Resilience and related factors in colorectal cancer patients: A systematic review

Latent profile analysis of anxiety, depression, and resilience among elderly colorectal cancer patients in China

In China, most colorectal cancer patients aged 65 years and above often suffer from poor psychological states, including high levels of anxiety and depression, as well as low resilience, due to the disease and its related symptoms. Analyzing the heterogeneity of anxiety, depression, and resilience in these patients can help intervene timely to improve their psychological well-being and prognosis. It was a cross-sectional study, and participants were recruited at the Affiliated Hospital of Qingdao University. Latent profile analysis (LPA) was used to determine the optimal latent profile model, one-way analysis of variance (ANOVA) was conducted to compare the differences across each latent profile, multinomial logistic regression was employed to analyze the influencing factors. 221 older colorectal cancer patients were identified and classified as low negative emotions and high resilience (49.8%), medium negative emotions, low and unstable resilience (30.8%) and high negative emotions and medium resilience (19.4%). There were significant differences in the scores of anxiety, depression, resilience and social support among these patients. Multinomial logistic regression showed that age, gender, marital status, employment, tumor size, positive lymph nodes, degree of differentiation, and social support were influential in these three profiles. Three heterogeneous subgroups of anxiety, depression, and resilience were identified among older patients with colorectal cancer.

The Relationship Between Psychological Resilience, Ruminative Thoughts, and Spiritual Well-Being of Individuals Diagnosed With Cancer: Descriptive and Correlational Research

AIM

This study was conducted to examine the relationship between psychological resilience, ruminative thoughts and spiritual well-being of individuals diagnosed with cancer.

BACKGROUND

Cancer, which can cause fear, anger and future anxiety in individuals from the moment of diagnosis, is a disease that individuals can associate with death, pain, and suffering.

DESIGN

A descriptive and correlational research design was employed.

METHODS

The study sample consisted of 382 patients receiving outpatient treatment at an oncology center affiliated with a university hospital in Turkey. Data were collected using the Introductory Information Form, Ruminative Reactions Scale, Psychological Resilience Scale, and FACIT-Sp Spiritual Well-Being Scale. We evaluated the data via descriptive statistics, Pearson correlation, and multiple regression analyses.

RESULTS

The resilience score of the participants was 52.48 ± 6.96, the ruminative reactions score was 44.26 ± 15.11, and the FACIT-Sp total score was 38.97 ± 8.23. In the study, there was a moderate and statistically significant positive relationship between the mean psychological resilience score and the mean scores of FACIT-Sp on the meaning, FACIT-Sp peace, FACIT-Sp faith sub-dimensions, and the total scale of FACIT-Sp (p < 0.05). Also, a moderate and statistically significant negative relationship existed between the mean psychological resilience and the ruminative response scores (p < 0.05).

CONCLUSION

Participants' psychological resilience was slightly higher than moderate, their ruminative thoughts were moderate, and their spiritual well-being was high. In addition, there was a relationship between psychological resilience, ruminative reactions, and spiritual well-being.

RELEVANCE TO CLINICAL PRACTICE

They may be important for nurses to plan and implement interventions that will reduce patients' ruminative thinking and increase their spiritual well-being and resilience. Therefore, the results obtained in this study may help nursing care be more effective.

REPORTING METHOD

The reporting of the results of the study was conducted in accordance with the STROBE guidelines.

The impact of perceived social support on chronic disease self-management among older inpatients in China: The chain-mediating roles of psychological resilience and health empowerment

BACKGROUND

Chronic disease self-management is a critical concern in public health, in which perceived social support plays an important role. However, the underlying pathways and mechanisms linking perceived social support to chronic disease self-management remained unclear. This study investigated whether psychological resilience and health empowerment mediated the relationship between perceived social support and the effectiveness of chronic disease self-management.

METHODS

A total of 368 older inpatients with chronic non-communicable diseases were recruited from three grade-A tertiary hospitals in Changsha City, China, using a convenience sampling method between January and June 2023. Data were collected using the General Information Questionnaire, the Chronic Disease Self-Management Scale, the Perceived Social Support Scale, the Connor-Davidson Resilience Scale, and the Health Empowerment Scale. Descriptive demographic analysis and Pearson correlation analysis were conducted using SPSS 26.0, and model 6 in the macro program Process 4.1 was employed to test the chain mediation effect.

RESULTS

Most older inpatients were aged 60-69 years (52.2%), followed by those aged 70-79 years (30.7%). Regression analysis revealed that perceived social support, psychological resilience, and health empowerment collectively explained 45.7% of the variance in chronic disease self-management. Mediation analysis demonstrated that perceived social support not only had a direct positive impact on chronic disease self-management (effect = 0.141, 95% CI: LL = 0.041, UL = 0.241), but also indirectly affected chronic disease self-management through three significant mediating pathways: the independent mediating effect of psychological resilience (effect = 0.102, 95% CI: LL = 0.061, UL = 0.155), the independent mediating effect of health empowerment (effect = 0.042, 95% CI: LL = 0.010, UL = 0.080), and the chain mediating effect between psychological resilience and health empowerment (effect = 0.024, 95% CI: LL = 0.006, UL = 0.047).

CONCLUSION

Perceived social support influenced chronic disease self-management directly and indirectly through psychological resilience and health empowerment. These findings offered practical guidance for developing more effective intervention strategies aimed at improving chronic disease self-management among older inpatients.

Resilience and Counseling Received by Colorectal Cancer Patients During a 1-Year Follow-Up: PHASE II of a Longitudinal Study

Longitudinal studies on the resilience of colorectal cancer patients and the counseling they receive are rare. This study's purpose was threefold: to describe the resilience and received counseling of colorectal cancer patients after 1 year post surgery; the relationships between background characteristics, resilience, and counseling; and the changes that occurred in the findings. Data were collected in Finland in 2020-2023 after 1 month (phase I) and a year (phase II) of the colorectal cancer surgery using the Connor-Davidson Resilience Scale© and the Counseling Quality Instrument©. A total of 103 participants completed phase I, 51 participants completed phase II, and 41 participants completed both phases. Phase II of the study showed that among the respondents (n = 51), resilience was low (mean 73.3) and significantly related to marital status (p = .007). Most (75%) evaluated counseling as good, and the evaluations were similar in both study phases (n = 103, n = 51). The lowest scores were for psychosocial support, patient-centeredness, and goal-directedness. Knowledge of the illness and its care, general health and patient attitudes, and disease treatment and self-care decreased significantly within the year (n = 41). Changes in resilience were not found (n = 41). The findings suggest that colorectal cancer patients might need more psychosocial support. Patients' care should be carefully planned to better address their needs.

