The association of depressive symptoms, personality traits, and sociodemographic factors with health-related quality of life and quality of life in patients with advanced-stage lung cancer: an observational multi-center cohort study

The impact of KRAS mutational status on patient-reported outcomes in advanced non-small-cell lung cancer: a cross sectional study in France and Germany

OBJECTIVES

Health-related quality of life (HRQoL) studies in patients with advanced non-small-cell lung cancer (NSCLC) according to KRAS mutational status are limited. This study aimed to report real-world evidence on HRQoL outcomes based on KRAS mutational status in patients with advanced NSCLC tumors receiving second-line or later (2L+) treatment in France and Germany.

METHODS

In this real-world, non-interventional, cross-sectional, multicenter, patient-reported outcome (PRO) study conducted in France (15 contributing sites) and Germany (8 contributing sites), physicians enrolled adult patients with locally advanced and unresectable or metastatic NSCLC with known KRAS mutation status (KRAS G12C, KRAS non-G12C, or KRAS wildtype [WT]), who received a 2L + treatment. Study outcomes included sociodemographic characteristics; HRQoL evaluations based on EORTC Global Health Status QoL scores (QLQ-C30) and EQ-5D-5L scores. Data were analyzed descriptively.

RESULTS

Of 156 enrolled patients, data from 149 patients were included in the final analysis (France, n = 103; Germany, n = 46). Median (quartile [Q]1, Q3) age was 67.0 (61.0, 71.0) years; 56.4% of patients were male. In total, 38.9% (n = 58), 26.2% (n = 39), and 34.9% (n = 52) of patients had tumors with KRAS G12C mutation, KRAS non-G12C mutation and WT KRAS, respectively. Mean (±SD) QLQ-C30 Global Health Status QoL scores were 56.99 (20.30) for the overall population, and 56.03 (22.55), 58.97 (18.67) and 56.57 (19.05) for KRAS G12C, non-G12C, and WT subpopulations. In the overall population, moderate-to-extreme problems were reported in all EQ-5D-5L dimensions (range: overall population, 15.5%-39.6%; KRAS G12C, 15.6%-46.6%; non-G12C, 7.8%-23.1%; WT, 21.1%-44.2%).

CONCLUSION

HRQoL was broadly similar across KRAS G12C, non-G12C, and WT subpopulations.

The effect of resistance inspiratory muscle training in the management of breathlessness in patients with thoracic malignancies: a randomised controlled trial

PURPOSE

To assess the effects of resistance inspiratory muscle training (IMT) on breathlessness in patients with thoracic malignancies.

METHODS

This is a two-arm, non-blinded, randomised controlled trial (RCT). A total of 196 participants were randomly assigned (1:1) into two groups: a control group (routine care) and an intervention group (routine care + IMT training using a pressure threshold device). The intervention duration was 12 weeks with 30 min/day, 5 days/week. The primary outcome was breathlessness severity, assessed by the modified Borg scale (mBorg). Secondary outcomes were worst and average breathlessness over the past 24 h (assessed by the 11-point Numerical Rating Scale), breathlessness severity (assessed by the Dyspnoea-12, D-12), the 6-min walk distance (assessed by the 6-min walk test, 6MWT), quality of life (assessed by the St George's Respiratory Questionnaire, SGRQ), and emotional status (assessed by the Hospital Anxiety and Depression Scale). Assessments were conducted at baseline (T1), week 8 (T2), and week 12 (T3). Adjusted generalized estimating equations (GEE) models for repeated measures over time were performed using the Statistical Package for Social Science (SPSS) software. The modified intention-to-treat principle was used for data analysis.

RESULTS

Of the 196 participants, 190 completed the trial, and six dropped out. 31.63% of participants completely adhered to the required sessions of IMT. In the adjusted GEE model, statistical and minimal clinically important differences were observed on the m-Borg score at week 8 (P = 0.002), while no significant group-by-time effect was observed in the mBorg. Compared with the control group and baseline, participants in the intervention group showed a significant reduction in D-12 total scores at week 8 (P = 0.005) and week 12 (P = 0.004). No significant group-by-time interaction effects were observed for worst and average breathlessness over the past 24 h, anxiety, depression, 6MWT, and SGRQ scores.

CONCLUSIONS

This study highlights the short-term benefits of IMT for reducing breathlessness among patients with thoracic malignancies. However, the long-term effects should be explained with caution due to the participants' suboptimal adherence. Future studies should explore different strategies to improve adherence and further evaluate the sustained effects of IMT over time.

