Effectiveness of mindfulness-based interventions on anxiety, depression, and fatigue in people with lung cancer: A systematic review and meta-analysis

Development of a dyadic mindfulness self-compassion intervention for patients with lung cancer and their family caregivers: A multi-method study

Objective

Lung cancer and its prolonged treatment are profoundly unsettling for patients and their family caregivers, and developing dyadic measures to alleviate their negative affectivity is pivotal. This study aimed to develop a complex intervention to alleviate dyadic psychological stress among patients with lung cancer and their family caregivers.

Methods

A stepwise multi-method study was conducted following the Medical Research Council framework. Three phases were adopted, namely: (1) a preparation phase, a systematic review was conducted to identify the evidence base, (2) a development phase, empirical data from a quantitative study and a qualitative study were integrated to identify effective components, and (3) a modification phase, an online Delphi survey was carried out to refine the intervention.

Results

The dyadic Mindfulness Self-Compassion intervention developed in this study consists of six weekly sessions. The key components of the intervention include: (1) getting along with cancer (introductory session targets illness perception), (2) practising mindful awareness (core session for mindfulness), (3) defining dyadic relationships and introducing self-compassion (core session for self-compassion), (4) promoting dyadic communication (maintenance session targets communication skills), (5) promoting dyadic coping (maintenance session targets coping skills), and (6) a summary session reviewing the rewards and challenges of dyadic adaptation named embracing the future.

Conclusions

An evidence-based, theory-driven, and culturally appropriate dyadic Mindfulness Self-Compassion intervention was developed for patients with lung cancer and their family caregivers. Future studies are warranted to pilot and evaluate the usability, feasibility, acceptability, satisfaction, and effectiveness of this complex intervention.

Trial registration

ClinicalTrial.gov NCT04795700.

Effectiveness of Baduanjin exercise on pulmonary function, quality of life, psychological well-being and exercise tolerance in postoperative patients with non-small cell lung cancer: Systematic review and meta-analysis of randomized controlled trials

OBJECTIVE

To evaluate the influence of engaging in Baduanjin exercise on pulmonary function, quality of life (QoL), mental well-being and exercise tolerance among postoperative individuals diagnosed with non-small cell lung cancer (NSCLC).

METHODS

A comprehensive search of randomized controlled trials (RCTs) in eleven different electronic databases, spanning from their inception up until July 3, 2024, was conducted. Following this exhaustive search, the literature was thoroughly screened, relevant information was carefully extracted, and the potential for bias within the selected studies was critically evaluated by two independent researchers. Employing Revman 5.4 software, statistical analyses were then carried out.

RESULTS

A comprehensive compilation of 6 RCTs, involving a collective 540 patients diagnosed with NSCLC, was analyzed. The pooled findings revealed that engaging in Baduanjin exercise leads to a significant enhancement in forced vital capacity (FVC) (WMD=0.23, 95% CI=0.06 ∼ 0.41, P = 0.009), forced expiratory volume in the first second (FEV1) (WMD=0.16, 95% CI=0.00 ∼ 0.32, P = 0.05) in NSCLC patients, as well as QoL (WMD=24.09, 95% CI=20.68 ∼ 27.51, P<0.00001) and functional well-being (WMD=6.70, 95% CI=5.50 ∼ 7.90, P < 0.00001). Meanwhile, Baduanjin exercise reduced Self-Rating Anxiety Scale (SAS) (WMD=-9.58, 95% CI=-10.58 ∼ -8.58, P < 0.00001) scores in patients with NSCLC. However, sensitivity analyses revealed that the results for physical well-being, social/family well-being, emotional well-being, lung cancer subscales, Self-Rating Depression Scale (SDS) scores, and 6 min walk distance (6MWD) lacked robustness. Subgroup analysis was conducted based on the intervention frequency, revealed that both 3 and 10 weekly training sessions improved 6MWD in NSCLC patients. Notably, 10 weekly training sessions (WMD=54.72, 95% CI=28.76 ∼ 80.69, P<0.0001) were found to be twice as effective as 3 weekly training sessions (WMD=26.96, 95% CI=17.31 ∼ 36.61, P<0.00001) in enhancing 6MWD . However, no improvement in 6MWD was observed in the 8 weekly training sessions (WMD=-18.34, 95%CI=-41.55 ∼ 4.87, P<0.00001).

CONCLUSION

The meta-analysis revealed that for individuals diagnosed with NSCLC, Baduanjin exercise demonstrated significant effectiveness in terms of pulmonary function enhancement, QoL elevation, anxiety alleviation and exercise endurance improvement. However, the methodological limitations significantly constrain the strength of clinical evidence. Meanwhile, the lack of robustness in some outcomes as indicated by sensitivity analyses, suggest significant constraints in the external validity and generalizability of the findings to broader populations.

Effects of Psychological Intervention Based on Digital Health Technology on Psychological Outcomes in Cancer Survivors: Systematic Review and Meta-Analysis

OBJECTIVES

Digital health technology (DHT)-based psychological interventions are emerging as a means to enhance psychological outcomes for cancer survivors. This study aims to assess the effects of DHT-based psychological interventions on anxiety, depression, sleep disturbances, fatigue, and quality of life among cancer survivors.

METHODS

A systematic search was conducted in PubMed, Web of Science, the Cochrane Library, and Embase. The Cochrane risk-of-bias tool RoB 2 was used to evaluate the quality of the included studies. The Template for Intervention Description and Replication (TIDieR) checklist was used to check if the interventions reviewed were described in detail to be implemented in the clinical setting. Data synthesis was conducted in Review Manager (Version 5.4), and the effect size was calculated by the standardized mean difference and its 95% confidence interval. Sensitivity analysis and subgroup analysis were also conducted. The certainty of evidence was rated using the Grading of Recommendations, Assessment, Development and Evaluation approach.

RESULTS

This meta-analysis encompassed 46 randomized controlled trials, involving 5211 participants. DHT-based psychological interventions significantly reduced anxiety (SMD = -0.41, 95% CI -0.59/-0.24), depression (SMD = -0.26, 95% CI -0.39/-0.13), sleep disturbance (SMD = -0.39, 95% CI -0.64/-0.14), fatigue (SMD = -0.47, 95% CI -0.77/-0.17), and improved quality of life (SMD = 0.42, 95% CI 0.22/0.62). Subgroup analysis indicated that interventions lasting for a duration of ≥ 12 weeks, and integrated interventions might be the most effective in addressing adverse psychological outcomes. And cognitive-behavioral therapy interventions demonstrated significant effectiveness in managing sleep disturbance.

CONCLUSION

DHT-based psychological interventions might be effective for improving anxiety, depression, sleep disturbances, fatigue, and quality of life in cancer survivors. We cannot draw definitive conclusions due to intervention and study design heterogeneity. Further rigorous trials are crucial to identify optimal interventions for different types of cancers, determine suitable durations, specify types of DHT-based psychological interventions and validate intervention therapies.

Effects of internet-based mindfulness interventions on anxiety and depression symptoms in cancer patients: A meta-analysis

OBJECTIVE

This meta-analysis aimed to evaluate the effectiveness of internet-based mindfulness interventions on anxiety and depression symptoms in patients with cancer.

METHODS

Eight databases (Cochrane Library, PubMed, Embase, and PsycINFO CNKI, Wanfang, VIP, and CBM) were systematically searched from the inception of databases to August 2023 for randomized controlled trials (RCTs). Two independent reviewers rigorously assessed the risk of bias and extracted data using a pre-established form. The meta-analysis, conducted using Stata version 16, calculated pooled effect sizes and 95% confidence intervals (CIs). Sensitivity analysis was employed to find the source of heterogeneity, and potential publication bias was evaluated through funnel plot analysis and the Egger test.

RESULTS

This study included 10 studies, involving a total of 1314 patients. The results of the meta-analysis showed that Internet-based mindfulness interventions were effective in reducing anxiety [SMD = -0.38, 95% CI (-0.51, -0.25), P < 0.01] and depression [SMD = -0.36, 95% CI (-0.49, -0.23), P < 0.01], particularly when the duration of the program was within 8 weeks and each session lasted <45 min. Interventions guided by therapists proved to be more effective than those without therapist guidance in improving anxiety and depression in cancer patients, and synchronous online interaction with therapists were found to yield the most noticeable improvements in anxiety and depression.

CONCLUSION

Internet-based mindfulness interventions, especially synchronous online interaction with therapists, contribute to alleviating anxiety and depression symptoms in cancer patients. The effectiveness is more pronounced when the intervention duration per session is limited to 45 min and the overall intervention duration is within 8 weeks. The medium to long-term efficacy of the intervention needs further validation through more high-quality research.

Benefits of a mindfulness and compassion program for cancer patients: experience in a Spanish public hospital setting

BACKGROUND

Mindfulness-based interventions have been shown to improve the quality of life of cancer patients and are widely recommended.