Relationship between psychological resilience and quality of life in cancer patients and the multiple mediating roles of stigma and self perceived burden

The goal of this study was to explore the impact of psychological resilience on the QOL of cancer patients and the multiple mediating roles of stigma and self-perceived burden. This study utilized a cross-sectional design. The study population consisted of 364 cancer patients selected by convenience sampling method between November 2022 and May 2023 in two tertiary hospitals in Jinzhou City, Liaoning Province. All participants volunteered to participate in the study and signed an informed consent form. Data were collected using questionnaires. The questionnaires included the General Information Questionnaire, the Psychological Resilience Scale, the Stigma Scale, the Self-Perceived Burden Scale, and the Quality of Life Questionnaire. SPSS 25.0 and PROCESS 3.5 macros were employed for description statistics and related analyses of the data, as well as multiple mediation effect tests. Psychological resilience directly affects QOL (β = 0.929, 95% CI 0.729-1.130) and indirectly through three mediating pathways: stigma (β = 0.275, 95% CI 0.154-0.398, 19.76% of total effect), self-perceived burden (β = 0.115, 95% CI 0.046-0.205, 8.26% of total effect), and both stigma and self-perceived burden (β = 0.073, 95% CI 0.029-0.132, 5.24% of total effect), accounting for 33.26% of the overall mediated effect. Stigma and self-perceived burden act as mediators in influencing psychological resilience and QOL of cancer patients. Enhancing psychological resilience and reducing stigma and self-perceived burden is crucial for improving their QOL.

Relationship between psychological resilience and cognitive function on breast cancer chemotherapy patients: a person-centered method

BACKGROUND

Previous studies have indicated a connection between resilience and cognitive function, but critical gaps persist regarding limited data exploring the relationship between resilience profiles and cognition using person-centered methodologies, especially in the context of breast cancer patients.

OBJECTIVES

While the general correlation between resilience and cognitive function is known, how various resilience profiles impact cognitive function in breast cancer patients remains unclear. The study aimed to identify resilience profiles and explore the relationship with cognitive function in breast cancer (BC) patients.

METHODS

This study was a cross-sectional study in descriptive research. BC patients (n = 425) from a tertiary oncology hospital completed the Functional Assessment of Cancer Therapy-Cognitive Function (FACT-Cog) scale and Connor-Davidson Resilience Scale (CD-RISC- 25). Latent profile analysis was adopted to identify subgroups of patients with distinct resilience profiles according to model fit indices. An ANOVA analysis and Chi-square test were also employed.

RESULTS

Three profiles were identified, including Class 3, "High resilience-positive coping group" (n = 187, 44.7%), Class 2, "Medium resilience-effort regulation group" (n = 157, 37.6%), and Class 1, "Low resilience-negative coping" (n = 74, 17.7%). The results demonstrate that perceived cognitive impairment (CogPCI), other people's appraisal (CogOth), perceived cognitive ability (CogPCA), impact on quality of life (CogQOL), and FACT-Cog were significant differences in all three potential latent resilience profiles (P < 0.001). The CogPCI and FACT-Cog scores in Class 3 were the best, while Class 1 was the lowest.

CONCLUSION

The psychological resilience profile contains three classes, and the findings provide evidence that high resilience potentially serves as a crucial protective factor for cognitive function in BC patients. Healthcare providers should improve their ability to recognize and evaluate factors influencing resilience, including social support and physical activity, which will enable the development of precise nursing interventions to mitigate the long-term adverse effects of trauma and reduce the impact of cognitive impairment on BC patients.

Psychosocial factors associated with quality of life in cancer patients undergoing treatment: an umbrella review

BACKGROUND

Cancer treatment greatly impacts physical and psychological functioning of cancer patients, negatively affecting their quality of life (QoL). This Umbrella Review (UR) aims to systematically summarize psychological and social factors positively or negatively associated with QoL in cancer patients undergoing treatment.

METHOD

Four scientific databases (PubMed, Embase, Scopus, and PsycInfo) were searched to identify systematic reviews between 2012 and 2023 analyzing the relationship between QoL and psychosocial factors in cancer patients in treatment. The UR was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and Joanna Briggs Institute (JBI) review guidelines. The methodological quality of the included studies was evaluated using Assessment of Multiple Systematic Reviews 2 (AMSTAR2).

RESULTS

Eighteen systematic reviews were included. The major psychological factors influencing QoL are depression, coping strategies, anxiety, and distress. Results also demonstrate the significant impact of social factors on QoL: perceived social support has a positive influence on QoL of cancer patients, while lowered social support, impaired social functioning, interactions, and role limitations worsen their QoL and overall well-being.

CONCLUSION

This UR provides a comprehensive overview of the psychosocial factors impacting QoL of cancer patients and serves as a prominent base for developing questionnaires and policies aimed at measuring QoL in cancer patients undergoing treatment. Moreover, the findings of the study can guide future research or the development of personalized clinical interventions aimed at improving QoL for this cancer population group.

Roles of benefit finding in psychological and inflammatory adjustments in persons with colorectal cancer: a prospective analysis on the multidimensionality of benefit finding

OBJECTIVE

This study examined the unique associations of different dimensions of the resilience factor, benefit finding, on concurrent and prospective psychological and biological adjustment outcomes over the first year after a colorectal cancer diagnosis.

METHODS AND MEASURES

Individuals newly diagnosed with colorectal cancer (n = 133, mean age = 56 years old, 59% female, 46% Hispanic) completed questionnaires assessing the multidimensional aspects of benefit finding around 4 months post-diagnosis (T1). Psychological (depressive symptoms and life satisfaction) and biological [C-reactive protein (CRP) and interleukin-10 (IL-10)] adjustments were assessed at T1 and one-year post-diagnosis (T2).

RESULTS

Structural equation modeling revealed that at T1, greater reprioritization was concurrently related to higher depressive symptoms (p=.020). Lower acceptance, lower empathy, and greater positive self-view predicted higher life satisfaction at T2 (ps<.010). Additionally, lower empathy and greater family valuation predicted higher CRP at T2 (ps<.004), whereas greater positive self-view predicted higher IL-10 at T2 (p=.039). Greater overall benefit finding was associated with lower IL-10 at T1 (p=.013).

CONCLUSION

Various aspects of benefit finding differentially relate to psychological and inflammatory markers during the first year after diagnosis in persons with colorectal cancer. Interventions designed to specifically enhance positive self-view may promote both the psychological and biological health of individuals with cancer.

Associations between depression, resilience, and fatigue in patients with multivessel coronary disease: A cross-lag study

Objectives

This study aimed to examine the associations between depression, resilience, and fatigue in patients with multivessel coronary disease and verify their causal relationships.

Methods

Between October 2023 and June 2024, 316 patients with multivessel coronary disease were recruited from three tertiary hospitals in Tangshan, China. The Patient Health Questionnaire, Connor-Davidson Resilience Scale, and the Multidimensional Fatigue Inventory were administered to the patients on the third day of admission (T1), one month after discharge (T2), and three months after discharge (T3). Pearson correlation analysis was conducted to examine the relationships among depression, resilience, and fatigue in patients with multivessel coronary disease, and cross-lagged analysis to explore the temporal causal relationships.

