospitals located in the more economically developed eastern or central regions of China, scored higher on the VTE awareness level. The association between lower educational levels and lower VTE awareness suggests a need for simplified and more accessible educational materials targeting this subgroup, thereby enhancing the effectiveness of health education.


This study highlights a critical need for improved VTE awareness among breast cancer surgery patients, especially in the aspects of clinical symptoms/signs and risk factors of VTE. Health education programs are recommended especially tailored for patients with lower education levels, no history of VTE, or without prior surgery or chemotherapy, to improve their understanding of VTE.


This study has several limitations. First, despite being a multicenter cross-sectional survey, significant variation in sample size across centers may limit the representativeness of the findings. Second, we only investigated the awareness level of VTE in breast cancer patients, which also limits the generalizability of the research results. It is also important to consider a broader range of cancer types to understand the variability in VTE awareness across different patient populations. Future studies could aim for a more balanced sample distribution across centers or include a wider range of cancer types to enhance the generalizability and applicability of the research.

Data availability

The data used to support the findings of this study are available from the corresponding author upon reasonable request.



Venous thromboembolism


Deep vein thrombosis


Pulmonary embolism


Central venous catheterization


  1. ISTH Steering Committee for World Thrombosis Day. Thrombosis: a major contributor to global disease burden. Thromb Haemost. 2014;112(5):843–52.

    Google Scholar 

  2. Jha AK, Larizgoitia I, Audera-Lopez C, Prasopa-Plaizier N, Waters H, Bates DW. The global burden of unsafe medical care: analytic modelling of observational studies. BMJ Qual Saf. 2013;22(10):809–15.

    PubMed  Google Scholar 

  3. National Health Commission of the People’s Republic of China, National Medical Quality and Safety Improvement Goals. 2021. 2021. Accessed: December 20, 2023.

  4. National Health Commission of the People’s Republic of China. 2022 National Medical Quality and Safety Improvement Goals. 2022. Accessed: December 20, 2023.

  5. Office of the Surgeon General (US) and National Heart, Lung, and Blood Institute (US). The surgeon general’s call to action to prevent deep vein thrombosis and pulmo- nary embolism. Rockville, MD: Office of the Surgeon General; 2008. Accessed July 20, 2023.

  6. Walker AJ, West J, Card TR, Crooks C, Kirwan CC, Grainge MJ. When are breast cancer patients at highest risk of venous thromboembolism? A cohort study using English health care data. Blood. 2016;127(7):849–57. quiz 953.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  7. Scotte F, Martelli N, Vainchtock A, Borget I. The cost of thromboembolic events in hospitalized patients with breast or prostate cancer in France. Adv Ther. 2015;32(2):138–47.

    Article  PubMed  Google Scholar 

  8. Masoomi H, Paydar KZ, Wirth GA, Aly A, Kobayashi MR, Evans GR. Predictive risk factors of venous thromboembolism in autologous breast reconstruction surgery. Ann Plast Surg. 2014;72(1):30–3.

    Article  CAS  PubMed  Google Scholar 

  9. Chew HK, Wun T, Harvey DJ, Zhou H, White RH. Incidence of venous thromboembolism and the impact on survival in breast cancer patients. J Clin Oncology: Official J Am Soc Clin Oncol. 2007;25(1):70–6.

    Article  Google Scholar 

  10. Khorana AA, Francis CW, Culakova E, Kuderer NM, Lyman GH. Thromboembolism is a leading cause of death in cancer patients receiving outpatient chemotherapy. J Thromb Haemostasis: JTH. 2007;5(3):632–4.

    Article  CAS  Google Scholar 

  11. Sørensen HT, Mellemkjaer L, Olsen JH, Baron JA. Prognosis of cancers associated with venous thromboembolism. N Engl J Med. 2000;343(25):1846–50.

    Article  PubMed  Google Scholar 

  12. Konoeda H, Yamaki T, Hamahata A, Ochi M, Osada A, Hasegawa Y, Kirita M, Sakurai H. Incidence of deep vein thrombosis in patients undergoing breast reconstruction with autologous tissue transfer. Phlebology. 2017;32(4):282–8.

    Article  PubMed  Google Scholar 

  13. Chavez-MacGregor M, Zhao H, Kroll M, Fang S, Zhang N, Hortobagyi GN, Buchholz TA, Shih YC, Giordano SH. Risk factors and incidence of thromboembolic events (TEEs) in older men and women with breast cancer. Ann Oncol. 2011;22(11):2394–402.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  14. Debourdeau P, Espié M, Chevret S, Gligorov J, Elias A, Dupré PF, Desseaux K, Kalidi I, Villiers S, Giachetti S, et al. Incidence, risk factors, and outcomes of central venous catheter-related thromboembolism in breast cancer patients: the CAVECCAS study. Cancer Med. 2017;6(11):2732–44.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  15. Liu Y, Ma R. Clinical study on calf intermuscular vein thrombosis after breast cancer surgery. Zhejiang Clin Med J. 2017;19(5):829–31.