METHODS

This was a non-randomized, single-center study designed to assess the feasibility and benefits of a mindfulness and compassion program for individuals living with cancer (MCP-C). The primary objective was to evaluate the feasibility of the program, while the secondary objective was to assess its effectiveness in adult cancer patients and their relatives. Before and after completing the program, participants completed the 12-item General Health Questionnaire (GHQ- 12) and the Hospital Anxiety and Depression Scale (HADS). A qualitative study was also conducted using focus groups and a structured qualitative survey.

RESULTS

A total of eight courses were delivered, six in person in 2019 and two online in 2020. A total of 153 participants were enrolled, of whom 142 were considered evaluable. Among them, 90 (64.3%) completed the program, including 75 patients (83.3%) and 15 relatives. The intervention was associated with significant reductions (p < 0.01) in mean scores on the GHQ- 12 and the HADS-A and HADS-D subscales. In the qualitative assessment, participants reported multiple benefits, including increased awareness of health-related decision-making, improved relationship with the disease, a sense of companionship, emotional support, and overall enhancements in daily life.

CONCLUSIONS

Implementing an 8-week mindfulness and self-compassion program within the routine practice of a public hospital was feasible and led to significant improvements in the psychological well-being of cancer patients and their relatives.

The Effectiveness of Online Interpretation Bias Modification on Coping Strategies in College Students With Type D Personality

Background: Individuals with Type D personality typically employ maladaptive coping strategies, particularly in ambiguous situations, which may exacerbate their psychological distress. This study aims to evaluate the effectiveness of online interpretation bias modification intervention on improving coping strategies among college students with Type D personality. Methods: This study was conducted within a positivist paradigm using a quantitative approach. The target population comprised students from Persian Gulf University. A total of 84 students identified with Type D personality, as measured by Type D Personality Scale, were randomly assigned to either an experimental group or a control group. The Coping Strategy Questionnaire was used to assess coping strategies. The experimental group participated in 10 sessions of an Android application-based interpretation bias modification over a period of 8 weeks. Data were analyzed using SPSS software, version 26. Results: The results indicate that ten sessions of the online interpretation bias modification significantly improved coping strategies among students with Type D personality (p < .0001). Specifically, the intervention significantly increased positive adaptation, problem-solving, emotional support seeking, and self-regulation while significantly decreasing withdrawal and disengagement behaviors (p < .0001). Conclusion: The study demonstrates that online interpretation bias modification is effective on enhancing coping strategies among Type D personality college students. These findings suggest its potential utility for psychologists and mental health professionals.

Exploring Cutaneous Melanoma Patients' Experiences with Follow-Up Radiology: A Qualitative Study

Background/Objectives: Diagnostic examinations that cutaneous melanoma (CM) patients undergo during follow-up can generate various emotional states related to the possibility of recurrence or disease progression. Understanding the emotions and perceptions of patients during the wait for diagnostic exams is crucial for improving care. This study aims to explore the experiences of CM patients awaiting follow-up diagnostic investigations. Methods: This is a qualitative descriptive inductive, single-center study, structured according to COREQ criteria. The sample of CM patients was recruited at the Radiology and Diagnostic Imaging Unit of the San Gallicano Dermatological Institute in Rome. Data were collected through semi-structured interviews and analyzed using Framework Analysis, as described by Ritchie and Spencer. Results: A total of 30 patients with an average age of 57.4 were recruited. The interviews revealed the following four themes: waiting influences the emotional experience; the double face of family support; strategies of support during the waiting period; and waiting requires attention to the person and the environment. Conclusions: This study revealed that waiting for a diagnostic exam for cutaneous melanoma (CM) is often characterized by anxiety and worry. Healthcare professionals need to implement positive coping strategies, balanced family support, and improved communication to enhance patient care and satisfaction in oncology settings. Recognizing and addressing patients' emotional dynamics is crucial for improving care. Training healthcare staff, providing psychological interventions, and leveraging technological innovation can improve the waiting experience, foster a more welcoming and reassuring environment, and enhance patients' psychological well-being and satisfaction with care pathways.

The mediating effects of coping strategies between symptom clusters and quality of life in lung cancer patients undergoing immunotherapy

OBJECTIVE

Immunotherapy has significantly improved the survival rates of lung cancer patients. However, prevalent adverse immune reactions associated with this treatment can detrimentally affect their quality of life. Coping strategies play a crucial role throughout the cancer treatment process. Consequently, this study hypothesised that coping strategies act as a mediating factor between symptom clusters and quality of life. This study intended to provide a theoretical foundation and empirical data to support the optimisation of coping strategies for lung cancer patients, thereby enhancing their overall quality of life.

METHOD

This study consisted of a cross-sectional survey. Data were collected using the Memorial Symptom Assessment Scale, the Medical Coping Modes Questionnaire, the Quality of Life Questionnaire-Lung Cancer 43, and a self-designed General Information Evaluation Form. The data were fitted, and the model was refined using the maximum likelihood estimation method. Additionally, the Bootstrap method was employed to assess mediating effects.

RESULTS

In total, 240 participants completed the survey. During immunotherapy, lung cancer patients predominantly adopted the acceptance-resignation coping strategy, which served as a mediating factor between symptom clusters and quality of life. In contrast, the mediating effects of confrontation and avoidance coping strategies between symptom clusters and quality of life were not significant.

CONCLUSION

Both symptom clusters and the acceptance-resignation coping strategy negatively impacted quality of life, with acceptance-resignation serving as a mediating factor between symptom clusters and quality of life. Future research should focus on developing interventions for cognitive behaviour to improve coping strategies and quality of life throughout the disease trajectory.

A nomogram for predicting cancer-related cognitive impairment in lung cancer patients from a nursing science precision health model perspective

PURPOSE

The nursing science precision health (NSPH) model considers identifying the biological basis of symptoms in order to develop precise intervention strategies that ultimately improve the overall health of the symptomatic individual. This study sought to construct a nomogram for predicting cancer-related cognitive impairment (CRCI) in patients with lung cancer within the context of the NSPH model.

METHODS

A cohort of 252 patients with lung cancer was prospectively collected and randomly divided into training and validation cohorts in a 7:3 ratio. The least absolute shrinkage and selection operator (LASSO) regression method optimized variable selection, followed by multivariate logistic regression to develop a model, which subsequently formed the basis for the nomogram. The nomogram's discrimination and calibration were evaluated using a calibration plot, the Hosmer-Lemeshow test, and the receiver operating characteristic curve (ROC). Decision curve analysis (DCA) quantified the net benefits of the nomogram across various threshold probabilities.

RESULTS

Five pivotal variables were incorporated into the nomogram: age (≥ 65 years), treatment, education level, albumin, and platelet-to-lymphocyte ratio (PLR). The area under the ROC curve (0.970 for the training cohort and 0.973 for the validation cohort) demonstrated the nomogram's excellent discriminative ability. Calibration curves closely aligning with ideal curves indicated accurate predictive capability. Moreover, the nomogram exhibited a positive net benefit for predicted probability thresholds ranging from 1 to 98% in DCA.

CONCLUSION

Key risk factors, including advanced age (≥ 65 years), low education level, combined chemotherapy, low albumin, and high PLR, were significantly associated with higher CRCI incidence. This nomogram model has good performance and can help identify CRCI with high accuracy in lung cancer patients.

Feasibility of Modified Mindfulness Training Program for Antenatal Depression and Perceived Stress Among Expectant Mothers with Male Child Preference

Background/Objectives: Antenatal depression and perceived stress are prevalent mental health challenges faced by pregnant women, and they are associated with male child preference. This study aimed to assess the feasibility of a modified mindfulness training program for reducing antenatal depression and perceived stress levels among expectant mothers with a male child preference at a public sector tertiary care hospital in Karachi, Pakistan. Material and Methods: The present feasibility trial was conducted among expectant mothers with antenatal depression and perceived stress with a male child preference using the ADAPT-ITT framework. Assessments of the needs and experiences of the new target population were carried out through an exploratory and descriptive qualitative study. In-depth interviews were conducted using a semi-structured interview guide and analyzed using a thematic analysis process. Repeated-measures MANOVA was employed to investigate the effect of time on antenatal depression and perceived stress scores in the feasibility of the intervention. Results: Five major themes emerged from the qualitative data. A significant influence of time was established on the antenatal depression scores, with perceived scores of F (2, 326) = 21.244, p < 0.001, and F (2, 326) = 310.748, p < 0.001. The antenatal depression scores significantly decreased from pre-intervention to post-intervention (mean difference = 4.00, p < 0.001), and there was a slightly significant decline from post-intervention to follow-up (mean difference = 1.167, p = 0.001). The perceived stress scores were significantly reduced from pre-intervention to post-intervention (mean difference = 10.214, p < 0.001), and there was a minor but significant decline from post-intervention to follow-up (mean difference = 0.333, p = 0.043). Conclusions: This study concludes that the modified mindfulness training program is a culturally suitable, contextually relevant intervention in the context of Pakistan and it significantly reduced antenatal depression and perceived stress in expectant mothers with a male child preference. The modified mindfulness training program was modified in accordance with the context of Islamic teaching regarding health-promoting lifestyles and religious spirituality.