Results

In patients with multivessel coronary disease, levels of depression and fatigue decreased from T1 to T3, while resilience scores increased during the same period. The correlation analysis revealed significant relationships among depression, resilience, and fatigue at T1, T2, and T3 (P < 0.01). The autoregressive paths indicated high stability over time for depression, medium stability for resilience, and low stability for fatigue. Cross-lagged paths demonstrated that depression at T1 significantly predicted fatigue at T2 (β = 0.461, P < 0.001), and depression at T2 significantly predicted fatigue at T3 (β = 0.957, P < 0.001). And resilience at T1 significantly predicted fatigue at T2 (β = -0.271, P < 0.001), and resilience at T2 significantly predicted fatigue at T3 (β = -0.176, P < 0.001). Additionally, resilience had a moderating effect on the relationship between depression and fatigue (β = -0.760, P < 0.001).

Conclusions

Our study confirmed that depression and resilience predicted fatigue in patients with multivessel coronary disease. To prevent and mitigate fatigue, alleviating depressive symptoms and enhancing resilience levels in patients at an early stage is essential.

A longitudinal study of resilience and social function in patients with colorectal cancer and stomas

OBJECTIVE

To explore the dynamic changes, influencing factors, and relationships between resilience and social function in patients with colorectal cancer (CRC) and stomas at different postoperative stages, and to inform precise psychosocial rehabilitation interventions.

METHODS

A longitudinal study was conducted at a tertiary hospital in eastern China from January 2021 to June 2023. Patients completed a self-designed socio-demographic questionnaire one month post-surgery, and the Connor and Davidson Resilience Scale (CD-RISC) and Social Dysfunction Screening Scale (SDSS) at 1, 3, and 5 months post-surgery. Data were analyzed using repeated measures ANOVA, Spearman correlation, group-based trajectory modeling, and binary logistic regression.

RESULTS

A total of 131 patients were included in the analysis. Resilience showed an initial increase followed by a decline, while social function consistently improved. A moderate negative correlation between social dysfunction and resilience was observed at all time points. Influencing factors for resilience and social function varied across different postoperative stages. Significant differences in resilience trajectories were observed based on education and family income. Resilience trajectories significantly impacted social function trajectories (OR 19.39, 95 % CI 2.46-152.91, P < 0.05).

CONCLUSIONS

This study identifies distinct trajectories of resilience and social function in patients with colorectal cancer and stomas. Low resilience is linked to severe social function deficits. Stage-specific interventions are crucial to enhance social adaptation and improve overall quality of life. Tailored support is needed throughout recovery to address the unique challenges faced by these patients.

Impact of gratitude on posttraumatic growth in patients with coronary stent implantation: the mediating role of resilience and perceived social support

Introduction

This study focused on investigating the extent of posttraumatic growth (PTG) and explored how resilience and perceived social support (PSS) mediate the relationship between gratitude and PTG among patients with a history of coronary stent implantation.

Methods

A total of 242 patients with coronary stent implantation completed the Posttraumatic Growth Inventory, the Gratitude Questionnaire-Six Item Form, the Resilience Scale, and the Perceived Social Support Scale. We used structural equation modeling to evaluate the mediating effects of resilience and PSS on gratitude and PTG.

Results

The mean score for posttraumatic growth was 55.54 (standard deviation = 15.01). Gratitude had a direct positive effect on PTG in patients with coronary stents (β = 0.126) and an indirect positive effect through the mediating effects of resilience and PSS (β = 0.105 and 0.081, respectively). Furthermore, resilience and PSS acted through serial multiple mediation effects in the relationship between gratitude and PTG.

Discussion

Gratitude positively affected PTG directly and indirectly through the single-and chain-mediating effects of resilience and PSS in patients with coronary stent implantation. These findings offer compelling evidence of the key interrelating mechanisms among protective factors that contribute to PTG. Therefore, accounting for the predictive influence of gratitude, resilience, and PSS in PTG when developing relevant intervention strategies may help improve patients' quality of life.

Turkish validation of a resilience scale from older people's perspectives: resilience scale for older adults

Background

As the global population ages and life expectancy increases, older adults encounter challenges like chronic illnesses and losing loved ones; resilience is crucial for adapting to these difficulties. This study aims to culturally and linguistically adapt the psychological resilience scale designed for older adults to the Turkish context.

Methods

This methodological study included 566 individuals aged 65 and older. All participants completed the Resilience Scale for Older Adults, the Perceived Stress Scale, the Geriatric Depression Scale, and the Quality of Life in Older Adults Scale-Short Form. Construct validity was assessed through confirmatory and exploratory factor analyses, while convergent and discriminant validity were evaluated through the correlation of the scales. Reliability was determined using internal consistency and the split-half method.

Results

The scale retains its original structure with 33 items and four sub-dimensions (Intrapersonal, Interpersonal, Spiritual, and Experiential). The content validity index of the scale is 0.98, with item loadings ranging from 0.406 to 0.947, according to exploratory factor analysis. Confirmatory factor analysis indicates good fit indices. Convergent validity is supported by a strong positive correlation (r = 0.657, p < 0.001) between the Resilience Scale for Older Adults and the Quality of Life in Older Adults Scale-Short Form. Reliability measures include a Cronbach's alpha internal consistency coefficient of 0.93 and a Guttman split-half reliability coefficient of 0.723.

Conclusion

The results show that the Turkish version of the Resilience Scale for Older Adults is a valid and reliable measurement tool.

Conceptualisation and Measurement of Resilience of Adults With Cancer: An Umbrella Review

AIMS

To (1) clarify the key components of resilience of adults with cancer; (2) summarise and analyse the resilience measures used in this population; and (3) discuss future evaluation directions.

DESIGN

An umbrella review.

DATA SOURCES

MEDLINE, Embase, CINAHL, PsycINFO, Scopus, Cochrane library and Epistemonikos were searched in December 2023.

METHODS

The Joanna Briggs Institute (JBI) guidelines were followed for undertaking this umbrella review. Systematic and narrative reviews that defined resilience of adults with cancer and reported resilience measures, published in English, were included. The methodological quality was assessed using the JBI appraisal tool.

RESULTS

Fourteen eligible reviews were included. Four key resilience components from various resilience conceptualisations were identified. Twenty resilience measures were used among cancer patients, with the 25-item Connor-Davidson Resilience Scale providing a relatively comprehensive assessment of individual resilience. Recommended future research with cancer patients includes assessing these resilience components: (1) available individual resources-key psychological factors that enhance individual resilience; (2) access to social resources-close interpersonal relationships, family cohesion and social support; (3) adaptive coping ability-problem-solving skills, emotional management strategies and experiences in managing adversity; (4) ability to regain mental health and well-being-the capacity to recover a relatively stable psychological state and promote positive psychological functioning.

CONCLUSION

The findings provide evidence for refining future resilience measurement in the adult cancer population. Examining the four key components of resilience with this population across cultures is warranted.

IMPACT

Understanding the key components of resilience of cancer patients can help healthcare professionals identify individuals who may need further support and facilitate early intervention or referral to psychosocial support services. The 25-item Connor-Davidson Resilience Scale is recommended over other tools for use in the cancer population.

PATIENT OR PUBLIC CONTRIBUTION

Patient or public involvement is not applicable in this study.

