Supportive Care in Cancer最新文献

Purpose: To investigate the effects of dynamic-static combined relaxation therapy on fatigue and sleep disorders in breast cancer patients undergoing chemotherapy.

Methods: A total of 114 patients receiving chemotherapy at Tangshan People's Hospital (September 2023-June 2024) were randomly divided into three groups: control (routine nursing), experiment group 1 (static Benson relaxation), and experiment group 2 (dynamic yoga + static Benson relaxation). The intervention lasted 8 weeks. Cancer-related fatigue and sleep disorders were assessed before and after intervention using the Revised Piper Fatigue Scale and the Pittsburgh Sleep Quality Index (PSQI).

Results: Prior to intervention, there were no significant differences in fatigue and sleep quality across groups (P > 0.05). Post-intervention, both experiment groups showed significant improvements in fatigue and sleep quality compared to the control (P < 0.001). Experiment group 2 showed greater reductions in behavior, body, and total fatigue scores compared to experiment group 1 (P < 0.001). Sleep quality also improved significantly in both experiment groups, with experiment group 2 demonstrating superior outcomes in sleep quality, duration, daytime dysfunction, and total PSQI score (P < 0.05).

Conclusion: The Benson relaxation technique and dynamic-static combined relaxation therapy are effective in reducing fatigue and improving sleep quality in breast cancer chemotherapy patients, with the dynamic-static combined relaxation therapy offering greater benefits.

Trial number: RMYY-LLKS-2024068.

Objectives: This study explores the impact of family dignity interventions (FDI) on palliative patients and their family caregivers through a systematic review and meta-analysis of randomized controlled trials (RCTs).

Methods: A systematic search was conducted in PubMed, Embase, and Cochrane databases for RCTs related to family-centered dignity interventions, with the search period extending from the inception of the databases up to July 2024. Statistical analyses were conducted using standardized mean difference (SMD) as the effect size with Stata 17.0 software for analysis, and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) was employed to assess the certainty of evidence.

Results: A total of 7 RCTs involving 556 pairs of palliative patients and their caregivers were included. Compared to the control group, palliative patients who received FDI demonstrated greater improvements in dignity (SMD, - 0.27; 95% confidence interval (CI), - 0.43; - 0.10), hope (SMD, 0.50; 95% CI, 0.24; 0.75), sense of meaning (SMD, 0.39; 95% CI, 0.18; 0.75), and spiritual well-being (SMD, 0.43; 95% CI, 0.24; 0.61). Concurrently, their family caregivers experienced more significant reductions in anxiety (SMD, - 0.61; 95% CI, - 0.92; - 0.30), depression (SMD, - 0.52; 95% CI, - 0.69; - 0.34), and anticipatory grief (SMD, - 0.71; 95% CI, - 1.12; - 0.31). Subgroup analysis indicated that the benefits gained by palliative patients disappeared 2 months after the intervention, whereas the benefits for their family caregivers persisted 2 months after the intervention.

Conclusion: Current low-quality evidence suggests that FDI may have short-term positive effects on the psycho-spiritual well-being of palliative care patients and reduce psychological distress in their family caregivers. Future research should focus on conducting high-quality RCTs to assess the dose-response effect of FDI on the families of palliative care patients, providing evidence to optimize intervention strategies.

Purpose: This multi-institutional observational study aimed to assess the incidence, severity, and impact of radiotherapy-related late toxicities of the cervical skin and soft tissue in head and neck cancer patients. We also explored patient interest in fat grafting as a potential treatment for skin and soft tissue sequelae.

Methods: This study was conducted across 19 institutions in Japan. The study involved head and neck cancer patients who received ≥ 60 Gy of cervical radiotherapy concomitant with a history of neck dissection and were free of cancer recurrence ≥ 3 years after the final treatment. Consenting outpatients completed a self-administered questionnaire to collect data on symptom severity and the attending outpatient physicians reported data on demographics and treatments in a case report form.

Results: A total of 222 patients were enrolled. The incidence proportion of late cervical skin and soft tissue toxicities was 96%, with 32% of patients reporting their symptoms as severe, and 69% of patients reporting an impact on quality of life (QOL). An interest in or consideration of fat grafting was reported by 34% of patients, with a greater desire among those with severe symptoms.

Conclusion: This study elucidated the incidence, severity, and life impact of late toxicities affecting the cervical skin and soft tissue after radiotherapy for head and neck cancer. These late toxicities were highly prevalent and significantly impacted QOL. There is a substantial demand for new treatments, such as fat grafting, to address these complications and enhance the QOL for survivors of head and neck cancer.