TRIAL REGISTRATION

ClinicalTrials.gov NCT03834116.

DATE OF REGISTRATION

2019-02-06.

Prevalence and determinants of depression and its association with social support among cancer patients: implications for enhancing oncology care

BACKGROUND

Early detection of depression in cancer patients is essential for improving health outcomes. This study assessed the prevalence and determinants of depression among cancer patients and examined its association with social support.

METHOD

A cross-sectional study was conducted at Al Amal Cancer Center, Al-Thawra Hospital, Hodeida City, Yemen (January-March 2023). Data on sociodemographic characteristics, depression (Patient Health Questionnaire, PHQ-9), and social support (Oslo Social Support Scale, OSSS-3) were collected. Multivariate binary logistic regression identified significant depression factors, and Pearson's correlation was used to assess the relationship between social support and depression. A p value of < 0.05 indicated statistical significance.

RESULTS

Depression incidence among cancer patients was 55% (n = 192). Multivariate analysis revealed that married (AOR = 9.472, p < 0.001) and divorced/widowed patients (AOR = 11.649, p < 0.001) were more likely to have depression than single individuals were. Higher education (diploma or above) was protective (AOR = 0.071, p < 0.001). Elevated lipid levels were linked to a lower depression risk (AOR = 0.189, p = 0.003), and a family history of cancer (AOR = 4.239, p < 0.001), longer disease duration (> 4 years) (AOR = 3.197, p = 0.006), and difficulty in activities (AOR = 8.704, p < 0.001) increased depression risk. A significant negative correlation between depression and social support was found (r = - 0.237, p < 0.001).

CONCLUSION

Over half of cancer patients experience depression, which is influenced by marital status, education, and disease-related factors. Social support significantly mitigates depression.

IMPLICATIONS FOR PRACTICE

Enhancing social support and integrating mental health assessments by psychiatric professionals in oncology care is essential for improving the emotional well-being and overall quality of life of cancer patients.

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.

Review of Psychological Interventions in Oncology: Current Trends and Future Directions

Background and Objectives: Cancer imposes a profound burden on both physical and psychological health, particularly at advanced stages, which are associated with a poor prognosis and heightened emotional distress. Psychotherapeutic interventions have gained recognition for their role in alleviating distress, enhancing the quality of life, and supporting a holistic approach to cancer care. This review examines the effectiveness of psychotherapeutic interventions in improving psychological well-being in cancer patients. Materials and Methods: Conducted as a literature review following PRISMA guidelines, this study analyzed experimental research on psychotherapeutic interventions for cancer patients published in the past decade. Literature searches were performed in PubMed, Google Scholar, the Cochrane Library, Web of Science, PsycINFO, and Consensus, supplemented by manual reference checks. The inclusion criteria focused on randomized controlled trials (RCTs). Results: The analysis included 20 RCTs spanning over three decades, evaluating interventions such as individual meaning-centered psychotherapy (IMCP), Mindfulness-Based Cognitive Therapy (MBCT), and supportive-expressive group therapy (SEGT). IMCP emerged as being particularly effective in reducing depression, anxiety, and demoralization while enhancing spiritual well-being. MBCT demonstrated significant reductions in the fear of recurrence, while SEGT effectively addressed traumatic stress and fostered social support. Although the survival benefits were inconsistently reported, psychosocial improvements, including an enhanced quality of life and emotional resilience, were consistently observed. The methodological quality varied, with nine studies meeting high-quality standards. Conclusions: Psychotherapeutic interventions, particularly IMCP and MBCT, play a critical role in oncology by alleviating distress, fostering resilience, and improving the quality of life. Integrating these approaches into routine cancer care can ensure a more holistic treatment framework that prioritizes the emotional and psychological needs of patients.

Does Personality Influence the Quality of Life of Patients with Brain Tumors Treated with Radiotherapy?