Cross-cultural adaptation and psychometric evaluation of the Thai version of the Enhancing Recovery in Coronary Heart Disease Social Support Inventory in individuals with chronic illnesses

Objectives

This study aimed to translate and psychometrically test the 7-item Enhancing Recovery in Coronary Heart Disease (ENRICHD) Social Support Inventory (ESSI) scale within the Thai population.

Methods

A scale translation and cross-sectional validation study was conducted. The English version was translated for Thai involved nine steps: preparation, forward translation, reconciliation, back-translation, back-translation review, harmonization, cognitive debriefing, review of cognitive debriefing and finalization, and proofreading. Psychometrics testing used data from a cross-sectional study from July to November 2022 at 16 primary care centers in southern Thailand, involving 405 participants. Structural validity was tested with exploratory and confirmatory factor analysis (EFA and CFA). Hypothesis testing validity was assessed through correlations with the Self-Care Self-Efficacy Scale version 3.0 (SCSES-v3.0) and the Self-Care of Chronic Illness Inventory version 4.c (SC-CII-v4.c). Reliability was evaluated using Cronbach's α coefficient and the intraclass correlation coefficient.

Results

The Thai ESSI demonstrated excellent content validity. EFA revealed a one-factor structure, with high factor loadings for the first six items assessing informational, emotional, and instrumental support. The last item on structural support demonstrated inadequate factor loadings, suggesting its removal. CFA confirmed a well-fit one-factor structure for the 6-item ESSI. Hypothesis testing showed positive correlations with the SCSES-v3.0 and SC-CII-v4.c scales. Cronbach's α coefficient improved from 0.88 for the 7-item to 0.91 for the 6-item ESSI. Both the 7-item and the 6-item scales exhibited excellent test-retest reliability.

Conclusions

Our study affirms the strong validity and reliability of the ESSI in the Thai population with chronic illnesses. The ESSI is deemed appropriate for evaluating social support in the context of chronic illness self-care.

The lived experience of resilience in chronic disease among adults in Asian countries: a scoping review of qualitative studies

BACKGROUND

Chronic diseases pose significant threats to persons' well-being and mental health leading to stress, anxiety and depression without effective resilience strategies. However, experiences to gain resilience in living with chronic disease in the context of Asian countries remain insufficiently explored. This review seeks to provide a comprehensive summary of qualitative evidence that explores the lived experience that cultivates resilience in chronic diseases among adults within Asian countries.

METHODS

A comprehensive review of five databases - Web of Sciences, Ebsco (Medline), PubMed, Science Direct, and Scopus was carried out, following the Joanna Brings Institute (JBI) standards and employing PRISMA Extension for Scoping Review (PRISMA-ScR) reporting guideline. The review encompassed studies published in English from January 2013 to December 2023. Four reviewers assessed the literature's eligibility and extracted relevant lived experiences to address the research question based on prior studies. Subsequently, a content analysis was performed.

RESULTS

Of the 3651 articles screened, 12 were included in this review. Three key themes emerged: (1) Sociocultural norms shaped resilience, delved into the culturally-mediated childhood development, traditional cultural beliefs, social relationships and supports and spirituality (2) Positive emotions nurtured resilience highlighted optimistic about becoming healthy, self-efficacy in self-care, endurance during hardship, self-reflection on health, acceptance of having disease, and appreciation of life while (3) Problem-solving strategies fostered resilience underlined improve disease literacy, ability to deal with disease challenges and engage in meaningful activities.

CONCLUSION

Our review addresses important research gaps on sociocultural norms that shaped resilience in chronic disease despite a small number of research. Therefore, this warrants further studies on how the traditional cultures and beliefs influence resilience among the Asian population living with chronic disease. Further research should thoroughly describe the qualitative methodologies and theoretical framework to provide more comprehensive information on the experience of resilience in chronic disease.

Changes in work status after cancer diagnosis and their associations with depressive symptoms among cancer survivors: findings from the Korean longitudinal study of ageing1

PURPOSE

Cancer survivors encounter significant psychological suffering and are prone to develop depressive symptoms. Work contributes to personal fulfillment and social connections, and by doing so, enhances a cancer survivor's resilience against adversities. However, maintaining employment can be challenging for some cancer survivors. This research aimed to identify the association between changes in work status and depressive symptoms among cancer survivors in South Korea.

METHODS

This study used the panel data from the Korean Longitudinal Study of Ageing (KLoSA) and included 199 cancer survivors-799 observations-aged 65 or younger, between 2005 and 2018. Changes in work status consisted of continuous unemployment or employment, quitting a job, and getting a job. We defined depressive symptoms as a CES-D-10 score of 10 or higher and a cut-off of 4 was utilized for sensitivity analysis. Multivariable generalized estimating equation was employed to estimate the odds ratio (OR), adjusting for the number of household members, education level, sex, age, marital status, occupations, cancer treatment, cancer type, catastrophic healthcare expenditure (CHE), and survivorship. Subgroup analysis and interaction between changes in work and cancer types were further explored.

RESULTS

For depressive symptoms, the OR of the continuous unemployment group was 2.27 (95% CI = 1.10-4.69), and the OR of the group that quit a job was 2.20 (95% CI = 1.03-4.72), compared to the continuous employment group. As survivorship increased, the odds of depressive symptoms decreased (OR = 0.94, 95% CI = 0.89-1.00). CHE was associated with depressive symptoms (OR = 2.23, 95% CI = 1.18-4.20). In cancer types with a low tendency to depression, continuous unemployment was associated with depressive symptoms (OR = 3.19, 95% CI = 1.12-9.06). In sensitivity analysis, changes in work, survivorship, and CHE were consistently associated with depressive symptoms.

CONCLUSIONS

Cancer survivors who quit a job or continued unemployment were more likely to experience depressive symptoms. The findings of this study imply that assistance for cancer survivors to continue a job or return to employment, including adjustment of workload and hours, may be helpful. Psychological care may be crucial, particularly in the early stage of cancer survivorship. Furthermore, support may be needed to alleviate the burden of healthcare expenditure.

Does All Social Support Work? Examining the Mechanisms of Patient-Reported Symptom Interference after Esophagectomy Affecting Life Satisfaction

Purpose

We intended to explore the chain mediation role of resilience and different sources of social support on the relationship between symptom interference and life satisfaction from the patient-reported perspective.

Patients and Methods

Two hundred and twenty-six patients after esophagectomy were investigated using four validated scales to estimate the symptom interference, resilience, different sources of social support, and life satisfaction. The chain mediation analysis was conducted using SPSS PROCESS Macro Model 6.

Results

Mediation analysis showed that symptom interference indirectly influenced life satisfaction through two significant mediating pathways: (i) resilience (B = -0.138, 95% CI: -0.194 to -0.091); (ii) the chain mediators involving in resilience and family support (B = -0.049, 95% CI: -0.073 to -0.026). Surprisingly, the mediating pathway of family support was not significant.

