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Chau YF, Zhou H, Chen B, Ren H, Ma Z, Zhang X, Duan J. Screening for depression and anxiety in lung cancer patients: A real-world study using GAD-7 and HADS. Thorac Cancer 2024; 15:1041-1049. [PMID: 38523362 PMCID: PMC11062860 DOI: 10.1111/1759-7714.15287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2023] [Revised: 03/03/2024] [Accepted: 03/06/2024] [Indexed: 03/26/2024] Open
Abstract
BACKGROUND The psychological well-being of lung cancer patients is critical in-patient care but frequently overlooked. METHODS This study, employing a cross-sectional, questionnaire-based design, aimed to elucidate the prevalence of depressive and anxiety symptoms among lung cancer patients and identify associated risk factors. Participants' demographic, medical history, disease stage, and pathology were systematically collected. Psychological assessment was conducted using the general anxiety disorder-7 (GAD-7), patient health questionnaire-9 (PHQ-9), and hospital anxiety and depression scale (HADS). Statistical analyses were performed using SPSS software (version 25.0). RESULTS Out of 294 distributed questionnaires, 247 lung cancer patients were included in the final analysis, with an average completion time of 9.08 min. Notably, 32.4% exhibited depressive symptoms, while 30% displayed signs of anxiety. A significant correlation was found between both depressive and anxiety symptoms and a history of tobacco and alcohol consumption. Specifically, increased nicotine dependence and greater cumulative tobacco use were linked to higher rates of depressive symptoms, whereas cumulative alcohol consumption was associated with increased risks of anxiety symptoms. CONCLUSION The study affirms the feasibility of GAD-7, PHQ-9, and HADS as screening tools for depressive and anxiety symptoms in lung cancer patients. It further highlights tobacco and alcohol consumption as significant risk factors for poor psychological health in this population.
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Affiliation(s)
- Yi Fung Chau
- CAMS Key Laboratory of Translational Research on Lung Cancer, State Key Laboratory of Molecular Oncology, Department of Medical OncologyNational Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences, Peking Union Medical CollegeBeijingChina
| | - Huixia Zhou
- CAS Key Laboratory of Mental HealthInstitute of Psychology, Chinese Academy of SciencesBeijingChina
- Department of PsychologyUniversity of Chinese Academy of SciencesBeijingChina
| | | | - Hengqin Ren
- CAS Key Laboratory of Mental HealthInstitute of Psychology, Chinese Academy of SciencesBeijingChina
- Department of PsychologyUniversity of Chinese Academy of SciencesBeijingChina
| | - Zixiao Ma
- CAMS Key Laboratory of Translational Research on Lung Cancer, State Key Laboratory of Molecular Oncology, Department of Medical OncologyNational Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences, Peking Union Medical CollegeBeijingChina
| | - Xiangyang Zhang
- CAS Key Laboratory of Mental HealthInstitute of Psychology, Chinese Academy of SciencesBeijingChina
- Department of PsychologyUniversity of Chinese Academy of SciencesBeijingChina
| | - Jianchun Duan
- CAMS Key Laboratory of Translational Research on Lung Cancer, State Key Laboratory of Molecular Oncology, Department of Medical OncologyNational Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences, Peking Union Medical CollegeBeijingChina
- Department of Medical OncologyShanxi Province Cancer Hospital/Shanxi Hospital Affiliated to Cancer Hospital, Chinese Academy of Medical Sciences/Cancer Hospital Affiliated to Shanxi Medical UniversityTaiyuanChina
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Choe YH, Lee S, Lim Y, Kim SH. Machine learning-derived model for predicting poor post-treatment quality of life in Korean cancer survivors. Support Care Cancer 2024; 32:143. [PMID: 38315224 DOI: 10.1007/s00520-024-08347-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Accepted: 01/25/2024] [Indexed: 02/07/2024]
Abstract
PURPOSE A substantial number of cancer survivors have poor quality of life (QOL) even after completing cancer treatment. Thus, in this study, we used machine learning (ML) to develop predictive models for poor QOL in post-treatment cancer survivors in South Korea. METHODS This cross-sectional study used online survey data from 1,005 post-treatment cancer survivors in South Korea. The outcome variable was QOL, which was measured using the global QOL subscale of the European Organization of Cancer and Treatment for Cancer Quality of Life Questionnaire, where a global QOL score < 60.4 was defined as poor QOL. Three ML models (random forest (RF), support vector machine, and extreme gradient boosting) and three deep learning models were used to develop predictive models for poor QOL. Model performance regarding accuracy, area under the receiver operating characteristic curve, F1 score, precision, and recall was evaluated. The SHapely Additive exPlanation (SHAP) method was used to identify important features. RESULTS Of the 1,005 participants, 65.1% had poor QOL. Among the six models, the RF model had the best performance (accuracy = 0.85, F1 = 0.90). The SHAP method revealed that survivorship concerns (e.g., distress, pain, and fatigue) were the most important factors that affected poor QOL. CONCLUSIONS The ML-based prediction model developed to predict poor QOL in Korean post-treatment cancer survivors showed good accuracy. The ML model proposed in this study can be used to support clinical decision-making in identifying survivors at risk of poor QOL.
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Affiliation(s)
- Yu Hyeon Choe
- Department of Nursing, Inha University, Incheon, Republic of Korea
| | - Sujee Lee
- Department of Industrial and Information Systems Engineering, Soongsil University, Seoul, Republic of Korea
| | - Yooseok Lim
- Department of Industrial and Information Systems Engineering, Soongsil University, Seoul, Republic of Korea
| | - Soo Hyun Kim
- Department of Nursing, Inha University, Incheon, Republic of Korea.
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Antoniadis D, Giakoustidis A, Paramythiotis D, Michalopoulos A, Mandanas ZN, Papadopoulos VN. Mental health well-being and functional adjustment in colorectal cancer patients: a prospective cohort study. Acta Chir Belg 2024; 124:20-27. [PMID: 36369863 DOI: 10.1080/00015458.2022.2145725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 11/05/2022] [Indexed: 11/14/2022]
Abstract
BACKGROUND Colorectal cancer significantly affects the quality of life of patients, while at the same time contributing to the development of symptoms of psychopathology. The aim of this prospective study, is to investigate the role of the disease in the quality of life of patients with colon cancer and in the appearance of symptoms of anxiety and depression, as well as the connection of the above characteristics during the recovery process, given the distress symptoms experienced by the patients. METHODS In the present study, HADS, FACT - C, well as the DT are use, in a sample of 118 patients of an average age of 70.5 ± 8.5 years, which were submitted to partial or total colectomy surgery. RESULTS Moderate levels of anxiety (M = 8.25, SD = 3.87) and low levels of depression (M = 6.90, SD = 2.97) and distress (M = 5.84, SD = 2.60) emerged preoperatively, while the improvement was significant of patients' quality of life level 6 months after surgery. At the same time, a significant negative effect of the patients' distress level preoperatively on their quality of life, during the recovery process was observed. CONCLUSION Preoperative anxiety is not considered to be an element that affects the functionality and the psychological and physical adaptation to the disease of patients with colon cancer. On the contrary, the feelings of distress they experience can be a predictive factor of their quality of life after the partial or total colectomy surgery.
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Affiliation(s)
- Diomidis Antoniadis
- Post-doctoral researcher, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Alexander Giakoustidis
- 1st Department of Surgery, School of Medicine, Aristotle University of Thessaloniki, General Hospital Papageorgiou, Thessaloniki, Greece
| | - Daniel Paramythiotis
- 1st Propaedeutic Surgery Department, School of Medicine, Aristotle University of Thessaloniki, General Hospital AHEPA, Thessaloniki, Greece
| | - Antonios Michalopoulos
- 1st Propaedeutic Surgery Department, School of Medicine, Aristotle University of Thessaloniki, General Hospital AHEPA, Thessaloniki, Greece
| | | | - Vasileios N Papadopoulos
- 1st Department of Surgery, School of Medicine, Aristotle University of Thessaloniki, General Hospital Papageorgiou, Thessaloniki, Greece
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Milzer M, Wagner AS, Schmidt ME, Maatouk I, Hermann S, Kiermeier S, Steindorf K. Patient-physician communication about cancer-related fatigue: a survey of patient-perceived barriers. J Cancer Res Clin Oncol 2024; 150:29. [PMID: 38270814 PMCID: PMC10810981 DOI: 10.1007/s00432-023-05555-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 11/27/2023] [Indexed: 01/26/2024]
Abstract
PURPOSE Cancer-related fatigue is a subjective, distressing, and common sequela of cancer which is often disregarded and underdiagnosed. Fatigue is assessed by self-report requiring communication between patient and physician. In this study, we investigated the patients' perspective on the patient-physician communication about fatigue. METHODS On average five months after diagnosis 1179 cancer patients, recruited in Germany, completed a survey as part of the LIFT project. The survey included questions on sociodemographic data, fatigue, depression, fatigue management, patient-physician communication, and communication barriers. Data were analyzed descriptively and using logistic regression analyses. RESULTS Half of the participants reported that their physician had never asked them whether they felt exhausted. Patients undergoing chemo-, radio-, or immunotherapy were more likely to be asked about fatigue, while older age and major depression decreased the likelihood. Sixty-four percent of the patients felt impeded by communication barriers. Common barriers were not knowing who to turn to for fatigue (39%), time constraints (31%), and the fear of being perceived as weak (22%). Almost half of the participants indicated that their physicians were not appreciative and did not deal adequately with fatigue-related questions. CONCLUSION This study revealed gaps in the patient-physician communication regarding cancer-related fatigue. Contrary to guideline recommendations a minority of physicians addressed fatigue. On the other hand, cancer patients felt reluctant to bring up this topic due to structural barriers and fears. Physicians should routinely address fatigue and adopt a communication style which encourages patients to likewise state their symptoms and raise their questions. TRIAL REGISTRATION Clinicaltrials.gov, identifier: NCT04921644. Registered in June 2021.
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Grants
- Grants No. MA 7865/3-1, SCHM 3423/3-1, STE 1493/6-1, Project No. 438839893 Deutsche Forschungsgemeinschaft
- Grants No. MA 7865/3-1, SCHM 3423/3-1, STE 1493/6-1, Project No. 438839893 Deutsche Forschungsgemeinschaft
- Grants No. MA 7865/3-1, SCHM 3423/3-1, STE 1493/6-1, Project No. 438839893 Deutsche Forschungsgemeinschaft
- Grants No. MA 7865/3-1, SCHM 3423/3-1, STE 1493/6-1, Project No. 438839893 Deutsche Forschungsgemeinschaft
- Grants No. MA 7865/3-1, SCHM 3423/3-1, STE 1493/6-1, Project No. 438839893 Deutsche Forschungsgemeinschaft
- Deutsches Krebsforschungszentrum (DKFZ) (1052)
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Affiliation(s)
- Marlena Milzer
- Division of Physical Activity, Prevention and Cancer, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Medical Faculty, University of Heidelberg, Heidelberg, Germany
- National Center for Tumor Diseases (NCT), NCT Heidelberg, a partnership between DKFZ and University Medical Center Heidelberg, Heidelberg, Germany
| | - Anna S Wagner
- Section of Psychosomatic Medicine, Psychotherapy and Psychooncology, Department of Internal Medicine II, Julius-Maximilian-University, Würzburg, Germany
| | - Martina E Schmidt
- Division of Physical Activity, Prevention and Cancer, German Cancer Research Center (DKFZ), Heidelberg, Germany
- National Center for Tumor Diseases (NCT), NCT Heidelberg, a partnership between DKFZ and University Medical Center Heidelberg, Heidelberg, Germany
| | - Imad Maatouk
- Section of Psychosomatic Medicine, Psychotherapy and Psychooncology, Department of Internal Medicine II, Julius-Maximilian-University, Würzburg, Germany
| | - Silke Hermann
- Epidemiological Cancer Registry of Baden-Württemberg, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Senta Kiermeier
- Section of Psychosomatic Medicine, Psychotherapy and Psychooncology, Department of Internal Medicine II, Julius-Maximilian-University, Würzburg, Germany
| | - Karen Steindorf
- Division of Physical Activity, Prevention and Cancer, German Cancer Research Center (DKFZ), Heidelberg, Germany.
