The Correlation Between Quality of Life and Positive Psychological Resources in Cancer Patients: A Meta-Analysis

Leveraging natural language processing and machine learning to characterize psychological stress and life meaning and purpose in pediatric cancer survivors: a preliminary validation study

Objective

To determine if natural language processing (NLP) and machine learning (ML) techniques accurately identify interview-based psychological stress and meaning/purpose data in child/adolescent cancer survivors.

Materials and Methods

Interviews were conducted with 51 survivors (aged 8-17.9 years; ≥5-years post-therapy) from St Jude Children's Research Hospital. Two content experts coded 244 and 513 semantic units, focusing on attributes of psychological stress (anger, controllability/manageability, fear/anxiety) and attributes of meaning/purpose (goal, optimism, purpose). Content experts extracted specific attributes from the interviews, which were designated as the gold standard. Two NLP/ML methods, Word2Vec with Extreme Gradient Boosting (XGBoost), and Bidirectional Encoder Representations from Transformers Large (BERTLarge), were validated using accuracy, areas under the receiver operating characteristic curves (AUROCC), and under the precision-recall curves (AUPRC).

Results

BERTLarge demonstrated higher accuracy, AUROCC, and AUPRC in identifying all attributes of psychological stress and meaning/purpose versus Word2Vec/XGBoost. BERTLarge significantly outperformed Word2Vec/XGBoost in characterizing all attributes (P <.05) except for the purpose attribute of meaning/purpose.

Discussion

These findings suggest that AI tools can help healthcare providers efficiently assess emotional well-being of childhood cancer survivors, supporting future clinical interventions.

Conclusions

NLP/ML effectively identifies interview-based data for child/adolescent cancer survivors.

A Dyadic Analysis of Optimism, Pessimism, and Fear of Cancer Recurrence in Couples Coping With Early-Stage Breast Cancer

PURPOSE

Fear of cancer recurrence (FCR) is a common yet unaddressed concern among breast cancer (BC) survivors and their intimate partners. Moderate-to-severe FCR has been associated with numerous negative health outcomes and diminished functioning among survivors and their intimate partners. Therefore, it is essential to understand what factors are associated with higher FCR for both patients and partners. Dispositional traits, such as optimism and pessimism, have been associated with FCR severity at the individual (intrapersonal) level. However, few studies have focused on this link in a dyadic, interpersonal context. To address this gap, the present study sought to investigate the association between optimism, pessimism, and FCR in BC survivors and their intimate partners.

METHODS

Optimism, pessimism, and FCR were assessed for 79 couples (n = 158 paired individuals) in which one partner was an early-stage BC survivor who had recently completed adjuvant treatment. The intrapersonal (actor) and interpersonal (partner) associations between optimism or pessimism and FCR were simultaneously investigated using actor-partner interdependence modeling.

RESULTS

A significant positive intrapersonal effect was observed between pessimism and FCR for both survivors and partners, but not between optimism and FCR. No significant interpersonal effects were observed between either optimism or pessimism and FCR.

CONCLUSIONS

Findings indicated that higher levels of pessimism (rather than optimism) are uniquely associated with higher FCR in early-stage BC survivors and their partners. Understanding the role of pessimism in FCR susceptibility will allow for more efficient and timely support of BC survivors and their intimate partners following a cancer diagnosis.

Factors Associated With Quality of Life Among Posttreatment Cancer Survivors in Korea: A Meta-analysis

BACKGROUND

Identification of factors associated with quality of life (QOL) among cancer survivors is crucial for identifying potential targets for intervention.

OBJECTIVES

We aimed to provide evidence of factors associated with the QOL among posttreatment cancer survivors in Korea.

METHODS

We performed a systematic literature search from January 2000 to September 2022 using PubMed, EMBASE, CINAHL, PsycINFO, and Korean databases (RISS, SCIENCEON). We evaluated study quality using the Joanna Briggs Institute Quality Appraisal Checklists for Analytical Cross-sectional Studies and performed statistical analysis using the R 3.0 software (R Foundation for Statistical Computing, Vienna, Austria) package. We analyzed the pooled effect sizes of potential QOL correlates by the random-effects model.

RESULTS

This meta-analysis included 31 studies with 8934 participants. The pooled estimates were significantly large for economic status ( r = -0.53); significantly medium for fatigue ( r = -0.39), anxiety ( r = -0.29), depression ( r = -0.42), self-efficacy ( r = 0.37), and social support ( r = 0.30); and significantly small for education level ( r = -0.18), job status ( r = -0.09), cancer stage ( r = -0.20), and time since diagnosis ( r = -0.26).

