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Hao J, He Z, Li Y, Huang B, Remis A, Yao Z, Zhu D. Virtual reality-based supportive care interventions for patients with cancer: an umbrella review of systematic reviews and meta-analyses. Support Care Cancer 2024; 32:603. [PMID: 39167153 DOI: 10.1007/s00520-024-08813-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2024] [Accepted: 08/14/2024] [Indexed: 08/23/2024]
Abstract
PURPOSE This umbrella review aimed to identify, critically appraise, and synthesize current evidence from systematic reviews and meta-analyses on the applications of virtual reality-based supportive care interventions in cancer. METHODS Three bibliographic databases were searched from inception to February 1, 2024. Two independent reviewers screened the titles and abstracts of 421 records and retrieved 26 full-text systematic reviews. Assessing the Methodological Quality of Systematic Reviews 2 (AMSTAR-2) was used for quality assessment. Qualitative syntheses were performed to investigate the effects of virtual reality-based supportive care interventions on quality of life and physical, psychological, cognitive, and functional outcomes. Meta-analysis was performed based on data from the distinct primary studies that were extracted from the included reviews. RESULTS This umbrella review included 20 systematic reviews that were published between 2018 and 2023; nine of them conducted meta-analyses. A total of 86 distinct primary studies were identified. According to the AMSTAR-2 assessment, two reviews were evaluated as moderate quality, nine as low, and nine as critically low. Meta-analyses of primary studies revealed significant effects of virtual reality on anxiety (p < 0.001), depression (p < 0.001), and pain (p < 0.001), but not fatigue (p = 0.263). Qualitative syntheses revealed positive effects of virtual reality on physical function, cognitive function, and quality of life. Limited evidence was reported regarding outcomes of balance, gait, mobility, and activities of daily living. CONCLUSION Virtual reality has proven to be a safe and feasible approach to deliver supportive care in cancer. Virtual reality can be implemented in various stages and settings of the cancer care continuum to support patients undergoing painful procedures, during or after chemotherapy, and after surgical interventions. Virtual reality can serve as an effective supportive care intervention to manage anxiety, pain, and depression for patients with cancer.
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Affiliation(s)
- Jie Hao
- Department of Physical Therapy and Rehabilitation, Southeast Colorado Hospital, Springfield, CO, USA.
- Department of Health & Rehabilitation Sciences, College of Allied Health Professions, University of Nebraska Medical Center, Omaha, NE, USA.
| | - Zhengting He
- Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Yanfei Li
- Department of Health & Rehabilitation Sciences, College of Allied Health Professions, University of Nebraska Medical Center, Omaha, NE, USA
| | - Biying Huang
- Department of Health & Rehabilitation Sciences, College of Allied Health Professions, University of Nebraska Medical Center, Omaha, NE, USA
| | - Andréas Remis
- Health Research Association of Keck Medicine, University of Southern California, Los Angeles, CA, USA
| | - Zixuan Yao
- Department of Rehabilitation Medicine, Beijing Hospital, National Center of Gerontology, Institution of Geriatric Medicine, Chinese Academy of Medical Science, Beijing, P.R. China
| | - Dongqi Zhu
- Department of Rehabilitation Medicine, Shanghai Sixth People's Hospital, Shanghai, P.R. China
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Wang MD, Yuan C, Wang KC, Wang NY, Liang YJ, Zhu H, Tong XM, Yang T. Efficacy of ginseng-based Renshenguben oral solution for cancer-related fatigue among patients with advanced-stage hepatocellular carcinoma: A prospective multicenter cohort study. Hepatobiliary Pancreat Dis Int 2024; 23:249-256. [PMID: 38040524 DOI: 10.1016/j.hbpd.2023.11.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Accepted: 11/16/2023] [Indexed: 12/03/2023]
Abstract
BACKGROUND Cancer-related fatigue (CRF) is a common and debilitating symptom experienced by patients with advanced-stage cancer, especially those undergoing antitumor therapy. This study aimed to evaluate the efficacy and safety of Renshenguben (RSGB) oral solution, a ginseng-based traditional Chinese medicine, in alleviating CRF in patients with advanced hepatocellular carcinoma (HCC) receiving antitumor treatment. METHODS In this prospective, open-label, controlled, multicenter study, patients with advanced HCC at BCLC stage C and a brief fatigue inventory (BFI) score of ≥ 4 were enrolled. Participants were assigned to the RSGB group (RSGB, 10 mL twice daily) or the control group (with supportive care). Primary and secondary endpoints were the change in multidimensional fatigue inventory (MFI) score, and BFI and functional assessment of cancer therapy-hepatobiliary (FACT-Hep) scores at weeks 4 and 8 after enrollment. Adverse events (AEs) and toxicities were assessed. RESULTS A total of 409 participants were enrolled, with 206 assigned to the RSGB group. At week 4, there was a trend towards improvement, but the differences were not statistically significant. At week 8, the RSGB group exhibited a significantly lower MFI score (P < 0.05) compared to the control group, indicating improved fatigue levels. Additionally, the RSGB group showed significantly greater decrease in BFI and FACT-Hep scores at week 8 (P < 0.05). Subgroup analyses among patients receiving various antitumor treatments showed similar results. Multivariate linear regression analyses revealed that the RSGB group experienced a significantly substantial decrease in MFI, BFI, and FACT-Hep scores at week 8. No serious drug-related AEs or toxicities were observed. CONCLUSIONS RSGB oral solution effectively reduced CRF in patients with advanced HCC undergoing antitumor therapy over an eight-week period, with no discernible toxicities. These findings support the potential of RSGB oral solution as an adjunctive treatment for managing CRF in this patient population.
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Affiliation(s)
- Ming-Da Wang
- Department of Hepatobiliary and Pancreatic Surgery, General Surgery Center, First Hospital of Jilin University, Changchun 130021, China; Department of Hepatobiliary Surgery, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University (Naval Medical University), Shanghai 200438, China
| | - Chen Yuan
- Department of Clinical Laboratory, Laboratory Medicine Center, Zhejiang Provincial People's Hospital, Hangzhou Medical College, Hangzhou 310000, China
| | - Ke-Chun Wang
- Department of Hepatobiliary Surgery, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University (Naval Medical University), Shanghai 200438, China
| | - Nan-Ya Wang
- Department of Hepatobiliary and Pancreatic Surgery, General Surgery Center, First Hospital of Jilin University, Changchun 130021, China
| | - Ying-Jian Liang
- Department of Hepatobiliary Surgery, First Affiliated Hospital of Harbin Medical University, Harbin 150007, China
| | - Hong Zhu
- Department of Medical Oncology, First Affiliated Hospital of Soochow University, Suzhou 215006, China
| | - Xiang-Min Tong
- Department of Clinical Laboratory, Laboratory Medicine Center, Zhejiang Provincial People's Hospital, Hangzhou Medical College, Hangzhou 310000, China; Department of Central Laboratory, Affiliated Hangzhou First People's Hospital, Westlake University School of Medicine, Hangzhou 310006, China.
| | - Tian Yang
- Department of Hepatobiliary and Pancreatic Surgery, General Surgery Center, First Hospital of Jilin University, Changchun 130021, China; Department of Hepatobiliary Surgery, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University (Naval Medical University), Shanghai 200438, China.