- National Center for Tumor Diseases (NCT), NCT Heidelberg, a partnership between DKFZ and University Medical Center Heidelberg, Heidelberg, Germany.
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Deng L, Chen B. Two-scale assessment of anxiety and depression in postoperative non-small cell lung cancer patients: their prevalence, risk factors, and prognostic potency. Ir J Med Sci 2023; 192:2613-2619. [PMID: 36826710 DOI: 10.1007/s11845-023-03321-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2023] [Accepted: 02/13/2023] [Indexed: 02/25/2023]
Abstract
OBJECTIVE Anxiety and depression commonly occur and correlate with poor prognosis in patients with cancer. The study aimed to assess the anxiety and depression in patients with postsurgical non-small cell lung cancer (NSCLC) using both Hospital Anxiety and Depression Scale (HADS) and Self-Rating Anxiety/Depression Scale (SAS/SDS) and to investigate their risk factors and linkage with prognosis. METHODS HADS and SAS/SDS were assessed in 350 patients with NSCLC at 3 months after surgical resection and 100 healthy controls (HCs). Patients with NSCLC were followed up for a median period of 27.0 (range: 6.0-52.0) months for prognostic evaluation. RESULTS HADS-identified anxiety rate (39.7% vs. 10.0%, P < 0.001), SAS-identified anxiety rate (34.9% vs. 9.0%, P < 0.001), HADS-identified depression rate (29.7% vs. 5.0%, P < 0.001), and SDS-identified depression rate (27.1% vs. 6.0%, P < 0.001) were all elevated in patients with NSCLC vs. HCs. Multivariate logistic regression analysis uncovered that diabetes, adjuvant therapy, postoperative complications, and poor differentiation were independently linked with increased HADS- or SAS-identified anxiety risk (all P < 0.05); meanwhile, female gender, hypertension, diabetes, poor differentiation, adjuvant therapy, postoperative complications, and TNM stage were independently linked with increased HADS- or SDS-identified depression risk (all P < 0.05). Furthermore, HADS-identified anxiety, SAS-identified anxiety, HADS-identified depression, and SDS-identified depression independently predicted shorter disease-free survival and overall survival (all P < 0.05). CONCLUSION Anxiety and depression are prevalent and linked with poor survival in patients with postsurgical NSCLC. Meanwhile, gender, comorbidities, advanced tumor features, adjuvant therapy, and postoperative complications relate to the prevalence of anxiety and depression.
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Affiliation(s)
- Liping Deng
- Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China
| | - Bei Chen
- Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China.
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Macharia JM, Raposa BL, Sipos D, Melczer C, Toth Z, Káposztás Z. The Impact of Palliative Care on Mitigating Pain and Its Associated Effects in Determining Quality of Life among Colon Cancer Outpatients. Healthcare (Basel) 2023; 11:2954. [PMID: 37998446 PMCID: PMC10671794 DOI: 10.3390/healthcare11222954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 11/10/2023] [Accepted: 11/10/2023] [Indexed: 11/25/2023] Open
Abstract
Pain continues to be a significant problem for cancer patients, and the impact of a population-based strategy on their experiences is not completely understood. Our study aimed to determine the impact of palliative care on mitigating pain and its associated effects in determining the quality of life (QoL) among colon cancer outpatients. Six collection databases were used to perform a structured systematic review of the available literature, considering all papers published between the year 2000 and February 2023. PRISMA guidelines were adopted in our study, and a total of 9792 papers were evaluated. However, only 126 articles met the inclusion criteria. A precise diagnosis of disruptive colorectal cancer (CRC) pain disorders among patients under palliative care is necessary to mitigate it and its associated effects, enhance health, promote life expectancy, increase therapeutic responsiveness, and decrease comorbidity complications. Physical activities, the use of validated pain assessment tools, remote outpatient education and monitoring, chemotherapeutic pain reduction strategies, music and massage therapies, and bridging social isolation gaps are essential in enhancing QoL. We recommend and place a strong emphasis on the adoption of online training/or coaching programs and the integration of formal and informal palliative care systems for maximum QoL benefits among CRC outpatients.
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Affiliation(s)
- John M. Macharia
- Doctoral School of Health Sciences, Faculty of Health Science, University of Pẻcs, Vörösmarty Str 4, 7621 Pẻcs, Hungary
| | - Bence L. Raposa
- Faculty of Health Sciences, University of Pécs, Vörösmarty Str 4, 7621 Pẻcs, Hungary
| | - Dávid Sipos
- Department of Medical Imaging, Faculty of Health Sciences, University of Pécs, Szent Imre Str 14/B, 7400 Kaposvár, Hungary
| | - Csaba Melczer
- Institute of Physiotherapy and Sport Science, Faculty of Health Sciences, University of Pécs, Vörösmarty Str 4, 7621 Pẻcs, Hungary;
| | - Zoltan Toth
- Doctoral School of Health Sciences, Faculty of Health Science, University of Pẻcs, Vörösmarty Str 4, 7621 Pẻcs, Hungary
| | - Zsolt Káposztás
- Faculty of Health Sciences, University of Pécs, Vörösmarty Str 4, 7621 Pẻcs, Hungary
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Veenman E, Roelofs AAJ, Stolwijk ML, Bootsma AM, van Nispen RMA. Experiences of people with dual sensory loss in various areas of life: A qualitative study. PLoS One 2023; 18:e0272890. [PMID: 37682938 PMCID: PMC10490834 DOI: 10.1371/journal.pone.0272890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Accepted: 08/27/2023] [Indexed: 09/10/2023] Open
Abstract
Individuals with dual sensory loss (DSL) appear to have limited ability to compensate for their visual impairment with residual hearing, or for their hearing impairment with residual vision, resulting in challenges in various areas of life. The aim of this qualitative study was to explore the diverse experiences facing individuals with DSL as well as to determine how they experience sensory compensation. Semi-structured interviews were carried out in twenty adults with DSL (13 females and 7 males, mean age 47 years). The causes of DSL severity varied amongst participants. Sensory compensation and experiences in regards to access to information, mobility, communication and fatigue were discussed. Interviews were audio recorded and transcribed verbatim. Framework analysis was used to summarize and interpret the data. In relation to access to information, our results show that, despite various challenges, the use of assistive technology such as voice command functions, enabled participants to operate effectively. Regarding mobility, most participants were capable of finding their way in familiar environments. However, if the setting was unfamiliar, assistance from others or reliance on navigation applications was necessary. Participants experienced little issues with having conversations in quiet settings, however, crowded settings were considered very difficult. The final results showed that most participants suffered from fatigue. Carefully considering which daily activities were feasible and having a daily routine helped to cope with fatigue. This study revealed the experiences of individuals with DSL in important areas of life. The results suggest that, even though many challenges are experienced, individuals with DSL are resourceful in finding compensation strategies. However, capturing participants' sensory compensation experiences was challenging.
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Affiliation(s)
- E. Veenman
- Amsterdam UMC Location Vrije Universiteit Amsterdam, Ophthalmology, Amsterdam, The Netherlands
- Amsterdam Public Health, Quality of Care, Amsterdam, The Netherlands
| | | | - M. L. Stolwijk
- Amsterdam UMC Location Vrije Universiteit Amsterdam, Ophthalmology, Amsterdam, The Netherlands
- Amsterdam Public Health, Quality of Care, Amsterdam, The Netherlands
| | - A. M. Bootsma
- Royal Dutch Visio – Het Loo Erf, Apeldoorn, The Netherlands
| | - R. M. A. van Nispen
- Amsterdam UMC Location Vrije Universiteit Amsterdam, Ophthalmology, Amsterdam, The Netherlands
- Amsterdam Public Health, Quality of Care, Amsterdam, The Netherlands
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Kim SH, Choe YH, Choi J, Park JY, Yi E. Factors Associated With Quality of Life Among Posttreatment Cancer Survivors in Korea: A Meta-analysis. Cancer Nurs 2023:00002820-990000000-00162. [PMID: 37523733 DOI: 10.1097/ncc.0000000000001273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/02/2023]
Abstract
BACKGROUND Identification of factors associated with quality of life (QOL) among cancer survivors is crucial for identifying potential targets for intervention. OBJECTIVES We aimed to provide evidence of factors associated with the QOL among posttreatment cancer survivors in Korea. METHODS We performed a systematic literature search from January 2000 to September 2022 using PubMed, EMBASE, CINAHL, PsycINFO, and Korean databases (RISS, SCIENCEON). We evaluated study quality using the Joanna Briggs Institute Quality Appraisal Checklists for Analytical Cross-sectional Studies and performed statistical analysis using the R 3.0 software (R Foundation for Statistical Computing, Vienna, Austria) package. We analyzed the pooled effect sizes of potential QOL correlates by the random-effects model. RESULTS This meta-analysis included 31 studies with 8934 participants. The pooled estimates were significantly large for economic status (r = -0.53); significantly medium for fatigue (r = -0.39), anxiety (r = -0.29), depression (r = -0.42), self-efficacy (r = 0.37), and social support (r = 0.30); and significantly small for education level (r = -0.18), job status (r = -0.09), cancer stage (r = -0.20), and time since diagnosis (r = -0.26). CONCLUSIONS Low education level, having no job, low economic status, advanced cancer stage, short disease period, fatigue, anxiety, and depression were significantly associated with worse QOL, whereas self-efficacy and social support were significantly associated with better QOL. IMPLICATIONS FOR PRACTICE The findings have potential implications for identifying "at-risk survivors" of deteriorated QOL and for suggesting powerful strategies (eg, enhancing self-efficacy or social support) for improving QOL.
