Efficacy and mechanisms of 4-week MBSR on psychological distress in lung cancer patients: A single-center, single-blind, longitudinal, randomized controlled trial

Evaluation of the E-Psycho-Oncological Short-Term Intervention "By Your Side" to Reduce Cancer-Related Distress: A Pilot Study

OBJECTIVE

A large number of patients with cancer experience distress, but not all of them receive adequate psychological support. The e-psycho-oncological short-term intervention "By your Side" was developed to offer evidence-based and low-threshold support for cancer patients dealing with distress.

METHODS

A longitudinal intervention pilot study was conducted from 4 March 2022 to 4 January 2023. N = 91 participants took part in the study. N = 82 completed the first module, while n = 23 successfully completed the whole intervention and were included in the final data analyses. "By your Side" consists of 16 modules based on cognitive behavioral therapy, acceptance and commitment therapy and mindfulness-based stress reduction. Differences in distress between the baseline (T0), post-intervention (T1), and follow-up (T2) were analyzed using an ANCOVA and post-hoc t-tests. Secondary outcomes (anxiety, depression, mindfulness, and self-efficacy) were also compared between measuring points, using ANOVAs and post-hoc tests.

RESULTS

A significant reduction (padj = 0.014, d = 0.654) in distress from baseline (T0, M = 52.68, SD = 16.34) to follow-up (T2, M = 43.84, SD = 17.59) was observed. There was a significant decrease in anxiety symptoms and a significant increase in mindfulness and self-efficacy. The user's satisfaction (M = 28.00, range 8-32) and the usability (M = 89.57, range 0-100) of the intervention were high.

CONCLUSION

The study provides preliminary evidence that the e-psycho-oncological short-term intervention "By your Side" can successfully reduce the distress of cancer patients. The high dropout rate (74.7%) must be taken into account.

TRIAL REGISTRATION

German Clinical Trial Register (https://www.drks.de/search/de/trial/DRKS00036001), DRKS number: 00036001 (retrospectively registered).

Development and validation of a web-based calculator for determining the risk of psychological distress based on machine learning algorithms: A cross-sectional study of 342 lung cancer patients

PURPOSE

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

METHODS

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

RESULTS

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

CONCLUSION

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

Positive health outcomes of mindfulness-based interventions for cancer patients and survivors: A systematic review and meta-analysis

Mindfulness-based interventions (MBIs) are commonly used for cancer patients and survivors to reduce symptoms, but little is known about effects on positive health outcomes. We conducted a systematic review and meta-analysis to determine the effects of MBIs on positive health outcomes (mindfulness skills, self-compassion, positive affect, coping, social support, well-being, personal growth, and spirituality) in cancer patients and survivors. Four databases (PubMed, PsycINFO, Web of Science, and CINAH) were searched (grey literature was not included), abstracts and full texts were screened, and MBI quality and risk of bias were assessed. Effect sizes were calculated and data was analyzed using a frequentist analytical strategy. Eligible studies were randomized controlled trials (RCTs) evaluating the effect of MBIs compared to any type of control on positive health outcomes in cancer patients or survivors. Based on 46 RCTs eligible for meta-analysis, statistical significant effects were observed for all positive health outcomes at post-treatment. Effect sizes ranged from small (positive affect; Hedges's g = 0.26) to large (spirituality, g = 0.91). At follow-up, mindfulness skills, self-compassion, personal growth, and spirituality reached statistical significance, with effect sizes ranging from small (positive affect; g = 0.07) to medium (spirituality; g = 0.61) and large (post-traumatic growth; g = 1.40). Taken together, significant effects of MBIs were found for several positive outcomes in cancer patients and survivors, with the strongest evidence found for mindfulness skills. MBIs may play a key role in improving well-being in this population.

Feasibility and effects of mindfulness-based stress reduction (MBSR) for improving resilience, posttraumatic stress disorder symptoms and posttraumatic growth among military medical college students

BACKGROUND

Increased stress among medical students in military college has been a challenge in the field of education. One approach to addressing stress reduction is mindfulness training. MBSR has been verified to improve the health status of different individuals. The aim of this study was to examine whether MBSR improves the psychological resilience, posttraumatic stress and posttraumatic growth of medical students in military college.