Conclusion

Interventions for resilience and family support could mitigate the adverse effects of symptom interference in patients after esophagectomy, improving life satisfaction. Of these, resilience may be more critical in terms of the utilization of social resources than family support.

Journey towards resiliency: A systematic review and meta-synthesis of cancer patients' experiences

PURPOSE

This systematic review and meta-synthesis seeks to explore cancer patients' journey towards resiliency. The secondary aim of this review is to identify unique resilience protective factors among cancer patients.

METHODS

A thorough search was conducted in eight electronic databases and the grey literature for published or unpublished qualitative and mixed methods studies. Studies that explored resilience among cancer patients were included. The studies were appraised using the Critical Appraisal Skill Programme Checklist. The overall certainty of evidence was further evaluated using the Grading of Recommendations, Assessment, Development, and Evaluation's Confidence in Evidence from Reviews of Qualitative Research. Themes identified were synthesized using Sandelowski and Barroso's meta-synthesis method.

RESULTS

A total of 34 studies comprising 987 cancer patients were included in this review. Three themes and nine subthemes were generated from the meta-synthesis. The themes were: (1) Confronting the cancer diagnosis, (2) personal adaptations to cancer, and (3) drawing strength from others. The findings highlighted how individuals overcame cancer adversities through resilience, which is influenced by various factors, including life experiences, social-cultural stigmas, spirituality, social support networks, coping strategies, motivation, acceptance of illness, positive mindset, and engagement with healthcare facilities.

CONCLUSIONS

This review highlights the role of resilience in a cancer patient's journey. It emphasizes on the importance of building resilience in both cancer patients and survivors to effectively overcome the challenges of their cancer diagnosis. These insights are essential for developing interventions that promote resilience and improve existing psychosocial oncology services. Future research should focus on longitudinal studies to better understand how resilience evolves and pinpoint factors that can further influence one's resilience.

Influencing Factors of Psychological Resilience in Stroke Patients: A Systematic Review and Meta-Analysis

OBJECTIVE

To systematically review the current status and influencing factors of psychological resilience in stroke patients and to provide a theoretical basis for future personalized rehabilitation support and psychological interventions.

METHOD

This systematic review and meta-analysis were conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist. A comprehensive search of databases including PubMed, Web of Science, Medline, PsycINFO, CINAHL, Cochrane Library, CNKI, VIP, CMB, and WANGFANG was conducted from inception until November 22, 2023, resulting in the retrieval of 2099 studies. Literature screening and data extraction were performed by two independent evaluators based on pre-defined inclusion and exclusion criteria, and meta-analysis was performed using Review Manager 5.4 software.

RESULTS

The final review included 23 studies. The results showed that self-efficacy, hope, confrontation coping, avoidance coping, functional independence, quality of life, and social support were positively associated with psychological resilience. Conversely, anxiety, depression, and resignation coping were negatively associated with psychological resilience.

CONCLUSIONS

Patients with stroke have a low level of psychological resilience, which was influenced by a variety of factors. However, longitudinal and large sample studies are needed to further confirm these findings. These results should be integrated into clinical practice for early assessment and targeted intervention in psychological resilience to assist patients in coping with the rehabilitation process and life changes after a stroke.

The experience of fertility concerns in patients with testicular cancer: a qualitative study

BACKGROUND

Testicular cancer usually occurs in young adult men between the ages of 20 and 40 years, which largely coincides with the age of men's reproductive intentions. However, a serious side effect of testicular cancer therapy could reduce the fertility of patients.

PURPOSE

To explore the experience of fertility concerns in patients with testicular cancer.

METHODS

A phenomenological research was conducted on 12 patients with testicular cancer. Data collection was from May 2023 to August 2023, and Colaizzi analysis method was used to analyze the data.

RESULTS

Four themes were found: (1) multiple worries and negative emotions, (2) fertility decision-making faces many challenges, (3) self-coping strategies for facing fertility concerns, (4) unmet supportive care needs.

CONCLUSION

Medical staff should pay attention to the fertility needs of patients with testicular cancer and provide relevant interventions and support to reduce their fertility concerns.

Resilience after severe critical illness: a prospective, multicentre, observational study (RESIREA)

BACKGROUND

Critical-illness survivors may experience post-traumatic stress disorder (PTSD) and quality-of-life impairments. Resilience may protect against psychological trauma but has not been adequately studied after critical illness. We assessed resilience and its associations with PTSD and quality of life, and also identified factors associated with greater resilience.

METHODS

This prospective, multicentre, study in patients recruited at 41 French ICUs was done in parallel with the NUTRIREA-3 trial in patients given mechanical ventilation and vasoactive amines for shock. Three months to one year after intensive-care-unit admission, survivors completed the Connor-Davidson Resilience Scale (CD-RISC-25), Impact of Event-Revised scale for PTSD symptoms (IES-R), SF-36 quality-of-life scale, Multidimensional Scale of Perceived Social Support (MSPSS), and Brief Illness Perception Questionnaire (B-IPQ).

RESULTS

Of the 382 included patients, 203 (53.1%) had normal or high resilience (CD-RISC-25 ≥ 68). Of these resilient patients, 26 (12.8%) had moderate to severe PTSD symptoms (IES-R ≥ 24) vs. 45 (25.4%) patients with low resilience (p = 0.002). Resilient patients had higher SF-36 scores. Factors independently associated with higher CD-RISC-25 scores were higher MSPSS score indicating stronger social support (OR, 1.027; 95%CI 1.008-1.047; p = 0.005) and lower B-IPQ scores indicating a more threatening perception of the illness (OR, 0.973; 95%CI 0.950-0.996; p = 0.02).

CONCLUSIONS

Resilient patients had a lower prevalence of PTSD symptoms and higher quality of life scores, compared to patients with low resilience. Higher scores for social support and illness perception were independently associated with greater resilience. Thus, our findings suggest that interventions to strengthen social support and improve illness perception may help to improve resilience. Such interventions should be evaluated in trials with PTSD mitigation and quality-of-life improvement as the target outcomes.

Resilience in the Face of Cancer: On the Importance of Defining and Studying Resilience as a Dynamic Process of Adaptation

Resilience is defined as the maintenance or relatively quick recovery of mental health during and after adversity. Rather than focusing on psychopathology and its causes, resilience research aims to understand what protective mechanisms shield individuals against developing such disorders and translate these insights to improve psychosocial care. This resilience approach seems especially promising for the field of oncology because patients face stressor after stressor from diagnosis to survivorship. Helping patients to learn how they can best use the resources and abilities available to them can empower patients to handle subsequent stressors. In the past few decades, resilience has increasingly been considered as a dynamic process of adaptation. While researchers use this definition, resilience has not yet been studied as a dynamic process in the field of oncology. As a result, the potential of resilience research to gain insight into what helps protect cancer patients from developing psychopathology is limited. We discuss conceptual and methodological proposals to advance resilience research in oncology. Most importantly, we propose applying prospective longitudinal designs to capture the dynamic resilience process. By gaining insight in how cancer patients engage in protective factors, resilience research can come to its full potential and help prevent psychopathology.