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Affiliation(s)
- Soo Hyun Kim
- Author Affiliations: Department of Nursing, Inha University, Incheon, South Korea
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Couderc AL, Bouhnik AD, Rey D, Bendiane MK, Greillier L, Nouguerède É, Pille A, Montegut C, Rousseau F, Villani P, Mancini J. Quality of life in older French long-term lung cancer survivors: VICAN5 national survey. Lung Cancer 2023; 180:107197. [PMID: 37116376 DOI: 10.1016/j.lungcan.2023.107197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Revised: 04/13/2023] [Accepted: 04/17/2023] [Indexed: 04/30/2023]
Abstract
OBJECTIVES This study aimed to describe quality of life (QoL) five years after diagnosis, in a representative sample of lung cancer (LC) survivors, to compare the QoL of survivors aged 70 years or older with that of younger ones, and to identify factors associated with poorer long-term QoL in both age groups. MATERIALS AND METHODS Our study sample consists of all individuals with a LC diagnosed between January 2010 and December 2011, who participated in the French national survey VICAN 5. RESULTS A total of 371 participants had LC. At the time of the survey, 21.3% of the participants were 70 years or older. In this older age group, feeling self-conscious about appearance and suspected neuropathic pain were independently associated with physical QoL impairment and lower Post-Traumatic Growth Inventory score, and suspected neuropathic pain was associated with impaired mental QoL. In younger patients, impaired physical QoL was independently associated with male gender, metastatic cancer, suspected neuropathic pain, report of severe after-effects of LC and difficulty breathing at rest in the past 7 days, and impaired mental QoL was independently associated with male gender, impaired ECOG-PS, and anxiety. CONCLUSION Factors associated with an impaired QoL in LC survivors, varied according to patient age. In both populations, psychological support and adapted physical activity can be offered to improve mental QoL and physical symptomatology. For older survivors with neuropathic pain, analgesic therapies can be discussed to improve long-term QoL.
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Affiliation(s)
- Anne-Laure Couderc
- Internal Medicine, Geriatrics and Therapeutic Unit, AP-HM, Marseille, France; Aix-Marseille Univ, CNRS, EFS, ADES, Marseille, France.
| | - Anne-Déborah Bouhnik
- Aix Marseille Univ, INSERM, IRD, ISSPAM, SESSTIM, Economics & Social Sciences Applied to Health & Analysis of Medical Information, Marseille, France
| | - Dominique Rey
- Internal Medicine, Geriatrics and Therapeutic Unit, AP-HM, Marseille, France; Aix-Marseille Univ, CNRS, EFS, ADES, Marseille, France
| | - Marc-Karim Bendiane
- Aix Marseille Univ, INSERM, IRD, ISSPAM, SESSTIM, Economics & Social Sciences Applied to Health & Analysis of Medical Information, Marseille, France
| | - Laurent Greillier
- Multidisciplinary Oncology and Therapeutic Innovations Department, AP-HM, Marseille, France; Aix-Marseille Univ, CNRS, INSERM, CRCM, Marseille, France
| | - Émilie Nouguerède
- Internal Medicine, Geriatrics and Therapeutic Unit, AP-HM, Marseille, France
| | - Ariane Pille
- Internal Medicine, Geriatrics and Therapeutic Unit, AP-HM, Marseille, France
| | - Coline Montegut
- Internal Medicine, Geriatrics and Therapeutic Unit, AP-HM, Marseille, France; Oncology Department, Institut Paoli Calmettes, Marseille, France
| | | | - Patrick Villani
- Internal Medicine, Geriatrics and Therapeutic Unit, AP-HM, Marseille, France; Aix-Marseille Univ, CNRS, EFS, ADES, Marseille, France
| | - Julien Mancini
- Aix Marseille Univ, INSERM, IRD, ISSPAM, SESSTIM, Economics & Social Sciences Applied to Health & Analysis of Medical Information, Marseille, France; APHM, BIOSTIC, Hop Timone, Marseille, France
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Kober KM, Roy R, Conley Y, Dhruva A, Hammer MJ, Levine J, Olshen A, Miaskowski C. Prediction of morning fatigue severity in outpatients receiving chemotherapy: less may still be more. Support Care Cancer 2023; 31:253. [PMID: 37039882 DOI: 10.1007/s00520-023-07723-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 04/01/2023] [Indexed: 04/12/2023]
Abstract
INTRODUCTION Fatigue is the most common and debilitating symptom experienced by cancer patients undergoing chemotherapy (CTX). Prediction of symptom severity can assist clinicians to identify high-risk patients and provide education to decrease symptom severity. The purpose of this study was to predict the severity of morning fatigue in the week following the administration of CTX. METHODS Outpatients (n = 1217) completed questionnaires 1 week prior to and 1 week following administration of CTX. Morning fatigue was measured using the Lee Fatigue Scale (LFS). Separate prediction models for morning fatigue severity were created using 157 demographic, clinical, symptom, and psychosocial adjustment characteristics and either morning fatigue scores or individual fatigue item scores. Prediction models were created using two regression and five machine learning approaches. RESULTS Elastic net models provided the best fit across all models. For the EN model using individual LFS item scores, two of the 13 individual LFS items (i.e., "worn out," "exhausted") were the strongest predictors. CONCLUSIONS This study is the first to use machine learning techniques to accurately predict the severity of morning fatigue from prior to through the week following the administration of CTX using total and individual item scores from the Lee Fatigue Scale (LFS). Our findings suggest that the language used to assess clinical fatigue in oncology patients is important and that two simple questions may be used to predict morning fatigue severity.
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Affiliation(s)
- Kord M Kober
- School of Nursing, University of California, San Francisco, CA, USA.
- Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, CA, USA.
- Bakar Computational Health Sciences Institute, University of California, San Francisco, CA, USA.
| | - Ritu Roy
- Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, CA, USA
| | - Yvette Conley
- School of Nursing, University of Pittsburg, Pittsburg, PA, USA
| | - Anand Dhruva
- School of Medicine, University of California, San Francisco, CA, USA
| | | | - Jon Levine
- School of Medicine, University of California, San Francisco, CA, USA
| | - Adam Olshen
- Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, CA, USA
- Bakar Computational Health Sciences Institute, University of California, San Francisco, CA, USA
- School of Medicine, University of California, San Francisco, CA, USA
| | - Christine Miaskowski
- School of Nursing, University of California, San Francisco, CA, USA
- Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, CA, USA
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Chen YP, Zhang Y, Chen X, Luo J, Chen Z, Zhao L, Xia G, Sui X, Li Y. The effects of different surgical approaches on the psychological status, medical coping mode and quality of life of patients with lung cancer. Front Psychol 2023; 14:1039501. [PMID: 37063587 PMCID: PMC10101174 DOI: 10.3389/fpsyg.2023.1039501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Accepted: 03/07/2023] [Indexed: 03/28/2023] Open
Abstract
ObjectiveThis study aimed to compare the effects of robot-assisted thoracic surgery (RATS), video-assisted thoracic surgery (VATS), and thoracotomy on the psychological status, medical coping mode, and quality of life of patients with lung cancer.MethodsA total of 158 patients with lung cancer were selected from the thoracic surgery center of a third-grade hospital in Hunan Province, China, from September to November 2020. The Self-Rating Anxiety Scale (SAS), Self-Rating Depression Scale (SDS), Medical Coping Modes Questionnaire (MCMQ), and Medical Outcomes Study (MOS) 36-item Short Form Health Survey (SF-36) were used to assess the effects of the surgical approaches on the study parameters before and 48–96 h after surgery. The t-test and analysis of variance were used to analyze the data.ResultsThe results revealed that the patients’ depression increased, their short-term quality of life decreased, and they tended to adopt a positive coping mode after surgery (p < 0.05). The RATS and VATS groups differed in avoidance dimension of medical coping modes (p < 0.05). The VATS and thoracotomy groups differed in the body pain dimension of quality of life (p < 0.05). Different surgical approaches had no effect on the psychological status, medical coping modes except the avoidance dimension, and quality of life except the body pain dimension.ConclusionSurgical approaches have little effect on the psychological status, medical coping modes, and quality of life of patients with lung cancer; however, their depression increased and quality of life decreased after the surgery.
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Affiliation(s)
- Yi-ping Chen
- Department of Gastroenterology, Shenzhen Hospital, Southern Medical University, Shenzhen, Guangdong, China
| | - Yi Zhang
- Hunan Key Laboratory of Oral Health Research & Xiangya Stomatological Hospital & Xiangya School of Stomatology, Central South University, Changsha, Hunan, China
| | - Xing Chen
- Department of Nursing Research, Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong, China
| | - Jiang Luo
- Hunan Key Laboratory of Oral Health Research & Xiangya Stomatological Hospital & Xiangya School of Stomatology, Central South University, Changsha, Hunan, China
| | - Zhangqun Chen
- Hunan Key Laboratory of Oral Health Research & Xiangya Stomatological Hospital & Xiangya School of Stomatology, Central South University, Changsha, Hunan, China
| | - Liping Zhao
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Guili Xia
- Department of Gastroenterology, Shenzhen Hospital, Southern Medical University, Shenzhen, Guangdong, China
- Guili Xia,
| | - Xueqi Sui
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Yunchen Li
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
- Department of Pediatrics, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
- *Correspondence: Yunchen Li,
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Hou W, Zhai L, Yang Y, Gu S, Li C, Yang Y, Zhu Y. Is physical activity effective against cancer-related fatigue in lung cancer patients? An umbrella review of systematic reviews and meta-analyses. Support Care Cancer 2023; 31:161. [PMID: 36781549 DOI: 10.1007/s00520-023-07627-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Accepted: 02/01/2023] [Indexed: 02/15/2023]
Abstract
OBJECTIVES To discuss the effects of physical activity on cancer-related fatigue (CRF) in lung cancer patients, summarize the types of physical activity in the published reviews, assess the quality of the evidence, and provide suggestions for the clinical selection of exercise intervention. METHODS PubMed, EMBASE, Web of Science, and the Cochrane Database of Systematic Reviews were searched through 8 November 2021 to identify relevant systematic reviews and meta-analyses. We also performed a manual search of the reference lists of included articles as supplements. Two researchers independently performed literature screening, data extraction, and quality assessment. The umbrella review has been registered in the International Prospective Register of Systematic Review (PROSPERO) registry (CRD42021292548). RESULTS From the 13 systematic reviews or meta-analyses identified, 10 physical activity interventions were included. The most mentioned intervention was aerobic combined with resistance exercise; however, no reduction of the symptoms of CRF was observed in lung cancer patients by this exercise intervention. Most of the patients who performed aerobic exercises alone showed improvement in CRF after the intervention. In addition, Tai Chi and breathing exercises have been shown to improve fatigue, but more high-quality research is still needed to support its effectiveness. CONCLUSIONS Aerobic exercise, respiratory muscle training, aerobic combined with balance training, and other exercise interventions have been shown to improve CRF in lung cancer patients. But it should be noted that according to the different treatment methods and disease stages of patients, individualized rehabilitation programs should be developed for patients. Due to the low methodological quality and evidence quality of some systematic reviews and meta-analyses included in this study, more high-quality clinical studies and systematic reviews are still needed for validation in the future. This umbrella review helps to identify effective ways of exercise to improve fatigue in lung cancer patients before dedicated evidence-based medical guidelines are established.