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Han R, Wang Y, Lu L. Sensitizing the Efficiency of ICIs by Neoantigen mRNA Vaccines for HCC Treatment. Pharmaceutics 2023; 16:59. [PMID: 38258070 PMCID: PMC10821464 DOI: 10.3390/pharmaceutics16010059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 12/21/2023] [Accepted: 12/25/2023] [Indexed: 01/24/2024] Open
Abstract
This study builds upon the groundbreaking mRNA vaccine Nobel Prize win in 2023 for COVID-19 prevention, paving the way for next-generation mRNA cancer vaccines to revolutionize immunotherapy. Despite the existing challenges, such as the presence of a suppressive tumor microenvironment and the identification of cancer-associated antigens, recent results from the KEYNOTE-942 trial have successfully demonstrated the effectiveness of mRNA-based cancer treatments, providing clinical evidence for the first time. This trial aimed to evaluate the efficacy and safety of combining immune checkpoint inhibitors with mRNA-based therapies in treating cancer. This advancement undeniably represents new hope for hepatocellular carcinoma (HCC) patients. However, progress in this field remains limited. In this article, we summarized the current state of applying immune checkpoint inhibitors (ICIs) combined with neoantigen mRNA vaccines. Additionally, we discussed potential targets for designing novel mRNA vaccines and potential mRNA vaccine delivery vehicles. The objective of this article is to inspire enthusiasm for the exploration of innovative therapeutic strategies that combine ICIs with neoantigen mRNA vaccines for HCC treatment and HCC prevention.
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Affiliation(s)
- Rui Han
- Department of Chinese Medicine Oncology, The First Affiliated Hospital of Naval Medical University, Shanghai 200433, China
- Department of Chinese Medicine, Naval Medical University, Shanghai 200433, China
- Department of Oncology, The First Hospital Affiliated to Guangzhou University of Chinese Medicine, Guangzhou 510405, China
- Department of Chronic Disease Epidemiology, Yale School of Public Health, Yale University, New Haven, CT 06520-8034, USA
| | - Yuqian Wang
- Department of Chinese Medicine Oncology, The First Affiliated Hospital of Naval Medical University, Shanghai 200433, China
- Department of Chinese Medicine, Naval Medical University, Shanghai 200433, China
| | - Lingeng Lu
- Department of Chronic Disease Epidemiology, Yale School of Public Health, Yale University, New Haven, CT 06520-8034, USA
- School of Medicine, Center for Biomedical Data Science, New Haven, CT 06520-8034, USA
- Yale Cancer Center, Yale University, New Haven, CT 06520-8034, USA
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Wang Y, Tian L, Liu X, Zhang H, Tang Y, Zhang H, Nie W, Wang L. Multidimensional Predictors of Cancer-Related Fatigue Based on the Predisposing, Precipitating, and Perpetuating (3P) Model: A Systematic Review. Cancers (Basel) 2023; 15:5879. [PMID: 38136423 PMCID: PMC10741552 DOI: 10.3390/cancers15245879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 10/22/2023] [Accepted: 12/15/2023] [Indexed: 12/24/2023] Open
Abstract
Cancer-related fatigue (CRF) is a widespread symptom with high prevalence in cancer patients, seriously affecting their quality of life. In the context of precision care, constructing machine learning-based prediction models for early screening and assessment of CRF is beneficial to this situation. To further understand the predictors of CRF for model construction, we conducted a comprehensive search in PubMed, Web of Science, Embase, and Scopus databases, combining CRF with predictor-related terms. A total of 27 papers met the inclusion criteria. We evaluated the above studies into three subgroups following the predisposing, precipitating, and perpetuating (3P) factor model. (1) Predisposing factors-baseline fatigue, demographic characteristics, clinical characteristics, psychosocial traits and physical symptoms. (2) Precipitating factors-type and stage of chemotherapy, inflammatory factors, laboratory indicators and metabolic changes. (3) Perpetuating factors-a low level of physical activity and poorer nutritional status. Future research should prioritize large-scale prospective studies with emerging technologies to identify accurate predictors of CRF. The assessment and management of CRF should also focus on the above factors, especially the controllable precipitating factors, to improve the quality of life of cancer survivors.
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Affiliation(s)
- Yiming Wang
- School of Nursing, Jilin University, No. 965 Xinjiang Street, Changchun 130021, China; (Y.W.); (L.T.)
| | - Lv Tian
- School of Nursing, Jilin University, No. 965 Xinjiang Street, Changchun 130021, China; (Y.W.); (L.T.)
| | - Xia Liu
- Senior Department of Hematology, The Fifth Medical Center of PLA General Hospital, Beijing 100071, China; (X.L.); (Y.T.); (H.Z.)
| | - Hao Zhang
- Yanda Medical Research Institute, Hebei Yanda Hospital, Sanhe 065201, China;
| | - Yongchun Tang
- Senior Department of Hematology, The Fifth Medical Center of PLA General Hospital, Beijing 100071, China; (X.L.); (Y.T.); (H.Z.)
| | - Hong Zhang
- Senior Department of Hematology, The Fifth Medical Center of PLA General Hospital, Beijing 100071, China; (X.L.); (Y.T.); (H.Z.)
| | - Wenbo Nie
- School of Nursing, Jilin University, No. 965 Xinjiang Street, Changchun 130021, China; (Y.W.); (L.T.)
| | - Lisheng Wang
- School of Nursing, Jilin University, No. 965 Xinjiang Street, Changchun 130021, China; (Y.W.); (L.T.)
- Yanda Medical Research Institute, Hebei Yanda Hospital, Sanhe 065201, China;
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Jones JM, Howell D, Longo C, Olson K, Bedard P, Amir E, Zheng S, Chow B, Avery L. The association of cancer-related fatigue on the social, vocational and healthcare-related dimensions of cancer survivorship. J Cancer Surviv 2023:10.1007/s11764-023-01451-9. [PMID: 37644355 DOI: 10.1007/s11764-023-01451-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 08/14/2023] [Indexed: 08/31/2023]
Abstract
BACKGROUND Cancer-related fatigue (CRF) is well documented in cancer survivors, but little is known about the personal and societal impact of CRF. This study aimed to examine the impact of CRF in relation to social and vocational functioning and health care utilization in a large sample of post-treatment cancer survivors. METHODS We conducted a cross-sectional descriptive study of early stage breast and colorectal cancer survivors (n = 454) who were within 5 years from treatment completion. Social difficulties (SDI-21), work status, absenteeism and presenteeism (WHO-HPQ) and healthcare utilization (HSUQ) were compared in those with (CFR +) and without (CRF -) clinically significant fatigue (FACT-F ≤ 34). RESULTS A total of 32% met the cut-off criteria for CRF (≤ 34). Participants with CRF + had significantly higher scores on the SDI-21 across all domains and 55% of CRF + vs. 11% in CRF - was above the SDI cut-off (> 10) for significant social difficulties. Participants with CRF + were 2.74 times more likely to be unemployed or on leave (95% CI 1.62, 4.61, p < 0.001). In the subgroup of participants who were currently working (n = 249), those with CRF + reported working on average 27.4 fewer hours in the previous 4 weeks compared to CRF - (p = 0.05), and absolute presenteeism was on average 13% lower in the CRF + group (95% CI 8.0, 18.2, p < 0.001). Finally, individuals with CRF + reported significantly more physician (p < 0.001), other health care professional (p = 0.03) and psychosocial visits (p = 0.002) in the past month. CONCLUSIONS AND IMPLICATIONS FOR CANCER SURVIVORS CRF is associated with substantial disruption in social and work role functioning in the early transitional phase of cancer survivorship. Better management of persistent CRF and funding for the implementation of existing guidelines and recommended evidence-based interventions are urgently needed.
