{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T16:38:25Z","timestamp":1784133505415,"version":"3.55.0"},"reference-count":106,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2025,11,11]],"date-time":"2025-11-11T00:00:00Z","timestamp":1762819200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,11,11]],"date-time":"2025-11-11T00:00:00Z","timestamp":1762819200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Advanced Nursing"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>To evaluate bioecology and environmental influences of patients presenting with alopecia regarding decisions made for hair camouflage.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>A descriptive qualitative design was used.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Sixteen adult patients with alopecia were purposefully recruited from two specialised trichology clinics across the Jiangsu Province, China. Surveys and in\u2010depth semi\u2010structured interviews were conducted between October 2024 and December 2024. Practical thematic analysis of transcribed data was informed through Bronfenbrenner's ecological systems theory.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Five major facilitators (camouflaged demands drive, camouflaged psychological resilience, habituation and dependence, family resilience and cross\u2010border support, social acceptance) and four major barriers (limited future orientation, perceived coordination barriers, marginalisation of camouflage\u2010related information, runaway costs) to hair camouflage were identified. These themes align with different levels of the ecological systems theory.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This study captures the complex ecological and intersectional nature of choice, experience and decision\u2010making in patients' views on hair camouflage amid alopecia. Nursing professionals must understand these complexities to provide informed support and evidence\u2010based interventions throughout patients' experiences with alopecia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Implications for the Profession and\/or Patient Care<\/jats:title>\n                    <jats:p>This study uses patient voices to offer ecological insights for a holistic understanding of their experiences. It provides knowledge relevant to nursing practice and alopecia patient support. Understanding patient\u2010identified barriers and facilitators in alopecia camouflage is essential to inform more patient\u2010centred approaches to choice, decision\u2010making and psychological adaptation. Nurses are pivotal in this process, making enhanced understanding crucial for improving patients' psychological wellbeing and quality of life.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Impact<\/jats:title>\n                    <jats:p>Our research reveals factors that equip nurses and the broader healthcare team to develop targeted counselling strategies, educational programs and resources related to camouflage for patients with alopecia. The hair\u2010camouflage industry can use these insights to create more personalised and accessible products, better addressing patients' concealment needs and preferences.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Reporting Method<\/jats:title>\n                    <jats:p>Standards for Reporting Qualitative Research.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patient and Public Contribution<\/jats:title>\n                    <jats:p>No patient or public contribution.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jan.70357","type":"journal-article","created":{"date-parts":[[2025,11,11]],"date-time":"2025-11-11T11:33:35Z","timestamp":1762860815000},"page":"7495-7512","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["The Management of Patients With Alopecia: A Qualitative Study of 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