Visual analysis of home management of lung cancer based on Web of Science

Background: This study explores the development status, research hotspots, and frontiers of lung cancer home management through visual analysis of lung cancer home management literature, providing reference for subsequent research. Methods: The relevant literatures about home management of lung cancer included in Web of Science from 2000 to 2022 were searched by computer. CiteSpace (6.1.R3) was used to draw the research country, co-cited articles, keyword co-occurrence and time axis of co-cited clustering map of lung cancer home management literature. Results: 171 articles were included. The countries with more documents are the United States, China and Japan. The cooperation between countries is centered on the United States. The intermediary role of the United States is obvious. The co-cited articles show that the reliability and validity of the scale, aerobic exercise training and natural radon gas have an important impact on the research of home management of lung cancer. The research keywords focus on lung cancer, exercise, quality of life, etc. Conclusion: There are few researches on home management of lung cancer. In the future research, more attention should be paid to the research related to home management of lung cancer. Nurse managers need to be more aware of the new era of directing nursing care into home care. So as to improve the quality of life of lung cancer patients at home and promote their rehabilitation.


Background
Lung cancer is currently one of the most common malignant tumors worldwide, seriously endangering people's health.In China, the incidence rate and mortality of lung cancer are the highest among malignant tumors [1].According to the data published by the National Cancer Center in 2022, the incidence rate of lung cancer was 59.89/100,000 and the mortality rate was 47.51/100,000.At present, home management in China is still in the exploratory and initial stage, and there is no comprehensive home rehabilitation system in the community [2].Nowadays, most of China's home management models focus on chronic diseases such as diabetes, stroke, cardio cerebral Vascular disease [3][4][5].Related studies have shown that there are many problems with home management for lung cancer patients, such as poor compliance with lung rehabilitation exercises, psychological depression, and inability to promptly provide feedback to medical staff regarding doubts and discomfort.Nursing of home of non-small cell lung cancer patients during the postoperative period are feasible and effective in improving the quality of life, postoperative symptoms [6].An integrated nursing can effectively relieve the patient's negative feelings, improve their self-management ability, reduce the burden of family care and improve the satisfaction with nursing activities for lung cancer patients [7].There are studies on home care for lung cancer, but they are not systematic and further research is needed.It is necessary for us to review relevant research on home management of lung cancer and plan for future research [8].
CiteSpace (6.1.R3) developed by Dr. Chen Chaomei from Drexel University is an application based on Java for data analysis.It is a good tool for bibliometric and visualization analysis of literature and has been widely used to summarize the hotspots and research trends of various fields in medicine.However, no visualization study on home management of lung cancer has been reported.
In this study, CiteSpace (6.1.R3) software was used to visually analyze the literature on home management of lung cancer in the Web of Science database from 2000 to 2022.This study reviewed the literature on home management of small cell lung cancer (SCLC) and non-small cell lung cancer (NSCLC).The purpose of this study is to grasp the research status of this field, explore the research hot spot in this field, and provide reference for the future research on the continuous treatment of lung cancer.

Search strategy
The relevant literature on home management of lung cancer was searched in the Web of Science database from January 1, 2000 to September 1, 2022.The search criteria for the English subject words were ("Pulmonary cancer" or "lung neoplasm", "lung cancer" or "small cell lung cancer" or "non-small cell lung cancer", "SCLC" or "NSCLC") and ("Home management" or "Home" or "domiciliary" or "Home-based").After manual analysis of literature content, we eliminated abstracts, repeated publications, literature unrelated to the topic, conference abstracts, popular science propaganda, etc.The articles were screened by two reviewers independently.If a disagreement between two reviewers appeared, a consensus was reached by the third reviewer.

Data analysis
CiteSpace (6.1.R3) software was used to analyze the research strength, hot spots and frontier visual analysis of home management of lung cancer.National cooperation map, literature co-citation map, keyword co-occurrence map analysis, and co-citation cluster label time-axis view analysis were drawn.The visualization knowledge network created by CiteSpace (6.1.R3) consisted of nodes and lines.The nodes in the network stood for items, such as authors, countries, institutions, and cited references, and lines between the nodes represented cooperation, co-occurrence, or co-citation relationships.The size of each node indicated the count.