Continuous nursing symptom management in cancer chemotherapy patients using deep learning

To assess the efficacy of a deep learning platform for managing symptoms in chemotherapy patients, aiming to enhance their quality of life. A non-randomized controlled trial was conducted from September 2022 to March 2024, involving 144 chemotherapy patients divided into intervention (n = 72) and control (n = 72) groups. The intervention group received the deep learning platform, whereas the control group received standard care. Anxiety, depression, and quality of life were evaluated using the SAS, SDS, and QOL scores at baseline and after 6 months. Initial non-significant differences in SAS, SDS, and QOL scores between groups were observed. After intervention, significant improvements were noted in the intervention group for SAS, SDS, and various QOL aspects (P < 0.05). The platform received a high satisfaction score of 4.93 ± 0.13. The deep learning platform significantly reduced anxiety and depression and improved QOL in chemotherapy patients, demonstrating high patient satisfaction and potential for clinical application.Clinical trial registration: The trial was registered in clinical trials.gov with the registration number ChiCTR2400093540. The first registration date was 06/12/2024.

Global research and emerging trends in depression in lung cancer: a bibliometric and visualized study from 2014 to 2024

Background

The impact of depression on the physical and psychological well-being of lung cancer patients has raised significant concerns. This study explored lung cancer-related depression research from a bibliometric perspective.

Methods

Articles and reviews on depression in lung cancer published from 2014 to 2024 in the Web of Science Core Collection were retrieved and identified. The information extracted included "Full Record and Cited References". Bibliometric analysis was conducted using CiteSpace and Excel to examine relevant publications in terms of country, institution, authorship, journal, citations, and keywords.

Results

A total of 761 publications on depression in lung cancer were identified for analysis, contributed by 4,667 authors from 305 institutions and 58 countries. The annual publication count has steadily increased, culminating in a peak in 2024. China (275 papers), Harvard University (58 publications), and Joseph A. Greer (25 publications) were the most productive and influential country, institution, and author, respectively. Jennifer S. Temel emerges as a highly influential author, securing the second position in terms of both publication count and citation impact. The journal with the highest number of publications is Supportive care in cancer, while the Journal of Clinical Oncology has garnered the most citations. Reference and keyword analysis indicated that the research hotspots mainly included 1) Epidemiology of lung cancer-related depression; 2) The deleterious impact of depression on lung cancer patients, particularly with regards to their quality of life; 3) Association between inflammation and depression in lung cancer; 4) Treatment.

Conclusions

Our study employed bibliometric analysis to identify prevalent focal areas and emerging trends in the field of research on lung cancer-related depression. Our study found that numerous unanswered questions persist, including the intricate relationship between lung cancer and depression, the profound impact of depression on lung cancer patients, and the interplay between inflammation and depression in this specific population. Furthermore, a current challenge in clinical practice involves the development of secure and more efficacious treatment strategies for individuals with lung cancer-related depression. These findings provide valuable guidance for scholars seeking to explore new avenues of investigation.

Deep learning paradigms in lung cancer diagnosis: A methodological review, open challenges, and future directions

Lung cancer is the leading cause of global cancer-related deaths, which emphasizes the critical importance of early diagnosis in enhancing patient outcomes. Deep learning has demonstrated significant promise in lung cancer diagnosis, excelling in nodule detection, classification, and prognosis prediction. This methodological review comprehensively explores deep learning models' application in lung cancer diagnosis, uncovering their integration across various imaging modalities. Deep learning consistently achieves state-of-the-art performance, occasionally surpassing human expert accuracy. Notably, deep neural networks excel in detecting lung nodules, distinguishing between benign and malignant nodules, and predicting patient prognosis. They have also led to the development of computer-aided diagnosis systems, enhancing diagnostic accuracy for radiologists. This review follows the specified criteria for article selection outlined by PRISMA framework. Despite challenges such as data quality and interpretability limitations, this review emphasizes the potential of deep learning to significantly improve the precision and efficiency of lung cancer diagnosis, facilitating continued research efforts to overcome these obstacles and fully harness neural network's transformative impact in this field.

Higher Levels of Multiple Types of Stress Are Associated With Worse State Anxiety and Morning Fatigue Profiles in Patients Receiving Chemotherapy

BACKGROUND

Anxiety and fatigue are common problems in patients receiving chemotherapy. Unrelieved stress is a potential cause for the co-occurrence of these symptoms.

OBJECTIVES

The aims of this study were to identify subgroups of patients with distinct state anxiety and morning fatigue profiles and evaluate for differences among these subgroups in demographic and clinical characteristics, as well as measures of global, cancer-specific, and cumulative life stress and resilience and coping.

METHODS

Patients (n = 1335) completed measures of state anxiety and morning fatigue 6 times over 2 cycles of chemotherapy. All of the other measures were completed prior to the second or third cycle of chemotherapy. Latent profile analysis was used to identify the state anxiety and morning fatigue profiles.

RESULTS

Three distinct joint profiles were identified: Low Anxiety and Low Morning Fatigue (59%), Moderate Anxiety and Moderate Morning Fatigue (33.4%), and High Anxiety and High Morning Fatigue (7.6%). Patients in the 2 highest classes were younger, were less likely to be married/partnered, and had a higher comorbidity burden. All of the stress scores demonstrated a dose-response effect (ie, as anxiety and morning fatigue profiles worsened, stress increased). Patients in the 2 highest classes reported higher rates of emotional abuse, physical neglect, physical abuse, and sexual harassment.

CONCLUSIONS

More than 40% of these patients experienced moderate to high levels of both anxiety and morning fatigue. Higher levels of all 3 types of stress were associated with the 2 highest profiles.

IMPLICATIONS FOR PRACTICE

Clinicians need to perform comprehensive evaluations of patients' levels of stress and recommend referrals to psychosocial services.

Efficacy and Budget Impact of a Tailored Psychological Intervention Program Targeting Cancer Patients With Adjustment Disorder: A Randomised Controlled Trial

BACKGROUND

Evidence on the efficacy of psychological interventions targeting cancer patients diagnosed with an adjustment disorder is scarce.

AIMS

This study aimed to investigate the efficacy and budget impact of a tailored psychological intervention program (AD-program) targeting cancer patients with adjustment disorder (AD).

METHODS

Patients (n = 59) were randomised to the intervention or control group. The AD-program consisted of three modules: psychoeducation (1-4 sessions) and two additional modules (maximum of 6 sessions per module) provided when needed. The primary outcome was psychological distress (HADS). Secondary outcomes were mental adjustment to cancer (MAC) and health-related quality of life (EORTC QLQ-C30). Measures were completed at baseline and 3 and 6 months after randomisation. The budget impact analyses were based on the population size, the costs of the AD-program, and other costs potentially affected by the AD-program.

RESULTS

The mean psychological distress score in the intervention group (n = 33) decreased over time (M = 19.2 at T0, M = 15.6 at T6). This decrease was not significantly different from decrease in the control condition (n = 26, M = 17.5 at T0, M = 15.9 at T6, p > 0.05). Also, there were no significant differences between the two conditions on the secondary outcomes. The budget impact of the AD-program was estimated at 7-28 million euros per year (to treat 14,430 patients).

CONCLUSIONS

The effect of the AD-program was not statistically significant in this RCT. Limitations include that this study was underpowered due to recruitment difficulties during the COVID-19 pandemic. More research on the efficacy and implementation of the AD-program is warranted.

TRIAL REGISTRATION

Netherlands Trial Register identifier: NL7763. Registered on 3 June 2019.

Mental Health Care among Cancer Patients with BRCA Gene Mutations: The Potential of Mindfulness-based Intervention

Hereditary breast and ovarian cancer syndrome (HBOC) is a hereditary tumor syndrome caused by mutations in BRCA genes. Advances in genetic testing technologies have enabled surveillance and risk-reducing surgeries for carriers of BRCA mutations, allowing for the early detection and prevention of cancer. However, the research and support infrastructure for addressing the psychological and social impacts of genetic diagnostics remain insufficient, and there is a need for mental and psychological support based on the needs of patients and their families. Here, we provide an overview of mindfulness, a psychotherapy that has been demonstrated to be effective in alleviating psychological distress in cancer patients, and we discuss the prospects for mindfulness therapy in HBOC patients.

Exploring Psychotherapy Approaches for Dyspnea: A Systematic Review Protocol

Introduction

Dyspnea, a common and debilitating symptom, affects over half of the patients with cancer, with increasing frequency and severity as the end of life approaches. It substantially affects the daily lives of patients by contributing to anxiety, depression, fatigue, and reduced physical activity, ultimately diminishing their quality of life. Although pharmacological treatments remain standard, nonpharmacological interventions, including psychotherapy, are increasingly recommended owing to their safety and accessibility. Psychotherapy is particularly relevant for alleviating psychological distress associated with dyspnea; however, research on its efficacy in managing dyspnea among patients with cancer is limited. This systematic review aims to synthesize evidence on the following four key psychotherapy techniques for managing dyspnea: mindful breathing, guided imagery, progressive muscle relaxation, and meditation. The review will assess the optimal delivery methods, evaluate the quality of existing studies, and provide clinical recommendations for implementing these interventions in cancer care.

