Acceptability and Feasibility of a Guided Biopsychosocial Online Intervention for Cancer Patients Undergoing Chemotherapy

Effect of Intensive Nursing Management on Quality of Life and Mental Health in Elderly Gastric Cancer Patients Undergoing Chemotherapy: A Retrospective Study

Aims/Background Implementing effective nursing management is particularly critical in the case of elderly gastric cancer (GC) patients receiving chemotherapy, who are more vulnerable to risk events. Therefore, this study explored the effect of intensive nursing management on quality of life (QoL) and mental health in elderly GC patients receiving chemotherapy. Methods A total of 155 elderly patients with GC undergoing chemotherapy in Central Hospital Affiliated to Shandong First Medical University from July 2021 to July 2023 were selected as the study subjects. The sample was divided into two groups according to different nursing methods: 74 patients who received intensive nursing management were classified in the observation group, while 81 patients treated with routine nursing management were classified under the reference group. The QoL, mental health and adverse reactions to chemotherapy were compared between the two groups. Results Before nursing management was implemented, there was no significant difference in the scores of the quality of life questionnaire-core 30 (QLQ-C30), patient health questionnaire-9 items (PHQ-9), and the Chinese version of the M.D. Anderson Symptom Inventory (MDASI-C) (p > 0.05). After management, in comparison with the reference group, the observation group showed significantly higher scores in each dimension of QLQ-C30, as well as significantly lower scores in PHQ-9 and MDASI-C (p < 0.001). The incidences of gastrointestinal reaction, myelosuppression, neurotoxicity, and hepatorenal damage were lower in the observation group than in the reference group (45.95% vs 70.37%, 40.54% vs 65.43%, 35.14% vs 53.09%, and 33.78% vs 51.25%, respectively; p < 0.05). Conclusion The application of intensive nursing management in treating elderly GC patients during chemotherapy effectively improves their physical and mental states, ameliorates clinical symptoms and enhances the QoL, showing certain clinical application value.

An offline to online cognitive behavioral stress management caring program effectively improves psychological pressure, spiritual well-being, and quality of life in postoperative hepatocellular carcinoma patients

BACKGROUND

This study designed an offline to online cognitive behavioral stress management (OOCBSM) caring program, intending to investigate its effect on mental health and quality of life (QoL) using multiple scales in postoperative hepatocellular carcinoma (HCC) patients.

METHODS

254 postoperative HCC patients were randomly (1:1) allocated into OOCBSM (included a 10-week offline CBSM and subsequent online CBSM until M6) and normal care (NC) groups (10-week NC). Hospital anxiety-and-depression scale (HADS), Zung's self-reporting anxiety (SAS) and depression scale (SDS), FACIT-SP, European quality-of-life-5 dimensions (EQ-5D), and quality-of-life questionnaire-core30 (QLQ-C30) were assessed over 6 months (M).

RESULTS

HADS-defined-anxiety rates at M3 (P = 0.036) and M6 (P = 0.025), SAS-defined-anxiety rate at M6 (P = 0.049), HADS-defined-depression rates at M3 (P = 0.026) and M6 (P = 0.049), and SDS-defined-depression rates at M3 (P = 0.015) and M6 (P = 0.043) were all lower in OOCBSM group compared to NC group. Furthermore, FACIT-SP scores at M1 (P = 0.004), M3 (P = 0.003), and M6 (P<0.001) were higher in OOCBSM group compared with NC group. EQ-5D scores at M1 (P = 0.025) and M3 (P = 0.030) but not M6 (P = 0.128), and QLQ-C30-symptom score at M3 (P = 0.014) but not M1 (P = 0.198) and M6 (P = 0.058) were lower in OOCBSM group versus NC group; QLQ-C30-global-health-status scores at M3 (P = 0.027) and M6 (P = 0.001) but not M1 (P = 0.312), QLQ-C30-function scores at M3 (P = 0.005) and M6 (P = 0.001) but not M1 (P = 0.084) were higher in OOCBSM group versus NC group. Patients with younger ages or higher education benefited more from OOCBSM.

CONCLUSION

OOCBSM improves psychological pressure, spiritual well-being, and QoL in postoperative HCC patients, especially in those with younger ages or higher education.

Effects of family-centered positive psychological intervention on psychological health and quality of life in patients with breast cancer and their caregivers

PURPOSE

Positive psychological intervention could improve individual's psychological health and quality of life. This study aimed to examine the effectiveness of family-centered positive psychological intervention on resilience, hope, perceived benefits, and quality of life in breast cancer patients and their caregivers.

METHODS

A two-group, randomized controlled study, including 98 dyads of breast cancer patients and caregivers, was conducted. Dyads were randomly assigned to intervention (n = 49) and control (n = 49) groups. Both the control and intervention groups received 4 weeks of health education, while the intervention group additionally received a 4-week family-centered positive psychological intervention. Outcome measures compared at baseline (T1), immediately after the intervention (T2), and at 1-month follow-up (T3), included validated measures of resilience (Connor-Davidson Resilience Scale), hope (Herth Hope Index), perceived benefits (Perceived Benefits of Diagnosis and Treatment of Breast Cancer, Positive Aspects of Caregiving), and quality of life (Functional Assessment of Cancer Therapy-Breast, Caregiver Quality of Life Scale).