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Affiliation(s)
- Jennifer M Jones
- Cancer Rehabilitation and Survivorship Program, Princess Margaret Cancer Centre and Department of Psychiatry, University of Toronto, 200 Elizabeth Street, B-PMB-045, Toronto, ON, M5G 2C4, Canada.
| | - Doris Howell
- Department of Supportive Care, Princess Margaret Cancer Centre and Lawrence Bloomberg Faculty of Nursing, University of Toronto, Toronto, Canada
| | - Christopher Longo
- Health Policy and Management, DeGroote School of Business, McMaster University, Hamilton, Canada
| | - Karin Olson
- Faculty of Nursing, University of Alberta, and Edmonton Clinic Health Academy, Edmonton, Canada
| | - Philippe Bedard
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre and Department of Medicine, University of Toronto, Toronto, Canada
| | - Eitan Amir
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre and Department of Medicine, University of Toronto, Toronto, Canada
| | - Shiyu Zheng
- MD Program, University of Toronto, Toronto, Canada
| | - Brittany Chow
- Department of Family and Community Medicine, University of Toronto, Toronto, Canada
| | - Lisa Avery
- Department of Biostatistics, Princess Margaret Cancer Centre, and Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
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Sharbafchi MR, Malekian A, Ahmadzadeh Z, Torkian S, Baharizadeh A, Zarean E. Evaluate the Effectiveness of a Group Psychoeducational Intervention in Reducing the Level of Cancer-Related Fatigue in Women Receiving Chemotherapy for Breast Cancer: A Randomized Controlled Trial. Adv Biomed Res 2023; 12:151. [PMID: 37564460 PMCID: PMC10410410 DOI: 10.4103/abr.abr_137_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Revised: 02/10/2023] [Accepted: 02/13/2023] [Indexed: 08/12/2023] Open
Abstract
Background One of the most debilitating symptoms in breast cancer survivors is cancer-related fatigue (CRF). CRF weakens patients' physical, cognitive, and occupational functions. It is associated with poorer quality of life and may reduce recurrence-free and overall survival. This study aimed to evaluate the efficacy of a group psychoeducational intervention in improving CRF in breast cancer patients. Materials and Methods Fifty breast cancer patients who suffered from CRF were randomly assigned to receive a group psychoeducational intervention or control group. This study was designed as an eight weeks clinical trial. The psychoeducational intervention mainly consisted of concentrative movement therapy and energy conservation strategies. Primary outcome measures were the changes in the Fatigue Visual Analogue scale, Cancer Fatigue scale, and Piper Fatigue scale at the study endpoint. Measure assessments were made on four occasions: at baseline, after the intervention, one week, and four weeks post intervention. Statistical analysis was performed using SPSS26. Results The intervention improved CRF significantly (P < 0.001). All subscales of the Cancer Fatigue scale and the sensory, affective, and cognitive subscales of the Piper Fatigue scale showed statistically significant effects (P < 0.001) at all time points. However, the behavioral subscale of the Piper Fatigue scale was different only at the end of the study (P < 0.001). Conclusions The group psychoeducational intervention improved CRF significantly. All the sensory, behavioral, physical, affective, and cognitive subscales improved. Accessible and confirmatory treatment can help patients to cope with fatigue in communities.
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Affiliation(s)
- Mohammad Reza Sharbafchi
- Department of Psychiatry, School of Medicine, Isfahan University of Medical Sciences and Iranian Cancer Control Center (MACSA), Isfahan, Iran
| | - Azadeh Malekian
- Clinical Research Development Center (CRDC), Islamic Azad University, Najafabad Independent Branch, Najafabad, Iran
| | - Zahra Ahmadzadeh
- Cancer Research Center, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Samaneh Torkian
- Department of Epidemiology, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Alireza Baharizadeh
- College of Skill and Entrepreneurship, Shahrekord Branch, Islamic Azad University, Shahrekord, Iran
| | - Elham Zarean
- Cancer Research Center and Department of Psychiatry, School of Medicine, Shahrekord University of Medical Sciences, Shahrekord, Iran
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Campanini I, Ligabue MB, Bò MC, Bassi MC, Lusuardi M, Merlo A. Self-managed physical activity in cancer survivors for the management of cancer-related fatigue: A scoping review. PLoS One 2022; 17:e0279375. [PMID: 36542639 PMCID: PMC9770433 DOI: 10.1371/journal.pone.0279375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Accepted: 12/06/2022] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVE Cancer-related fatigue (CRF) is a disabling chronic condition that cancer survivors could experience during and after recovery and that might benefit from self-managed physical activity (PA) programs. This scoping review aimed to map self-managed PA interventions found in literature for the management of CRF. METHODS Given the heterogeneity of the topic, scoping review methodological frameworks were used. Pubmed, Cinahl and Cochrane databases were searched for primary literature. Inclusion criteria: self-managed PA meant as any exercise program prescribed by a professional either with or without initial supervision and training which then continued independently for a given time frame; patient-reported fatigue assessment included in the outcome measures. Articles dealing with entirely supervised interventions, dietary or psychological-only therapies, and with palliative care were excluded. RESULTS Of the 543 experimental or observational studies screened, 63 were included. Of these forty-three studies were randomized controlled trials. Data were summarized in tables describing self-managed interventions according to: type of self-managed activity, frequency and duration, strategies to promote adherence, professionals supervising the treatment, outcome measures, and efficacy. A narrative synthesis was also added to further explain findings. CONCLUSIONS We collected the available evidence on PA when this was self-managed by patients after prescription by a healthcare provider. Clinicians and researchers should consider incorporating self-care programs in CRF patients' recovery journey gradually, identifying the best strategies to integrate them into daily life. Researchers should specify the characteristics of PA programs when designing new studies. This review highlighted the areas to be investigated for future studies pertaining to self-managed PA.