CONCLUSIONS

Low education level, having no job, low economic status, advanced cancer stage, short disease period, fatigue, anxiety, and depression were significantly associated with worse QOL, whereas self-efficacy and social support were significantly associated with better QOL.

IMPLICATIONS FOR PRACTICE

The findings have potential implications for identifying "at-risk survivors" of deteriorated QOL and for suggesting powerful strategies (eg, enhancing self-efficacy or social support) for improving QOL.

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 Efficacy of Virtual Reality-Based Interventions on Pain, Anxiety, Depression, and Quality of Life Among Patients With Cancer: A Meta-analysis of Randomized Controlled Trials

BACKGROUND

Although cancer patients are living longer, the numerous physical and psychological outcomes of cancer can still be burdensome. Pain, anxiety, depression, and decreased quality of life are symptoms that are highly impacted by cancer. The availability of modalities to cope with these symptoms is critical. Virtual reality-based interventions have been used among patients with cancer, but their effects on pain, anxiety, depression, and quality of life remain unclear.

OBJECTIVE

To determine the efficacy of virtual reality-based interventions on pain, anxiety, depression, and quality of life among cancer patients and to assess the efficacy of different contents and duration.

METHODS

Nine databases were retrieved from inception to July 31, 2024. The methodological quality was evaluated via the Cochrane Risk of Bias 2.0 tool. Data synthesis was conducted with Stata version 16.0, and sensitivity analysis and subgroup analysis were also performed.

RESULTS

Virtual reality-based interventions can soothe pain and anxiety. Subgroup analysis revealed that interventions focused on playing games and watching videos were effective at reducing pain. In addition, enjoying landscapes, receiving treatment-related health education, and watching videos were effective at decreasing anxiety; moreover, short-term (≤6 weeks) interventions were effective at relieving pain.

CONCLUSIONS

Virtual reality-based interventions are effective at decreasing pain and anxiety. The contents and duration of the intervention had an impact on their effectiveness.

IMPLICATIONS FOR NURSING PRACTICE

Symptom management is a paramount aspect of clinical cancer care. In daily oncology nursing, we encourage nurses to utilize the benefits of virtual reality-based interventions to improve cancer patients' experience with medical treatment.

Subjective well-being among Iranian breast cancer patients: Exploring the influential role of psychological capital

PURPOSE

Breast cancer is a prevalent and emotionally challenging condition that profoundly affects women worldwide. Effectively managing the mental and emotional dimensions of this disease is crucial for the holistic well-being of patients. Psychological capital (PsyCap) has emerged as a pivotal psychological construct with the potential to effectively address these challenges. This study aims to explore the influential role of PsyCap and its constructs on the subjective well-being (SWB) of Iranian breast cancer patients.

METHODS

A total of 173 breast cancer patients participated in this study, selected through a random sampling approach. Face-to-face interview data on socio-demographics, PsyCap, and SWB were collected using a structured questionnaire. The analytical procedures encompassed independent sample t-tests, ANOVA tests, Pearson correlation tests, and stepwise multiple regression.

RESULTS

The findings revealed that the majority of participants fell within the 41-50 age group (38.7%), with an average age of 46.50 ± 11.76 years, and 35.8% had tumor growth in the upper left lobe. The average PsyCap score was 107.93 ± 1.52 (out of a possible score of 144), whereas SWB scored 196.51 ± 1.90 (out of 291). Notably, PsyCap showed a positive correlation with SWB (r = 0.119), accounting for approximately 8% of the variance in SWB. The final regression model showed the substantial predictive roles of PsyCap (1.667), self-efficacy (-3.692), age (-2.977), and education (-3.939) in shaping SWB.

CONCLUSIONS

Focusing on understanding and addressing factors like PsyCap, self-efficacy, and educational support could improve SWB, offering a potential avenue for comprehensive and individualized psychosocial care for women with breast cancer.

Mindfulness, coping, and optimism as mechanisms of change in the 3RP-NF intervention

INTRODUCTION

Neurofibromatosis (NF) is chronic neurogenetic condition that increases risk for poor quality of life, depression, and anxiety. Given the lack of biomedical treatments, we developed the "Relaxation Response Resiliency for NF" (3RP-NF) program to improve psychosocial outcomes among adults with NF.

OBJECTIVE

To move toward effectiveness testing, we must understand mechanisms that explained treatment effects. We tested whether our hypothesized mechanisms of change-mindfulness, coping, and optimism-mediated improvements in quality of life, depression, and anxiety among adults in the 3RP-NF program (N = 114; ages 18-70; 72.80% female; 81.58% White).