Background: Understanding the role of personality traits in shaping treatment outcomes is crucial given the multifaceted challenges posed by brain tumors and the significant adverse impact of radiotherapy (RT) on patients' well-being. Purpose: This study aimed to provide insights into how personality traits affect psychosocial well-being and quality of life during RT in patients with high-grade malignant brain tumors. Methods: Personality traits in patients with high-grade glioma were assessed using the Eysenck Personality Questionnaire-Revised (EPQ-R). Quality of life was analyzed using EORTC questionnaires: the Questionnaire-Core 30 (QLQ-C30) and the Brain Cancer Module (QLQ-BN20). Patients were evaluated before RT, immediately after 6 weeks of RT, and 3 months post-RT. Results: Neuroticism predicted emotional function only three months post-RT. Extraversion decreased quality of life in global health status (third assessment), role function (second assessment), and emotional function (second and third assessments) but improved cognitive (first assessment) and social function (second assessment). The trait associated with lying was linked to a better quality of life in all domains except physical and cognitive function. Anxiety predicted a lower quality of life in brain tumor patients across all domains at various stages of RT treatment. Conclusions: This study advances our understanding of the psychosocial aspects of brain tumor care by highlighting the influence of personality traits on quality-of-life outcomes during RT. Identifying high-grade glioma patients at greater risk of a diminished quality of life based on personality profiles allows healthcare professionals to tailor interventions to address specific psychosocial needs, ultimately enhancing patient outcomes and holistic care during oncological treatment.

Health-Related Quality of Life and the Role of the Big Five Personality Traits in Postlingually Deaf Cochlear Implant Users

PURPOSE

This study aimed to investigate the relationships between generic health-related quality of life (HRQoL), the Big Five personality traits, speech understanding, and sociodemographic factors in a group of postlingually deaf cochlear implant (CI) users.

METHOD

The study group included 81 participants who met the inclusion criteria: profound sensorineural hearing loss, 18 years of age or more, and using at least one CI implanted after 18 years of age. Some 18% were bilateral CI users. The mean age of the participants was 60 ± 11 years. They completed the Assessment of Quality of Life (AQoL-8D) and the Short Form IPIP-BFM-20 (shortened version of the 50-item Big Five Markers Questionnaire from the International Personality Item Pool). The response rate was 57%.

RESULTS

The HRQoL was lower in the study group than in the general population. Moreover, all Big Five personality characteristics were significantly lower than the Polish norm. The personality traits of intellect/imagination, emotional stability, and extraversion contributed to higher overall HRQoL scores, particularly for most psychosocial AQoL-8D dimensions. Higher agreeableness predicted higher HRQoL in the Independent Living, Pain, Coping, and Relations dimensions, whereas higher extraversion predicted higher physical HRQoL in the Senses dimension. Better speech understanding in quiet and noisy environments correlated with better physical HRQoL. Additionally, male gender and higher education were linked to higher global HRQoL. Conversely, being female was associated with lower global psychosocial and physical HRQoL, particularly in Pain. Higher education also contributed to improved physical HRQoL.

CONCLUSIONS

In general, CI users have lower physical and psychosocial HRQoL as well as in measures that depend on personality traits. In terms of physical HRQoL, speech understanding plays an important role. It might prove useful if CI candidates and users were given a Big Five personality evaluation and an HRQoL assessment based on which they might be offered counseling or psychological intervention.

The cerebral metabolic mechanism of group computer magnanimous therapy based on magnetic resonance spectroscopy: effects on improving magnanimous-enterprising levels of lung cancer patients

Introduction

This study aims to evaluate the effects of group computer magnanimous therapy (GCMT) on magnanimous-enterprising levels and brain metabolic changes in patients with advanced lung cancer.

Methods

In this multicenter, randomized controlled trial, 47 participants diagnosed with advanced stage (III or IV) lung cancer were randomly assigned to either the GCMT group (GCMTG, n = 31) or the control group (CTRLG, n = 16). The GCMTG received routine oncotherapy and care along with eight sessions of GCMT over 2 weeks, while the CTRLG received only oncotherapy and routine care. Psychological and brain metabolic changes were assessed using the Enterprising and Magnanimous Questionnaire (EMQ) and proton magnetic resonance spectroscopy (1H-MRS).

Results

After 2 weeks, the GCMTG showed significant improvements in the EMQ "total score" and "enterprising" dimensions compared to baseline (p < 0.05), while the CTRLG showed no significant changes. Significant increases in NAA/Cr levels were observed in the right amygdala, and significant decreases in mI/Cr levels were observed in the right cingulate gyrus in the GCMTG. Pearson correlation analysis indicated that changes in Cho/Cr levels in the left amygdala and Glx/Cr levels in the left hippocampus were significantly correlated with improvements in the enterprising dimension.

Conclusions

GCMT significantly enhanced enterprising attitudes and induced beneficial changes in brain metabolites among patients with advanced lung cancer. Further research with larger sample sizes is warranted to confirm these results and explore the long-term effects of GCMT.