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Affiliation(s)
- Isabella Campanini
- LAM - Motion Analysis Laboratory, Neuromotor and Rehabilitation Department, San Sebastiano Hospital, Azienda USL-IRCCS di Reggio Emilia, Correggio, Reggio Emilia, Italy
| | - Maria Bernadette Ligabue
- Motor Rehabilitation Unit, Neuromotor and Rehabilitation Department, San Sebastiano Hospital, Azienda USL-IRCCS di Reggio Emilia, Correggio, Reggio Emilia, Italy
| | | | - Maria Chiara Bassi
- Medical Library, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Mirco Lusuardi
- Neuromotor and Rehabilitation Department, Azienda USL-IRCCS Reggio Emilia, Reggio Emilia, Italy
| | - Andrea Merlo
- LAM - Motion Analysis Laboratory, Neuromotor and Rehabilitation Department, San Sebastiano Hospital, Azienda USL-IRCCS di Reggio Emilia, Correggio, Reggio Emilia, Italy
- Merlo Bioengineering, Parma, Italy
- * E-mail:
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Impact of radiation therapy on fatigue at 1 year in breast cancer survivors in the prospective multicentre CANcer TOxicity cohort. Eur J Cancer 2022; 177:143-153. [PMID: 36356418 DOI: 10.1016/j.ejca.2022.09.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 09/22/2022] [Accepted: 09/23/2022] [Indexed: 01/06/2023]
Abstract
BACKGROUND Fatigue is a common and disabling symptom after breast cancer (BC) treatment, significantly impacting patients' quality of life. We aimed to assess the impact of radiation therapy (RT) modalities on fatigue one year after treatment among patients with early-stage BC. METHODS We used CANTO-RT, a subcohort of CANcer TOxicity (CANTO; NCT01993498), a multicentric nationwide prospective cohort of stages I-III BC treated from 2012 to 2017. Our primary outcome was severe global fatigue 1 year after RT completion (European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-C30 score ≥40/100). The secondary outcomes included severe physical, emotional and cognitive fatigue (European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-FA12). RT-related variables were used as independent variables. Multivariable logistic regression models assessed associations between RT-related variables and fatigue. RESULTS The final analytic cohort included 3295 patients. The prevalence of severe global fatigue 1 year after treatment was 33.3%. Internal mammary chain RT (adjusted odds ratio [OR] 1.48 [95% confidence interval [CI] 1.03-2.13; p = 0.0355]) and normofractionated RT (adjusted OR 1.88 [95% CI 1.06-3.31; p = 0.0298]) were associated with increased odds of severe global fatigue. In addition, there was a significant association between normofractionated RT (adjusted OR 1.849 [95% CI 1.04-3.3; p = 0.0354]) and an increased likelihood of severe physical fatigue. CONCLUSION We found a significant association between internal mammary chain RT (versus No), normofractionated RT (versus hypofractionated RT) and increased likelihood of persistent severe global fatigue. Our data add to the current understanding of treatment-related factors affecting fatigue after BC and could lead to personalised interventions to improve the prevention and management of this disabling symptom.
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Correlates of Cancer-Related Fatigue among Colorectal Cancer Patients Undergoing Postoperative Adjuvant Therapy Based on the Theory of Unpleasant Symptoms. Curr Oncol 2022; 29:9199-9214. [PMID: 36547134 PMCID: PMC9777281 DOI: 10.3390/curroncol29120720] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 11/18/2022] [Accepted: 11/23/2022] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Cancer-related fatigue (CRF) is a common and burdensome symptom in cancer patients that is influenced by multiple factors. Identifying factors associated with CRF may help in developing tailored interventions for fatigue management. This study aimed to examine the correlates of CRF among colorectal cancer patients undergoing postoperative adjuvant therapy based on the theory of unpleasant symptoms. METHODS A cross-sectional study was implemented, and finally, a sample of 363 participants from one tertiary general hospital and one tertiary cancer hospital was purposively recruited. Data were collected using the general information questionnaire, cancer fatigue scale, the distress disclosure index, Herth hope index, and perceived social support scale. Univariate analysis and multiple linear regression analysis were performed to determine the correlates of CRF. RESULTS The mean score of CRF among colorectal cancer patients was 21.61 (SD = 6.16, 95% CI 20.98-22.25), and the fatigue degree rating was "moderate". The multiple linear regression model revealed that 49.1% of the variance in CRF was explained by hope, sleep disorder, internal family support, self-disclosure, pain, and time since operation. CONCLUSIONS Our study identified several significant, modifiable factors (self-disclosure, hope, internal family support, pain, and sleep disorder) associated with CRF. Understanding these correlates and developing targeted psychosocial interventions may be associated with the improvement of CRF in patients with colorectal cancer.
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Merz EL, Gholizadeh S. Mental and Physical Health Concerns in the Context of COVID-19: Opportunities and Applications for Behavioral Medicine. FOCUS (AMERICAN PSYCHIATRIC PUBLISHING) 2022; 20:292-300. [PMID: 37205014 PMCID: PMC10172526 DOI: 10.1176/appi.focus.20220044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
Numerous physical and mental health concerns have been documented in the context of COVID-19, and it is likely that patients, survivors, frontline health care workers, and other affected individuals will present to psychiatry for treatment. Behavioral medicine, an interdisciplinary field that is defined by a behavioral and biomedical conceptualization of clinical care, offers an opportunity for collaboration with psychiatry and other health care providers to meet the myriad needs resulting from the pandemic. This review summarizes a conceptual framework of behavioral medicine and clinical health psychology, COVID-19-related quality of life concerns that may be applicable to behavioral medicine referrals, clinical assessment directions, and intervention opportunities. The review combines both findings specific to COVID-19 and general behavioral medicine principles with an overall goal of providing a basic introduction to behavioral medicine practice, applications, and opportunities for management of medical and psychological symptoms.