METHODS

MBSR was performed with students from a military medical university. A total of 372 students were surveyed by questionnaires, including the 10-item of Connor-Davidson Resilience Scale, Posttraumatic Growth Inventory, PTSD Checklist for DSM-5, Satisfaction with Life Scale, and Mindful Attention Awareness Scale, before the intervention, after the intervention and one month later. A control group of students also answered the questionnaires at the three time points but did not participate in the MBSR intervention. Statistical analyses were performed using repeated-measures ANOVA.

RESULTS

The results suggest that the MBSR group experienced significant improvements in resilience, posttraumatic growth, life satisfaction, and mindful attention awareness scores, as well as significant reductions in depression, anxiety, and PTSD intrusive symptoms scores after the intervention. These results were not found in the control group. One month after the intervention, all of these variables showed varying degrees of maintenance effects in the MBSR group.

CONCLUSION

The MBSR intervention was effective, as the medical students in military college in the MBSR group exhibited improvements in psychological resilience, posttraumatic growth, satisfaction with life and mindful attention awareness, depression, anxiety and intrusive symptoms.

Interventions to Reduce Lung Cancer and COPD-Related Stigma: A Systematic Review

BACKGROUND

Many individuals with lung cancer and chronic obstructive pulmonary disease (COPD) experience high levels of stigma, which is associated with psychological distress and delayed help-seeking.

PURPOSE

To identify interventions aimed at reducing the stigma of lung cancer or COPD and to synthesize evidence on their efficacy.

METHODS

A systematic review was conducted by searching PubMed, Scopus, PsycINFO, and CINAHL for relevant records until March 1, 2024. Studies were eligible if they described an intervention designed to reduce internalized or external stigma associated with COPD or lung cancer and excluded if they did not report empirical findings.

RESULTS

We identified 476 papers, 11 of which were eligible for inclusion. Interventions included educational materials, guided behavior change programs, and psychotherapeutic approaches. Interventions targeted people diagnosed with, or at high risk of developing COPD or lung cancer or clinical staff. No interventions that aimed to reduce stigma associated with lung cancer or COPD in the general community were identified. Most interventions yielded a statistically significant reduction in at least one measure of stigma or a decrease in qualitatively reported stigma.

CONCLUSIONS

The emerging literature on interventions to reduce stigma associated with lung cancer and COPD suggests that such interventions can reduce internalized stigma, but larger evaluations using randomized controlled trials are needed. Most studies were in the pilot stage and required further evaluation. Research is needed on campaigns and interventions to reduce stigma at the societal level to reduce exposure to external stigma amongst those with COPD and lung cancer.

Association of childhood trauma, social support, cognition, and suicidality in females with bipolar disorder

BACKGROUND

Bipolar disorder (BD) is a severe mental disorder with heavy disease burden. Females with BD are special populations who suffer a lot from childhood trauma, social support, cognitive deficits, and suicidality. In this study, the relationship among childhood trauma, social support, and clinical symptoms of BD was investigated and the risk factors for suicidality were explored in female patients with BD.

METHODS

This study included 57 drug-naive female BD patients, 64 female BD patients with long-term medication, and 50 age-matched female healthy controls. Childhood trauma, social support, clinical symptoms, cognition, and suicidality (suicide ideation, suicide plan, suicide attempt, suicide frequency) were measured with scales.

RESULTS

Compared with healthy controls, females with BD showed higher levels of childhood trauma and suicidality, and lower levels of social support and cognitive deficits. In the drug-naïve BD group, social support mediated the relationship between childhood trauma and insomnia symptoms (indirect effect: ab = 0.025). In the BD with long-term medication group, mania symptom was associated with suicide plan (OR = 1.127, p = 0.030), childhood trauma was associated with suicide attempt (OR = 1.088, p = 0.018), and years of education (OR = 0.773, p = 0.028), childhood trauma (OR = 1.059, p = 0.009), and delayed memory (OR= 1.091, p= 0.016) was associated with suicide frequency (OR = 1.091, p = 0.016).

CONCLUSIONS

This study provides initial evidence that social support partially explains the relationship between childhood trauma and clinical symptoms in females with BD. Additionally, mania symptoms, childhood trauma, and delayed memory were risk factors for suicidality. Interventions providing social support and improving cognitive function may be beneficial for females with BD who are exposed to childhood trauma and with high suicide risk.