Clinical trial registration

https://www.chictr.org.cn/showproj.html?proj=129557, identifier ChiCTR2100053015.

The Mediation Role of Coping With Stress in the Relationship Between Psychological Flexibility and Posttraumatic Growth in Cancer Patients

Objectives: Active and adaptive coping strategies have been identified as factors that can assist cancer patients in effectively managing and overcoming the crisis, leading to the potential for post-traumatic growth during the diagnosis and treatment stages. Psychological flexibility is another factor that can protect individuals and promote more adaptive reactions to traumatic situations. The study aims to examine the investigation of the mediation role of coping with stress in the relationship between psychological flexibility and posttraumatic growth in cancer patients. Methods: This study was conducted with 97 (63 women, 34 male) participants aged between 38 and 82 who are literate and diagnosed with breast cancer or gynecological cancers (endometrial, cervical, vulvar) undergoing radiotherapy planning at the Radiation Oncology Clinic of Zonguldak Bülent Ecevit University Hospital. Demographic Information Form, Psychological Flexibility Scale, Post-Traumatic Growth Inventory, and Coping Styles Scale were applied to the participants. The mediation effects were interpreted using bootstrap confidence intervals and VAF values. Results: This study showed that the active coping styles partially mediated the relationship between psychological flexibility and posttraumatic growth. Conclusion: In this regard, by organizing psychoeducational programs and interventions aimed at increasing psychological flexibility for individuals diagnosed with cancer or undergoing treatment, individuals can be enabled to cope with stress more actively, and thus post-traumatic growth can be achieved.

Early Changes in Nutritional Status of Elderly Patients with Lung Cancer Undergoing Chemotherapy Are Positively Related with Symptoms of Depression: A Prospective Follow-Up Study

This study aims to assess early effects of chemotherapy on symptom alleviation, nutritional status, and mental health in elderly patients with advanced non-small-cell lung cancer (NSCLC). This prospective study included 45 NSCLC patients (32 males, 13 females) aged 65-82 years (mean age 70.0 ± 4.5 years) with good performance status. Assessments were conducted immediately after diagnosis and after two chemotherapy cycles, focusing on nutritional status (assessed with MNA questionnaire), quality of life (QoL, based on FACT-L and FACT-TOI questionnaires), lung cancer-related symptoms (based on LCSS), and mental health (based on PHQ-9 questionnaire). Despite significant alleviation of symptoms like cough, dyspnea, and body weight loss, there was no significant correlation between changes in symptoms burden and changes in nutritional status (r2 = 0.122, P = 0.427), and change of patients' mental condition (r2 = -0.141, P = 0.255). No significant QoL changes were noted, but a decrease in severe depression frequency was observed. The improvement of patients' mental condition was related strictly to the improvement of nutritional status (r2 = -0.589, P < 0.001). The study highlights the vital link between nutritional status and mental health in elderly NSCLC patients, emphasizing the need for integrated care approaches that address both aspects to enhance treatment effectiveness and patient well-being.

Health-related quality of life and its influencing factors among lung cancer patients receiving immune checkpoint inhibitors: A cross-sectional study

PURPOSE

The aim of this study was to examine the level of health-related quality of life (HRQOL) of lung cancer patients receiving immune checkpoint inhibitors (ICIs) and analyze its influencing factors.

METHOD

A cross-sectional study was conducted. From April 2022 to March 2023, 560 lung cancer patients receiving ICIs at three medical bases in Guangzhou, China were recruited using a convenient sampling method. A general information questionnaire, the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30), the Social Support Rating Scale (SSRS) and the Medical Coping Modes Questionnaire (MCMQ) were used for collecting data on sociodemographic and clinical characteristics, HRQOL, social support and medical coping mode. A descriptive analysis was conducted to describe HRQOL. Multiple regression analysis was applied to determine the factors influencing HRQOL.

RESULTS

For lung cancer patients receiving ICIs, the mean score of HRQOL was 59.21 ± 19.86. Multivariate analysis indicated that acceptance-resignation coping mode (β = -0.37, P < 0.01), Eastern Cooperative Oncology Group (ECOG) score (β = -0.35, P < 0.01), combination of chemotherapy and/or bevacizumab (β = -0.14, P < 0.01), and subjective support (β = 0.07, P = 0.04) all contributed to 42.7% of the variance in HRQOL of the patients receiving ICIs.