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Affiliation(s)
- Erin L Merz
- Department of Psychology, College of Natural and Behavioral Sciences, California State University, Dominguez Hills, Carson (Merz); TheKey Research Group™, San Diego (Gholizadeh)
| | - Shadi Gholizadeh
- Department of Psychology, College of Natural and Behavioral Sciences, California State University, Dominguez Hills, Carson (Merz); TheKey Research Group™, San Diego (Gholizadeh)
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Legg M, Meertens RM, van Roekel E, Breukink SO, Janssen ML, Keulen ETP, Steindorf K, Weijenberg MP, Bours M. The Association between Sleep Quality and Fatigue in Colorectal Cancer Survivors up until Two Years after Treatment: A Cross-Sectional and Longitudinal Analysis. Cancers (Basel) 2022; 14:cancers14061527. [PMID: 35326678 PMCID: PMC8945971 DOI: 10.3390/cancers14061527] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 03/02/2022] [Accepted: 03/11/2022] [Indexed: 02/01/2023] Open
Abstract
Simple Summary Fatigue is a distressing complaint with high detriment to quality of life that persists in one third of colorectal cancer survivors after cancer treatment. Surprisingly, the contribution of poor sleep quality to fatigue in colorectal cancer survivors is underinvestigated. We aimed to investigate the association between sleep quality and fatigue in colorectal cancer survivors up until two years post-treatment. Results showed worse sleep quality in colorectal cancer patients was associated with higher levels of fatigue during the first two years post-treatment. The results of this study suggest that more attention for sleep quality in colorectal cancer survivors and offering sleep health interventions may lead to less fatigue and better quality of life in this group. Abstract Fatigue is a distressing complaint with high detriment to quality of life that persists in one-third of colorectal cancer survivors after cancer treatment. Previous studies in mixed groups of cancer patients have suggested sleep quality is associated with fatigue. We aimed to investigate this association in colorectal cancer survivors up until two years post-treatment. Data on n = 388 stage I–III colorectal cancer patients were utilized from the EnCoRe study. Sleep quality and fatigue were measured at 6 weeks and 6, 12, and 24 months post-treatment. Sleep quality was measured using the Pittsburgh Sleep Quality Index (cross-sectional analysis only) and the single-item insomnia scale from the EORTC QLQ-C30. Fatigue was measured by the Checklist Individual Strength. Linear and mixed-model regression analyses analysed associations between sleep quality and fatigue cross-sectionally and longitudinally. Longitudinal analysis revealed worsening sleep quality over time was significantly associated with increased levels of fatigue over time (β per 0.5 SD increase in the EORTC-insomnia score = 2.56, 95% Cl: 1.91, 3.22). Significant cross-sectional associations were observed between worse sleep quality and higher levels of fatigue at all time points. Worse sleep quality in colorectal cancer patients was associated with higher levels of fatigue during the first two years post-treatment.
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Affiliation(s)
- Meera Legg
- Department of Health Promotion, Care and Public Health Research Institute (CAPHRI), School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, 6200 MD Maastricht, The Netherlands;
- Department of Epidemiology, GROW School for Oncology and Developmental Biology, Maastricht University, 6200 MD Maastricht, The Netherlands; (E.v.R.); (M.P.W.); (M.B.)
| | - Ree M. Meertens
- Department of Health Promotion, Care and Public Health Research Institute (CAPHRI), School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, 6200 MD Maastricht, The Netherlands;
- Correspondence:
| | - Eline van Roekel
- Department of Epidemiology, GROW School for Oncology and Developmental Biology, Maastricht University, 6200 MD Maastricht, The Netherlands; (E.v.R.); (M.P.W.); (M.B.)
| | - Stéphanie O. Breukink
- Department of Surgery, GROW School for Oncology and Developmental Biology, Maastricht University Medical Center+, 6202 AZ Maastricht, The Netherlands;
| | - Maryska L. Janssen
- Department of Clinical Epidemiology, VieCuri Medical Centre, Tegelseweg 210, 5912 BL Venlo, The Netherlands;
| | - Eric T. P. Keulen
- Department of Internal Medicine and Gastroenterology, Zuyderland Medical Centre, Dr. H. van der Hoffplein 1, 6162 BG Sittard-Geleen, The Netherlands;
| | - Karen Steindorf
- Division of Physical Activity, Prevention and Cancer, National Center for Tumor Diseases (NCT) and German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120 Heidelberg, Germany;
| | - Matty P. Weijenberg
- Department of Epidemiology, GROW School for Oncology and Developmental Biology, Maastricht University, 6200 MD Maastricht, The Netherlands; (E.v.R.); (M.P.W.); (M.B.)
| | - Martijn Bours
- Department of Epidemiology, GROW School for Oncology and Developmental Biology, Maastricht University, 6200 MD Maastricht, The Netherlands; (E.v.R.); (M.P.W.); (M.B.)
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12
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Bahar-Ozdemir Y, Kaya S, Babacan NA, Al T, Albayrak E, Coskun N, Akyuz G. Can assessment of disease burden and quality of life based on mobility level in patients with end-stage cancer provide an insight into unmet needs? An exploratory cross-sectional study. Physiother Theory Pract 2022; 39:1141-1151. [PMID: 35100940 DOI: 10.1080/09593985.2022.2035029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
PURPOSE The purpose of this study was to: 1) investigate the differences in the needs of end-stage cancer who can move independently, using mobility aids (MA), or are bedridden; and 2) determine the effects of these different mobility levels on the patients' current quality of life (QoL), fatigue, and mental conditions. METHODS The study employed an exploratory prospective cross-sectional study design, which was carried out in two hospitals. The study included 99 end-stage cancer. The mobility levels of the patients were evaluated in three groups: Group 1: bedridden; Group 2: mobile with MA; and Group 3: ambulatory (under supervision or fully independent). A core cancer-specific questionnaire-integrating system for assessing health-related QOL (EORTC-QLQ-C15-PAL), the Piper Fatigue Scale (PFS), and the Hospital Anxiety-Depression scale were utilized. The median age was 60years (31-83). Cancer types were as follows: gastrointestinal (45.5%), lung (38.4%), breast (4%), genitourinary system (4%), and others (8%). Forty-two percent of the patients were completely bedridden, 42.2% used MA, and 15.2% were independently ambulatory. The EORTC QLQ-C15-PAL physical (=.000) and emotional function values (=.029) differed among mobilization statuses. There was a significant difference among mobilization groups, in terms of behavioral values, in the PFS (=.006). The depression rate in the independent ambulatory group was lower than in the bedridden and MA groups (=0.011; =0.004). p p p p1 p2 . CONCLUSION Health-related QoL, fatigue level, and emotional state vary in end-stage cancer who undergo evaluations according to their mobility levels. These patients should be assessed comprehensively, and treatment plans should be organized carefully, with a multidisciplinary approach.