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Affiliation(s)
- Weiqian Hou
- The Fifth Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, 450000, Henan, China
- Academy of Medical Sciences, Zhengzhou University, Zhengzhou, 450000, Henan, China
| | - Liwen Zhai
- The Fifth Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, 450000, Henan, China
- Academy of Medical Sciences, Zhengzhou University, Zhengzhou, 450000, Henan, China
| | - Yujie Yang
- University of Health and Rehabilitation Sciences, Qingdao, 266000, Shandong, China
| | - Shanshan Gu
- Department of Physical Therapy, University of Toronto, Toronto, Ontario, Canada
| | - Conghui Li
- The Fifth Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, 450000, Henan, China
- Academy of Medical Sciences, Zhengzhou University, Zhengzhou, 450000, Henan, China
| | - Yao Yang
- The Fifth Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, 450000, Henan, China
- Academy of Medical Sciences, Zhengzhou University, Zhengzhou, 450000, Henan, China
| | - Yi Zhu
- The Fifth Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, 450000, Henan, China.
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Li J, Li C, Puts M, Wu YC, Lyu MM, Yuan B, Zhang JP. Effectiveness of mindfulness-based interventions on anxiety, depression, and fatigue in people with lung cancer: A systematic review and meta-analysis. Int J Nurs Stud 2023; 140:104447. [PMID: 36796118 DOI: 10.1016/j.ijnurstu.2023.104447] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 01/17/2023] [Accepted: 01/18/2023] [Indexed: 01/31/2023]
Abstract
BACKGROUND Lung cancer is one of the most common cancers and poses a physical and psychological threat to patients. Mindfulness-based interventions are emerging forms of psychotherapy that are effective in improving physical and psychological symptoms, but no review has summarized their effectiveness on anxiety, depression, and fatigue in people with lung cancer. OBJECTIVES To evaluate the effectiveness of mindfulness-based interventions in reducing anxiety, depression, and fatigue in people with lung cancer. DESIGN Systematic review and meta-analysis. METHODS We searched the PubMed, Web of Science, Embase, China Biology Medicine disc, Wanfang Data, China National Knowledge Infrastructure, and China Science and Technology Journal databases from inception to 13 April 2022. Eligible studies included randomized controlled trials of people with lung cancer receiving mindfulness-based interventions reporting on the outcomes of anxiety, depression, and fatigue. Two researchers independently reviewed the abstracts and full texts, extracted the data and assessed the risk of bias independently by using the Cochrane 'Risk of bias assessment tool'. The meta-analysis was performed by using Review Manager 5.4, and the effect size was calculated by the standardized mean difference and its 95% confidence interval. RESULTS The systematic review included 25 studies (2420 participants), whereas the meta-analysis included 18 studies (1731 participants). Mindfulness-based interventions significantly decreased levels of anxiety [standardized mean difference = -1.15, 95% confidence interval (-1.36, -0.94), Z = 10.75, P < 0.001], depression [standardized mean difference = -1.04, 95% confidence interval (-1.60, -0.48), Z = 3.66, P < 0.001], and fatigue [standardized mean difference = -1.29, 95% confidence interval (-1.66, -0.91), Z = 6.79, P < 0.001]. The subgroup analysis indicated that programs lasting less than eight weeks in length with structured intervention components (e.g., mindfulness-based stress reduction and mindfulness-based cognitive therapy) and 45 min of daily home practice implemented in patients with advanced stage lung cancer showed better effects than programs lasting more than eight weeks in length with less structured components and more than 45 min of daily home practice implemented in patients with mixed stage lung cancer. The overall quality of the evidence was low due to the lack of allocation concealment and blinding and the high risk of bias in most studies (80%). CONCLUSIONS Mindfulness-based interventions might be effective in reducing anxiety, depression, and fatigue in people with lung cancer. However, we cannot draw definitive conclusions because the overall quality of the evidence was low. More rigorous studies are needed to confirm the effectiveness and examine which intervention components may be most effective for improved outcomes.
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Affiliation(s)
- Juan Li
- Xiangya School of Nursing, Central South University, Changsha 410013, China.
| | - Chan Li
- The Fifth Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou 510405, China
| | - Martine Puts
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto M5T1P8, Canada.
| | - Yu-Chen Wu
- School of Nursing, Yueyang Vocational Technical College, Yueyang 414000, China
| | - Meng-Meng Lyu
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore.
| | - Bo Yuan
- Department of Emergency, Xinzheng Public People's Hospital, Xinzheng 451100, China
| | - Jing-Ping Zhang
- Xiangya School of Nursing, Central South University, Changsha 410013, China.
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Han Y, Yu Q, Ma Q, Zhang J, Shi Y, Zhang Z, Qiang G, Xiao F, Liang C. Assessment of preoperative anxiety and depression in patients with pulmonary ground-glass opacities: Risk factors and postoperative outcomes. Front Surg 2023; 10:1102352. [PMID: 36793311 PMCID: PMC9922859 DOI: 10.3389/fsurg.2023.1102352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 01/09/2023] [Indexed: 02/03/2023] Open
Abstract
Objective A large number of patients with pulmonary ground-glass opacities (GGOs) have anxiety and depression. However, the contributing factors and effects of anxiety and depression on postoperative outcomes are still unclear. Methods Clinical data for patients undergoing surgical resection for pulmonary GGOs were collected. We prospectively evaluated levels and risk factors for anxiety and depression in patients with GGOs before surgery. The relationship between psychological disorders and postoperative morbidity was evaluated. Quality of life (QoL) was also assessed. Results A total of 133 patients were enrolled. Prevalence rates of preoperative anxiety and depression were 26.3% (n = 35) and 18% (n = 24), respectively. Multivariate analysis revealed depression [odds ratio(OR) = 16.27, p < 0.001] and multiple GGOs (OR = 3.146, p = 0.033) to be risk factors for preoperative anxiety. Anxiety (OR = 52.166, p < 0.001), age > 60 (OR = 3.601, p = 0.036), and unemployment (OR = 8.248, p = 0.006) were identified as risk factors for preoperative depression. Preoperative anxiety and depression were associated with lower QoL and higher postoperative pain scores. Our results also revealed that the incidence of postoperative atrial fibrillation was higher in patients with than in those without anxiety. Conclusions In patients with pulmonary GGOs, comprehensive psychological assessment and appropriate management are required before surgery to improve QoL and reduce postoperative morbidity.
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Affiliation(s)
- Yu Han
- Department of General Thoracic Surgery, China-Japan Friendship Hospital, Beijing, China,Department of Thoracic Surgery, NationalCenter for Respiratory Medicine, Beijing, China
| | - Qiduo Yu
- Department of General Thoracic Surgery, China-Japan Friendship Hospital, Beijing, China,Department of Thoracic Surgery, NationalCenter for Respiratory Medicine, Beijing, China
| | - Qianli Ma
- Department of General Thoracic Surgery, China-Japan Friendship Hospital, Beijing, China,Department of Thoracic Surgery, NationalCenter for Respiratory Medicine, Beijing, China
| | - Jin Zhang
- Department of General Thoracic Surgery, China-Japan Friendship Hospital, Beijing, China,Department of Thoracic Surgery, NationalCenter for Respiratory Medicine, Beijing, China
| | - Yuhui Shi
- Department of General Thoracic Surgery, China-Japan Friendship Hospital, Beijing, China,Department of Thoracic Surgery, NationalCenter for Respiratory Medicine, Beijing, China
| | - Zhenrong Zhang
- Department of General Thoracic Surgery, China-Japan Friendship Hospital, Beijing, China,Department of Thoracic Surgery, NationalCenter for Respiratory Medicine, Beijing, China
| | - Guangliang Qiang
- Department of General Thoracic Surgery, China-Japan Friendship Hospital, Beijing, China,Department of Thoracic Surgery, NationalCenter for Respiratory Medicine, Beijing, China
| | - Fei Xiao
- Department of General Thoracic Surgery, China-Japan Friendship Hospital, Beijing, China,Department of Thoracic Surgery, NationalCenter for Respiratory Medicine, Beijing, China,Correspondence: Chaoyang Liang Fei Xiao
| | - Chaoyang Liang
- Department of General Thoracic Surgery, China-Japan Friendship Hospital, Beijing, China,Department of Thoracic Surgery, NationalCenter for Respiratory Medicine, Beijing, China,Correspondence: Chaoyang Liang Fei Xiao
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Development and external validation of a machine learning-based prediction model for the cancer-related fatigue diagnostic screening in adult cancer patients: a cross-sectional study in China. Support Care Cancer 2023; 31:106. [PMID: 36625943 DOI: 10.1007/s00520-022-07570-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Accepted: 12/30/2022] [Indexed: 01/11/2023]
Abstract
PURPOSE Cancer-related fatigue (CRF) is the most common symptom in cancer patients and may interfere with patients' daily activities and decrease survival rate. However, the etiology of CRF has not been identified. Diagnosing CRF is challenging. Thus, our study aimed to develop a CRF prediction model in cancer patients, using data that healthcare professionals routinely obtained from electronic health records (EHRs) based on the 3P model and externally validate this model in an independent dataset collected from another hospital. METHODS Between April 2022 and September 2022, a cross-sectional study was conducted on adult cancer patients at two first-class tertiary hospitals in China. Data that healthcare professionals routinely obtained from electronic health records (EHRs) based on the 3P model were collected. The outcome measure was according to ICD-10 diagnostic criteria for CRF. Data from one hospital (n = 305) were used for model development and internal validation. An independent data set from another hospital (n = 260) was utilized for external validation. logistic regression, random forest (RF), Naive Bayes (NB), and extreme gradient boosting (XGBoost) were constructed and compared. The model performance was evaluated in terms of both discrimination and calibration. RESULTS The prevalence of CRF in the two centers was 57.9% and 56.1%, respectively. The Random Forest model achieved the highest AUC of 0.86 among the four types of classifiers in the internal validation. The AUC of RF and NB were above 0.7 in the external validation, suggesting that the models also have an acceptable generalization ability. CONCLUSIONS The incidence of CRF remains high and deserves more attention. The fatigue prediction model based on the 3P theory can accurately predict the risk of CRF. Nonlinear algorithms such as Random Forest and Naive Bayes are more suitable for diagnosing and evaluating symptoms.
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16
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Mun S, Park H. The impact of peripheral neuropathy symptoms, self-care ability, and disturbances to daily life on quality of life among gynecological cancer patients undergoing chemotherapy: a cross-sectional survey. KOREAN JOURNAL OF WOMEN HEALTH NURSING 2022; 28:296-306. [PMID: 36617481 PMCID: PMC9830113 DOI: 10.4069/kjwhn.2022.11.21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Accepted: 11/21/2022] [Indexed: 12/31/2022] Open
Abstract
PURPOSE This study investigated the effects of peripheral neuropathy symptoms, self-care ability,and disturbances to daily life on quality of life (QoL) among gynecological cancer patients undergoing chemotherapy. METHODS The participants included 144 patients with gynecological cancer undergoing anticancerchemotherapy at a tertiary hospital in Seoul, South Korea, from December 1, 2021 to January 28,2022. Convenience sampling was used to recruit patients who had received 4 or more cycles of chemotherapy using a paclitaxel-platinum regimen, and a self-reported questionnaire was used to collect data. Descriptive statistics, the t-test, analysis of variance, Scheffé test, Pearson correlation coefficients, and multiple regression analysis were performed. RESULTS Most of the participants had ovarian cancer (70.1%) or endometrial cancer (14.6%), andthe most common number of treatment cycles was 6 to 10 (29.2%). The mean QoL (60.83±19.89)was greater than the midpoint. The regression model analyzing the patients' QoL was statisticallysignificant (F=15.38, p<.001) with an explanatory power of 56.7%. Self-care ability (β=.39, p<.001),disturbances to daily life (β=-.38, p<.001), the duration of peripheral neuropathy symptoms(β=2.14, p=.034), and regular exercise (β=-2.12, p=.036) were found to significantly affect QoL. CONCLUSION Efforts to improve the self-care ability of gynecological cancer patients who have experienced peripheral neuropathy after receiving chemotherapy and mitigate disturbances to their dailylife can improve their QoL. Healthcare professionals should identify peripheral neuropathy symptoms and examine the effects of the symptoms on patients' daily lives. Improving the self-care abilityof patients and alleviating their limitations in daily life may improve QoL.