Results
The trend of publication outputs Literatures unrelated to home management of lung cancer were screened and eliminated by manual analysis.CiteSpace (6.1.R3) (6.1.R3) software was used to eliminate duplicate literature, and a total of 171 literatures related to home management of lung cancer were retrieved (Figure 1).The Web of Science database shows that the literature on home management of lung cancer was first published in 2009 and has increased slowly since then.From 2009 to 2011, the number of published papers was relatively small, but from 2012, the number of published papers increased significantly.The annual number of published papers in 2019 reached 20, and since the deadline is September 1, 2022, according to the fitted trend line, the number of published papers will reach a peak in 2022.Besides,the frequency of the thesis also shows that research in home management of lung cancer field garnered incredible attention.

Analysis of countries
CiteSpace (6.1.R3) can visually display the amount of research literature on home management of lung cancer in different countries in the form of tree rings.In Figure 2, the size of the circle nodes represents the number of issued documents by the country.The top 9 countries in terms of home management of lung cancer are the United States, China, Japan, England, Canada, France, Spain, Australia, and the Netherlands.The number of articles published in the United States is significantly higher than that in other countries, and the concern about home management of lung cancer is the highest.The thicker the ring, the higher the citation rate for the year corresponding to the ring.The links between the different nodes represent the cooperative relationship between the various countries to publish articles.The

Analysis of co-cited literatures
Co-cited literatures indicate that it has an important impact within the relevant field.Figure 3 is a visual map of the co-cited articles, and Table 1 summarizes the seven most frequently cited articles and their main research contents [9][10][11][12][13][14][15].The seven most cited research papers focused on the following topics: the study on the reliability and validity of the scale for lung cancer patients, and the impact of exercise on lung cancer patients.The highly cited articles are mainly published in high-level journals such as Cancer-Am Cancer Soc, which represent the main research direction at present and lead and promote further research in this field.

Analysis of keywords
Keyword co-occurrence is a concentrated expression of current research problems and describes the frontiers of research.The key management, palliative care, etc.The results are shown in Figure 4.
Figure 5 shows strong outburst intensity and duration of never words of home management of lung cancer focus on lung cancer, exercise, quality of life, pulmonary rehabilitation, radon, symptom smoking, thoracotomy, lung, and coal.The X-axis is the year in which the keyword is located, and the Y-axis is the cluster label to which the keyword belongs.Keywords in the same cluster are arranged on the same timeline in chronological order to obtain the timeline view of the co-cited cluster labels in the research, as shown in Figure 6.In this study, the first 3 keywords under each cluster label were selected to display the clustering topic more comprehensively.The results are shown in Table 2. Lung cancer home management 10 clusters according to the order of occurrence, the general research trend can be divided into 3 stages.The first stage: #0(exercise), #2(quality of life), #5(qualitative research).This kind of research appeared in the earliest time, mainly focused on the exercise and quality of life management of lung cancer patients at home, but more qualitative research on home management.The second stage: #1(radon), #3(palliative care), #6(machine learning),     6 shows the #1 cluster to the #5 cluster persistence and popularity has continued to this day.