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Affiliation(s)
- Yeliz Bahar-Ozdemir
- Department of Physical Medicine and Rehabilitation, Health Sciences University Sultan Abdulhamid Han Training and Research Hospital, Istanbul, Turkey
| | - Sefik Kaya
- Department of Physical Medicine and Rehabilitation, Arnavutkoy State Hospital, Istanbul, Turkey
| | - Nalan Akgul- Babacan
- Department of Clinical Oncology, Marmara University School of Medicine, Istanbul, Turkey
| | - Tugce Al
- Emergency Medicine Clinic, Mardin State Hospital, Mardin, Turkey
| | - Ece Albayrak
- Department of Internal Medicine, Ammerland Klinik GmbH, Westerstede, Germany
| | - Nilufer Coskun
- Department of Anesthesiology and Reanimation, Sancaktepe Sehit Prof Dr Ilhan Varank Training and Research Hospital, Istanbul, Turkey
| | - Gulseren Akyuz
- Department of Physical Medicine and Rehabilitation and Division of Pain Medicine, Marmara University School of Medicine, Istanbul, Turkey
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13
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Di Meglio A, Havas J, Soldato D, Presti D, Martin E, Pistilli B, Menvielle G, Dumas A, Charles C, Everhard S, Martin AL, Coutant C, Tarpin C, Vanlemmens L, Levy C, Rigal O, Delaloge S, Lin NU, Ganz PA, Partridge AH, André F, Michiels S, Vaz-Luis I. Development and Validation of a Predictive Model of Severe Fatigue After Breast Cancer Diagnosis: Toward a Personalized Framework in Survivorship Care. J Clin Oncol 2022; 40:1111-1123. [PMID: 35061509 PMCID: PMC8966972 DOI: 10.1200/jco.21.01252] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
PURPOSE Fatigue is common and troublesome among breast cancer survivors; however, limited tools exist to predict its risk. PATIENTS AND METHODS Participants with stage I-III breast cancer were prospectively included from CANTO (ClinicalTrials.gov identifier: NCT01993498), collecting longitudinal data at diagnosis (before the initiation of any cancer treatment) and 1 (T1), 2 (T2), and 4 (T3) years after diagnosis. The main outcome was severe global fatigue at T2 (score ≥ 40/100, European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire-C30). Analyses at T3 were exploratory. Secondary outcomes included physical, emotional, and cognitive fatigue (EORTC Quality of Life Questionnaire-FA12). Multivariable logistic regression models retained associations with severe fatigue by bootstrapped Augmented Backward Elimination. Validation methods included 10-fold internal cross-validation, overoptimism-corrected area under the receiver operating characteristic curves, and external validation. RESULTS Among 5,640, 5,000, and 3,400 patients at T1, T2, and T3, respectively, the prevalence of post-treatment severe global fatigue was 35.6%, 34.0%, and 31.5% in the development cohort. Retained risk factors for severe global fatigue at T2 were severe pretreatment fatigue (adjusted odds ratio v no 3.191 [95% CI, 2.704 to 3.767]); younger age (for 1-year decrement 1.015 [1.009 to 1.022]), higher body mass index (for unit increment 1.025 [1.012 to 1.038]), current smoking behavior (v never 1.552 [1.291 to 1.866]), worse anxiety (v noncase 1.265 [1.073 to 1.492]), insomnia (for unit increment 1.005 [1.003 to 1.007]), and pain at diagnosis (for unit increment 1.014 [1.010 to 1.017]), with an area under the receiver operating characteristic curve of 0.73 (95% CI, 0.72 to 0.75). Receipt of hormonal therapy was a risk factor for severe fatigue at T3 (v no 1.448 [1.165 to 1.799]). Dimension-specific risk factors included body mass index for physical fatigue and emotional distress for emotional and cognitive fatigue. CONCLUSION We propose a predictive model to assess fatigue among breast cancer survivors, within a personalized survivorship care framework. This may help clinicians to provide early management interventions or to correct modifiable risk factors and offer more tailored monitoring and education to patients at risk of severe post-treatment fatigue.
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Affiliation(s)
- Antonio Di Meglio
- INSERM Unit 981-Molecular Predictors and New Targets in Oncology, Gustave Roussy, Villejuif, France; University Paris-Saclay.,Department of Medical Oncology, Gustave Roussy, Villejuif, France
| | - Julie Havas
- INSERM Unit 981-Molecular Predictors and New Targets in Oncology, Gustave Roussy, Villejuif, France; University Paris-Saclay
| | - Davide Soldato
- INSERM Unit 981-Molecular Predictors and New Targets in Oncology, Gustave Roussy, Villejuif, France; University Paris-Saclay.,Department of Internal Medicine and Medical Specialties, University of Genova, Genova, Italy
| | - Daniele Presti
- INSERM Unit 981-Molecular Predictors and New Targets in Oncology, Gustave Roussy, Villejuif, France; University Paris-Saclay.,Department of Internal Medicine and Therapeutics, University of Pavia, Pavia, Italy
| | - Elise Martin
- INSERM Unit 981-Molecular Predictors and New Targets in Oncology, Gustave Roussy, Villejuif, France; University Paris-Saclay
| | - Barbara Pistilli
- INSERM Unit 981-Molecular Predictors and New Targets in Oncology, Gustave Roussy, Villejuif, France; University Paris-Saclay.,Department of Medical Oncology, Gustave Roussy, Villejuif, France
| | - Gwenn Menvielle
- Sorbonne University, INSERM, Pierre Louis Institute of Epidemiology and Public Health, Paris, France
| | - Agnes Dumas
- Universite de Paris, ECEVE UMR 1123, INSERM, Paris, France
| | - Cecile Charles
- INSERM Unit 981-Molecular Predictors and New Targets in Oncology, Gustave Roussy, Villejuif, France; University Paris-Saclay
| | | | | | | | | | | | | | | | - Suzette Delaloge
- INSERM Unit 981-Molecular Predictors and New Targets in Oncology, Gustave Roussy, Villejuif, France; University Paris-Saclay.,Department of Medical Oncology, Gustave Roussy, Villejuif, France
| | | | | | | | - Fabrice André
- INSERM Unit 981-Molecular Predictors and New Targets in Oncology, Gustave Roussy, Villejuif, France; University Paris-Saclay.,Department of Medical Oncology, Gustave Roussy, Villejuif, France
| | - Stefan Michiels
- Service de Biostatistique et d'Epidémiologie, Gustave Roussy, Villejuif, France.,Oncostat U1018, Inserm, University Paris-Saclay, Ligue Contre le Cancer, Villejuif, France
| | - Ines Vaz-Luis
- INSERM Unit 981-Molecular Predictors and New Targets in Oncology, Gustave Roussy, Villejuif, France; University Paris-Saclay.,Department of Medical Oncology, Gustave Roussy, Villejuif, France
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14
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Spahrkäs SS, Looijmans A, Sanderman R, Hagedoorn M. How does the Untire App alleviate Cancer‐Related Fatigue?A Longitudinal Mediation Analysis. Psychooncology 2022; 31:970-977. [PMID: 35060222 PMCID: PMC9303515 DOI: 10.1002/pon.5886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 12/13/2021] [Accepted: 01/07/2022] [Indexed: 11/08/2022]
Affiliation(s)
- Simon S. Spahrkäs
- Department of Health Psychology University Medical Center Groningen University of Groningen The Netherlands
| | - Anne Looijmans
- Department of Health Psychology University Medical Center Groningen University of Groningen The Netherlands
| | - Robbert Sanderman
- Department of Health Psychology University Medical Center Groningen University of Groningen, The Netherlands and Department of Psychology Health & Technology University of Twente The Netherlands
| | - Mariët Hagedoorn
- Department of Health Psychology University Medical Center Groningen University of Groningen The Netherlands
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15
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Bahceli PZ, Arslan S, Ilik Y. The effect of slow-stroke back massage on chemotherapy-related fatigue in women with breast cancer: An assessor blinded, parallel group, randomized control trial. Complement Ther Clin Pract 2021; 46:101518. [PMID: 34844069 DOI: 10.1016/j.ctcp.2021.101518] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2021] [Revised: 11/19/2021] [Accepted: 11/22/2021] [Indexed: 11/16/2022]
Abstract
OBJECTIVE This randomized controlled parallel-group trial was conducted to investigate the effect of slow-stroke back massage (SSBM) on the level of fatigue in women with breast cancer undergoing chemotherapy. METHODS Sixty-four women with breast cancer receiving chemotherapy were randomly assigned to SSBMG (n:32), who received SSBM, and CG (n:32), who received routine treatment only. Women with breast cancer in the intervention group received SSBM for a total of 20 min, 10 min before and after each chemotherapy infusion (2nd, 3rd, and 4th cycle). The Brief Fatigue Inventory (BFI) was completed before and after three cycles of chemotherapy (2nd, 3rd, and 4th) to assess the level of fatigue in women with breast cancer. RESULTS After using SSBM, the BFI score was significantly lower in SSBMG than in CG (p 0.001) at all three-time points (1st, 2nd, and 3rd-time points). While the within-group change (Δ) in SSBMG differed significantly between time points (p = 0.018, η2 = 0.14), in contrast, the within-group change (Δ) in CG was found not to differ between time points. CONCLUSION This study has shown that SSBM, one of the non-pharmacological methods, has a positive effect on the level of fatigue in women with breast cancer.