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Affiliation(s)
- Sohee Mun
- Department of Nursing, Asan Medical Center, Seoul, Korea,College of Nursing, Ewha Womans University, Seoul, Korea
| | - Hyojung Park
- Department of Nursing, Asan Medical Center, Seoul, Korea,Corresponding author: Hyojung Park College of Nursing, Ewha Womans University, 52 Ewhayeodae-gil, Seodaemun-gu, Seoul 03760, Korea Tel: +82-3277-2824 E-mail:
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Mosher CE, Secinti E, Johns SA, Kroenke K, Rogers LQ. Comparative responsiveness and minimally important difference of Fatigue Symptom Inventory (FSI) scales and the FSI-3 in trials with cancer survivors. J Patient Rep Outcomes 2022; 6:82. [PMID: 35870034 PMCID: PMC9308850 DOI: 10.1186/s41687-022-00488-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Accepted: 07/12/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Fatigue is a highly prevalent and disabling symptom in cancer survivors. Although many measures have been developed to assess survivors’ fatigue, their ability to accurately capture change following intervention has rarely been assessed in post-treatment survivors. Ultra-brief fatigue measures are preferable in clinical practice but have limited evidence supporting their use with cancer survivors. We examined the psychometric properties of four Fatigue Symptom Inventory (FSI) measures, including the new FSI-3, in cancer survivors. Examined properties included responsiveness to change and minimally important differences (MIDs).
Methods
We analyzed data from three randomized controlled trials with post-treatment cancer survivors (N = 328). Responsiveness to change was evaluated by comparing standardized response means for survivors who reported their fatigue as being better, the same, or worse at 2–3 months. Responsiveness to intervention was assessed via effect sizes, and MIDs were estimated by using several methods. We also computed area under the curve (AUC) values to assess FSI measures’ discriminative accuracy compared to an established cut-point.
Results
All FSI measures differentiated survivors who reported improvement at 2–3 months from those with stable fatigue, but did not uniformly differentiate worsening fatigue from stable fatigue. Measures showed similar levels of responsiveness to intervention, and MIDs ranged from 0.29 to 2.20 across FSI measures. AUC analyses supported the measures’ ability to detect significant fatigue.
Conclusions
Four FSI scales show similar responsiveness to change, and estimated MIDs can inform assessment of meaningful change in fatigue. The FSI-3 shows promise as an ultra-brief fatigue measure for survivors.
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Swisher AK, Kennedy-Rea S, Starkey A, Duckworth A, Burkart M, Graebe G, Harper R, Yanosik MA, Hudson A. Bridging the gap: identifying and meeting the needs of lung cancer survivors. J Public Health (Oxf) 2022. [DOI: 10.1007/s10389-020-01332-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Wang X, Ma X, Yang M, Wang Y, Xie Y, Hou W, Zhang Y. Proportion and related factors of depression and anxiety for inpatients with lung cancer in China: a hospital-based cross-sectional study. Support Care Cancer 2022; 30:5539-5549. [PMID: 35318530 PMCID: PMC9046329 DOI: 10.1007/s00520-022-06961-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Accepted: 03/05/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND Lung cancer was often accompanied by depression and anxiety. Nowadays, most investigations for depression and anxiety were concentrated in western medical hospitals, while few related studies have been carried out in the tradition Chinese medicine (TCM) ward. It was necessary to understand the proportion and related factors of depression and anxiety in the inpatients with lung cancer in TCM hospital. METHODS This study adopted cross-sectional research method, which enrolled a total of 222 inpatients with lung cancer in TCM hospital. PHQ-9 and GAD-7 scales were used to assess depression and anxiety for the inpatients, respectively. Demographic and clinical data were also collected. Statistical methods of the univariate analysis and the multivariate logistic regression model were used. RESULTS The proportion of depression and anxiety in the inpatients with lung cancer were 58.1% and 34.2%, respectively. Multivariate logistic regression analysis prompted that the common related factor of depression and anxiety was the symptom of insomnia(odds ratio [OR] 3.274, 95%CI 1.723-6.219; OR 2.201, 95%CI 1.132-4.277). Constipation and gender were the two anther-related factors of depression(OR 1.458, 95%CI 0.372-1.606; OR 1.298, 95%CI 0.151-1.588). CONCLUSION Depression and anxiety were common for the inpatients with lung cancer in TCM hospital. Gender, insomnia, and constipation were related factors for depression, and insomnia was related factor for anxiety. Therefore, medical workers should pay close attention to the emotional changes of these high-risk patients and intervene the symptoms as early as possible.
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Affiliation(s)
- Xueqian Wang
- Department of Oncology, Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, 100053 China
| | - Xuejiao Ma
- Department of Oncology, Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, 100053 China
| | - Mo Yang
- Department of Oncology, Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, 100053 China
| | - Yan Wang
- Department of Oncology, Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, 100053 China
| | - Yi Xie
- Department of Oncology, Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, 100053 China
| | - Wei Hou
- Department of Oncology, Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, 100053 China
| | - Ying Zhang
- Department of Oncology, Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, 100053 China
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Effects of Walking on Fatigue in Cancer Patients: A Systematic Review and Meta-analysis. Cancer Nurs 2021; 45:E270-E278. [PMID: 34870943 DOI: 10.1097/ncc.0000000000000914] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Walking is a simple form of exercise that is easily accepted by patients. Exercise is one of the main ways to control cancer-related fatigue (CRF). However, there are conflicting data on the association between walking and severity of CRF. OBJECTIVE The aim of this study was to assess the overall effect of walking on CRF among adult cancer patients. METHODS Databases including PubMed, CINAHL, EMBASE, and Cochrane Library were systematically reviewed to identify suitable randomized controlled trials from inception to February 29, 2020. Two reviewers independently evaluated the risk of bias and extracted correlated data with Cochrane Handbook of Systematic Reviews on Interventions. The data analysis was performed by Review Manager 5.3. RESULTS A total of 12 studies with 1064 patients were identified. Integrated result analysis of walking yielded a statistically significant effect on CRF (standard mean difference [SMD], -0.66; 95% confidence interval [CI], -1.06 to -0.26). Subgroup analysis demonstrated that intervention time longer than 6 weeks (SMD, -0.89; 95% CI, -1.22 to -0.57) had a better effect on fatigue compared with that of less than 6 weeks (SMD, 0.03; 95% CI, -0.39 to 0.45). The study showed walking was statistically more effective than the control intervention in patients undergoing cancer treatment (SMD, -0.79; 95% CI, -1.16 to -0.42). Descriptive analysis also showed that walking was effective for cancer patients who completed treatment. CONCLUSIONS Walking is effective for CRF during and after cancer therapy. IMPLICATIONS FOR PRACTICE The results provide evidence for a general exercise form to relieve fatigue in cancer patients and facilitate support for future clinical trials and work.
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21
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Subgroups of patients undergoing chemotherapy with distinct cognitive fatigue and evening physical fatigue profiles. Support Care Cancer 2021; 29:7985-7998. [PMID: 34218321 DOI: 10.1007/s00520-021-06410-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2021] [Accepted: 06/28/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE The purpose was to model cognitive fatigue and evening physical fatigue together to determine subgroups of patients with distinct cognitive fatigue AND evening physical fatigue profiles. Once these profiles were identified, differences among the subgroups in demographic and clinical characteristics, co-occurring symptoms, and quality of life outcomes were evaluated. METHODS Oncology patients (n = 1332) completed self-report measures of cognitive fatigue and evening physical fatigue, six times over two cycles of chemotherapy. Latent profile analysis, which combined the two symptom scores, was done to identify subgroups of patients with distinct cognitive fatigue AND evening physical fatigue profiles. RESULTS Three distinct profiles (i.e., Low [20.5%], Moderate [39.6%], and High [39.6%]) were identified. Compared to the Low class, patients in the High class were younger, female, and more likely to live alone and had a higher comorbidity burden and a lower functional status. In addition, these patients had a higher symptom burden and a poorer quality of life. CONCLUSION Based on clinically meaningful cutoff scores, 80% of the patients in this study had moderate to high levels of both cognitive fatigue and evening physical fatigue. In addition, these patients experienced high levels of other common symptoms (e.g., anxiety, depression, sleep disturbance, and pain). These co-occurring symptoms and other modifiable characteristics associated with membership in the Moderate and High classes may be potential targets for individualized symptom management interventions.
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Pozzar RA, Hammer MJ, Cooper BA, Kober KM, Chen LM, Paul SM, Conley YP, Levine JD, Miaskowski C. Symptom Clusters in Patients With Gynecologic Cancer Receiving Chemotherapy. Oncol Nurs Forum 2021; 48:441-452. [PMID: 34143001 DOI: 10.1188/21.onf.441-452] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVES To describe ratings of symptom occurrence, severity, and distress for 38 symptoms and to identify and compare the number and types of symptom clusters identified using these ratings. Although patients with gynecologic cancer experience multiple co-occurring symptoms, little is known about how these symptoms cluster together. SAMPLE & SETTING Eligible patients (N = 232) had gynecologic cancer and were receiving chemotherapy. METHODS & VARIABLES Symptoms were assessed using the Memorial Symptom Assessment Scale. Symptom clusters were identified through exploratory factor analysis. Geomin-rotated factor loadings with absolute values of 0.3 or greater were considered meaningful. Factor solutions (i.e., symptom clusters) were assessed for simple structure and clinical relevance. RESULTS Lack of energy, hair loss, and "I don't look like myself" were the most common, severe, and distressing symptoms. Hormonal, respiratory, and weight change clusters were identified across all three dimensions. IMPLICATIONS FOR NURSING Research that explores how symptom clusters change over time and their underlying mechanisms is warranted.