Purpose: Individuals who experience complex biomedical factors and poorer social determinants of health (SDoH) have worse cancer outcomes than other people with cancer. This study appraised the clinical utility of the Nursing Equity Assessment Tool (NEAT), designed to facilitate early and systematic identification of such factors to optimise timely referral for support.

Methods: A prospective, mixed-methods case-series study was conducted at a specialist cancer centre. The NEAT comprises 15 items mapping to four biopsychosocial domains. Clinical nurse consultants (CNCs) completed the NEAT with newly diagnosed patients during consultations. Semi-structured interviews exploring clinical utility aspects (appropriateness, acceptability, and practicability) were undertaken with patients at 2 weeks, and CNCs at 12- and 24-week post-completion of the NEAT; then analysed using qualitative content analysis. Participant characteristics were collected via self-report and medical records. Patient-reported outcome measures were completed prior to interviews. Healthcare utilisation data were gathered 12- and 24-week post-completion of the NEAT. Quantitative data were analysed descriptively using measures of association.

Results: Thirty-seven patients and seven CNCs participated. All participants considered the NEAT highly acceptable and appropriate, with potential to improve patient outcomes. Feedback recommended refinements to content and CNC training. Implementation considerations included advocacy for service investment to enable timely receipt of support to address disadvantage.

Conclusions: Patients and CNCs considered this novel point-of-care tool was acceptable, appropriate, and demonstrated promise to help quickly identify and address newly diagnosed cancer patients at risk of complex care needs stemming from medical and non-medical factors.

Purpose: Based on a dyadic perspective, the interaction between two variables of dyadic coping and post-traumatic growth in couples with breast cancer is explored, which facilitates an empirical basis for healthcare professionals to develop an intervention program to improve psychological care and quality of life for breast cancer couples.

Methods: Two hundred ten pairs of breast cancer couples attending the department of surgical oncology of a hospital affiliated with Bengbu Medical University from July to December 2023 were surveyed through a cross-sectional method. Both breast cancer couples' completed questionnaire data were investigated using the General Information Questionnaire, the Dyadic Coping Inventory, and the Post-Traumatic Growth Inventory. Investigating the connection between post-traumatic growth and dyadic coping in patients and partners using an actor-partner interdependence model.

Results: Breast cancer patients had higher dyadic coping scores (118.32 ± 12.10) than their spouses (117.76 ± 11.93); post-traumatic growth scores (65.30 ± 10.24) were significantly higher than their spouses (62.11 ± 10.30). In breast cancer couples, positive dyadic coping positively predicted post-traumatic growth in both themselves and their partners (P < 0.001). Patients' and spouses' negative dyadic coping had a negative effect on their post-traumatic growth.

Conclusion: Dyadic coping is an important correlate of post-traumatic growth in spouses and patients with breast cancer. Accordingly, healthcare professionals can incorporate dyadic coping into family-wide dyadic interventions that enhance the couple's post-traumatic growth and life quality.

Purpose: Early and accurate identification of the risk of psychological distress allows for timely intervention and improved prognosis. Current methods for predicting psychological distress among lung cancer patients using readily available data are limited. This study aimed to develop a robust machine learning (ML) model for determining the risk of psychological distress among lung cancer patients.

Methods: A cross-sectional study was designed to collect data from 342 lung cancer patients. Least Absolute Shrinkage and Selection Operator (LASSO) was used for feature selection. Model training and validation were conducted with bootstrap resampling method. Fivefold cross-validation evaluated and optimized the model with parameter tuning. Feature importance was assessed using SHapley additive exPlanations (SHAP) method.

Results: The model identified seven independent risk factors of psychological distress: residence (β = 0.141), diagnosis duration (β = 0.055), TNM stage (β = 0.098), pain severity (β = 0.067), perceived stigma (β = 0.052), illness perception (β = 0.100), and coping style (β = 0.097). Among the eight ML algorithms evaluated, the extreme gradient boosting (XGBoost) algorithm demonstrated the highest performance with AUROC values of 0.988, 0.945, and 0.922 for the training, validation, and test sets, respectively. The model's results were further explained using SHAP, which revealed the importance and contribution of each risk factor to the overall distress risk. A web-based tool was developed based on this model to facilitate clinical use.

Conclusion: The XGBoost classifier demonstrated exceptional performance, and clinical implementation of the web-based risk calculator can serve as an easy-to-use tool for health practitioners to formulate early prevention and intervention strategies.