CONCLUSIONS

It is imperative to address and resolve the HRQOL issue for lung cancer patients receiving ICIs. The findings suggest nurse practitioners should be aware of a variety of factors that influence HRQOL and provide tailored inventions to patients as early as possible to help them achieve better HRQOL.

Decrements in Both Physical and Cognitive Function Are Associated With a Higher Symptom Burden in Oncology Patients

OBJECTIVES

Physical and cognitive function are two of the most important patient-reported outcomes. In oncology patients receiving chemotherapy (N = 1331), purposes were to identify subgroups of patients with distinct joint physical and cognitive function profiles and evaluate for differences in demographic and clinical characteristics, severity of common symptoms, and quality of life outcomes.

DATA SOURCES

Measures of physical and cognitive functions were obtained six times over two cycles of chemotherapy. All of the other measures were done prior to the second or third cycle of chemotherapy. Latent profile analysis was done to identify the distinct joint physical and cognitive function profiles. Differences among the profiles were evaluated using parametric and nonparametric tests.

CONCLUSION

Five distinct profiles were identified (ie, Very Low Physical and Low Cognitive Function [18.4%; Both Low], Low Physical and High Cognitive Function [19.8%], Moderate Physical and Low Cognitive Function [26.7%], Changing Physical and Cognitive Function [5.4%], and Normal Physical and Cognitive Function [29.7%]). Patients in the Both Low class had the highest symptom burden and the poorest quality of life. Over 70% of the sample had moderate to severe decrements in one or both of these extremely important patient outcomes.

IMPLICATIONS FOR NURSING PRACTICE

Clinicians need to assess for both physical and cognitive function using simple subjective and objective measures.

Relationship of Hepatocellular Carcinoma Stage and Hepatic Function to Health-Related Quality of Life: A Single Center Analysis

Health-related quality of life (HRQoL) is known to be an important prognostic indicator and clinical endpoint for patients with hepatocellular carcinoma (HCC). However, the correlation of the Barcelona Clinic Liver Cancer (BCLC) stage with HRQoL in HCC has not been previously studied. We examined the relationship between BCLC stage, Child-Pugh (CP) score, and Eastern Cooperative Oncology Group (ECOG) performance status on HRQoL for patients who presented at a multidisciplinary liver cancer clinic. HRQoL was assessed using the Functional Assessment of Cancer Therapy-Hepatobiliary (FACT-Hep) questionnaire. Fifty-one patients met our inclusion criteria. The FACT-Hep total and subscales showed no significant association with BCLC stages (p = 0.224). Patients with CP B had significantly more impairment in FACT-Hep than patients with CP A. These data indicate that in patients with HCC, impaired liver function is associated with reduced quality of life, whereas the BCLC stage poorly correlates with quality of life metrics. Impairment of quality of life is common in HCC patients and further studies are warranted to determine the impact of early supportive interventions on HRQoL and survival outcomes.

Psychosocial factors influencing quality of life in patients with primary brain tumors in Pakistan: an analytical cross-sectional study

OBJECTIVE

Despite quality of life (QoL) being recognized as an important outcome in neuro-oncology, there is a lack of research from Pakistan where sociocultural differences may influence QoL. This study aimed to measure the QoL in patients with primary brain tumors (PBTs) and assess its association with mental health outcomes and social support.

RESULTS

Our study included a total of 250 patients, with a median age of 42 years (range 33-54 years). The commonest brain tumors were glioma (46.8%) and meningioma (21.2). The mean global QoL of the sample was 75.73 ± 14.9. The majority of patients had high social support (97.6%) and were not depressed (90%) or anxious (91.6%). On multivariable linear regression, global QoL was inversely associated with no or low income (beta coefficients: -8.75 to -11.84), having hypertension (-5.53), currently using a urine catheter (-13.55), having low social support (-28.16) suffering from mild (-15.31) or symptomatic (-23.84) depression, or mild anxiety (-13.22).

Psychotherapy for advanced cancer patients: A meta-analysis of the quality of life and survival assessments

OBJECTIVES

A meta-analysis has explored the effect of psychotherapy on the quality of life (QOL) but has not explored the effect on advanced cancer patients' survival, which is highly debated. Therefore, we consider the survival days and QOL as the primary outcomes in our analysis.