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Ma RC, Zhao Y, Liu X, Cao HP, Wang YQ, Yin YY, Xie J. Multimodal Exercise Program: A Pilot Randomized Trial for Patients With Lung Cancer Receiving Surgical Treatment. Clin J Oncol Nurs 2021; 25:E26-E34. [PMID: 34019026 DOI: 10.1188/21.cjon.e26-e34] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Curative lung resection is the best option for patients with stage I-III lung cancer, and the best exercise intervention in these patients has not been determined. OBJECTIVES This pilot study explored whether a short-term pre- and postsurgery multimodal exercise program affected dyspnea, exercise capacity, inspiratory capacity, anxiety, and depression. METHODS A total of 101 patients were randomly allocated into the combined intervention group (n = 34), the breathing exercise group (n = 32), or the control group (n = 35). During hospitalization, patients in the two intervention groups received one or more kinds of exercise intervention, and patients in the control group only received usual care. Outcomes were assessed at admission, on the day before surgery, and at discharge. FINDINGS Both intervention groups achieved significant improvements in dyspnea, exercise capacity, and inspiratory capacity, and patients in the combined intervention group exhibited greater improvements in outcomes as compared to those randomized to the breathing exercise group.
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24
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Zhou L, Chen Q, Zhang J. Effect of Exercise on Fatigue in Patients with Lung Cancer: A Systematic Review and Meta-Analysis of Randomized Trials. J Palliat Med 2021; 24:932-943. [PMID: 33835877 DOI: 10.1089/jpm.2020.0504] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/09/2022] Open
Abstract
Background: Fatigue is a frequent debilitating symptom among patients with lung cancer. The effect of exercise on fatigue remains to be quantified. Objective: This review aimed to examine the effect of exercise on fatigue by synthesizing findings from randomized controlled trials (RCTs). Methods: This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A systematic search was conducted in five electronic databases from inception to March 2020. Only RCT was included. The primary outcome was fatigue and the secondary outcomes included depression, anxiety, quality of life, and functional capacity. Pooled weighted or standardized mean difference (WMD or SMD) with 95% confidence interval (CI) was calculated. Results: Eight RCTs were included. The exercise intervention was delivered in the supervised environment (n = 6) or free-living settings (n = 2). Exercise reduced the level of fatigue (SMD = -0.33; 95% CI = -0.54 to -0.13). Exercise also decreased depressive symptom (WMD = -1.57; 95% CI = -2.69 to -0.44) and anxiety (WMD = -1.39; 95% CI = -2.60 to -0.18). Exercise showed a moderate effect on the quality of life, with an SMD of 0.33 (95% CI = 0.08 to 0.58). Exercise intervention increased functional capacity as measured by the six-minute walk test by 20 meters (95% CI = 14.2 to 55.0), but the effect was not significant (p = 0.247). Conclusion: Exercise demonstrated a moderate effect on fatigue in patients with lung cancer. Exercise also improved depressive symptoms, anxiety, and quality of life; however, its impact on functional capacity was not significant. More clinical trials are warranted to explore the mechanisms underlying the impact of exercise on fatigue. Strategies improving adherence to exercise prescription should be developed to help these patients overcome potential challenges.
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Affiliation(s)
- Liang Zhou
- Second Department of Respiratory and Critical Care Medicine, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, China
| | - Qijiu Chen
- Second Department of Respiratory and Critical Care Medicine, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, China
| | - Jianyong Zhang
- Second Department of Respiratory and Critical Care Medicine, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, China
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25
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Determining Risk Factors Associated with Depression and Anxiety in Young Lung Cancer Patients: A Novel Optimization Algorithm. ACTA ACUST UNITED AC 2021; 57:medicina57040340. [PMID: 33916080 PMCID: PMC8065798 DOI: 10.3390/medicina57040340] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 03/18/2021] [Accepted: 03/24/2021] [Indexed: 12/24/2022]
Abstract
Background and Objectives: Identifying risk factors associated with psychiatrist-confirmed anxiety and depression among young lung cancer patients is very difficult because the incidence and prevalence rates are obviously lower than in middle-aged or elderly patients. Due to the nature of these rare events, logistic regression may not successfully identify risk factors. Therefore, this study aimed to propose a novel algorithm for solving this problem. Materials and Methods: A total of 1022 young lung cancer patients (aged 20-39 years) were selected from the National Health Insurance Research Database in Taiwan. A novel algorithm that incorporated a k-means clustering method with v-fold cross-validation into multiple correspondence analyses was proposed to optimally determine the risk factors associated with the depression and anxiety of young lung cancer patients. Results: Five clusters were optimally determined by the novel algorithm proposed in this study. Conclusions: The novel Multiple Correspondence Analysis-k-means (MCA-k-means) clustering algorithm in this study successfully identified risk factors associated with anxiety and depression, which are considered rare events in young patients with lung cancer. The clinical implications of this study suggest that psychiatrists need to be involved at the early stage of initial diagnose with lung cancer for young patients and provide adequate prescriptions of antipsychotic medications for young patients with lung cancer.
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26
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Liu YJ, Schandl A, Markar S, Johar A, Lagergren P. Psychological distress and health-related quality of life up to 2 years after oesophageal cancer surgery: nationwide population-based study. BJS Open 2021; 5:6073387. [PMID: 33609371 PMCID: PMC7893460 DOI: 10.1093/bjsopen/zraa038] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Accepted: 10/12/2020] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Patients are at higher risk of suffering from psychological distress and reduced health-related quality of life (HRQoL) after oesophageal cancer surgery. This Swedish nationwide population-based longitudinal study aimed to evaluate the association between psychological distress and HRQoL up to 2 years after oesophageal cancer surgery. METHODS The study included patients with oesophageal cancer who had survived for 1 year after oesophageal cancer surgery. The exposure was psychological distress measured using the Hospital Anxiety and Depression Scale. Patients scoring at least 8 on either the anxiety or the depression subscale were classified as having psychological distress. The outcome was HRQoL assessed by the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire generic and disease-specific questionnaires (EORTC QLQ-C30 and QLQ-OG25). Exposure and outcome were measured at 1, 1.5, and 2 years after operation. Fixed-effects models with adjustment for all time-invariant confounding and potential time-varying confounders were used to examine the mean score difference in HRQoL between patients with and without psychological distress. RESULTS In total, 180 patients were analysed. Clinically relevant, statistically significant and time-constant mean score differences were found in emotional function, social function, dyspnoea, anxiety, eating difficulty, eating in front of others, and weight loss (mean score difference range 10-29). Mean score differences for global quality of life, cognitive function, appetite loss, EORTC QLQ-C30 summary score, and trouble with taste increased over time, and reached clinical and statistical significance at 1.5 and/or 2 years after surgery. For body image, there was a clinically relevant decrease in mean score difference over time. CONCLUSION Psychological distress was associated with several aspects of poor HRQoL up to 2 years after surgery for oesophageal cancer.
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Affiliation(s)
- Y J Liu
- Surgical Care Science, Department of Molecular Medicine and Surgery, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - A Schandl
- Surgical Care Science, Department of Molecular Medicine and Surgery, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
- Department of Anaesthesiology and Intensive Care, Södersjukhuset, Stockholm, Sweden
| | - S Markar
- Surgical Care Science, Department of Molecular Medicine and Surgery, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
- Department of Surgery and Cancer, Imperial College London, London, UK
| | - A Johar
- Surgical Care Science, Department of Molecular Medicine and Surgery, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - P Lagergren
- Correspondence to: Surgical Care Science, Department of Molecular Medicine and Surgery, Karolinska Institutet, Retzius väg 13 a, Level 4, 171 77 Stockholm, Sweden (e-mail: )
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27
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Sullivan DR. The Role of Palliative Care in Lung Cancer. Respir Med 2021. [DOI: 10.1007/978-3-030-81788-6_12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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28
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Prevalence and risk factors of cancer-related fatigue: A systematic review and meta-analysis. Int J Nurs Stud 2020; 111:103707. [DOI: 10.1016/j.ijnurstu.2020.103707] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Revised: 06/02/2020] [Accepted: 06/25/2020] [Indexed: 12/14/2022]
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29
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Pang L, Liu Z, Lin S, Liu Z, Liu H, Mai Z, Liu Z, Chen C, Zhao Q. The effects of telemedicine on the quality of life of patients with lung cancer: a systematic review and meta-analysis. Ther Adv Chronic Dis 2020; 11:2040622320961597. [PMID: 33101621 PMCID: PMC7549184 DOI: 10.1177/2040622320961597] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Accepted: 09/01/2020] [Indexed: 12/20/2022] Open
Abstract
Background and aims: Lung cancer patients suffer from deterioration in their physical and
psychological function, which exerts a negative influence on their quality
of life (QOL). Telemedicine has been proven to be an effective intervention
for patients with several chronic diseases. The aim of this systematic
review and meta-analysis was to investigate the efficacy of telemedicine in
improving QOL in lung cancer patients. Methods: PubMed, Cochrane Library, EMBASE, Web of Science and Scopus databases were
searched for randomized controlled trials that investigated the
effectiveness of telemedicine in lung cancer patients. Review Manager 5.3
and Stata 15.1 were used to perform data analysis. Results: Our meta-analysis included eight clinical trials with a total of 635 lung
cancer patients. The results showed that the telemedicine group had
significantly higher QOL than the usual care group [standard mean difference
(SMD) 0.96, 95% confidence interval (CI) 0.29–1.63,
I2 = 91%]. In addition, the telemedicine
group had lower anxiety (SMD −0.44, 95% CI −0.66 to −0.23,
I2 = 3%) and depression scores (SMD −0.48,
95% CI −0.91 to −0.05, I2 = 66%) than the usual
care group. However, no significant differences were found in fatigue and
pain outcomes between the two groups. Conclusion: Telemedicine may be an effective method of improving QOL in lung cancer
patients and the further development and use of telemedicine care is
recommended.
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Affiliation(s)
- Lanlan Pang
- Department of Intensive Care Unit, Sun Yat-sen University Cancer Centre, State Key Laboratory of Oncology in South China, Collaborative Innovation Centre for Cancer Medicine, Guangzhou, China
| | - Zefu Liu
- Department of Urology, Sun Yat-sen University Cancer Centre, State Key Laboratory of Oncology in South China, Collaborative Innovation Centre for Cancer Medicine, Guangzhou, China
| | - Sheng Lin
- Department of pulmonary and critical care medicine, Shengli Clinical Medical College of Fujian Medical University, Fujian Provincial Hospital, Fuzhou, Fujian, China
| | - Zhidong Liu
- Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, Guangdong Province, China
| | - Hengyu Liu
- Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, Guangdong Province, China
| | - Zihang Mai
- Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, Guangdong Province, China
| | - Zhuowei Liu
- Department of Urology, Sun Yat-sen University Cancer Centre, State Key Laboratory of Oncology in South China, Collaborative Innovation Centre for Cancer Medicine, Guangzhou, China
| | - Chongxiang Chen
- Department of Intensive Care Unit, Sun Yat-sen University Cancer Centre, State Key Laboratory of Oncology in South China, Collaborative Innovation Centre for Cancer Medicine, Dongfeng East Road 651, Guangzhou 510060, China
| | - Qingyu Zhao
- Department of Intensive Care Unit, Sun Yat-sen University Cancer Centre, State Key Laboratory of Oncology in South China, Collaborative Innovation Centre for Cancer Medicine, Guangzhou 510060, China
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30
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Chen S, Mei R, Tan C, Li X, Zhong C, Ye M. Psychological resilience and related influencing factors in postoperative non-small cell lung cancer patients: A cross-sectional study. Psychooncology 2020; 29:1815-1822. [PMID: 33459436 DOI: 10.1002/pon.5485] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2020] [Revised: 06/05/2020] [Accepted: 07/10/2020] [Indexed: 12/24/2022]
Abstract
OBJECTIVE The psychological resilience of postoperative non-small cell lung cancer (NSCLC) patients is influenced by many factors. The purpose of this study is to investigate the current state of psychological resilience and identify its influencing factors in postoperative NSCLC patients. METHODS This descriptive cross-sectional study used a convenience sampling method and recruited 382 inpatients from two Class A hospitals in Hunan, China. The Connor-Davidson Resilience Scale (CD-RISC), Strategies Used by People to Promote Health (SUPHH), Medical Coping Modes Questionnaire (MCMQ), and Multidimensional Scale of Perceived Social Support (MSPSS) were used. RESULTS Postoperative NSCLC patients' psychological resilience was at a low level, with a score of (57.18 ± 8.55). Stepped Linear Regression showed that the related influencing factors of psychological resilience of postoperative NSCLC patients were age (β = -0.313, P < .001), family average income (β = 0.143, P < .001), self-efficacy (β = 0.416, P < .001), confrontation (β = 0.116, P < .001) and acceptance-resignation (β = -0.155, P < .001), which could explain 58.0% of the total variation in psychological resilience (F = 103.68, P<.001). CONCLUSIONS Psychological resilience is positively predicted by average income, self-efficacy, confrontation, but negatively predicted by age and acceptance-resignation. Self-efficacy is the most important variable influencing psychological resilience in postoperative NSCLC patients. In the future, a series of targeted interventions need to be implemented to strengthen patients' self-efficacy and psychological resilience, which can also improve the quality of life of postoperative NSCLC patients.