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Affiliation(s)
- Pinar Zorba Bahceli
- Izmir Bakircay University, Faculty of Health Sciences, Nursing Department, Izmir, Turkey.
| | - Selda Arslan
- Necmettin Erbakan University, Faculty of Nursing, Konya, Turkey.
| | - Yeter Ilik
- Necmettin Erbakan University, Faculty of Medicine, Yunus Emre Mahallesi, Beysehir Caddesi, No. 281, Konya, Turkey.
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16
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Zeng Y, Xia J, Chen Z, Tian X, Ren Y. Transcutaneous electrical acupoint stimulation (TEAS) for cancer-related fatigue: study protocol for a systematic review and meta-analysis. BMJ Open 2021; 11:e049318. [PMID: 34819280 PMCID: PMC8614145 DOI: 10.1136/bmjopen-2021-049318] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Cancer-related fatigue (CRF) is a prevalent symptom in cancer survivors. Transcutaneous electrical acupoint stimulation (TEAS) has been reported as a promising therapy for CRF. This protocol is proposed for a systematic review that aims to assess the efficacy and safety of TEAS for CRF. METHODS AND ANALYSIS Cochrane Central Register of Controlled Trials, PubMed, Medline, Embase, Chinese National Knowledge Infrastructure, VIP, Wanfang database, Chinese Biomedical Literature Database, Chinese Clinical Trial Registry System, ClinicalTrials.gov and WHO International Clinical Trial Registry Platform will be searched from inception to 31 January 2021 without language limitations. The eligible randomised controlled trials will be included. The primary outcomes include changes in the revised Piper fatigue scale, the Brief fatigue inventory, the Multidimensional fatigue inventory and the Functional assessment of chronic illness therapy fatigue. The secondary outcomes are the quality-of-life measurement index, the Hamilton anxiety scale, the Hamilton depression scale and adverse events. The selection of studies, data extraction and assessment of risk of bias will be conducted independently by two reviewers. Data synthesis will be performed using RevMan V.5.4.1. The quality of evidence will be evaluated with the Grading of Recommendations, Assessment, Development and Evaluation system. This study will strictly adhere to the Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines. ETHICS AND DISSEMINATION Ethical approval is not required as this is a systematic review and meta-analysis based on previously published studies involving no private information of patients. The results of this study will be disseminated in a peer-reviewed journal. PROSPERO REGISTRATION NUMBER CRD42020220282.
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Affiliation(s)
- Yiwei Zeng
- School of Acupuncture and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Jialin Xia
- School of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Zhihan Chen
- School of Acupuncture and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Xiaoping Tian
- School of Chinese Classics, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Yulan Ren
- School of Chinese Classics, Chengdu University of Traditional Chinese Medicine, Chengdu, China
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17
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Tolotti A, Bonetti L, Pedrazzani C, Bianchi M, Moser L, Pagnucci N, Sari D, Valcarenghi D. Nursing management of fatigue in cancer patients and suggestions for clinical practice: a mixed methods study. BMC Nurs 2021; 20:182. [PMID: 34583693 PMCID: PMC8477483 DOI: 10.1186/s12912-021-00699-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Accepted: 08/19/2021] [Indexed: 01/29/2023] Open
Abstract
Background Fatigue is a complex and frequent symptom in cancer patients, influencing their quality of life, but it is still underestimated and undertreated in clinical practice. The aims of this study were to detect the presence of fatigue in cancer patients, describe how patients and nurses perceived it and how nurses managed fatigue. Methods This is a mixed methods study. Data were collected in two oncological wards using the Brief Fatigue Inventory (BFI), an ad hoc questionnaire, patient interviews, focus groups with nurses and the review of nursing records. Interviews and focus groups were analysed through thematic analysis. We used SPSS 22.0 for quantitative data and Nvivo 10 for qualitative data analysis. Results A total of 71 questionnaires were analysed (39 males, mean age 65.7 years). Fatigue was reported 5 times (7%) in nursing records, while in 17 cases (23.9%) problems associated to it were reported. Twelve patients were interviewed. Five themes were identified: feeling powerless and aggressive, my strategies or what helps me, feeling reassured by the presence of family members, feeling reassured by nurses’ gestures, and being informed. Three themes were identified through the focus groups: objectivity and subjectivity in the assessment of fatigue, nurses’ contribution to the multidisciplinary management of fatigue, and difficulty in evaluating outcomes. Conclusions The approach to the management of fatigue was unstructured. Patients were satisfied with the care they received but needed more information and specific interventions. Useful aspects were identified that could be used to change health professionals’ approach towards the management of fatigue. Supplementary Information The online version contains supplementary material available at 10.1186/s12912-021-00699-9.
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Affiliation(s)
- Angela Tolotti
- Nursing Research and Development Unit, Oncology Institute of Southern Switzerland (IOSI), Via Gallino, 12, 6500, Bellinzona, Switzerland
| | - Loris Bonetti
- Nursing Research and Development Unit, Oncology Institute of Southern Switzerland (IOSI), Via Gallino, 12, 6500, Bellinzona, Switzerland. .,Department of Business Economics, Health and Social Care, University of Applied Sciences and Arts of Southern Switzerland (SUPSI), Manno, Switzerland.
