Effects of nurse-led supportive-expressive group intervention for post-traumatic growth among breast cancer survivors: A randomized clinical trial

Task-sharing for non-communicable disease prevention and control in low- and middle-income countries in the context of health worker shortages: A systematic review

Health workers are pivotal for non-communicable disease (NCD) service delivery, yet often are unavailable in low- and middle-income countries (LMICs). There is limited evidence on what NCD-related tasks non-physician health workers (NPHWs) can perform and their effectiveness. This study aims to understand how task-sharing is used to improve NCD prevention and control in LMICs. We also explored barriers, facilitators, and unexpected consequences of task-sharing. Databases searched in two phases and included MEDLINE, EMBASE, CENTRAL, CINAHL, Cochrane, and clinical trial registries, and references of included studies from inception until 31st July 2024. We included randomised control trials (RCTs), cluster RCTs, and associated process evaluation and cost effectiveness studies. The risk of bias was assessed using the Cochrane Risk of Bias Tool v2. PROSPERO: CRD42022315701. The study found 5527 citations, 427 full texts were screened and 149 studies (total population sample>432567) from 31 countries were included. Most studies were on tasks shared with nurses (n=83) and community health workers (n=65). Most studies focussed on cardiovascular disease (n=47), mental health (n=48), diabetes (n=27), cancer (n=20), and respiratory diseases (n=10). Seventeen studies included two or more conditions. Eighty-one percent (n=120) of studies reported at least one positive primary outcome, while 19 studies reported neutral results, one reported a negative result, eight (5.4%) reported mixed positive and neutral results, and one reported neutral and negative findings. Economic analyses indicated that task-sharing reduced total healthcare costs. Task-sharing is an effective intervention for NCDs in LMICs. It is essential to enhance the competencies and training of NPHWs, provide resources to augment their capabilities, and formalise their role in the health system and community. Optimising task-sharing for NCDs requires a holistic approach that strengthens health systems while supporting NPHWs in effectively addressing the diverse needs of their communities. Registration: PROSPERO CRD42022315701.

Addressing Mental Health Needs in Patients With Cancer: A Recent Systematic Review and Meta-Analysis of the Effectiveness of Nurse-Led Interventions

BACKGROUND

Depression and anxiety are prevalent among patients with cancer, impacting their quality of life and treatment outcomes. Nurse-led interventions are promising but show variable effectiveness.

PURPOSE

This review assessed the effectiveness of nurse-led interventions in reducing depression and anxiety in patients with cancer.

METHODS

A systematic search identified studies evaluating nurse-led approaches for depression and anxiety. Meta-analysis used Cohen's d with a random-effects model, and heterogeneity was assessed using the I2 statistic.

RESULTS

Eighteen studies (n = 2054) showed significant reductions in depression (-1.29, 95% confidence interval [CI]: -1.52 to -1.06) and anxiety (-1.31, 95% CI: -1.55 to -1.07). Effective strategies included self-care education, cognitive-behavioral therapy, and peer support. Moderate to high heterogeneity (I2 = 70%-75%) was partly resolved through sensitivity analyses.

CONCLUSIONS

Nurse-led interventions effectively reduce depression and anxiety in patients with cancer. Integrating these strategies into oncology care and standardizing protocols can further improve outcomes.

Non-Pharmacological Interventions for Managing the Symptoms of Depression in Women with Breast Cancer: A Literature Review of Clinical Trials

Symptoms of depression represent a significant burden to patients with breast cancer, not only because of the psychological stress associated with their diagnosis, but also because of the adverse effects of its treatment. We reviewed the clinical trials examining the management of the symptoms of depression in breast cancer patients through different non-pharmacological interventions in different databases (PubMed, Embase, Scopus, and the American Psychological Association). Cognitive behavioural therapy, interpersonal psychotherapy or psychodynamic psychotherapy, as well as acceptance and commitment therapy have been effective in improving symptoms of depression in cancer patients with moderate to severe symptoms. Physical exercise, yoga, mindfulness, and support groups have been shown to benefit patients with mild depressive symptoms. These interventions not only showed positive results in interventions in women with breast cancer in terms of the symptoms of depression, but also highlighted their benefits for comorbid anxiety, stress, and poor sleep quality; moreover, it is suggested that these interventions should be leveraged to manage mental health issues in breast cancer patients. The molecular effects of these interventions, such as the reduction in inflammatory cytokines and cortisol levels, have seldom been reported and need further studies.