The Mediating Role of Resilience in the Relationship Between Hope and Spiritual Well-being in Cancer Patients: A Study From Turkey

BACKGROUND

Cancer is a significant public health concern in the healthcare landscape. Amidst this challenging journey, the levels of hope, spiritual well-being, and resilience in patients with cancer have emerged as pivotal factors influencing the healing process.

OBJECTIVE

This study aimed to evaluate the relationship between hope and spiritual well-being in cancer patients and the mediating role of resilience in the relationship between hope and spiritual well-being levels.

METHODS

This study is a descriptive, cross-sectional, correlational study. The study included 152 cancer patients undergoing treatment. A patient information form, the 12-item Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being (FACIT-SP-12) Scale, the Dispositional Hope Scale, and the Brief Resilience Scale were used to collect study data.

RESULTS

Positive and meaningful correlations were observed between the Dispositional Hope Scale and FACIT-SP-12, Brief Resilience Scale, and FACIT-SP-12 (r = 0.390, P < .05; r = 0.246, P < .05). Mediation analysis indicated that Brief Resilience Scale scores partially mediated the relationship between the Dispositional Hope Scale and FACIT-SP-12 Scale scores; the indirect effect of hope on spiritual well-being through resilience was 0.351 (P < .05).

CONCLUSION

The study has indicated a direct relationship between hope and spiritual well-being, and resilience partially mediated the relationship between hope and spiritual well-being.

IMPLICATIONS FOR PRACTICE

It is significant to provide psychosocial care to cancer patients to increase their resilience levels and to support their hope and spiritual well-being.

Quality of Life of Colorectal Cancer Survivors: Mapping the Key Indicators by Expert Consensus and Measures for Their Assessment

Quality of life (QoL) assessments are integral to cancer care, yet their effectiveness in providing essential information for supporting survivors varies. This study aimed to elucidate key indicators of QoL among colorectal cancer survivors from the perspective of healthcare professionals, and to evaluate existing QoL questionnaires in relation to these indicators. Two studies were conducted: a Delphi study to identify key QoL indicators and a scoping review of questionnaires suitable for colorectal cancer survivors. Fifty-four healthcare professionals participated in the Delphi study's first round, with 25 in the second. The study identified two primary QoL domains (physical and psychological) and 17 subdomains deemed most critical. Additionally, a review of 12 questionnaires revealed two instruments assessing the most important general domains. The findings underscored a misalignment between existing assessment tools and healthcare professionals' clinical priorities in working with colorectal cancer survivors. To enhance support for survivors' QoL, efforts are needed to develop instruments that better align with the demands of routine QoL assessment in clinical practice.

Social support, family resilience and psychological resilience among maintenance hemodialysis patients: a longitudinal study

BACKGROUND

Psychological distress is common in maintenance hemodialysis patients, and high psychological resilience can promote psychological well-being. The current research focuses on psychological resilience protective factors such as family resilience and social support. However, the trajectories of psychological resilience, family resilience, and social support over time and their longitudinal relationships in maintenance hemodialysis patients have not been fully explored yet. Therefore, this study aims to explore the longitudinal relationship between these factors.

METHODS

Patients who received regular hemodialysis treatment for more than three months at dialysis centers of three tertiary hospitals in Zhejiang, China, were recruited from September to December 2020. A total of 252 patients who met the inclusion and exclusion criteria completed three follow-up surveys, including social support, family resilience, and psychological resilience assessments. A repeated measures ANOVA was used to explore differences in their respective scores at different time points. The cross-lagged analysis was performed in AMOS using the maximum likelihood method to examine the the reciprocal predictive relationships between these factors.

RESULTS

Social support and psychological resilience remained relatively stable over time, whereas family resilience indicated a little increasing trend. According to the cross-lagged analysis, higher T1 social support predicted higher family resilience at T2 [β = 0.123, 95% CI (0.026-0.244)]. Further, the effects of T2 social support to T3 family resilience [β = 0.194, 95%CI (0.039-0.335)] and psychological resilience [β = 0.205, 95%CI (0.049-0.354)] were significant. Finally, the effects of T2 family resilience to T3 social support [β = 0.122, 95%CI (0.010-0.225)] and psychological resilience [β = 0.244, 95%CI (0.119-0.359)] were also significant.

CONCLUSIONS

The study showed that the directionality of the relationship appears to be from social support or family resilience to patients' psychological resilience but not vice versa. This finding reminds healthcare professionals to emphasize the vital role of social and family resources in providing appropriate support and interventions for maintenance hemodialysis patients to promote psychological resilience and mental health development.

Factors Associated With Quality of Life Among Colorectal Cancer Patients: Cross-Sectional Study

INTRODUCTION

Colorectal cancer is a chronic condition that affects a substantial proportion of the global population. Ensuring a satisfactory quality of life (QoL) for these patients is, therefore, of critical importance.

OBJECTIVE

To examine the relationship between sociodemographic, economic, lifestyle, and health-related variables and quality of life in patients with colorectal cancer receiving treatment at a leading health institution in Medellín, Colombia.

METHODS

This cross-sectional study included all patients aged 18 years and older who were diagnosed with colorectal cancer and treated at the VIDA Clinic Foundation in 2022. Descriptive and bivariate analyses were conducted to characterize the population and explore factors associated with QoL, as assessed using the Functional Assessment of Cancer Therapy-Colorectal (FACT-C) scale. The Mann-Whitney U and Kruskal-Wallis tests were applied to compare median values across variables. A Generalized Linear Model (GLM) with a Gamma family distribution and identity link function was used to identify explanatory variables influencing QoL. Regression coefficients and 95% confidence intervals were calculated.

RESULTS

A total of 126 patients with colorectal cancer were evaluated, of whom 60.3% were women, with a median age of 61.5 years. The regression model identified poor sleep quality, lack of financial support, dissatisfaction with income, and unemployment as significant factors negatively associated with QoL, after adjusting for sociodemographic variables.

CONCLUSION

This study provides an initial exploration of health-related QoL in a Colombian population diagnosed with colorectal cancer. The findings highlight the critical influence of both health-related and socioeconomic factors on patients' QoL. A holistic approach to addressing these dimensions could enhance patient care and inform more effective support strategies.

Psychological resilience and quality of life among middle-aged and older adults hospitalized with chronic diseases: multiple mediating effects through sleep quality and depression

BACKGROUND

The present study is intended to examine the multiple mediating roles of sleep quality and depression in the relationship between psychological resilience and quality of life in middle-aged and older adults hospitalized with chronic diseases.

METHODS

From October 2, 2021, to February 27, 2022, a questionnaire survey was conducted using a multistage stratified sampling method among 339 middle-aged and older adults (45 years and over) hospitalized with chronic diseases. These participants were recruited from a hospital in Zhejiang Province, China. The questionnaire included the Aged Cumulative Disease Rating Scale, the Psychological Resilience Scale, the Pittsburgh Sleep Quality Index Scale, the Depression Scale, and the Quality-of-Life Scale. A descriptive analysis was performed to characterize the sample. Linear regression was utilized to evaluate the relationship between psychological resilience and quality of life. Amos 24.0 was used to analyze the multiple mediated effects of sleep quality and depression.