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Affiliation(s)
- Shihao Chen
- Xiangya Nursing School of Central South University, Changsha, China
| | - Ranran Mei
- Xiangya Nursing School of Central South University, Changsha, China
| | - Chuxia Tan
- Xiangya Nursing School of Central South University, Changsha, China
| | - Xuting Li
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital, Central South University, Changsha, China.,Department of Thoracic Surgery, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Chenxi Zhong
- Xiangya Nursing School of Central South University, Changsha, China
| | - Man Ye
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital, Central South University, Changsha, China.,Department of Thoracic Surgery, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
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31
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Wang YQ, Cao HP, Liu X, Yang Z, Yin YY, Ma RC, Xie J. Effect of breathing exercises in patients with non-small cell lung cancer receiving surgical treatment: A randomized controlled trial. Eur J Integr Med 2020. [DOI: 10.1016/j.eujim.2020.101175] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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32
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Receipt of psychological counseling and integrative medicine services among breast cancer survivors with anxiety. Breast Cancer Res Treat 2020; 184:301-310. [PMID: 32772224 DOI: 10.1007/s10549-020-05859-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Accepted: 08/04/2020] [Indexed: 10/23/2022]
Abstract
PURPOSE To define the prevalence and risk factors of anxiety and examine rates and predictors of psychotherapy and integrative medicine service use in breast cancer survivors on aromatase inhibitors (AIs). METHODS Observational study of patients with histologically confirmed stage 0-III hormone receptor-positive breast cancer taking a third-generation AI at the time of enrollment. Patients completed self-report measures of anxiety and utilization of psychotherapy and integrative medicine services at a single time-point. We used multivariate logistic regression analyses to identify factors associated with anxiety and receipt of anxiety treatment services. RESULTS Among the 1085 participants, the majority were younger than 65 years of age (n = 673, 62.0%) and white (n = 899, 82.9%). Approximately one-third (30.8%) reported elevated anxiety (≥ 8 on the anxiety subscale of the Hospital Anxiety and Depression Scale). Of patients with elevated anxiety, only 24.6% reported receiving psychological counseling, 25.3% used integrative medicine services, and 39.8% received either type of treatment since their diagnosis. Patients with an education level of high school or less were less likely to receive psychological counseling (AOR, 0.43, 95% CI 0.19-0.95) and integrative medicine services (OR 0.30, 95% CI 0.12-0.72) than patients with higher levels of education. CONCLUSIONS Anxiety is common in breast cancer patients treated with AIs yet the majority of anxious patients do not receive evidence-based treatment, even when these treatments are available. Better systematic anxiety screening and treatment initiation are needed to reduce disparities in care by education level.
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33
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Huang X, Zhang TZ, Li GH, Liu L, Xu GQ. Prevalence and correlation of anxiety and depression on the prognosis of postoperative non-small-cell lung cancer patients in North China. Medicine (Baltimore) 2020; 99:e19087. [PMID: 32176035 PMCID: PMC7440182 DOI: 10.1097/md.0000000000019087] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Identify the prevalence of postoperative anxiety and depression as well as their correlations with clinical features and survival profiles in non-small-cell lung cancer (NSCLC) patients who underwent resection.Four hundred NSCLC patients who underwent resection were recruited, and their anxiety and depression were assessed by hospital anxiety and depression scale (HADS) at discharge after surgery. Besides, 480 healthy controls (HCs) were also enrolled and assessed by HADS.The HADS-Anxiety score of NSCLC patients (7.8 ± 3.9) was greatly higher than that of HCs (4.8 ± 2.7), and the anxiety prevalence of NSCLC patients (49.6%) were dramatically increased compared with HCs (13.8%). Furthermore, the HADS-Depression score (7.2 ± 3.6) of NSCLC patients was considerably increased compared with HCs (4.2 ± 2.6), and the depression prevalence of NSCLC patients (38.3%) was significantly raised compared with HCs (10.0%). Besides, anxiety correlated with gender, marital status, hypertension, diabetes, pathological differentiation, tumor size, lymph node metastasis, TNM stage and carcinoembryonic antigen level, meanwhile, depression correlated with marital status, employment status before surgery, diabetes, pathological differentiation, and TNM stage in NSCLC patients. Additionally, the anxiety and depression predicted shorter disease-free survival in NSCLC patients. And the anxiety predicted worse overall survival (OS), while no association of depression with OS was observed in NSCLC patients.Post-operative anxiety and depression are highly prevalent and implicated in the ongoing care and prognosis prediction in NSCLC patients who underwent resection.
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34
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De Ruysscher D, Faivre-Finn C, Nackaerts K, Jordan K, Arends J, Douillard J, Ricardi U, Peters S. Recommendation for supportive care in patients receiving concurrent chemotherapy and radiotherapy for lung cancer. Ann Oncol 2020; 31:41-49. [DOI: 10.1016/j.annonc.2019.10.003] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Revised: 09/06/2019] [Accepted: 10/08/2019] [Indexed: 12/13/2022] Open
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35
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Xu A, Wang Y, Wu X. Effectiveness of e-health based self-management to improve cancer-related fatigue, self-efficacy and quality of life in cancer patients: Systematic review and meta-analysis. J Adv Nurs 2019; 75:3434-3447. [PMID: 31566769 DOI: 10.1111/jan.14197] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Revised: 08/20/2019] [Accepted: 09/04/2019] [Indexed: 12/24/2022]
Abstract
AIMS To integrate the overall effect of e-health based self-management on cancer-related fatigue (CRF), self-efficacy, and quality of life (QOL) among adult cancer patients. DESIGN A systematic review and meta-analysis of randomized controlled trials. DATA SOURCES We researched PubMed, Cumulative Index Nursing and Allied Health Literature, Cochrane Central Register of Controlled Trials, Web of Science and Embase up to 14 July 2019. REVIEW METHODS We conducted the review with the Cochrane Handbook (version 5.1.0) and measured the quality of evidence with the Grading of Recommendations Assessment, Development and Evaluation criteria. RESULTS Literature searching identified 15 trials with a total of 2,337 participants. Integrated results analysis of e-health based self-management demonstrated a statistically significant but small effect on CRF and self-efficacy, but no statistically significant improvement on the QOL. Meanwhile, subgroup analysis indicated that e-health based self-management had a larger effect on fatigue compared with usual care/waiting list control. CONCLUSION E-health based self-management is effective for CRF and self-efficacy, but not the QOL. More high-quality randomized control trials are warranted to confirm these conclusions. IMPACT Results showed e-health could improve fatigue and self-efficacy but not the QOL. Health providers could take into the various factors of e-health interventions when providing telehealth service. Other researchers might be inspired by the current review before they begin a study about e-health.
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Affiliation(s)
- Anqi Xu
- School of Nursing, Peking University, Beijing, P.R. China.,Health Science Centre for Evidence-Based Nursing: A Joanna Briggs Institute Centre of Excellence, Peking University, Beijing, P.R. China
| | - Yinping Wang
- School of Public Health, Peking University, Beijing, P.R. China
| | - Xue Wu
- School of Nursing, Peking University, Beijing, P.R. China.,Health Science Centre for Evidence-Based Nursing: A Joanna Briggs Institute Centre of Excellence, Peking University, Beijing, P.R. China
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36
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O'Regan P, McCarthy G, O'Reilly S, Power D, Bird BH, Murphy CG, Hegarty J. Cancer‐related fatigue and self‐care agency: A multicentre survey of patients receiving chemotherapy. J Clin Nurs 2019; 28:4424-4433. [DOI: 10.1111/jocn.15026] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Revised: 04/05/2019] [Accepted: 08/03/2019] [Indexed: 12/21/2022]
Affiliation(s)
- Patricia O'Regan
- School of Nursing and Midwifery University College Cork Cork Ireland
| | | | - Seamus O'Reilly
- Cork‐Mercy‐South Infirmary Victoria University Hospitals University College Cork Cork Ireland
| | - Derek Power
- The Mercy University Hospital/Cork University Hospital Cork Ireland
| | | | | | - Josephine Hegarty
- School of Nursing and Midwifery University College Cork Cork Ireland
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37
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Bonhof CS, van de Poll-Franse LV, Vissers PAJ, Wasowicz DK, Wegdam JA, Révész D, Vreugdenhil G, Mols F. Anxiety and depression mediate the association between chemotherapy-induced peripheral neuropathy and fatigue: Results from the population-based PROFILES registry. Psychooncology 2019; 28:1926-1933. [PMID: 31293046 PMCID: PMC6771569 DOI: 10.1002/pon.5176] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Revised: 07/02/2019] [Accepted: 07/08/2019] [Indexed: 01/20/2023]
Abstract
OBJECTIVE Chemotherapy-induced sensory peripheral neuropathy (CIPN) is common among colorectal cancer (CRC) survivors. The aim of this study was to examine whether CIPN is associated with both psychological distress (ie, anxiety and depression) and fatigue and whether the relationship between CIPN and fatigue can (partly) be explained by psychological distress. METHODS All CRC survivors diagnosed between 2000 and 2009 as registered by the population-based Netherlands Cancer Registry (Eindhoven region) were eligible for participation. Chemotherapy-treated survivors completed questions on CIPN (EORTC QLQ-CIPN20), psychological distress (HADS), and fatigue (FAS) on average 5.6 years after diagnosis. Simple and multiple mediation analyses were performed to examine anxiety and depression as possible mediators in the association between CIPN and fatigue. RESULTS Survivors with high (ie, upper 30% of scores) CIPN (n = 172) reported more anxiety and depressive symptoms and more fatigue compared with those with low CIPN (n = 299). Furthermore, among survivors with high CIPN, those who were anxious, depressed, or both reported more fatigue compared with those without psychological distress. These differences were clinically relevant. Finally, mediation analyses showed that while CIPN was directly associated with fatigue, the relationship between CIPN and fatigue was also significantly mediated by both anxiety and depression. CONCLUSIONS CRC survivors with high CIPN report more fatigue, especially those who are also anxious and/or depressed. More research is needed on the direction of the relationship between CIPN, psychological distress, and fatigue. For now, the treatment of fatigue should also focus on addressing psychological distress, as treating fatigue alone might not be sufficient.