A cross-sectional study on posttraumatic growth and influencing factors among parents of premature infants

OBJECTIVE

Preterm birth is a significant public health concern that negatively affects parents' mental health. Posttraumatic growth (PTG) is a positive response to trauma that can effectively help parents cope with the stress of preterm birth. However, few studies have investigated PTG among parents with preterm infants. This study aimed to examine the level and influencing factors of PTG among parents with preterm infants and to explore its relationship with social support coping styles.

METHODS

A cross-sectional study was conducted among 160 parents of premature infants in a hospital in Shenzhen, China, from May 2022 to August 2022. Parents' demographic information and birth-related characteristics were collected through a self-designed general information questionnaire. PTG was assessed using the Chinese version of the Posttraumatic Growth Inventory (PTGI). Social support and coping style were measured using the Social Support Scale(SSS) and the Ways of Coping Questionnaire(WCQ). Pearson correlation analysis was used to investigate the relationship between PTGI and WCQ and SSS .A stepwise multiple linear regression analysis was performed to explore independent influencing factors of PTG.

RESULTS

The parents had an average PTG score of 66.41 ± 10.37, with 81.11% having a low and medium level of PTG. The total score of coping style of parents of premature infants was (34.28 ± 4.97) points, which was in the middle and upper level; the total score of social support of parents of premature infants was (14.28 ± 4.97) points, which was in the middle level. In addition, older gestational age at birth (B = 2.396, P < 0.001) ,higher Apgar score at 5 min at birth (B = 2.117, P = 0.023), positive coping style (B = 0.850, P < 0.001), and higher social support score (B = 1.978, P < 0.001) were associated with higher PTG scores.

CONCLUSION

Parents of preterm infants have low to medium levels of PTG, indicating much room for improvement. Older gestational age, higher Apgar score at five minutes at birth, positive coping styles, and high levels of social support were associated with higher PTG levels. Our findings provide helpful guidance for the development of effective and targeted intervention programs to improve parents' PTG and well-being.

Resilience's impact on quality of life and post-traumatic growth in breast cancer patients during treatment

BACKGROUND

This article aims to examine how psychological resilience influences the interplay between quality of life and post-traumatic growth among breast cancer patients receiving follow-up care and treatment in Türkiye.

METHODS

The study involved 119 female individuals diagnosed with breast cancer who visited the Oncology outpatient clinic at a state hospital in Türkiye from January to September 2023. Data were gathered through the administration of a survey form and the utilization of several assessment tools, including the Adult Life Quality Scale in Cancer Survivors (QLACS), the Brief Resilience Scale (BRS), and the Post-traumatic Growth Inventory (PTGI). Data analysis was carried out using SPSS 25 software.

RESULTS

The participants demonstrated an inverse correlation between Post-Traumatic Growth (PTG) and two QLACS sub-dimensions, namely recurrence and family concern. Conversely, a positive association was identified between PTG and the advantages of dealing with cancer. Furthermore, a statistically significant positive association was established between BRS and all QLACS sub-dimensions, except for family concern and appearance. However, it was determined that psychological resilience did not act as a moderator in the relationship between PTG and QLACS.

CONCLUSION

It is important to enhance psychological resilience in women who have survived cancer at all stages of the cancer journey, including the years after treatment, to have a positive impact on post-traumatic growth and quality of life.

Distress and Psycho-Oncological Support for Patients With Advanced Breast Cancer

OBJECTIVES

Patients with advanced breast cancer (ABC) face an incurable disease that brings along many challenges. Health care professionals, and nurses in particular, have a main role in supporting these patients to adapt and adjust to their condition. In this study, we discuss how good communication skills can be the first level of emotional support to patients and families; and how the high prevalence of distress in this population makes it of great importance to screen for distress regularly and treat it when needed.

DATA SOURCES

We present our research study on the impact of negative effects on biobehavioral processes that contribute to disease progression, and comment on the psychological interventions that may reduce it, with a particular focus on the CALM therapy model we validated for the Portuguese ABC patients. We also report on the added human value of a retreat for couples and professionals that our team has tested with ABC patients and their partners.

CONCLUSION

It is critical to screen for distress in ABC patients who have a higher prevalence of distress. There are available evidence-based interventions to assist clinicians in reducing their suffering. CALM therapy and a retreat format may be options to consider with ABC patients.