RESULTS

Resilience, hope, perceived benefits, and quality of life of dyads were significantly higher in the intervention group than those in the control group at T2 and T3 (all p < 0.05). Linear mixed model analysis demonstrated a significant interaction effect of group × time × role (p = 0.007) on hope and a significant difference in the improvement of hope (p < 0.05) between patients and their caregivers.

CONCLUSIONS

Our family-centered positive psychological intervention was effective in improving psychological health and quality of life for breast cancer patients and caregivers. This study provides evidence for the effectiveness of positive clinical psychological interventions.

TRIAL REGISTRATION

ChiCTR2300072809.

A pilot and feasibility study of a randomized clinical trial testing a self-compassion intervention aimed to increase physical activity behaviour among people with prediabetes

BACKGROUND

Seventy-five per cent of individuals with prediabetes will eventually be diagnosed with type 2 diabetes. Physical activity is a cornerstone in reducing type 2 diabetes risk but can be a challenging behaviour to adopt for those living with prediabetes. Individuals with prediabetes experience difficult emotions associated with being at risk for a chronic disease, which can undermine self-regulation. Self-compassion enhances self-regulation because it mitigates difficult emotions and promotes adaptive coping. We performed a pilot randomized controlled trial to determine the feasibility and acceptability of a self-compassion informed intervention to increase physical activity for persons with prediabetes.

METHODS

This explanatory mixed methods study tested the feasibility and acceptability of a two-arm, randomized, single-blind, actively controlled, 6-week online intervention. Using a 1:1 allocation ratio, participants (identified as people with prediabetes, low physical activity, and low self-compassion) were randomized to a self-compassion (Mage = 60.22 years) or control condition (Mage = 56.13 years). All participants received behaviour change education (e.g. SMART goals, action-coping planning) and either other health knowledge (control condition: e.g. sleep, benefits of water) or self-compassion training (intervention condition: practising mindfulness, writing a letter to themselves offering the same support that they would offer to a friend). The primary outcome was to determine the feasibility and acceptability of the trial. To be considered feasible, our outcomes needed to meet or surpass our pre-determined criteria (e.g. time for group formation: 14-20 participants per month). Feasibility was assessed by examining the recruitment rates, retention, adherence, fidelity, and capacity. Semi-structured interviews were conducted with participants to determine trial acceptability. As a secondary purpose, we examined the means on key study variables (secondary and exploratory variables; see Table 1) at all planned time points (baseline, intervention-end, 6- and 12-week follow-up) to identify if they are suitable to include in the efficacy trial (see Additional Table 3).

RESULTS

Eighteen participants were screened and randomized to one of two conditions. Retention, instructor fidelity, safety, capacity, adherence to most of the study aspects, and acceptability by participants and facilitators all met the criteria for feasibility. Recruitment rate, process time, and adherence to home practice were below our criteria, and we offer ways to address these shortcomings for the efficacy trial.

CONCLUSION

The results from this study suggest that it should be feasible to deliver our intervention while highlighting the alterations to components that may be altered when delivering the efficacy trial. We outline our changes which should improve and enhance the feasibility and acceptability of our planned intervention. Funding for this study was from the Canadian Institutes of Health Research (CIHR).

TRIAL REGISTRATION

ClinicalTrials.gov, NCT04402710 . Registered on 09 April 2020.

eHealth intervention to manage symptoms for patients with cancer on immunotherapy (SOFIA): a study protocol for a randomised controlled external pilot trial

INTRODUCTION

Immune checkpoint therapy (ICT) is associated with a distinct pattern of immune-related adverse events (irAEs) caused by inadvertently redirecting immune responses to healthy tissues. IrAEs can occur at any time; however, in most cases, they arise during the first 14 weeks of the beginning of immune checkpoint blockade. In many cases, immunotherapy must be discontinued due to irAEs. Early detection of irAEs triggers the temporary withholding of ICT or initiation of short-term immunosuppressive treatment, is crucial in preventing further aggravation of irAEs and enables safe re-exposure to ICT. This prospective study aims to evaluate the feasibility of an eHealth intervention for patients under immunotherapy (managing symptoms of immunotherapy, SOFIA). The SOFIA-App consists of two components: SOFIA-Monitoring, a tool to rate patient-reported outcomes (PROs) including irAEs, and SOFIA-Coaching, which provides important information about cancer-specific and immunotherapy-specific topics and the counselling services of the National Centre for Tumour Diseases (NCT) Heidelberg.

METHODS AND ANALYSIS

We outlined a patient-level two-arm randomised controlled pilot trial of the intervention (SOFIA) versus no-SOFIA for patients with cancer beginning an immunotherapy, aged ≥18 years, recruited from the NCT, Heidelberg. Feasibility outcomes include: recruitment rate; drop-out rate; reasons for refusal and drop-out; willingness to be randomised, utilisation rate of SOFIA-Monitoring and utilisation time of SOFIA-Coaching, physicians utilisation rate of the PROs; feasibility of the proposed outcome measures and optimal sample size estimation. The clinical outcomes are measures of quality of life, psychosocial symptoms, self-efficacy, physician-patient communication and medical process data, which are assessed at the beginning of the intervention, postintervention and at 6-month follow-up.

ETHICS AND DISSEMINATION

This trial protocol was approved by the Ethical Committee of Heidelberg University, Germany (Reference, S-581/2018).

TRIAL REGISTRATION NUMBER

We registered the study in the German Clinical Trial Register (Reference: DRKS00021064). Findings will be disseminated broadly via peer-reviewed empirical journals, articles and conference presentations.