Method and Analysis

This review adheres to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses protocols. A systematic search will be conducted on some databases such as PubMed. Relevant studies will also be identified through reference lists and manual searches of key journals. The search terms will include keywords related to dyspnea and psychotherapeutic techniques. Four independent reviewers will screen and assess the articles, extracting data using a standardized charting form. The quality of the studies will be assessed using the Mixed Methods Assessment Tool. The results will be summarized via a psychotherapeutic technique, providing a comprehensive overview of the interventions and their applicability.

Non-pharmacological Therapies for Depression in Women With Breast Cancer at Different Treatment Phases: A Systematic Review and Network Meta-Analysis

CONTEXT

Various non-pharmacological therapies (NPTs) have been found to be helpful for depression in women with breast cancer (BC). However, the relative efficacy of different NPTs in women with BC during different treatment phases is unclear.

OBJECTIVES

To conduct a systematic review and network meta-analysis (NMA) to compare the relative efficacy of various NPTs for improving depression in women with BC during the inter-/post-treatment periods.

METHODS

We searched eight databases (Embase, PubMed, PsycINFO, The Cochrane Library, Chinese Biomedical Database, China National Knowledge Infrastructure, Chinese Scientific Journal Database, and WanFang Database) to identify relevant randomized controlled trials published in English and Chinese from their inception to 31 January 2024. We assessed the methodological quality of the included studies using the Cochrane Collaboration Risk of Bias Tool. NMA was conducted using a frequentist approach. The surface under the cumulative ranking (SUCRA) probabilities were used to rank the NPTs.

RESULTS

A total of 41 articles involving 5408 participants studied 18 NPTs. Based on NMA, in the intertreatment phase, mindfulness-based cognitive therapy (MBCT), psychological education, virtual reality (VR) and yoga significantly improved depression in women with BC. MBCT, psychological education, and VR were the three most effective NPTs in this period. In the post-treatment phase, mindfulness-based stress reduction significantly improved depression in women with BC, which was the most effective NPTs in this period. Based on the GRADE framework, most results were rated as "high" to "very low" for the confidence of evidence.

CONCLUSIONS

Our study confirmed the efficacy of several NPTs for depression in women with BC during inter-/post-treatment phases. These results should inform future clinical decisions and guidelines for depression in women with BC.

Prevalence and influencing factors of the dyadic psychological stress among patients with lung cancer and their family caregivers: a cross-sectional study

BACKGROUND

A lung cancer diagnosis has a huge impact on the psychological well-being of both patients and family caregivers. However, the current psychological stress status among dyads remains unclear. We aimed to determine the prevalence of anxiety and depression and identify the factors that influence patients with lung cancer and their caregivers.

METHODS

We conducted a cross-sectional study of 254 dyads of lung cancer patients and family caregivers from four tertiary hospitals in Hunan Province, China from January 2021 to June 2021. Besides, we used several instruments to collect data on depression, anxiety, illness perception, mindfulness, self-compassion, and dyadic coping. The independent samples t-test, analysis of one-way variance, Spearman's correlation analysis, and multiple linear regression analysis were employed.

RESULTS

Results showed that 21.3% of patients and 29.5% of caregivers experienced depression, while 22.0% of patients and 33.5% of caregivers reported anxiety. For lung cancer patients, patients' illness perception positively predicted their depression scores and patients' level of mindfulness and level of self-compassion negatively predicted their depression scores; patients' illness perception positively predicted their anxiety scores, and only living with children, patients' mindfulness and self-compassion levels were negatively predicted their anxiety scores. For caregivers, caregivers' level of illness perception and the number of other caregivers positively predicted their depression and anxiety scores, and caregiver's dyadic coping level, residence (county or town, and city), and caregiver's self-compassion level, were negatively predicted their depression and anxiety scores.

CONCLUSION

The prevalence of psychological stress response of lung cancer patients and caregivers was high and influenced by family living situation, number of persons assisting in care, place of residence, patient-caregiver relationship, levels of illness perception, mindfulness, self-compassion, and dyadic coping.

TRIAL REGISTRATION

ClinicalTrial.gov NCT06746948.

The Psychometric Performance of State Mindfulness Scales Around Sitting and Walking on Desert Trails: A Pilot Study

State mindfulness is a dynamic construct reflecting current mindfulness, or purposeful attention to the present moment with openness, non-judgment, non-reactivity, and acceptance. Despite its popularity and research in psychology and medicine, measuring state mindfulness remains a challenge. Validity and reliability of the State Mindfulness Scale (SMS) and State Mindfulness Scale for Physical Activity (SMS-PA) in applied settings like nature require more data to be established. This pilot study aimed to evaluate these scales and introduce a new, one-item scale, the Visual Analog Scale-Mindfulness (VAS-M), for quicker mindfulness assessment. Participants completed the SMS, SMS-PA, and VAS-M upon arrival at a desert trail, after 10 minutes of sitting, and after 10 minutes of walking. A subset repeated the intervention 24 hours later. The study found that the SMS and SMS-PA could be given before, during, and after nature immersion. The SMS-PA showed evidence of concurrent validity with the SMS (ρ = .89, p < .001). However, the VAS-M did not meet the criteria for concurrent validity with the other scales. None of the scales met the criteria for test-retest reliability. This study underscores the need to validate state mindfulness scales, especially in non-laboratory settings. While the SMS-PA shows promise, further validation and refinement of the VAS-M are needed. The findings enhance our understanding of measuring state mindfulness, particularly in natural environments. While the scales are already in use, our study helps address gaps in evidence and informs future decisions about their application.

Effectiveness of Traditional Chinese Medicine in Psychological Rehabilitation After Lung Cancer Surgery: Systematic Review and Meta-Analysis protocol

BACKGROUND

The incidence and mortality of lung cancer is the highest among malignant tumors worldwide, and it seriously threatens human life and health. Surgery is the primary radical treatment for lung cancer. However, patients often experience discomfort, changes in social roles, economic pressures, and other postsurgical challenges. These factors frequently cause various psychological disorders such as anxiety and depression, significantly diminishing the quality of life and elevating the risks of recurrence, metastasis, and mortality. Therefore, effective strategies for mental function rehabilitation should be urgently developed. Traditional Chinese medicine can significantly improve psychological function and physical symptoms after lung cancer surgery, and prolong patient survival. However, its effectiveness for mental function rehabilitation after lung cancer surgery remains unclear. This study aimed to investigate the effects of Chinese medicine on mental function recovery after lung cancer surgery through a systematic review and meta-analysis.

METHODS

This study will systematically search the following databases: PubMed, Cochrane Library, EMBASE, Web of Science, ClinicalTrials.gov, China National Knowledge Infrastructure, Wanfang database, VIP database, and Chinese BioMedical Literature database. Search for studies published from the inception of each database until April 22, 2024. This study will be limited to clinical randomized controlled trials (RCTs). The primary outcome will be depression or anxiety, as indicated by the scale score. Data analysis will be performed using RevMan 5. The Cochrane Risk of Bias Assessment Tool will be used to evaluate the quality of included studies. Finally, the quality of the evidence will be classified using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) System.

RESULTS

This meta-analysis aims to offer comprehensive evidence of the effectiveness of traditional Chinese medicine in mental function rehabilitation after lung cancer surgery. The study will assess the quality of the reports and conduct a subgroup analysis based on various postoperative stages, intervention measures, intervention duration, and sex to gather more evidence to fill the gap in psychological function rehabilitation after lung cancer surgery. These data can be used to guide clinical practice and inform future studies. More importantly, the results of this study will provide evidence to support the development of expert consensus and clinical guidelines in the field of mental function rehabilitation after lung cancer surgery.

Interventions to mitigate reproductive concerns in individuals with cancer: A systematic review

BACKGROUND

Individuals of reproductive age with cancer may experience reproductive concerns (RCs) due to impaired fertility and disrupted family planning, which can negatively impact their quality of life and psychological well-being. There is limited research on interventions that mitigate the negative effects of RCs among individuals with cancer.

OBJECTIVE

This systematic review aimed to identify and evaluate the effectiveness of interventions developed to mitigate RCs among individuals with cancer.

METHODS

This systematic review was conducted following the Joanna Briggs Institute (JBI) Manual for Evidence Synthesis and reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. A systematic search of nine English and Chinese electronic databases including PubMed, Cochrane Library, CINAHL Plus, Embase, PsycINFO, Web of Science, Wan Fang Data, Chinese National Knowledge Infrastructure (CNKI), and SinoMed, was conducted for relevant studies from inception to November 2023. Intervention studies designed to mitigate RCs among individuals with cancer were included. Two reviewers independently performed study selection, data extraction, and quality appraisal where JBI Critical appraisal tools were used. Narrative syntheses were conducted to summarize the characteristics and effectiveness of interventions due to high heterogeneity across studies.