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Affiliation(s)
- Cynthia S Bonhof
- Center of Research on Psychology in Somatic Disorders (CoRPS), Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands.,Department of Research, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands
| | - Lonneke V van de Poll-Franse
- Center of Research on Psychology in Somatic Disorders (CoRPS), Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands.,Department of Research, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands.,Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Pauline A J Vissers
- Department of Research, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands
| | - Dareczka K Wasowicz
- Department of Surgery, Elisabeth-TweeSteden Hospital, Tilburg, The Netherlands
| | | | - Dóra Révész
- Center of Research on Psychology in Somatic Disorders (CoRPS), Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands
| | - Gerard Vreugdenhil
- Department of Internal Medicine, Máxima Medical Centre, Eindhoven, The Netherlands
| | - Floortje Mols
- Center of Research on Psychology in Somatic Disorders (CoRPS), Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands.,Department of Research, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands
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38
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Yan X, Chen X, Li M, Zhang P. Prevalence and risk factors of anxiety and depression in Chinese patients with lung cancer:a cross-sectional study. Cancer Manag Res 2019; 11:4347-4356. [PMID: 31190999 PMCID: PMC6514253 DOI: 10.2147/cmar.s202119] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Accepted: 04/08/2019] [Indexed: 01/07/2023] Open
Abstract
Background: Lung cancer is very common in China. The low cure rate, limited overall survival, and continuous therapies lead the patients to experience considerable psychological distress. Traditional Chinese medicine therapy is one unique treatment method in China. Nevertheless, most patients in the existing studies on anxiety and depression were treated in western medical hospitals. Therefore, it is necessary to identify the prevalence and risk factors of these emotional disorders in lung cancer patients treated in traditional Chinese medical hospitals. These findings may assist in clinical intervention. Patients and methods: A total of 315 patients with lung cancer were enrolled. Individuals completed the Hospital Anxiety and Depression Scale to assess their levels of anxiety and depression. Demographic and clinical data were also collected. Binary logistic regression analysis was used to identify factors that significantly predicted anxiety and depression. Results: The anxiety and depression prevalence rates of lung cancer patients were 43.5% and 57.1%, respectively. In the univariate analysis, patients without surgery, who were young, or who received radiotherapy were more likely to experience anxiety. Patients without surgery, who were young, or who had late-stage cancer, were more likely to experience depression. Binary logistic regression analysis showed that the risk factors of both anxiety and depression were lack of surgery and young and middle age (<65, especially 45–65 years). Conclusion: Anxiety and depression were very common in lung cancer patients. Lack of surgery, young, and middle age, were independent risk factors for anxiety and depression. Therefore, medical workers should pay close attention to the emotional changes of young or middle-aged patients, or patients without the chance to undergo surgery.
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Affiliation(s)
- Xiaoru Yan
- Department of Oncology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, People's Republic of China.,Graduate School, Tianjin University of Traditional Chinese Medicine, Tianjin, People's Republic of China
| | - Xun Chen
- Graduate School, Beijing University of Chinese Medicine, Beijing, People's Republic of China.,Department of Gastroenterology, Dongfang Hospital, Beijing University of Chinese Medicine, Beijing, People's Republic of China
| | - Meng Li
- Department of Oncology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, People's Republic of China.,Graduate School, Beijing University of Chinese Medicine, Beijing, People's Republic of China
| | - Peitong Zhang
- Department of Oncology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, People's Republic of China
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39
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Lee K, Oh EG, Kim S, Kim S. Symptom experiences and health‐related quality of life among non‐small cell lung cancer patients participating in clinical trials. J Clin Nurs 2019; 28:2111-2123. [DOI: 10.1111/jocn.14803] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Revised: 01/11/2019] [Accepted: 01/14/2019] [Indexed: 01/01/2023]
Affiliation(s)
- Kyunghwa Lee
- Department of Nursing Yonsei University Graduate School Seoul Korea
| | - Eui Geum Oh
- Mo‐Im Kim Nursing Research Institute Yonsei University College of Nursing Seoul Korea
| | - Sanghee Kim
- Mo‐Im Kim Nursing Research Institute Yonsei University College of Nursing Seoul Korea
| | - Sang‐We Kim
- Department of Oncology, Asan Medical Center University of Ulsan College of Medicine Seoul Korea
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40
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Granger CL, Edbrooke L, Denehy L. The nexus of functional exercise capacity with health-related quality of life in lung cancer: how closely are they related? ANNALS OF TRANSLATIONAL MEDICINE 2019; 6:S131. [PMID: 30740452 DOI: 10.21037/atm.2018.12.35] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Catherine L Granger
- Department of Physiotherapy, The University of Melbourne, Parkville, Victoria, Australia.,Department of Physiotherapy, Royal Melbourne Hospital, Parkville, Victoria, Australia
| | - Lara Edbrooke
- Department of Physiotherapy, The University of Melbourne, Parkville, Victoria, Australia.,Allied Health, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Linda Denehy
- Allied Health, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.,Melbourne School of Health Sciences, The University of Melbourne, Parkville, Victoria, Australia
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41
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Hu T, Xiao J, Peng J, Kuang X, He B. Relationship between resilience, social support as well as anxiety/depression of lung cancer patients: A cross-sectional observation study. J Cancer Res Ther 2018. [PMID: 29516963 DOI: 10.4103/jcrt.jcrt_849_17] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Objective The mood of patients with lung carcinoma would be greatly influenced by the diagnosing and treating processes. This study was aimed to explore the effects of resilience between social assistance and anxiety/depression of patients with lung cancer, which may assist in clinical intervention. Design and Methods A cross-sectional pilot study was conducted on lung cancer patients at Xiangya Hospital of Central South University, China. A total of 289 patients aged 25-81 years were included in this study. Results Correlational analyses revealed that anxiety/depression was negatively associated with psychological resilience and each dimension of social assistance, including subjective support, objective support along with the supports utilization (P < 0.01). Furthermore, psychological resilience was positively related to subjective support (P < 0.01), support utilization (P < 0.01) along with objective support (P < 0.05). Mediational analyses showed that, on the one hand, resilience could partially mediate the relation between anxiety and subjective support and totally mediate the relationship between support utilization and anxiety. On the other hand, resilience could totally mediate the relation between depression and subjective support and partially mediate the relation between support utilization and depression. However, resilience did not play an intermediary role between anxiety/depression and objective support. Conclusion Lower psychological anxiety and depression would be experienced by lung cancer patients with higher resilience and social support. The level of anxiety and depression would be indirectly affected by social support through the mediation of resilience.
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Affiliation(s)
- Tingjie Hu
- Department of Geriatrics, Xiangya Hospital of Central South University, Changsha, Hunan Province, China
| | - Jian Xiao
- Department of Geriatrics, Xiangya Hospital of Central South University, Changsha, Hunan Province, China
| | - Juan Peng
- Department of Geriatrics, Xiangya Hospital of Central South University, Changsha, Hunan Province, China
| | - Xiao Kuang
- Department of Geriatrics, Xiangya Hospital of Central South University, Changsha, Hunan Province, China
| | - Bixiu He
- Department of Geriatrics, Xiangya Hospital of Central South University, Changsha, Hunan Province, China
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42
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Gu W, Xu YM, Zhong BL. Health-related quality of life in Chinese inpatients with lung cancer treatedin large general hospitals: across-sectional study. BMJ Open 2018; 8:e019873. [PMID: 29691245 PMCID: PMC5922485 DOI: 10.1136/bmjopen-2017-019873] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
OBJECTIVE In China, psychosocial problems of patients with cancer are under-recognised and undertreated in medical oncology practice. This study examined the health-related quality of life (QOL) in inpatients with lung cancer treated in large general hospitals and explored the demographic, clinical and psychosocial factors associated with QOL. DESIGN Cross-sectional study. PARTICIPANTS AND SETTING Altogether, 148 inpatients with lung cancer were consecutively recruited from two large general hospitals in Tianjin, China. MAIN OUTCOME MEASURED QOL, pain intensity, depressive and anxiety symptoms, and social support were assessed with WHO QOL Scale Brief Version, four-point Verbal Rating Scale, Hospital Anxiety and Depression Scale and Social Support Rating Scale, respectively. RESULTS Compared with the normative data for the Chinese general population, patients had significantly lower scores in physical (t=-25.860, p<0.001) and psychological (t=-18.225, p<0.001) QOL. Being unmarried (β=-2.471, 95% CI -4.908 to -0.034), poor economic status (β=-1.764, 95% CI -2.964 to -0.564), cancer metastasis (β=-1.328, 95% CI -2.632 to -0.024), poor performance status (β=-0.959, 95% CI -1.542 to -0.376), depression (β=-0.465, 95% CI -0.631 to -0.299), anxiety (β=-0.208, 95% CI -0.354 to -0.062) and low utilisation of social support (β=-0.344, 95% CI -0.577 to -0.111) were independently associated with poor physical QOL, while female gender (β=-1.494, 95% CI -0.649 to -2.339), less education years (β=-0.209, 95% CI -0.294 to -0.123), currently receiving chemotherapy (β=-1.536, 95% CI -3.051 to -0.021), small-cell cancer (β=-1.157, 95% CI -2.223 to -0.091), more intense pain (β=-0.535, 95% CI -0.919 to -0.151), poor performance status (β=-0.930, 95% CI -1.383 to -0.477), anxiety (β=-0.178, 95% CI -0.248 to -0.108) and inadequate subjective social support (β=-0.137, 95% CI -0.153 to -0.121) were independently associated with poor psychological QOL. CONCLUSIONS Inpatients with lung cancer treated in Chinese large general hospitals have poorer QOL than the general population. Effective prevention and management of psychosocial problems are potentially effective to improve their QOL.
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Affiliation(s)
- Wen Gu
- Department of Psychiatry, Shenzhen Key Laboratory for Psychological Healthcare, Shenzhen Institute of Mental Health, Shenzhen Kangning Hospital, Shenzhen Mental Health Center, Shenzhen, China
| | - Yan-Min Xu
- Department of Psychiatry, Affiliated Wuhan Mental Health Center (The Ninth Clinical School), Tongji Medical College of Huazhong University of Science & Technology, Wuhan, China
| | - Bao-Liang Zhong
- Department of Psychiatry, Affiliated Wuhan Mental Health Center (The Ninth Clinical School), Tongji Medical College of Huazhong University of Science & Technology, Wuhan, China
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