Discussion
A total of 171 literatures related to home management of lung cancer were searched, indicating that the attention of such studies is far from enough, and relevant studies on home management of lung cancer need to be promoted.The number of articles published in the United States is significantly higher than that of other countries and more studies have been conducted with other countries.It not only has the highest attention but also plays an obvious mediating role in the field of home management of lung cancer.The United States has conducted more research in cooperation with other countries, and is in a leading position in this field, with a high academic influence.This may be because the United States is a developed country with the world's leading economic development, and has the strength to carry out relevant research on home-based patients, not only with the support of economic strength, but also with the relevant support of relevant technology and scientific research.The era of big data, artificial intelligence and the Internet of Things has become an essential part of daily operations and healthcare services in the United States [16,17].
Although China ranks second in the world in the number of papers published, it has few links with other countries, and should strengthen cooperation with other countries in future research.The most cited literature is the study on the reliability and validity of the lung cancer home-based patients scale, the effect of aerobic exercise training and natural radon gas on lung cancer home-based patients.This shows that relevant research needs to rely on the scale, the formulation of exercise programs, and the home environment.The research focus of home management of lung cancer is on lung cancer, exercise, quality of life, pulmonary rehabilitation, radon, symptom management, palliative care, etc.At present, aerobic exercise and pulmonary rehabilitation are mostly studied in chronic obstructive pulmonary disease patients, while home rehabilitation after lung cancer surgery has not been thoroughly analyzed [18].For such research, intervention studies can be carried out with the help of high-tech means such as artificial intelligence and big data in the future, so as to improve the efficacy of family self-management of patients and promote their rehabilitation.Radon is a major risk factor for lung cancer in non-smokers and the second risk factor for smoking patients.Attention to indoor radon is of strategic significance for the prevention and treatment of lung cancer [19,20].Symptom Submit a manuscript: https://www.tmrjournals.com/inmanagement is the self-care of patients, which mainly includes the behavior of maintaining physiological stability, symptom perception and management of symptom occurrence [21].Symptoms of patients with lung cancer at home will affect the quality of life of patients at home.However, domestic intervention studies on home-based patients are few and very limited [22].It is a future research direction to construct a safe and effective intervention program for lung cancer at home with high patient compliance and participation.The main purpose of palliative care is to relieve symptoms, relieve suffering and improve quality of life for patients.The most common symptoms of palliative care are as follows: fatigue, declining health status and anorexia symptoms, followed by lethargy, dyspnea, pain, cough, depression and anxiety, especially in advanced lung cancer patients [23].China is a developing country, most of the advanced lung cancer patients, especially in rural areas, will consider economic, traditional and other factors, will choose home treatment.Palliative care is another important research direction of home management of lung cancer in China.
The average hospital stay of lung cancer patients is 5-7 days, and pulmonary rehabilitation after pulmonary surgery is mostly carried out after discharge [24].Pulmonary rehabilitation is a comprehensive, long-term, patient-centered treatment system that includes strengthening respiratory muscles, airway clearance, and self-management.In Europe, the implementation of this educational program, a nurse-led educational programme for breathlessness management of lung cancer patients at home is a step toward achieving breathlessness self-management for patients with lung cancer [25].At present, for the management of patients discharged from hospital after pulmonary surgery in China, only telephone return visit can guarantee implementation [26].Telephone return visit for patients with cardiopulmonary function status can not be implemented in place.However, after the discharge of lung cancer patients, rehabilitation, respiratory exercise training, care and recuperation during the home period are very important.From the moment of diagnosis, patients and their families will have mental and economic burdens, and they will choose home treatment after surgery, but more than 90% of lung cancer patients will have pain, anxiety, dyspnea, fatigue and loss of appetite [27].In future studies, China can carry out research on the intervention of lung cancer patients at home.The specific performance can be carried out based on telemedicine to develop personalized aerobic exercise training real-time dialogue and adjustment, improve the patient's cardiopulmonary function.Symptom management for patients with advanced lung cancer at home to improve fatigue, health status and gastrointestinal symptoms.High technologies such as big data, artificial intelligence and the Internet of Things are used to ensure the effectiveness, security and real-time of intervention measures.
There are some limitations in the visual analysis of home management of lung cancer in this study.Due to the limitation of CiteSpace (6.1.R3) software itself, the data in this study were only from Web of Science databases, such as PubMed, and were not searched and analyzed.

Conclusion
This paper presents the research hotspots of home management of lung cancer from 2000 to 2022 by using bibliometrics, and the research results provide reference for the research direction.Although there are more and more studies on home management of lung cancer, researchers are still focusing on the related factors of lung cancer and perioperative treatment.The research on home management is far from enough and has not formed a complete system.The role of nurses in the perioperative management of patients with lung cancer should be made an integral part.Lung cancer patients One week after discharge, a follow-up call is should by the nurse to ascertain the current pain status, shortness of breath, body temperature, and activities [28].In future studies, more attention should be paid to home management of lung cancer, so as to improve the quality of life of lung cancer patients at home and promote their rehabilitation.
Nurse managers need to be more aware of the new era of directing nursing care into home care [29].

Figure 1
Figure 1 Trends of home management of lung cancer publications from 2009 to 2022.

Figure 2
Figure 2 Cooperative relationship network of countries issuing research.

Figure 3
Figure 3 Co-cited network literature.

Figure 5
Figure 5 Top 33 Keywords with the strongest citation bursts.

Figure 6
Figure 6 Time axis of co-cited clustering of research literature.

Table 2 The first three keywords of the cited cluster of research literature Cluster
number Cluster label The first three cluster keywords 0 exercise lung cancer; household air pollution; dietary supplements 1 radon residential radon; attributable risk; potential impact fraction 2 quality of life lung cancer; functional status; cancer-related fatigue 3 palliative care palliative care; lung neoplasms; home care services #8(access social support).At this stage, attention began to be paid to the home environment of lung cancer and the support related to lung cancer treatment.The third stage: #4(feasibility), #7(cancer cachexia), #9(indoor air pollution).At this stage, related studies on cachexia and indoor air in home patients began to sprout.Figure