METHODS

Eligible studies were collected from four databases (PubMed, Embase, Cochrane Library, and Web of Science) until February 20, 2021. The pooled effect sizes were presented as weighted mean difference (WMD) or relative risk (RR) with 95% confidence intervals (CIs). Publication bias was evaluated by Egger's test, and I2 statistics was used to assess the heterogeneity.

RESULTS

Thirty-three studies were finally included, containing 2,159 patients in the psychotherapy group and 2,170 patients in the control group. McGill Quality of Life Questionnaire (MQOL) and European Organization for Research and Treatment of Cancer Quality of Life-C15-Palliative (EORTC-QLQ-C15-Pal) supported that QOL of the psychotherapy group was significantly higher than that of the control group, and WMD value was 0.42 (95% CI: 0.12-0.71) and 17.26 (95% CI: 11.08-23.44), respectively. No significant difference was observed between the two groups regarding to the survival time (WMD: 17.85, 95% CI: -8.79, 44.49, P = 0.189). Moreover, the levels of anxiety, depression, confusion, pain, and suffering were lowered in psychotherapy group (all P < 0.05).

SIGNIFICANCE OF RESULTS

Psychotherapy could improve the QOL of advanced cancer patients but not affect the survival time.

Personality trait associations with quality-of-life outcomes following bariatric surgery: a systematic review

BACKGROUND

Obesity can be a significant challenge to health and quality of life (QoL). Bariatric surgery assists with weight loss and may help improve QoL. However, not all patients benefit from surgery. Personality traits may be related to QoL outcomes after bariatric surgery, but these associations are unclear.

PURPOSE

This research reviews the published literature on the associations between personality and QoL among post-operative bariatric patients.

METHOD

Four databases (CINAHL Complete, Medline with Full Text, APA PsycINFO, and Scopus) were searched from inception until March 2022. Forward searching was conducted using Google Scholar, and backward reference citation searches were also performed.

RESULTS

Five studies met inclusion criteria yielding data from N = 441 post-bariatric patients including both pre/post and cross-sectional designs. Higher agreeableness was related to lower overall health-related QoL (HRQol) and gastric HRQol and positively associated with psychological HRQol. Higher emotional stability was positively related to overall HRQol. Higher impulsivity was negatively associated with mental HRQol and was unrelated to physical HRQol. Effects for the remaining traits were either mainly mixed or null.

CONCLUSION

Personality traits may be associated with HRQol outcomes. However, it is difficult to reliably discern the role of personality traits for HRQol and QoL outcomes given the methodological issues and few published studies. More rigorous research is needed to address these issues and clarify possible associations.

Efficacy of a Combined Acceptance and Commitment Intervention to Improve Psychological Flexibility and Associated Symptoms in Cancer Patients: Study Protocol for a Randomized Controlled Trial

Psychological flexibility is a key concept of acceptation and commitment therapy (ACT). This factor has been linked with psychological wellbeing and associated factors, such as quality of life, in cancer patients. These and other positive results of acceptation and commitment therapy in cancer patients found in previous research could be enhanced by using mhealth tools. A three-arm randomized superiority clinical trial, with a pre-post-follow-up repeated measures intergroup design with a 1:1:1 allocation ratio is proposed. A hundred and twenty cancer patients will be randomly assigned to one of the following interventions: (1) face-to-face ACT + mobile application (app), (2) face-to-face ACT, and (3) Waitlist control group. The primary expected outcome is to observe significant improvements in psychological flexibility acceptance and action questionnaire- II (AAQ-II) in the face-to-face ACT + app group, after comparing baseline and post-treatment scores, and the scores will remain stable in the two assessment points, 3 and 6 months after the intervention. Secondary expected outcomes are significant increasing scores in quality of life (EORTC QLQ C-30) and post-traumatic-growth (PTGI-SF), and significant decreasing scores in anxiety and depression (HADS), insomnia (ISI) and fatigue (BFI) at the same assessment points. Also, it is expected that the scores of this group will be higher than the scores of the face-to-face ACT group and the waitlist control group. This study aims to assess the efficacy of a combined intervention (face-to face ACT + app) for psychological flexibility and associated symptoms in cancer patients. The results of this protocol may help to consider the use of acceptation and commitment therapy and mhealth applications in cancer settings as a valid therapeutic choice.

Right ventricular dysfunction during chemotherapy in patients with breast cancer

Aim. To assess the right ventricle (RV) during chemotherapy (CT) in patients with breast cancer (BC).