RESULTS

Psychological resilience exerted a remarkable direct effect on the quality of life in middle-aged and older adults hospitalized with chronic diseases (β = 0.239, 95% CI = 0.125-0.354), which represented 52.98% of the total effect. Through three significantly mediated pathways indirectly affect the quality of life: (1) through the sleep quality pathway (β = 0.115, 95% CI = 0.056-0.201), which represented 25.39% of the total effect; (2) through the depression pathway (β = 0. 060, 95% CI = 0.023-0.114), which represented 13.24% of the total effect; and (3) through both the sleep quality and depression pathway (β = 0. 038, 95% CI = 0.019-0.074), which represented 8.39% of the total effect. The total mediating effect was 47.02%.

CONCLUSIONS

Sleep quality and depression mediate the relationship between psychological resilience and quality of life in middle-aged and older adults hospitalized with chronic diseases. Therefore, healthcare professionals and stakeholders should be concerned about the sleep status and mental health of middle-aged and older adults hospitalized with chronic diseases, strengthen their attention to psychological resilience, and provide interventions and treatment measures for hospitalized patients who have sleep problems and depressive tendencies.

A latent class analysis of resilience and its association with patient-reported symptoms in patients with esophageal cancer after esophagectomy

Purpose

To identify the latent classes of resilience in patients with esophageal cancer after esophagectomy and develop a deeper understanding of the association between these classes and patient-reported symptoms.

Background

China accounts for more than half of the global burden of esophageal cancer, and patients with esophageal cancer experience numerous symptoms that affect their quality of life and prognosis. Given that resilience is a key element that alleviates the progression of symptoms, it may represent a potential means of to enhancing cancer patients' physical and psychological well-being.

Methods

The study was implemented in the thoracic surgery departments of three tertiary hospitals in eastern China. The participants were patients who were still hospitalized after esophagectomy. Data were gathered by self-report questionnaires, and a latent class analysis was utilized to identify different categories of resilience among the patients.

Results

A total of 226 patients were recruited. The three classes of resilience identified included high strength and striving (53.5%), medium resilience but weak self-recovery (35.9%), and minimal tenacity and external support (10.6%). Patients with low income (OR = 12.540, p = 0.004) were more likely to be in the minimal tenacity and external support class. Patients without comorbidities (OR = 2.413, p = 0.013) and aged 66-70 years (OR = 4.272, p < 0.001) were more likely to be in the high strength and striving class. The patient-reported symptoms and symptom-related interference of patients after esophagectomy varied considerably among the three categories of resilience.

Conclusion

Accurate interventions should be devised and executed according to the features of each type of resilience in patients after esophagectomy to maximize intervention efficacy. These findings highlight the important role of precision nursing.

Perspectives of Cancer Survivors with Low Income: A Content Analysis Exploring Concerns, Positive Experiences, and Suggestions for Improvement in Survivorship Care

The number of cancer survivors in Canada has reached 1.5 million and is expected to grow. It is important to understand cancer survivors' perspectives about the challenges they face after treatment is completed. Many factors create barriers to accessing assistance, and limited income may be a significant one. This study is a secondary analysis of data from a publicly available databank (Cancer Survivor Transitions Study) regarding the experiences of Canadian cancer survivors. The goal was to explore major challenges, positive experiences, and suggestions for improvement in survivorship care for low-income Canadian cancer survivors one to three years following treatment. A total of 1708 survey respondents indicated a low annual household income (<$25,000 CD). A content analysis was performed utilizing written comments to open-ended questions. The major challenges respondents described focused on physical capacity limits and treatment side effects; positive experiences emphasized support and attentive care; and suggestions for improvements highlighted the need for better support, information about self-care and side effect management, and timely follow-up care. The relationships between household income and the management of survivors' physical, emotional, and practical concerns require consideration. The design of follow-up care plans, programs, services, and financial assessments of patients may prepare survivors for predictable issues and costs in their transition to survivorship.

The relationship between resilience and quality of life in advanced cancer survivors: multiple mediating effects of social support and spirituality

Background

While previous studies have revealed a positive association between resilience and quality of life in advanced cancer survivors, the mechanisms of the relationship is still unclear. This study aimed to explore the relationships between resilience, social support, spirituality, and quality of life and determine the multiple mediation effects of social support and spirituality on the relationship between resilience and quality of life.

Methods

With 286 advanced cancer survivors, a cross-sectional, correlational survey was adopted using convenience sampling. Resilience, social support, spirituality, and quality of life were evaluated by self-report questionnaires. The PROCESS macro for SPSS was used to test the multiple mediation model.

Results

The scores for resilience, social support, spirituality and quality of life were positively correlated with one another. Resilience was found to be directly impact quality of life. Meanwhile, the relationship between resilience and quality of life was mediated by social support (effect = 0.067, 95% CI [0.019, 0.120]) and by spirituality (effect = 0.221, 95% CI [0.134, 0.332]), respectively, and by these two serially (effect = 0.036, 95% CI [0.015, 0.067]).

Conclusion

Social support and spirituality played multiple mediating roles in the relationship between resilience and quality of life. Interventions aimed at increasing resilience, and then boosting social support and spirituality may be beneficial for promoting quality of life of advanced cancer survivors.

Enablers, barriers and strategies to build resilience among cancer survivors: a qualitative study protocol

Cancer is a life-threatening illness affecting all dimensions of a person's health. Cancer survivors must build resilience to face this adversity and continue their life projects. The present study explores the enablers, barriers, and strategies to build resilience among cancer survivors. This qualitative, descriptive exploratory study will use purposive sampling to recruit cancer survivors and healthcare professionals from two hospital centers in Lisbon and Tagus Valley. Interviews will be conducted until data saturation occurs. Data analysis will be performed using an inductive content analysis process with the help of the QDA Miner Lite database. The findings from this study will generate knowledge that may help stakeholders to identify effective strategies to build resilience among cancer survivors. By implementing strategies to foster resilience, healthcare professionals can potentially promote positive adaptations to cancer by strengthening resilience enablers and reducing the impact of barriers.

"Keep Your Chin Up, and Keep Eating": Perceptions of Barriers and Facilitators to Healthful Dietary Behaviors Among Individuals With Gastrointestinal Cancer and Caregivers

BACKGROUND

This study explored perceptions of barriers and facilitators to healthful dietary behaviors among patients with gastrointestinal (GI) cancer and their caregivers, including caregiver preparedness, patient and caregiver self-efficacy for symptom management, and other environmental, social, and familial factors that may serve as barriers and facilitators to healthful eating.

METHODS

Using a concurrent mixed methods cross-sectional study design, individuals with GI cancer receiving outpatient chemotherapy and their caregivers completed surveys, dietary assessments, and interviews. Caregiving preparedness, self-efficacy for symptom management, and dietary intake were assessed using validated instruments. Dietary quality was measured using the Healthy Eating Index (HEI)-2020. In-depth interviews explored barriers and facilitators to healthful eating, symptom management, and caregiver preparedness.