RESULTS

Nine studies were included. Interventions were categorized into psychoeducational interventions (n = 6), couple-based interventions facilitating open communication and intimate relationships (n = 2), and mindfulness-based interventions (n = 1). A statistically significant reduction in RCs was observed in five psychoeducational interventions, two couple-based interventions, and one mindfulness-based stress reduction intervention. The effect sizes (Cohen's d) of the interventions on RCs varied substantially from 0.08 to 5.66.

LINKING EVIDENCE TO ACTION

Psychoeducation, couple-based, and mindfulness-based interventions demonstrated promising findings in mitigating RCs among individuals with cancer. However, more randomized controlled trials with larger sample sizes and rigorous designs are warranted to strengthen the current evidence.

Effects of Web-Based Acceptance and Commitment Therapy on Health-Related Outcomes Among Patients With Lung Cancer: A Feasibility Randomized Controlled Trial

OBJECTIVE

To identify the feasibility, acceptability, and effectiveness of web-based acceptance and commitment therapy (ACT) on health-related outcomes in patients with lung cancer.

METHODS

A feasibility, prospective, parallel, individual-based, assessor-blinded randomized controlled trial was designed. This study was conducted at a third-level hospital in Sichuan Province, China. A total of 101 participants were enrolled and randomly assigned to usual care group or 7-weekly web-based acceptance and commitment therapy group. The primary outcome was feasibility and acceptability of the intervention, and the secondary outcomes including quality of life, psychological flexibility, anxiety, depression, fatigue, and sleep disturbance. Generalized estimating equations were used to evaluate the group differences. All analyses followed the principle of intention-to-treat.

RESULTS

Web-based ACT presented good feasibility and acceptability in this study, with an attrition rate of 13.86%, a median compliance rate of 71.43%, and a satisfaction rate of 65.9%. Compared with control group, participants in intervention group reported statistically significant increases in quality of life (MD = 15.10, 95% CI: [10.09, 20.11], d = 0.37), psychological flexibility (MD = -8.42, 95% CI: [-10.81, -6.03], d = -1.47), anxiety (MD = -1.27, 95% CI: [-2.50, -0.05], d = -0.44), depression (MD = -2.11, 95% CI: [-3.28, -0.95], d = -0.76), and sleep disturbance (MD = -1.85, 95% CI: [-3.10, -0.59], d = 0.13) at postintervention, however, the improvement in fatigue was not statistically significant (MD = -2.02, 95% CI: [-9.02, 4.98], d = -0.12).

CONCLUSIONS

Web-based ACT was an approach with good feasibility and acceptability, and it could effectively improve quality of life, psychological flexibility, anxiety, depression, and sleep disturbance in patients with lung cancer. In order to achieve better results, there is a need to design a more tailored intervention plan and a more operational platform.

The effects of physical activity interventions on self-esteem during and after cancer treatment: a systematic review and meta-analysis

To investigate the effect of physical activity (PA) (both general and its type) on self-esteem during and after cancer treatment. A systematic search was conducted across PubMed, Web of Science, Scopus, SPORTDiscuss, and PsycINFO from their inception to February 2024. The systematic review included 32 studies, with 15 studies (13 RCT and 2 quasi-experimental) and 3604 participants (66.7% female) included in the meta-analysis involving controlled trials using a control group and at least one PA intervention group. The study was registered in PROSPERO (CRD42022309771). Risk of bias for RCTs was assessed using the Cochrane Collaboration's tool for assessing risk of bias (RoB2), and quasi-experimental studies with the Joanna Briggs Institute critical appraisal tool. PA significantly improved self-esteem during and after cancer treatment (pooled SMD = 0.32, p < 0.01). Specifically, aerobic PA (pooled SMD = 0.33, p = 0.04) and mind-body exercise (pooled SMD = 0.70, p = 0.03) had positive effects on self-esteem. Overall, PA interventions improved self-esteem during cancer treatment (pooled SMD = 0.50, p = 0.01) and in PA interventions lasting more than 12 weeks (pooled SMD = 0.44, p = 0.02). In conclusion, PA (specifically, aerobic and mind-body exercises) may have a positive effect on self-esteem during and after cancer treatment, with cancer status and the duration of the intervention being key factors.

The use of mindfulness-based stress reduction (MBSR) for breast cancer patients-meta-analysis

BACKGROUND

Mindfulness-based stress reduction (MBSR) intervention has been widely used to reduce the burden of symptoms in cancer patients, and its effectiveness has been proven. However, the effectiveness of MBSR on depression, anxiety, fatigue, quality of life (QOL), posttraumatic growth (PTG), fear of cancer recurrence (FCR), pain, and sleep in breast cancer patients has not yet been determined. This study aims to determine the role of mindfulness-based stress reduction therapy in patients with breast cancer.

OBJECTIVES

The objective was to systematically review the literature to explore the effect of MBSR on anxiety, depression, QOL, PTG, fatigue, FCR, pain, stress and sleep in breast cancer patients. To explore the effect of 8-week versus 6-week MBSR on the 9 indicators. Data were extracted from the original RCT study at the end of the intervention and three months after baseline to explore whether the effects of the intervention were sustained.

METHODS

We conducted searches on PubMed, Web of Science, Embase, and China National Knowledge Infrastructure from inception to November 2023. Eligible studies included randomized controlled trials of breast cancer patients who received mindfulness stress reduction intervention, reporting outcomes for anxiety, depression, fatigue, QOL, PTG, FCR, pain, stress, and sleep. Two researchers conducted separate reviews of the abstract and full text, extracted data, and independently evaluated the risk of bias using the Cochrane 'Bias Risk Assessment tool'. The meta-analysis utilized Review Manager 5.4 to conduct the study, and the effect size was determined using the standardized mean difference and its corresponding 95% confidence interval.

RESULTS

The final analysis included 15 studies with a total of 1937 patients. At the end of the intervention, the interventions with a duration of eight weeks led to a significant reduction in anxiety [SMD=-0.60, 95% CI (-0.78, -0.43), P < 0.00001, I2 = 31%], depression [SMD=-0.39, 95% CI (-0.59, -0.19), P = 0.0001, I2 = 55%], and QOL [542 participants, SMD = 0.54, 95% CI (0.30, 0.79), P < 0.0001, I2 = 49%], whereas no statistically significant effects were found in the intervention with a duration of six weeks. Similarly, in 3 months after baseline, the interventions with a duration of eight weeks led to a significant reduction in depression and QOL, however, no statistically significant effects were found at the 6-week intervention. MBSR led to a significant improvement in PTG at end of intervention [MD = 6.25, 95% CI (4.26, 8.25), P < 0.00001, I2 = 0%] and PTG 3 months after baseline. We found that MBSR reduced the fatigue status at end of intervention, but had no significant effect on fatigue status 3 months after baseline. There was no significant difference in improving pain, stress, and FCR compared to usual care.

CONCLUSIONS

In terms of effects on QOL, anxiety, depression, and fatigue, the 8-week MBSR intervention showed better results than the 6-week MBSR intervention. The intervention of MBSR on PTG was effective, and the effect lasted until 3 months after baseline. Future studies could further identify the most effective intervention components in MBSR.

TRIAL REGISTRATION

PROSPERO registration number: CRD42023483980.

The Effect of a Mindfulness-Based Stress Reduction Program on Depression and Quality of Life in Cancer Patients: A Meta-Analysis Study

Mindfulness-based interventions have been receiving growing attention in cancer care. This study was performed to determine the effect of a mindfulness-based stress reduction program on depression and quality of life in cancer patients. The screenings in the study were performed in January to May 2023 through the Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, Web of Science, Science Direct, and YÖK Thesis Center databases. After the reviews, 14 studies were included in the study. This meta-analysis showed that mindfulness-based stress reduction programs were effective on depression (SMD: -0.363; 95% CI: -0.711 to 0.015; Z = -2.042; P = .041; I2 = 85.229%) and quality of life (SMD: 0.363; 95 CI%: 0.111-0.615; Z = 2.822; P = .005; I2 = 75.222%). The type of cancer (SMD: 0.385; CI: between 0.005 and 0.528; P = .000); duration of therapy (SMD: 0.243; CI: between 0.093 and 0.393; P = .002); the person providing therapy (SMD: 0.335; CI: between 0.133 and 0.507; P = .001); scale used (SMD: 0.290; CI: between 0.148 and 0.432; P = .000); and the origin of the study (SMD: 0.298; CI: between 0.158 and 0.438; P = .000) moderators were found to play a role in the effectiveness of a mindfulness-based stress reduction program on the quality of life of cancer patients. The mindfulness-based stress reduction program yields positive outcomes by reducing depression, enhancing the quality of life in cancer patients, and promoting overall mental well-being in individuals.

Symptom clusters and symptom network analysis during immunotherapy in lung cancer patients

OBJECTIVE

This study analyzes symptoms in lung cancer patients undergoing immunotherapy to identify core symptom clusters through network analysis and lay a foundation for effective symptom management programs.

METHODS

The sample comprised 240 lung cancer patients receiving immunotherapy. Participants were assessed using the Memorial Symptom Assessment Scale. Exploratory factor analysis was used to extract symptom clusters, and network analysis using JASP 0.17.3 was performed to explore the centrality indices and density of the symptom network.