Material and methods. The study included 40 women aged 35-72 years with BC who underwent anthracycline chemotherapy. The main group (n=40) included women with BC, examined at the first contact, 37 of whom were reexamined after 6 months. Control group (n=25) included women without BC.

Results. In the main group, the median transverse dimension and anterior wall thickness of the RV were significantly greater than in the control group (p<0,001). Early diastolic transtricuspid flow velocity (Et) after 6 months was lower than in the control group (p=0,003). The ratio of Et to late (At) diastolic transtricuspid flow (Et/At) in BC patients significantly decreased during the follow-up period (p<0,05) when compared with the control group and baseline values. Higher values of Tei index were noted in the main group compared to the control one (p<0,05). Using logistic regression for the Tei index, the model included radiation therapy, the total anthracycline dose, and negative affectivity score as follows: F(3,17)=12,548, p<0,001, R2=0,729. For the Et/At ratio, additional radiation therapy and heart rate were significant factors as follows: F(2,16)=12,548, p=0,005, R2=0,526.

Conclusion. Against the background of CT, deterioration of RV systolic (increase in Tei index and RV volume) and diastolic (decrease in Et and Et/At ratio) function was noted.

Associations between Measured and Patient-Reported Physical Function and Survival in Advanced NSCLC

Background: There is a lack of tools for selecting patients with advanced lung cancer who benefit the most from systemic treatment. Patient-reported physical function (PRPF) has been identified as a prognostic factor in this setting, but little is known about the prognostic value in advanced non-small-cell lung cancer (NSCLC). The aim of this study was to investigate if measured physical performance was an independent or stronger prognostic factor than PRPF in patients with advanced NSCLC receiving platinum-doublet chemotherapy. Methods: We analyzed patients from a randomized trial comparing immediate and delayed pemetrexed therapy in stage III/IV NSCLC (n = 232) who performed timed up and go (TUG) and 5 m walk test (5 mWT) and reported physical function on the EORTC QLQ-C30 before chemotherapy commenced. Results: Overall, 208 patients performed TUG and 5 mWT and were included in the present study. Poor physical function was significantly associated with poor survival (TUG: HR 1.05, p < 0.01, 5 mWT: HR 1.05, p = 0.03, PRPF: 1.01, p < 0.01), but only PRPF remained an independent prognostic factor in multivariable analyses adjusting for baseline characteristics (HR 1.01, p = 0.03). Conclusions: Patient-reported, but not measured, physical performance was an independent prognostic factor for survival in patients with advanced NSCLC receiving platinum-doublet chemotherapy.

A descriptive systematic review of the relationship between personality traits and quality of life of women with non-metastatic breast cancer

BACKGROUND

Quality of life (QoL) is an important patient-reported outcome that has been studied extensively as an endpoint. There is a growing interest in factors that may influence QoL, such as personality. This descriptive systematic review examined the relationship between personality and QoL in women with non-metastatic breast cancer.  METHODS: On November 24th, 2020, with a update on March 7th, 2022, PubMed, PsycINFO, CINAHL, Web of Science and Embase were systematically searched for studies that assessed the direct relationship between personality traits and QoL among adult women diagnosed with non-metastatic breast cancer. The National Institutes of Health Study Quality Assessment Tool was used to assess the quality and risk of bias of the included studies. Three reviewers independently extracted data regarding objectives, population, setting, design, method, outcome measurements and key results. The results are descriptively reported.

RESULTS

Twelve studies (6 cohort studies and 6 cross-sectional studies) were included. Three studies were rated as poor, one study was rated as good, and the remaining studies were rated as moderate. There was a small to moderate effect of personality on QoL as correlation coefficients ranged from 0.10 to 0.77, and the explained variance ranged from 4 to 43%. The (strength of the) relationship depended on the personality trait and QoL domain that was measured and was most apparent for the personality traits 'optimism' and 'trait anxiety' on psychosocial QoL domains. The results for the personality traits (unmitigated) agency, agreeableness, conscientiousness, novelty seeking, and self-efficacy indicated a smaller but statistically significant correlation between these personality traits and QoL.

CONCLUSIONS

The results confirm that personality affects QoL in women with non-metastatic breast cancer and thus provides evidence that personality traits are indeed important influential factors of QoL. It is therefore strongly recommended for all future QoL research to measure personality traits and use these variables as predictive factors, as they are needed to accurately interpret QoL. Information regarding personality traits provide physicians and patients with an interpretation of low or deterioration of QoL, which could guide physicians to improve their patients' health outcomes and subsequently QoL using psycho-oncological support or treatment.