METHODS

We conducted mixed-effects models to assess whether these mechanisms uniquely mediated outcomes.

RESULTS

Improvements in quality of life were most explained by coping, (b = 0.97, SE = 0.28, CI [0.45, 1.56]), followed by mindfulness (b = 0.46, SE = 0.17, CI [0.15, 0.82]) and optimism (b = 0.39, SE = 0.12, CI [0.17, 0.65]). Improvements in depression and anxiety were most explained by mindfulness (b = -1.52, SE = 0.38, CI [-2.32, -0.85], CSIE = -0.26; b = -1.29, SE = 0.35, CI [-2.04, -0.67], CSIE = -0.23), followed by optimism (b = 0.39, SE = 0.12, CI [0.17, 0.65]; b = -0.49, SE = 0.20, CI [-0.91, -0.13]), but were not explained by coping (b = 0.22, SE = 0.43, CI [-0.62, 1.07]; b = 0.06, SE = 0.46, CI [-0.84, 0.97]), respectively.

CONCLUSIONS

Targeting mindfulness, coping, and optimism in psychosocial interventions may be a promising way to improve the lives of adults with NF.

Predictors of sense of quality of life and the moderating role of stage experience in a group of illusionists

BACKGROUND

The sense of the quality of life is an important variable, especially in the context of the profession; therefore it seems essential to capture the variables that predict this construct. The aim of the article was to show how self-esteem, emotional intelligence and social competences explain the sense of quality of life in a group of illusionists (N = 53).

PARTICIPANTS AND PROCEDURE

The aim of the article was to show how self-esteem, emotional intelligence and social competences explain the sense of quality of life in a group of illusionists (N = 53). Moreover, the moderating role of the stage experience of relationships between predictors and the explained variable was checked. Polish tools were used in the study: the Popular Questionnaire of Emotional Intelligence, the Questionnaire of Social Competences and the Sense of Quality of Life Questionnaire.

RESULTS

Among the predictors that explained the sense of quality of life to the greatest extent (in the psychosocial, subjective and metaphysical spheres) were the acceptance of emotions and social competences. Stage experience turned out to be a moderator of the relation between emotional intelligence and the subjective sphere of the sense of quality of life.

CONCLUSIONS

The conducted research may constitute the basis for changing the approach to everyday functioning in order to improve the sense of quality of life.

Psychological distress is involved in CRCI in breast cancer survivors via mediating cytokine levels

BACKGROUND

Cancer-related cognitive impairment (CRCI) is a frequent consequence in breast cancer survivors after chemotherapy and lowers their quality of life (QOL). Psychological distress is frequently experienced by breast cancer survivors. There are currently few studies investigating the role of psychological distress in the genesis of CRCI.

METHODS

In total, 122 breast cancer survivors after standard chemotherapy within a year were recruited and assessed using the Psychological Distress Thermometer (DT). Sixty breast cancer survivors had non-psychological distress (NPD group) and sixty-two breast cancer survivors with psychological distress (PD group). The scores of the Mini-Mental State Examination (MMSE), prospective and retrospective memory (PM and RM) Questionnaire (PRMQ), and Functional Assessment of Cancer Therapy-General (FACT-G) and the levels of cytokines including interleukin-1 beta (IL-1β), tumor necrosis factor-alpha (TNF-α), and interleukin-4 (IL-4) were compared between the two groups. Using PROCESS, we investigated whether psychological distress predicted cognitive function based on MMSE through IL-1β, TNF-α, and IL-4.

RESULTS

The PD group had higher scores on RM, PM, and FACT-G and lower scores on MMSE than the NPD group (t = -11.357, t = -10.720, t = -15.419, t = 10.162, respectively; p < 0.05). Meanwhile, a higher level of IL-1β, TNF-α, and IL-4 was observed in the PD group than in the NPD group (t = -3.961, t = -3.396, t = -3.269, respectively; p < 0.05). The link between psychological distress and cognitive function as measured by the MMSE was also mediated by IL-1β, TNF-α, and IL-4 (effect size: 26%, 25%, and 24%).

CONCLUSION

Breast cancer patients with psychological distress displayed poor cognitive function, poor memory, and inferior quality of life, which was accompanied by higher cytokine levels of IL-1β, TNF-α, and IL-4. This study demonstrated IL-1β, TNF-α, and IL-4 as potential pathways to CRCI in response to ongoing psychological distress, which provided evidence for the involvement of psychological distress in CRCI in breast cancer survivors.