IMPLICATIONS FOR NURSING PRACTICE

As front-line clinicians, nurses have an important role in providing provide emotional support to patients using good communication skills, but also in identifying patients at risk for distress, screening for it regularly, and referring patients for specialized psychosocial care when needed.

Psychosocial interventions on the posttraumatic growth of adults with cancer: A systematic review and meta-analysis of clinical trials

BACKGROUND

It has been increasingly recognized that some people experience post-traumatic growth (PTG) as a result of struggling with cancer.

OBJECTIVE

This systematic review aims to identify psychosocial interventions that might facilitate PTG in adults with cancer.

METHODS

A search was conducted in PsycINFO, PubMed, Scopus, the Cochrane Library, and ProQuest up to 16 September 2022. The PRISMA guidelines were followed; all included interventional studies had to comprise 30 or more adults with cancer, using the Posttraumatic Growth Inventory, from 1994 forward.

RESULTS

A total of 2731 articles were retrieved, 1028 of those were screened and 37 unique trials were included (46 articles). A large number of studies were published since 2018 (52.4%), were randomized controlled trials (43.2%), and had group interventions (34.8%), including mainly female participants (83.8%) with a single cancer type (54.1%). Most interventions (75.7%) were moderately to highly effective in increasing PTG (d = 0.65, 95% CI 0.39-0.91) with the most effective interventions using Cognitive Behavioral Therapy (d = 1.24, 95% CI: 0.05-2.44), Mindfulness-based (d = 0.54, 95% CI = 0.14-0.94) and Education, Peer Support and Health Coaching interventions (d = 0.28, 95% CI: 0.1-0.46). Expression-based and Positive Psychology-based approaches also showed promising results. Notably, the majority of studies had a high risk of bias.

CONCLUSIONS

PTG facilitation is a promising field that should be pursued as it not only allows people with cancer to overcome their trauma but also results in them going over and above their pre-cancer state, enhancing resilience, health, and well-being.

Global trends of research on depression in breast cancer: A bibliometric study based on VOSviewer

Background

Depression is common psychiatric morbidity in breast cancer survivors, seriously affecting patients’ quality of life and mental health. A growing body of research has investigated depression in breast cancer. However, no visual bibliometric analysis was conducted in this field. This study aimed to visualize the literature to identify hotspots and frontiers in research on breast cancer and depression.

Methods

The publications related to depression in breast cancer were retrieved in the Web of Science Core Collection between 1 January 2002 and 17 March 2022. VOSviewer was used to identify co-occurrences and collaborations among countries, institutions, and keywords. CiteSpace was used to detect keyword bursts.

Results

A total of 7,350 articles and reviews related to depression in breast cancer were identified. From 2002 to 2022, the United States and the People’s Republic of China were the most productive countries in this field. The University of California, Los Angeles, and the University of Toronto were the most productive institutions in this field. The Journal of Psycho-oncology, followed by Supportive Care in Cancer and the Journal of Clinical Oncology, had the most publications on depression in breast cancer. Of the top 10 journals, seven were from the United States, two were from England, and one was from Germany. Five research hotspots of depression in breast cancer were identified by co-word analysis. Research on post-traumatic growth, spiritual interventions, cognitive-behavioral therapy, physical activity, and symptom cluster management of depression in breast cancer was relatively mature in the core hotspots. Burst detection of keywords on depression in breast cancer showed the latest hotspots, such as mental health, cancer survivor mortality, and activity.

Conclusion

The research on depression in breast cancer is growing. Attention should be paid to the latest hotspots, such as mental health, cancer survivor, mortality, exercise, and physical activity.

Research Progress on Influencing Factors and Intervention Measures of Post-traumatic Growth in Breast Cancer Patients

Breast cancer is the highest incidence of female malignant tumor in the world, and it shows an increasing trend year by year. It poses a great threat to women's life and health and has become a public health issue of global concern. Paying attention to the psychological response of cancer patients is of definite value in helping patients cope with the disease, return to society, reshape an active and healthy life, and improve their quality of life with cancer. In recent years, researchers have increasingly focused on the positive changes experienced by cancer patients from the perspective of positive psychology, namely post-traumatic growth. It is of great significance to explore individual and social resources to help patients grow and improve their survival ability and quality of life by paying attention to the potential resources and positive forces in the process of patients' fighting against diseases. This paper summarizes the influencing factors and intervention measures of post-traumatic growth of breast cancer patients, providing ideas and reference for clinical medical staff to carry out relevant intervention.