Personal positioning of oncology patients in palliative care: a mixed-methods study

Background

Advanced oncological disease requires comprehensive health care, although attention is predominantly paid to the physical dimension of care. The consideration of personal positioning encompasses other dimensions of patients’ management of their illness, such as existential management and expanding forms of care. The objective of this study was to understand the personal positioning of cancer patients in palliative care.

Methods

This was a cross-sectional study using the mixed convergent parallel method. The sample consisted of 71 cancer patients in palliative care, of whom 14 participated in the qualitative and quantitative portions and 57 participated in only the quantitative portion. Phenomenological interviews were performed, and qualitative and quantitative methods were used to collect meaning of life (PIL-Test), quality of life (EORTC QLQ C-30), anxiety and depression (HADS) and sociodemographic data. The interview results were analysed according to the principles of classical phenomenology, and the quantitative data were analysed using the generalized structural equations model.

Results

The results showed that the patients turned to living, focusing on their possibilities and distancing themselves from the impact of the illness and the factuality of death, which the patients themselves associated with not succumbing to depression, a condition whose signs were exhibited by 21% of the sample. Sustaining this positioning required a tenacious fight, which feeds on sensitivity to life. Linked to this position was the belief in the continuation of life through religious faith, together with the patients’ realization of the meaning of their lives. In this same direction, there was a direct association between awareness of the meaning of life and increased scores on the functional scales (p <  0.01) and decreased scores for symptoms (p <  0.01), anxiety (p = 0.02) and depression (p < 0.01). The last element that emerged and structured this experience was the intense will to live and a sense of the value of life.

Conclusions

Through the use of mixed methods, the present study recognized the existential positioning of cancer patients in palliative care. This understanding can aid in the realization of more comprehensive and meaningful treatment plans and can contribute to the goal of achieving humanization in this area of treatment.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12904-022-00916-5.

Graphene quantum dots (GQDs) nanoarchitectonics for theranostic application in lung cancer

Lung cancer (LC) is heading up as a substantial cause of mortality worldwide. Despite enormous progress in cancer management, LC remains a crucial problem for oncologists due to the lack of early diagnosis and precise treatment. In this context, numerous early diagnosis and treatment approaches for LC at the cellular level have been developed using advanced nanomaterials in the last decades. Amongst this, graphene quantum dots (GQDs) as a novel fluorescent material overwhelmed the horizons of materials science and biomedical fields due to their multifunctional attributes. Considering the complex nature of LC, emerging diagnostic and therapeutic (Theranostics) strategies using GQDs proved to be an effective way for the current practice in LC. In this line, we have abridged various approaches used in the LC theranostics using GQDs and its surface-engineered motif. The admirable photophysical attributes of GQDs realised in photolytic therapy (PLT), hyperthermia therapy (HTT), and drug delivery have been discussed. Furthermore, we have engrossed the impasse and its effects on the use of GQDs in cancer treatments from cellular level (in vivo-in vitro) to clinical. Inclusively, this review will be an embodiment for the scientific fraternity to design and magnify their view for the theranostic application of GQDs in LC treatment.

Type C Personality: Conceptual Refinement and Preliminary Operationalization

In this paper, we have presented our proposal for reconceptualization and operationalization of Type C (cancer-prone) personality. Based on theoretical analyses, taking into account both the literature on Type C and models of personality structure, we have proposed a two-facet structure of Type C, comprising Submissiveness (the interpersonal aspect) and Restricted Affectivity (the intrapersonal aspect). The study devoted to the validation of the measure of Type C involved 232 participants aged 18-70 (M = 29.35, SD = 8.93; 54% male). We used (a) our proposed measure of Type C personality and (b) the Circumplex of Personality Metatraits Questionnaire (CPM-Q-SF; Strus and Cieciuch, 2017), assessing personality metatraits. The measure of Type C proved to have acceptable internal consistency (Cronbach's alpha was 0.85 for Submissiveness and 0.78 for Restricted Affectivity). The measurement model in confirmatory factor analysis with two latent variables proved to be well-fitted to the data. We have also confirmed the hypothesis concerning the location of the two facets of Type C personality close to each other in the theoretically predicted area between the Delta-Plus/Self-Restraint and Beta-Minus/Passiveness metatraits (in the Circumplex of Personality Metatraits). The clinical value of the theoretically refined Type C can be tested in the next step in research on patients with cancer.