RESULTS

Five symptom clusters were identified, i.e., emotion-related, lung cancer-related, physical, skin, and neural symptom clusters, with a cumulative variance contribution rate of 55.819%. Network analysis revealed that sadness was the most intense symptom (rs = 2.189), dizziness was the most central symptom (rc = 1.388), and fatigue was the most significant bridging symptom (rb = 2.575).

CONCLUSION

This study identified five symptom clusters and a symptom network among lung cancer patients during immunotherapy. The network analysis's centrality indices and network density results can assist healthcare professionals in devising more precise symptom management strategies.

The mechanism of cancer-depression comorbidity

Cancer and depression are closely interrelated, particularly in patients with advanced cancer, who often present with comorbid anxiety and depression for various reasons. Recently, there has been a growing interest in the study of depression in cancer patients, with the aim of assessing the possible triggers, predictors, adverse events, and possible treatment options for depression in several common cancers. The objective of this narrative review is to synthesize the extant literature on the relationship between the occurrence and progression of depression in several common patient categories. The authors conducted a comprehensive review of 75 articles published in PubMed over the past five years. This review was further evaluated in the present paper. Ultimately, it was determined that depression is a prevalent and detrimental phenomenon among cancer patients, particularly those with advanced disease. Consequently, there is a pressing need to prioritize research and interventions aimed at improving the quality of life and psychosocial well-being of cancer patients, including those with advanced disease. The relationship between cancer and depression has been evolving dynamically in recent times. The current research findings indicate a strong association between cancer and depression. However, the direction of causality remains unclear. Focusing on depression in cancer patients may, therefore, be beneficial for these patients.

A study on improving cancer-related fatigue and disease-related psychological variables in patients with cervical cancer based on online mindfulness-based stress reduction: a randomized controlled trial

BACKGROUND

The persistent destructive power of cancer-related fatigue (CRF) has been regarded as the biggest influencing factor affecting the postoperative physical and mental health of patients with cervical cancer. During this process, patients might also experience different feelings of disease-related psychological. Therefore, this study aimed to adopt mindfulness-based stress reduction (MBSR) to intervene in patients with cervical cancer, and conducted follow-up for 3 and 6 months to observe the effects of changes in CRF, uncertainty in illness, coping styles, sense of coherence (SOC), and perceived social support (PSS).

METHODS

A randomized controlled trial was conducted in ShengJing Hospital of China Medical University. A total of 102 patients were selected, and 78 patients completed the whole process, including 40 in the experimental group and 38 in the control group. Data were collected according to Cancer Fatigue Scale, Medical Coping Modes Questionnaire, Multidimensional Scale of Perceived Social Support, and Sense of Coherence-13. The change trend and difference of the two groups of research data were compared by repeated measurement analysis of variance. Bonferroni test was used for multiple tests between groups.

RESULTS

The CRF, SOC, and coping styles of the MBSR group showed a decreasing trend (P < 0.001) at after MBSR, 3 months follow-up, and 6 months follow-up compared to the before MBSR. However, the uncertainty in illness of the MBSR group showed a decreasing trend (P < 0.001) at after MBSR compared to the before MBSR, and it rose in 3 months follow-up and 6 months follow-up.

CONCLUSION

MBSR can effectively alleviate the fatigue of CRF after treatment, while improving their psychological environment. Medical workers can consider implementing online MBSR for patients with cervical cancer in their daily rehabilitation nursing, which is beneficial for their recovery.

TRIAL REGISTRATION

China Clinical Trial Registration Center ChiCTR2000040122 (https//www.chictr.org.cn/). Registered on November 21, 2020.

The impact of mindfulness intervention on negative emotions and quality of life in malignant tumor patients: a systematic review and meta-analysis

Objective

This study aims to assess the effect of mindfulness intervention on negative emotions (anxiety and depression) and quality of life in malignant tumor patients.

Methods

The databases, including CNKI, VIP, Wanfang, Chinese Biomedical Literature Database disc (CBMdisc), PubMed, Embase, Cochrane Library, and Web of Science (WoS), were searched from inception to January 2024. Randomized controlled trials examining the effects of mindfulness intervention on negative emotions and quality of life in malignant tumor patients were selected. Meta-analysis was conducted using RevMan 5.1.

Results

A total of 11 studies involving 993 patients were included. Compared with usual care, mindfulness intervention effectively reduced anxiety [SMD = -0.81, 95% CI (-1.01, -0.60), p < 0.00001], depression [SMD = -0.86, 95% CI (-1.01, -0.70), p < 0.00001], and improved patients' quality of life [SMD = 0.64, 95% CI (0.50, 0.78), p < 0.00001].

Conclusion

Mindfulness intervention can effectively alleviate negative emotions such as anxiety and depression in malignant tumor patients and positively impact their quality of life.

Risk factors for cancer-related cognitive impairment among individuals with lung cancer: a systematic review and meta-analysis

OBJECTIVES

Cancer-related cognitive impairment (CRCI) exerts a negative impact on the quality of life in lung cancer survivors. Risk factors for CRCI in lung cancer patients remain unclear.This study aimed to identify risk factors for CRCI in lung cancer patients.

METHODS

A comprehensive literature search was conducted across PubMed, CINAHL, Web of Science, Wanfang, VIP Database, Embase, and China National Knowledge Infrastructure (CNKI) from their inception until March 10, 2024. Studies were screened, data extracted, and quality assessed using the Agency for Healthcare Research and Quality and Newcastle-Ottawa Scale. Meta-analysis was performed using RevMan 5.4, assessing risk factors through odds ratios (OR) with 95% confidence intervals (CIs).

RESULTS

The analysis was comprised of nine studies, including 1,305 patients. Seven studies were high quality, and two were moderate quality. Identified risk factors for CRCI in lung cancer patients included advanced age (OR = 3.51, 95%CI: 2.14-5.74, I2 = 0.0%), cranial irradiation (OR = 2.12, 95% CI: 1.39-3.22, I2 = 0.0%), anxiety (OR = 2.92, 95% CI: 1.65-5.25, I2 = 37%), and symptom cluster burden (OR = 4.85, 95% CI: 2.99-7.87, I2 = 0.0%). Physical activity (OR = 0.37, 95% CI; 0.23-0.58, I2 = 9.0%) was identified as a protective factor.

CONCLUSION

Advanced age, cranial irradiation, anxiety, and symptom cluster burden are significant risk factors for CRCI, while physical activity serves as a protective factor. These insights provide healthcare professionals with an evidence-based framework for managing CRCI in lung cancer patients.

Prevalence and risk factors for anxiety in patients with early- and middle-stage lung cancer: a cross-sectional study

Objective

Lung cancer is a leading cause of cancer-related morbidity and mortality worldwide, with patients frequently experiencing significant psychological distress, particularly anxiety. Despite the high prevalence of anxiety in patients with cancer, there is limited comprehensive research focusing on the specific factors influencing anxiety in patients with early- and middle-stage lung cancer within the context of Chinese medicine hospitals. Therefore, we aimed to investigate the epidemiology and factors influencing anxiety disorders in patients with early- and middle-stage primary bronchial lung cancer through a cross-sectional study.

Methods

A total of 340 patients with early and middle-stage lung cancer admitted to the outpatient ward of the oncology department at Guang'anmen Hospital from June 2023 to December 2023 were included in this study. Survey data, including the patients' general condition questionnaire, Generalized Anxiety Scale (GAD-7), Hospital Anxiety and Depression Scale (HADS), and Mental Toughness Scale (CD-RISC-10), were collected and recorded in a database using a two-person input format. Data analysis was performed using SPSS 27.0 software.

Results

Out of the 340 patients with early- and middle-stage lung cancer included in this study, 133 had anxiety, resulting in an overall anxiety detection rate of 39.12%. The chi-square test showed that statistically significant differences in religion, marital status, surgical treatment, tobacco use, and alcohol history between the anxious and non-anxious groups (p < 0.05). Moreover, statistically significant differences were observed in per capita annual family income, pathological type, VAS score, targeted therapy, treatment stage, and mental toughness level (p < 0.001). Other factors were not significantly correlated with anxiety onset. Multivariate logistic regression analysis showed that higher per capita family income and completed treatment independently acted as protective factors against anxiety onset in patients with early- and middle-stage lung cancer. Conversely, rare pathological types, increased pain severity, and lower levels of mental toughness were identified as independent risk factors for anxiety onset in these patients.

Conclusion

Anxiety was prevalent in patients with early- and middle-stage lung cancers. Rare pathological types, increased pain severity, and lower levels of mental toughness were independent risk factors for anxiety. Therefore, clinicians and psychologists should pay more attention to patients with rare types of tumors, actively manage their pain symptoms, and consider implementing mental resilience training to improve patients' mental toughness.