RESULTS

Twenty-seven patient-caregiver dyads completed study activities (N = 54). Dietary quality scores ranged from 26 to 81, with a median score of 43 for patients and 42 for caregivers. Thematic analysis identified three barriers to healthful eating: caregiver self-efficacy and preparedness, caregiver needs are neglected, and nutrition as a source of conflict. Overall self-efficacy scores (Mdn, [IQR]) were 69.1 (45.0) for caregivers and 75.6 (34.1) for patients. Caregiver preparedness score was 2.99 ± .87; problem areas were identified, including addressing emotional needs, fluctuating eating habits, advanced disease progression and making care activities pleasant. Despite the challenges, three main facilitators were identified: increased awareness and value of nutrition, influential others, and positive coping.

CONCLUSION

Our findings suggest the importance of developing interventions that increase nutrition-related preparedness among caregivers and self-efficacy for managing treatment side effects. Future research should continue to explore the relationship between positive coping and dietary behaviors. While engaging patients and caregivers together during dietary interventions is a promising modality, strategies for maintaining personal nutrition-related goals when facing contrasting priorities between patients and caregivers should be addressed.

Current Advances in Chitosan Nanoparticles Based Oral Drug Delivery for Colorectal Cancer Treatment

As per the WHO, colorectal cancer (CRC) caused around 935,173 deaths worldwide in 2020 in both sexes and at all ages. The available anticancer therapies including chemotherapy, radiotherapy and anticancer drugs are all associated with limited therapeutic efficacy, adverse effects and low chances. This has urged to emerge several novel therapeutic agents as potential therapies for CRC including synthetic and natural materials. Orally administrable and targeted drug delivery systems are attractive strategies for CRC therapy as they minimize the side effects, enhance the efficacy of anticancer drugs. Nevertheless, oral drug delivery till today faces several challenges like poor drug solubility, stability, and permeability. Various oral nano-based approaches and targeted drug delivery systems have been developed recently, as a result of the ability of nanoparticles to control the release of the encapsulant, drug targeting and reduce the number of dosages administered. The unique physicochemical properties of chitosan polymer assist to overcome oral drug delivery barriers and target the colon tumour cells. Chitosan-based nanocarriers offered additional improvements by enhancing the stability, targeting and bioavailability of several anti-colorectal cancer agents. Modified chitosan derivatives also facilitated CRC targeting through strengthening the protection of encapsulant against acidic and enzyme degradation of gastrointestinal track (GIT). This review aims to provide an overview of CRC pathology, therapy and the barriers against oral drug delivery. It also emphasizes the role of nanotechnology in oral drug targeted delivery system and the growing interest towards chitosan and its derivatives. The present review summarizes the relevant works to date that have studied the potential applications of chitosan-based nanocarrier towards CRC treatment.

Design, synthesis, and biological evaluation of β-carboline 1,3,4-oxadiazole based hybrids as HDAC inhibitors with potential antitumor effects

A series of novel β-carboline 1,3,4-oxadiazole based hybrids were designed, synthesized, and tested for cytotoxicity and HDAC inhibition. Among the target compounds, compound ZDLT-1 displayed high inhibitory activity for class I HDACs 1, 2, and 3, and potent anti-proliferative activity against HCT116 cells with an IC₅₀ value of 0.173 ± 0.018 μM, it also exhibited better inhibitory activity with an IC₅₀ value of 6 nM for HDAC6 than SAHA (IC₅₀ = 15 nM). Furthermore, the pharmacological experiment of Hoechst staining, colony formation, cell apoptosis assay, and wound healing scratch assay indicated that compound ZDLT-1 was a potent cytotoxic agent against HCT116 cells with cell apoptosis induction. Further, in silico prediction of physicochemical properties, drug-likeness, and ADME parameters suggested that compound ZDLT-1 is a promising anticancer agent. Taken together, the high potency cytotoxicity and class I HDACs inhibitory activity of compound ZDLT-1, which with the β-carboline 1,3,4-oxadiazole based hybrids as potent anticancer agents could be nominated for further modification and optimization.

Resilience, social support, and anxious preoccupation in patients with advanced cancer during COVID-19 pandemic

This study examines the mediating role of social support between anxious preoccupation and resilience in patients with cancer during COVID-19. NEOetic_SEOM is a prospective, multicenter study involving individuals with advanced, unresectable cancer who completed the following scales: Resilience (BCRS), Social Support (Duke-UNC-11), and anxious preoccupation subscale of the Mini-Mental Adjustment to Cancer (M-MAC) before starting antineoplastic treatment. Between March 2020 and July 2021, 507 patients (55% male; mean age, 65) were recruited. No differences in resilience were observed based on sociodemographic or clinical characteristics. Social support in people with advanced, unresectable cancer promotes both decreased anxious preoccupation and greater resilience.

Predictive model for the preparedness level of the family caregiver

Background

Many caregivers are insufficiently prepared, and little is known about measures that can be employed to enhance their preparedness.

Aim

The aim of this study was to explore the factors associated with caregiver preparedness and establish a predictive model including the relationship between preparedness, burden, resilience and anxiety.

Design

A cross‐sectional design was used.

Methods

The sample included 172 family caregivers who were selected from one private hospital and daytime nursing centres. Caregivers were recruited from 2018 to 2019; they completed assessments for caregiver preparedness, anxiety, resilience and burden. A multiple linear regression analysis was performed to identify the factors associated with preparedness.

Results

Preparedness was significantly associated with high levels of resilience and a low level of burden, while it was not associated with anxiety. Caregivers' gender, experience and cohabitation status were the main predictors. Resilience is an explanatory factor for caregiver preparedness in the predictive model.

Conclusion

The demographic variables related to preparedness can be used to guide efforts to meet the needs of vulnerable caregivers. A caregiver's preparedness depends on their level of burden and resilience. Nursing interventions focused on these aspects could make the caregiver's role easier and improve the quality of care provided.

What is already known about this topic?

Many caregivers are inadequately prepared for this role, and ensuring adequate preparedness is important for family caregivers.

Preparedness and factors predictive of this in Spanish family caregivers have not been well‐documented.

Resilience, burden and anxiety affect caregivers, but the degree to which they influence caregivers' preparation levels is unknown.

What is the contribution of this paper?

Specific factors influence the preparedness of family caregivers. Men and caregivers who do not cohabit in the same household with the care‐dependent person may present greater deficits in preparedness. Moreover, poor health and lack of experience in caring can result in inadequate caregiving performance.

Readiness, resilience and burden are significantly related, and the best predictor of family caregivers' preparedness is resilience.

Resilience leads to greater preparedness in caregivers, and better‐prepared caregivers experience a lighter burden.

What are the implications of this paper?

Knowing the factors associated with preparedness in advance will allow health‐care professionals to prevent deficits in vulnerable family caregivers.

Resilience is a decisive factor which prevents negative consequences such as low preparedness. A resilient coping style can diminish the burden and promote successful adaptation in caregivers.