Predictive Models of Psychological Distress, Quality of Life, and Adherence to Medication in Breast Cancer Patients: A Scoping Review

Optimizing NCCN distress thermometer use in real-world settings: a systematic review and thematic synthesis of the literature

PURPOSE

This systematic review aims to examine the workflows in distress screening and referral using the NCCN distress thermometer (DT) in the US, aiming to identify key elements for flexible, organization-specific approaches.

METHODS

A systematic review of full-text manuscripts published from 2013 to May 2024 was conducted using MEDLINE, EMBASE, and CINAHL. Studies describing distress screening and referral protocols were included, while systematic reviews, commentaries, non-US studies, non-English publications, and studies on distress score-disease burden associations were excluded. Attributes of distress screening and referral pathways were extracted.

RESULTS

From an initial 1219 articles, 19 studies were included. Significant variability was observed in NCCN DT workflows, particularly in responder characteristics (e.g., cancer type, patient vs. caregiver). Nursing staff primarily administered screenings, varying by mode (paper vs. electronic), frequency, and location (home vs. clinic). A cut-off score of 4 or higher often triggered referrals, with some studies further stratifying distress levels for tailored follow-ups. Referral pathways included educational resources, behavioral and emotional health, social support, and rehabilitative and supportive care services. Caregiver distress screening was infrequent.

CONCLUSION

This review underscores the variability in NCCN DT workflows and the need for customizable protocols. While standardization is desirable, some variation is essential to accommodate the differing availability of resources and personnel for effective distress screening and referral.

IMPLICATIONS FOR CANCER SURVIVORS

Effective distress screening and referral pathways ensure survivors receive timely psychological, emotional, and social support, improving quality of life. Integrating caregiver distress screening into workflows could amplify overall support systems, fostering holistic survivorship care. A flexible yet structured approach enhances access to tailored interventions, promoting resilience in survivors and caregivers.

Protective effects of omega-3 against procarbazine-induced brain damage in the cerebellum and CA1 Hippocampus of male rats: a focus on oxidative stress mechanisms

The study examined the combined effects of procarbazine (PCZ) and omega-3 on cognitive functions, motor skills, and brain histology in male rats over ten days. While PCZ has antitumor properties, omega-3 is a dietary supplement with potential health benefits. Here, forty-eight adult male Wistar rats, averaging 230 to 250 g, were used in this study. Novel Object Recognition (NOR), Open Field Tests (OFT), and rotarod assessments were employed to evaluate cognitive and motor functions. Also, cell degeneration in pyramidal cells of the CA1 region and Purkinje cells in the cerebellum, along with measuring serum oxidant and antioxidant levels to gauge treatment impact on brain functions. Results showed significant weight loss in PCZ-treated rats, alongside fewer rearing instances and reduced distance traveled in OFT compared to the sham group (P < 0.05). However, cognitive performance in the NOR test remained unchanged. The PCZ group demonstrated lower rotarod performance than the sham group (P < 0.05), but the PCZ + omega-3 group showed improved balance. Antioxidant enzyme levels decreased in the PCZ group relative to the sham group (P < 0.05), with no significant change in malondialdehyde levels; omega-3 did not influence these levels in PCZ-treated rats. PCZ caused damage to pyramidal cells in the hippocampus and cerebellum, but omega-3 mitigated some of the cerebellar damage, suggesting it may partially reduce PCZ-induced toxicity. These findings suggest omega-3 could alleviate some negative effects of PCZ on brain functions, especially in the cerebellum.

Health Literacy Needs of Acute Pancreatitis Patients During the Diagnosis and Treatment Process Under the Lens of the Timing It Right Theory: A Qualitative Study

Background

The incidence and recurrence rate of acute pancreatitis (AP) continues to increase worldwide. The risk of AP attack and recurrence is closely related to the patient's health literacy. Previous studies have shown that AP patients had low levels of health literacy. Understanding patients' experience in AP's diagnosis and treatment process and their health literacy needs might significantly improve their health status.

Objective

This study aims to understand the experience of acute pancreatitis (AP) patients in the diagnostic and treatment process and explore their health literacy needs at various phases of this process.

Methods

This study utilized a qualitative approach based on Timing It Right theory. A purposive sampling strategy was employed to select 31 participants diagnosed with AP at various phases of the diagnosis and treatment process. These patients were selected from the Pancreatitis Treatment Centers of two tertiary hospitals in Eastern China. Subsequently, semi-structured in-depth interviews were conducted with the selected participants. The qualitative data was analyzed using the Colaizzi's method.

Results

The themes of AP patients' experiences and health literacy needs at various phases of the diagnosis and treatment process were presented as follows. 1. Diagnosis phase: inability to obtain disease information, psychological support seeking, and change unhealthy lifestyle; 2. Hospitalization phase: disease treatment information needs and medical professionals' healthcare. 3. Discharge Preparation phase: fear of recurrence, individualized healthy lifestyle instruction. 4. Home Recovery phase: self-management, continuous healthcare needs, and family support.

Conclusion

AP patients' HL needs and health-related problems vary during the diagnosis and treatment process. Medical professionals should comprehend AP patients' changing needs and individual differences, provide continuous healthcare, and involve families in patient management. These factors support patients' long-term self-management and preserve their overall health.