Comparative effect of different mindfulness-based intervention types and deliveries on depression in patients with breast cancer: a protocol for a systematic review and network meta-analysis

INTRODUCTION

Breast cancer has become the most common cancer worldwide. Various types of mindfulness-based interventions (e.g., mindfulness-based cognitive therapy, mindfulness-based stress reduction) have been conducted in different delivery methods (including face to face and internet delivered) to help patients with breast cancer mitigate their depression. However, at present, there are no studies that compare the effectiveness of all these types and deliveries of mindfulness-based interventions. Therefore, this protocol aims to conduct a systematic review and network meta-analysis to assess the effectiveness of various types and deliveries of mindfulness-based interventions in mitigating depression in patients with breast cancer.

METHODS

This protocol is according to the guidelines of the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P). The electronic databases, including PubMed, Web of Science, the Cochrane Library, Embase, Google Scholar, The China National Knowledge Infrastructure and OpenGrey, will be comprehensively retrieved for related randomised controlled trials (RCTs) from inception to December 2023. Two reviewers will independently assess the risk of bias using the Cochrane Risk of Bias Tool for Randomised Trials 2.0 (RoB 2.0). The network meta-analysis will be performed using the STATA V.16.0, and the assessment of heterogeneity, inconsistency, publication bias, evidence quality, subgroup analyses and sensitivity analyses will be conducted.

ETHICS AND DISSEMINATION

This protocol does not require approval from an ethics committee as it is based on previous research findings. The results will be disseminated via peer-reviewed publications.

PROSPERO REGISTRATION NUMBER

CRD42024495996.

The Usefulness of Virtual Reality in Symptom Management during Chemotherapy in Lung Cancer Patients: A Quasi-Experimental Study

Background: Virtual reality (VR) emerges as a promising non-pharmacological intervention for managing symptoms and providing distraction during chemotherapy. This study aims to assess VR's effectiveness on cancer-related symptoms, vital signs, and the patients' perception of chemotherapy in lung cancer patients. Methods: A quasi-experimental study was conducted on 100 patients. Participants were allocated into an intervention group (n = 55), which experienced immersive VR, and a comparison group (n = 45), which received usual care. Data were collected through questionnaires and checklists, including feedback on the VR experience, pain, vital signs, and common cancer symptoms, assessed through the Edmonton Symptom Assessment Scale. Results: VR had a significant impact on reducing the perception of chemotherapy length. Patients reported high levels of satisfaction and tolerability. No adverse events were observed. VR did not have significant influence on pain intensity or vital signs. The only exceptions were oxygen saturation, where a significant difference (p = 0.02) was reported, and the perception of chemotherapy duration. Conclusions: As a non-pharmacological intervention, VR proves to be beneficial in minimizing the perceived length of chemotherapy sessions for lung cancer patients, enhancing their overall treatment experience. The intervention was found to be a safe, feasible, and well-accepted distraction technique. Future research should explore VR's potential effects on a wider range of symptoms and evaluate its impact on long-term outcomes.

Effectiveness of Web-Based Mindfulness-Based Interventions for Patients With Cancer: Systematic Review and Meta-Analyses

BACKGROUND

Cancer has emerged as a considerable global health concern, contributing substantially to both morbidity and mortality. Recognizing the urgent need to enhance the overall well-being and quality of life (QOL) of cancer patients, a growing number of researchers have started using online mindfulness-based interventions (MBIs) in oncology. However, the effectiveness and optimal implementation methods of these interventions remain unknown.

OBJECTIVE

This study evaluates the effectiveness of online MBIs, encompassing both app- and website-based MBIs, for patients with cancer and provides insights into the potential implementation and sustainability of these interventions in real-world settings.

METHODS

Searches were conducted across 8 electronic databases, including the Cochrane Library, Web of Science, PubMed, Embase, SinoMed, CINAHL Complete, Scopus, and PsycINFO, until December 30, 2022. Randomized controlled trials involving cancer patients aged ≥18 years and using app- and website-based MBIs compared to standard care were included. Nonrandomized studies, interventions targeting health professionals or caregivers, and studies lacking sufficient data were excluded. Two independent authors screened articles, extracted data using standardized forms, and assessed the risk of bias in the studies using the Cochrane Bias Risk Assessment Tool. Meta-analyses were performed using Review Manager (version 5.4; The Cochrane Collaboration) and the meta package in R (R Foundation for Statistical Computing). Standardized mean differences (SMDs) were used to determine the effects of interventions. The Reach, Effectiveness, Adoption, Implementation, and Maintenance framework was used to assess the potential implementation and sustainability of these interventions in real-world settings.

RESULTS

Among 4349 articles screened, 15 (0.34%) were included. The total population comprised 1613 participants, of which 870 (53.9%) were in the experimental conditions and 743 (46.1%) were in the control conditions. The results of the meta-analysis showed that compared with the control group, the QOL (SMD 0.37, 95% CI 0.18-0.57; P<.001), sleep (SMD -0.36, 95% CI -0.71 to -0.01; P=.04), anxiety (SMD -0.48, 95% CI -0.75 to -0.20; P<.001), depression (SMD -0.36, 95% CI -0.61 to -0.11; P=.005), distress (SMD -0.50, 95% CI -0.75 to -0.26; P<.001), and perceived stress (SMD -0.89, 95% CI -1.33 to -0.45; P=.003) of the app- and website-based MBIs group in patients with cancer was significantly alleviated after the intervention. However, no significant differences were found in the fear of cancer recurrence (SMD -0.30, 95% CI -1.04 to 0.44; P=.39) and posttraumatic growth (SMD 0.08, 95% CI -0.26 to 0.42; P=.66). Most interventions were multicomponent, website-based health self-management programs, widely used by international and multilingual patients with cancer.

CONCLUSIONS

App- and website-based MBIs show promise for improving mental health and QOL outcomes in patients with cancer, and further research is needed to optimize and customize these interventions for individual physical and mental symptoms.

TRIAL REGISTRATION

PROSPERO CRD42022382219; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=382219.

Non-pharmaceutical interventions for depressive symptoms in patients with breast cancer: protocol for a systematic review and network meta-analysis

INTRODUCTION

Patients with breast cancer often suffer from depressive symptoms throughout various stages of cancer, significantly impacting their quality of life and treatment outcomes. Non-pharmaceutical interventions such as psychotherapy, mind-body therapies and physical exercise have shown effectiveness in addressing cancer-related depression. However, the efficacy and safety of different non-pharmacological interventions remain a topic of debate. Therefore, to provide an objective assessment and comparison of the impact of different non-pharmaceutical interventions on depression, we will conduct a network meta-analysis (NMA) to explore the effects of different non-pharmaceutical interventions on reducing depressive symptoms among patients with breast cancer.

METHODS AND ANALYSIS

We will search nine Chinese and English-language databases, from database inception to 31 July 2023, for randomised controlled trials published in Chinese or English. The English-language databases are PubMed, Medline, Embase, Web of Science and Cochrane Central Register of Controlled Trials, and the Chinese databases are CBM, CNKI, VIP and Wanfang. Two independent researchers will perform information extraction from eligible articles. The primary outcome will be the changes in depressive symptoms, while the secondary outcome will include adverse events. STATA V.15.0 will be used to conduct paired meta-analysis and NMA. Grading of Recommendations Assessment, Development and Evaluation will be used to assess the quality of evidence, and the Cochrane tool for assessing the risks of bias in randomised trials V.2 will be used for risk of bias assessment.

ETHICS AND DISSEMINATION

The study does not require ethical approval as it will analyse data from existing studies. It is expected that the results of the study will be published in peer-reviewed journals and presented at relevant conferences.

PROSPERO REGISTRATION NUMBER

CRD42023450494.

The effects of progressive muscle relaxation exercise applied to lung cancer patients receiving chemotherapy on dyspnea, pain and sleep quality: A randomized controlled trial

PURPOSE

The aim of the present study is the analysis of how progressive muscle relaxation exercise affects dyspnea, pain and sleep quality in patients with lung cancer receiving chemotherapy.

METHODS

Seventy-four patients diagnosed with lung cancer were included in this randomized controlled study. A total of 16 sessions of progressive muscle relaxation exercises were applied to the patients in the intervention group for a duration of 30 min, 2 days a week for 8 weeks. Patient Information Form, Medical Research Council Dyspnea Scale (MRC dyspnea scale), Pitssburg Sleep Quality Index (PSQI), Visual Analog Scale- Pain (VAS-P) were used to collect data.

RESULTS

Socio-demographic and disease characteristics were found to be similar in control and intervention groups. Final scores indicated significant differences between the experimental and control groups in all variables. The experimental group showed significantly more favorable results in dyspnea (p < 0.001), pain (p < 0.003) and sleep (p < 0.001) symptoms. When the effect size values (Cohen's d) of these findings were analyzed, PMR exercise was found to have a moderate effect on mean VAS-P scores (0.548) and a large effect on mean MRC dyspnea scale (1.073) and PSQI (0.970) scores. These results indicated significant differences in pre and post intervention mean scores.

CONCLUSION

Progressive muscle relaxation exercise applied to lung cancer patients receiving chemotherapy was found to be effective in reducing dyspnea and pain severity and improving sleep quality. Clinical trial registration at ClinicalTrials.gov. NCT04978805.