Objectives: Breast cancer (BC) impacts the patients' quality of life. Peer support can provide emotional understanding and enhances access to information, social support, coping strategies, and empowerment. Comunitats is an online peer support community app for BC survivors that involves healthcare professionals. This study aims to explore how participation in Comunitats promotes empowerment, and to identify the variables related to it.

Methods: A prospective, cross-sectional approach was applied. One hundred twenty-one women diagnosed with BC were included in Comunitats. Sociodemographic and clinical variables, along with measures of emotional distress (HADS), post-traumatic growth (PTGI), and empowerment (Van Uden-Kraan's Empowerment Questionnaire), were collected through an online questionnaire completed by the participants. Additionally, data on participation in the online community were obtained directly from the app. Assessments were conducted at inclusion and again 3 months later. Correlations were used to guide linear regression analysis to identify the variables predicting greater empowerment outcomes.

Results: Empowerment assessment indicated that participants felt empowered by their involvement in Comunitats. The most commonly experienced empowerment outcomes were "being better informed" and "improved acceptance of the illness." "Exchanging information" and "finding recognition" were the most strongly experienced empowerment processes and the strongest predictors of empowerment outcomes in the regression analysis.

Conclusion: Involvement in Comunitats enhances empowerment in BC survivors. Empowering processes within the community partially predict overall empowerment outcomes.

Practical implications: Empowerment positively impacts self-care autonomy, self-efficacy, and treatment adherence, promoting healthier lifestyles and enhanced treatment outcomes. Therefore, we recommend encouraging participation in online peer support communities, as it might enhance empowerment.

Purpose: The aim of this study was to investigate the effect of a 6-month Guolin Qigong on quality of life and serum cortisol among patients with cancer.

Methods: This study was a two-arm and non-randomized controlled trial. Forty-nine patients with cancer who were over 18 years of age and diagnosed with cancer were enrolled in this study and assigned to either the Guolin Qigong intervention group (IG, n = 26) or the usual care group (UC, n = 23) for 6 months. During the Guolin Qigong exercise, the participants completed a training program consisting of five sessions per week and 40-60 min per session. The UC group maintained their usual lifestyle. The main outcomes included self-reported quality of life (European Organization for Research and Treatment of Cancer, EORTC-QLQ-C30) and well-being (General Well-Being Schedule, GWB). The second outcome was stress-related hormone serum cortisol measured by enzyme-linked immunosorbent assay. All measurements were assessed at baseline and 6 months.

Results: Forty-nine participants (57.4% females, 26 in IG vs 23 in UC) were enrolled in the study, and forty-five participants completed all tests after the 6-month intervention (48.9% females, 25 in IG vs 20 in UC). Compared to the UC group, quality of life, physical function, and pain significantly improved in the IG (P < 0.05). Similarly, some sub-scales of GWB improved in the IG group compared to the UC group, especially for cheerful distracted and overall score (P < 0.05). However, there was no significant difference in serum cortisol between the two groups either at baseline or after intervention (P > 0.05).

Conclusions: Six-month Guolin Qigong could improve quality of life, physical function, and pain, and have a beneficial effect on the well-being of cancer patients. Further studies are warranted to confirm these results.

Objective: This study aims to enhance compliance with lower limb lymphedema (LLL) prevention care measures post-gynecologic oncology surgery (GOS) through quality control circle (QCC) activity, aiming to improve patient recovery outcomes and reduce postoperative complications.

Methods: A 6-month QCC activity was conducted within the hospital, employing the ten-step plan-do-check-act model for QCC activity. The root causes of inadequate implementation of LLL prevention care measures were analyzed, leading to the development of relevant strategies and protocols. Compliance rates of preventive care measures pre- and post-QCC activity were compared.

Results: The focus of this improvement initiative was on "inadequate postoperative preventive measures" and "lack of standardized discharge preventive measures." Strategies included ensuring nurses proficiently assess LLL following gynecologic malignancy surgeries, enhancing standardized preventive measures for LLL post-GOS, and establishing personalized and diversified education models. Following the implementation of QCC activity, there was a significant improvement in the compliance rate of LLL prevention care measures. The compliance rate increased from 74.00% before the activity to 92.80%, surpassing the target rate by 119.00%, with an improvement rate of 25.40%. Comprehensive evaluations of circle members' abilities showed significant improvement, with notable increases in problem-solving abilities, initiative, and confidence.

Conclusion: Implementation of QCC activity resulted in a substantial improvement in compliance with LLL prevention care measures following GOS, ensuring safer and more effective patient care services.