    Google Scholar 

  16. Zarb RM, Ramamurthi A, Doren EL, LoGiudice JA, Hijjawi JB, Adamson KA. Clinical course of venous thromboembolism following abdominally based microsurgical breast reconstruction: a case series. J Plast Reconstr Aesthet Surg. 2021;74(10):2550–6.

    Article  PubMed  Google Scholar 

  17. Chen L, Feng Q, Wang W, Liu L. Incidence and related factors for low-extremity deep vein thrombosis in breast Cancer patients who underwent Surgical Resection: what do we know and what should we care. Front Surg 2022, 9.

  18. Londero AP, Bertozzi S, Cedolini C, Neri S, Bulfoni M, Orsaria M, Mariuzzi L, Uzzau A, Risaliti A, Barillari G. Incidence and risk factors for venous thromboembolism in female patients undergoing breast surgery. Cancers 2022, 14(4).

  19. Li J, Qiang W-M, Wang Y, Wang X-Y. Development and validation of a risk assessment nomogram for venous thromboembolism associated with hospitalized postoperative Chinese breast cancer patients. J Adv Nurs. 2021;77(1):473–83.

    Article  PubMed  Google Scholar 

  20. Castaldi M, George G, Stoller C, Parsikia A, McNelis J. Independent predictors of venous thromboembolism in patients undergoing reconstructive breast Cancer surgery. Plast Surg. 2021;29(3):160–8.

    Article  Google Scholar 

  21. Fischer JP, Wes AM, Tuggle CT, Wu LC. Venous thromboembolism risk in mastectomy and immediate breast reconstruction: analysis of the 2005 to 2011 American College of Surgeons National Surgical Quality Improvement Program data sets. Plast Reconstr Surg. 2014;133(3):e263–73.

    Article  Google Scholar 

  22. Laws A, Anderson K, Hu J, McLean K, Novak L, Dominici LS, Nakhlis F, Carty M, Caterson S, Chun Y, et al. Implementation of a venous thromboembolism prophylaxis protocol using the Caprini risk assessment model in patients undergoing mastectomy. Ann Surg Oncol. 2018;25(12):3548–55.

    Article  PubMed  Google Scholar 

  23. Diem Vu TN, El Melik R, Nehring S, Bergquist W, Hoskin T, Day C, Jakub JW. Venous thromboembolism chemoprophylaxis in mastectomy patients: a 5-year follow-up study. J Surg Oncol. 2020;121(2):193–9.

    Article  Google Scholar 

  24. Haas SK, Freund M, Heigener D, Heilmann L, Kemkes-Matthes B, von Tempelhoff GF, Melzer N, Kakkar AK. Low-molecular-weight heparin versus placebo for the prevention of venous thromboembolism in metastatic breast cancer or stage III/IV lung cancer. Clin Appl thrombosis/hemostasis: Official J Int Acad Clin Appl Thrombosis/Hemostasis. 2012;18(2):159–65.

    Article  CAS  Google Scholar 

  25. Andtbacka RHI, Babiera G, Singletary SE, Hunt KK, Meric-Bernstam F, Feig BW, Ames FC, Ross MI, Dejesus Y, Kuerer HM. Incidence and prevention of venous thromboembolism in patients undergoing breast cancer surgery and treated according to clinical pathways. Ann Surg. 2006;243(1):96–101.

    Article  PubMed  PubMed Central  Google Scholar 

  26. Lemaine V, McCarthy C, Kaplan K, Mehrara B, Pusic AL, Cordeiro PG, Disa JJ. Venous thromboembolism following microsurgical breast reconstruction: an objective analysis in 225 consecutive patients using low-molecular-weight heparin prophylaxis. Plast Reconstr Surg. 2011;127(4):1399–406.

    Article  CAS  PubMed  Google Scholar 

  27. Li L, Han X, Zhou Y. Investigation and analysis of cognitive status of deep vein thrombosis in patients undergoing thoracic surgery and tumor surgery. Shanghai Nurs. 2015;15(6):35–7.

    Google Scholar 

  28. Wendelboe AM, McCumber M, Hylek EM, Buller H, Weitz JI, Raskob G. Global public awareness of venous thromboembolism. J Thromb Haemostasis: JTH. 2015;13(8):1365–71.