The Role of Attentional Control in Mindfulness Intervention for Emotional Distress: A Randomized Controlled Trial With Longitudinal Mediation Analyses

OBJECTIVE

This study aimed to investigate whether attentional control serves as a mediator for mindfulness-based interventions for emotional distress, utilizing a randomized waitlist (WL)-controlled design.

METHODS

A total of 498 participants with high emotional distress was recruited online and randomly assigned to a 49-day online Mindfulness Intervention for Emotional Distress (MIED) group (N = 249) or a WL control group (N = 249). Levels of attentional control, anxiety and depression were assessed at baseline (T0), Week 3 (T3), Week 5 (T5) and Week 7 (postintervention, T7).

RESULTS

Linear mixed models revealed significant Group-by-Time interaction effects for attentional control (p < 0.001), anxiety (p < 0.001) and depression (p < 0.05). Latent growth curve analyses demonstrated a significant increase in attentional control and a decrease in anxiety and depression levels during the MIED programme. These changes becoming evident starting Week 3. Longitudinal mediation analyses revealed that the slope of attentional control significantly mediated the effects of the MIED programme on the slope of anxiety and depression levels. Further, attentional control level at Week 3 significantly mediates the effect of MIED programme on anxiety and depression levels at Weeks 5 and 7. Similarly, attentional control level at Week 5 significantly mediates the MIED programme's effects on anxiety and depression levels at Week 7.

CONCLUSIONS

The present trial provides evidence suggesting that mindfulness interventions may alleviate emotional distress through the enhancement of attentional control.

TRIAL REGISTRATION

Chinese Clinical Trial Registry number: ChiCTR2200064140.

Cancer Care Supportive Text Messaging Program (Text4Hope) for People Living With Cancer and Their Caregivers During the COVID-19 Pandemic: Longitudinal Observational Study

BACKGROUND

Cancer is the leading cause of death in Canada, and living with cancer generates psychological demands, including depression and anxiety among cancer survivors and caregivers. Text4Hope-Cancer Care SMS text messaging-based service was provided to people with cancer and caregivers during the COVID-19 pandemic to support their mental health.

OBJECTIVE

The aim of this study is to examine the clinical effectiveness of and satisfaction with Text4Hope-Cancer Care in addressing mental health conditions among people living with cancer and caregivers.

METHODS

The study was conducted in Alberta, Canada. People who were diagnosed or receiving cancer treatment and caregivers self-subscribed to receive 3-months daily supportive cognitive behavioral therapy-based SMS text messages and a web-based survey was sent at designated time points to collect clinical and nonclinical data. The Hospital Anxiety and Depression scale (HADS) was used to examine changes in anxiety and depression symptoms after receiving the service. Satisfaction with the service was assessed using a survey with a Likert scale. Descriptive and inferential statistics were used, and test significance was considered with P≤.05.

RESULTS

Overall, 107 individuals subscribed to the service, and 93 completed the program (completion rate 93/107, 86.9%). A significant improvement in the anxiety symptoms (HADS-Anxiety [HADS-A] subscale) was reported after 3 months of Text4Hope-Cancer Care (t11=2.62; P=.02), with medium effect size (Hedges g=0.7), but not depression symptoms (HADS-Depression [HADS-D] subscale). Subscribers expressed high satisfaction and agreed that the service has helped them to cope with mental health symptoms and improve their quality of life. Most subscribers read the SMS text messages more than once (30/30, 100%); took time to reflect or took a beneficial action after reading the messages (27/30, 90%); and highly agreed (27/30, >80%) with the value of the received supportive SMS text messages as being relevant, succinct, affirmative, and positive. All subscribers recommended SMS text messaging for stress, anxiety, and depression and for cancer care support (30/30, 100%).

CONCLUSIONS

Text4Hope-Cancer Care was well-perceived and effectively addressed anxiety symptoms among people living with cancer and caregivers during the peak of the COVID-19 pandemic. This study provides evidence-based support and insight for policy and stakeholders to implement similar convenient, economic, and accessible mental health services that support vulnerable populations during crises.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

RR2-10.2196/20240.

The Effects of Mindfulness-Based Interventions in People with Parkinson's Disease: A Systematic Review and Meta-Analysis

OBJECTIVES

To examine the effectiveness of mindfulness-based interventions (MBIs) on psychological symptoms, motor symptoms, and quality of life in patients with Parkinson's disease (PD).

METHODS

Published studies in Chinese and English languages, conducted from inception to March 2023, were identified by searching PubMed, Web of Science, Cochrane Library, CINAHL, PsycINFO, and two Chinese electronic databases. The systematic review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta Analyses guidelines.

RESULTS

Twelve studies were selected for quantitative syntheses. The impact of MBIs on reducing depression and anxiety, and improving mindfulness and quality of life in PD patients was statistically significant compared to the control group. However, no statistically significant effect on motor symptoms was observed. Subgroup analysis indicated that participants from Asia, those who received face-to-face sessions, and those whose sessions lasted 1.5 hours showed a more positive effect than other subgroups.

CONCLUSIONS

Patients with PD may benefit from MBIs to improve psychological symptoms and quality of life. MBIs represent a pivotal non-pharmacological therapeutic approach in clinical practice.

CLINICAL IMPLICATIONS

MBIs confer positive improvements in psychological well-being and quality of life in PD patients. However, it remains challenging to conclusively determine their efficacy in addressing motor symptoms.

Online mindfulness-based stress reduction improves anxiety and depression status and quality of life in caregivers of patients with severe mental disorders

OBJECTIVES

To explore the effects of online mindfulness-based stress reduction (MBSR) on the anxiety and depression status, and quality of life in the caregivers of patients with severe mental disorders.

METHODS

Ninety-three caregivers for patients with schizophrenia or bipolar disorder, who were hospitalized in Yunnan Provincial Mental Hospital in March 2021, were enrolled and randomly divided into control group (n=47) and MBSR intervention group (n=46). Both groups received basic health education and rehabilitation skill training, while the intervention group received additional online MBSR for 8 weeks. The anxiety and depression status, and the quality of life of the caregivers were evaluated by Self-rating Anxiety Scale (SAS), Self-rating Depression Scale (SDS) and the 36-item Short Form Health Survey (SF-36) before and 8 weeks after intervention, respectively.

RESULTS

Thirteen caregivers dropped out of the study, and 80 subjects (40 in each group) were included in the final analysis. At the baseline, there were no significant differences in SAS, SDS and SF-36 scores between two groups (all P>0.05). Compared with the baseline, SAS and SDS scores in the intervention group significantly decreased after 8 weeks of intervention (both P<0.01) and were significantly lower than those in the control group (both P<0.01). There were no significant changes in the control group (all P>0.05). Except the physiological function dimension, the total score and the scores of each dimension of SF-36 in the intervention group were significantly increased after 8-week intervention (all P<0.05), and were significantly higher than those in the control group (all P<0.01). There were no significant changes in the control group before and after intervention (all P>0.05).

CONCLUSIONS

Online MBSR can reduce the anxiety and depression levels, improve the quality of life in the caregivers of patients with severe mental disorders.

Implementation Readiness and Initial Effects of a Brief Mindfulness Audio Intervention Compared With a Brief Music Control During Daily Radiation Therapy for Prostate Cancer: A Randomized Pilot Study

Background

The most common and debilitating side effects of radiation therapy (RT) for prostate cancer (PC) are fatigue, sleep disturbance, anxiety, and depression. Previous research has reported palliative benefits from certain self-management approaches, such as mindfulness meditation.

Objective

To develop, pre-test, and evaluate the feasibility, acceptability and initial benefit of brief, audio-based mindfulness delivered during daily RT for PC compared to a relaxing music control.

Methods

Following intervention development, participants were randomized to either brief guided mindfulness audio recordings or a relaxing music control during daily RT. A pre-testing phase was first conducted to determine optimal program start time, length, and content most associated with retention. A final program (n = 26) was delivered daily, starting on day one of week 2 of RT and lasting 4 consecutive weeks. Feasibility was defined as ≥70% on enrollment rate, retention, and audio program adherence. Acceptability was measured with a 12-item post-study survey. A secondary focus compared between group changes on patient reported outcomes of fatigue, anxiety, depression, sleep disturbance, and related outcomes at baseline and follow up assessments. Descriptive statistics and general linear models were used.

Results

Overall, 76% (n = 38) of approached men enrolled. Pre-testing retention rates were <70% while the final program's retention rate was 89%. The majority of acceptability criteria were met in both conditions, with relatively higher ratings in the mindfulness arm. Compared to music controls, mindfulness participants demonstrated significantly less uncertainty intolerance at 4-weeks (P = .046, d = .95); and significantly lower fatigue scores (P = .049, d = 1.3) and lower sleep disturbance scores (P = .035, d = 1.1) at the 3 months follow up.

Conclusion

The final intervention met feasibility and acceptability criteria. Pre-testing refinements played a key role for optimal program delivery and retention. Audio-based mindfulness delivered during RT for PC hold potential to help decrease RT-related physical and emotional side effects.