    Article  CAS  Google Scholar 

  29. Aggarwal A, Fullam L, Brownstein AP, Maynard GA, Ansell J, Varga EA, Friedman RJ, Rickles FR. Deep vein thrombosis (DVT) and pulmonary embolism (PE): awareness and prophylaxis practices reported by patients with cancer. Cancer Invest. 2015;33(9):405–10.

    Article  CAS  PubMed  Google Scholar 

  30. Lavall KA, Costello JF. Assessment of the public’s knowledge of venous thromboembolism. J Vasc Nurs. 2015;33(2):68–71.

    Article  PubMed  Google Scholar 

  31. Alsharif F, Almutairi W, Shibily F, Alhothari F, Batwa F, Batwa N, Alharbi L. The level of Lymphedema awareness among women with breast Cancer in the Kingdom of Saudi Arabia. Int J Environ Res Public Health 2021, 18(2).

  32. Chirumamilla S, Gulati M. Patient education and engagement through social media. Curr Cardiol Rev. 2021;17(2):137–43.

    PubMed  PubMed Central  Google Scholar 

  33. Kim SH, Utz S. Effectiveness of a social media-based, health literacy-sensitive diabetes self-management intervention: a randomized controlled Trial. J Nurs Scholarship: Official Publication Sigma Theta Tau Int Honor Soc Nurs. 2019;51(6):661–9.

    Article  Google Scholar 

  34. Lee AYL, Wong AKC, Hung TTM, Yan J, Yang S. Nurse-led Telehealth Intervention for Rehabilitation (Telerehabilitation) among Community-Dwelling patients with chronic diseases: systematic review and Meta-analysis. J Med Internet Res. 2022;24(11):e40364.

    Article  PubMed  PubMed Central  Google Scholar 

  35. Househ M, Borycki E, Kushniruk A. Empowering patients through social media: the benefits and challenges. Health Inf J. 2014;20(1):50–8.

    Article  Google Scholar 

  36. Baddeley E, Torrens-Burton A, Newman A, Nelson A, Pease N, Nelson R, Noble S. A mixed-methods study to evaluate a patient-designed tool to reduce harm from cancer-associated thrombosis: the EMPOWER study. Res Pract Thromb Haemost. 2021;5(5):e12545.

    Article  PubMed  PubMed Central  Google Scholar 

  37. Faye AS, Wen T, Ananthakrishnan AN, Lichtiger S, Kaplan GG, Friedman AM, Lawlor G, Wright JD, Attenello FJ, Mack WJ, et al. Acute venous thromboembolism risk highest within 60 days after discharge from the hospital in patients with inflammatory bowel diseases. Clin Gastroenterol Hepatol. 2020;18(5):1133–e11411133.

    Article  PubMed  Google Scholar 

  38. Merkow RP, Bilimoria KY, McCarter MD, Cohen ME, Barnett CC, Raval MV, Caprini JA, Gordon HS, Ko CY, Bentrem DJ. Post-discharge venous thromboembolism after cancer surgery: extending the case for extended prophylaxis. Ann Surg. 2011;254(1):131–7.

    Article  PubMed  Google Scholar 

  39. Moghadamyeghaneh Z, Alizadeh RF, Hanna MH, Hwang G, Carmichael JC, Mills S, Pigazzi A, Stamos MJ. Post-hospital discharge venous thromboembolism in colorectal surgery. World J Surg. 2016;40(5):1255–63.

    Article  PubMed  Google Scholar 

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This work was supported by a research grant from the Clinical new technology at West China Hospital of Sichuan University, Sichuan Province, P.R. China.[2022-020].

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Study concept, design and guide: Xiaoxia Zhang; Manuscript draft: Qiuzhou Wang and Hongxiu Chen; Data collection: Qiuzhou Wang, Qingyu Yang, Jiajia Qiu, Sijin Guo, Yi Zhou, Lihong Huang, Chen Li; Data analysis: Qiuzhou Wang and Hongxiu Chen; Final approval of the manuscript: All authors.

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Correspondence to Xiaoxia Zhang.

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This study was approved by the Institutional Review Boards of Sichuan University West China Hospital (Approval No. 2021 − 303). The electronic or paper informed consent form was signed by all participants. This study was conducted following relevant guidelines and regulations.

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Wang, Q., Chen, H., Yang, Q. et al. Awareness and associated factors of venous thromboembolism in breast cancer surgical patients: a cross-sectional study. BMC Cancer 24, 610 (2024).

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