| | - Carla Pedrazzani
- Department of Business Economics, Health and Social Care, University of Applied Sciences and Arts of Southern Switzerland (SUPSI), Manno, Switzerland
| | - Monica Bianchi
- Department of Business Economics, Health and Social Care, University of Applied Sciences and Arts of Southern Switzerland (SUPSI), Manno, Switzerland
| | - Laura Moser
- Clinical Trial Unit, Oncology Institute of Southern Switzerland (IOSI), Via Gallino, 12, 6500, Bellinzona, Switzerland
| | - Nicola Pagnucci
- Department of Surgical, Medical and Molecular Pathology and Critical Care, University of Pisa, Pisa, Italy
| | - Davide Sari
- Department of Nursing, Oncology Institute of Southern Switzerland (IOSI), Via Gallino, 12, 6500, Bellinzona, Switzerland
| | - Dario Valcarenghi
- Nursing Research and Development Unit, Oncology Institute of Southern Switzerland (IOSI), Via Gallino, 12, 6500, Bellinzona, Switzerland
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Hatlevoll I, Skolbekken JA, Oldervoll LM, Wibe A, Hofsli E. Colorectal cancer patients' experiences with supervised exercise during adjuvant chemotherapy-A qualitative study. Scand J Med Sci Sports 2021; 31:2300-2309. [PMID: 34519105 DOI: 10.1111/sms.14048] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Accepted: 09/06/2021] [Indexed: 12/21/2022]
Abstract
BACKGROUND Colorectal cancer (CRC) is a common cancer worldwide, with increasing numbers surviving and living with long-term side effects from treatment. Physical exercise during or after treatment may have several beneficial effects, but knowledge of CRC patients' reflections on exercising during adjuvant therapy is limited. The aim of this study was to explore the experiences of CRC patients participating in a supervised exercise program during adjuvant chemotherapy. METHODS This study included CRC patients participating in two intervention studies with individually tailored and supervised combinations of endurance, resistance, and balance exercises during adjuvant chemotherapy. Semi-structured interviews performed at the beginning, during, and immediately after the intervention period from 15 participants were analyzed using thematic analysis. RESULTS Four main themes identified were "structuring life with cancer," "motivation to exercise," "training experiences," and "effects of exercise." Scheduled appointments gave structure to daily life and served as an external motivational factor. The individual adjustments of exercise gave a sense of security and helped improving adherence, especially when feeling depressed or fatigued. Common expectations were improvement of endurance and strength and counteracting negative effects of chemotherapy. Experienced positive effects from exercising, both mentally and physically, contributed to inner motivation and inspired continued exercising after the study period. CONCLUSION This study offers important insights into CRC patients' experiences of participating in a physical exercise program during adjuvant chemotherapy. Based on our findings, we recommend supervised and individually tailored physical exercise during adjuvant chemotherapy to this patient group.
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Affiliation(s)
- Ingunn Hatlevoll
- Department of Oncology, St. Olav's University Hospital, Trondheim, Norway.,Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - John-Arne Skolbekken
- Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway
| | - Line Merethe Oldervoll
- Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway.,Center for Crisis Psychology, Faculty of Psychology, University of Bergen, Bergen, Norway
| | - Arne Wibe
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway.,Department of Surgery, St. Olav's University Hospital, Trondheim, Norway
| | - Eva Hofsli
- Department of Oncology, St. Olav's University Hospital, Trondheim, Norway.,Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
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Exploring Mentorship as a Novel Approach to Improving Quality of Life in Sarcoma Survivors: A Qualitative Pilot Study. Sarcoma 2021; 2021:2042785. [PMID: 34421328 PMCID: PMC8371637 DOI: 10.1155/2021/2042785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 07/20/2021] [Accepted: 08/04/2021] [Indexed: 11/21/2022] Open
Abstract
Backgrounds To investigate whether a formal mentoring program involving mentors from the business community could improve the quality of life (QoL) of sarcoma survivors struggling with the late effects of treatment. Methods Seven former sarcoma patients participated in an eight-month formal mentoring program. The program was assessed through a qualitative study involving a phenomenological approach that utilized a hermeneutical design. In-depth, semistructured interviews were conducted with the mentees after the intervention and six months later. The mentors were interviewed after the program was over. The gathered data were interpreted using a thematic analysis. Results The program facilitated dialogue between the mentors and mentees as well as between the mentees. Afterwards, the mentees were more willing to accept the challenges they faced following cancer treatment. During the program, the mentees were pushed out of their comfort zone, which led to mastery and personal growth in them all. However, the program also revealed some additional challenges, including unfulfilled expectations in two mentor-mentee relationships. Conclusions The mentoring program facilitated the mentees' reorientation and enhanced their QoL. Its eight-month duration appeared important in terms of allowing the mentees to go through a long-lasting process with continued support. The program could serve as the basis for larger studies involving other cancer survivors.
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CIUBEAN AD, CIORTEA VM, UNGUR RA, BORDA IM, POPA T, IRSAY L. Role of occupational therapy in rehabilitation of cancer patients. BALNEO AND PRM RESEARCH JOURNAL 2021. [DOI: 10.12680/balneo.2021.434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background. Most adult cancer survivors report a significant decrease of their quality of life and limitations in performing activities of daily living. Occupational therapy is a form of rehabilitation treatment that uses certain techniques and tools aimed at improving functional capacity, improve social participation and overall quality of life. Objective. The overall purpose of this narrative review is to provide a better understanding of the role that occupational therapy can play in the rehabilitation of cancer patients with a focus on the most important cancer-related aspects amenable and manageable by occupational therapy interventions and to increase awareness regarding this form of rehabilitation.
Discussion. Given the fact that there is constant grow in the number of cancer survivors with complex needs, rehabilitation and occupational therapy strategies can increase functionality and health-related quality of life of patients with cancer at any point of the disease, but it remains underused, due to certain barriers.
Conclusions. Occupational therapy, as part of cancer rehabilitation therapy, can lead to improvements in both short and long-term outcomes, while being cost-effective as goals are always set in collaboration with the patients and are aimed to identify and improve the activities most important and relevant for them.
Keywords: occupational therapy, cancer, rehabilitation, activities of daily living, quality of life,
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Affiliation(s)
- Alina Deniza CIUBEAN
- 1. Department of Rehabilitation, University of Medicine and Pharmacy “Iuliu Hatieganu”, Cluj-Napoca, Romania
| | - Viorela Mihaela CIORTEA
- 1. Department of Rehabilitation, University of Medicine and Pharmacy “Iuliu Hatieganu”, Cluj-Napoca, Romania 2. Department of Rehabilitation, Clinical Rehabilitation Hospital, Cluj-Napoca, Romania
| | - Rodica Ana UNGUR
- 1. Department of Rehabilitation, University of Medicine and Pharmacy “Iuliu Hatieganu”, Cluj-Napoca, Romania 2. Department of Rehabilitation, Clinical Rehabilitation Hospital, Cluj-Napoca, Romania
| | | | - Theodor POPA
- 2. Department of Rehabilitation, Clinical Rehabilitation Hospital, Cluj-Napoca, Romania
| | - Laszlo IRSAY
- 1. Department of Rehabilitation, University of Medicine and Pharmacy “Iuliu Hatieganu”, Cluj-Napoca, Romania 2. Department of Rehabilitation, Clinical Rehabilitation Hospital, Cluj-Napoca, Romania
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Wiens L, Schäffeler N, Eigentler T, Garbe C, Forschner A. Psychological Distress of Metastatic Melanoma Patients during Treatment with Immune Checkpoint Inhibitors: Results of a Prospective Study. Cancers (Basel) 2021; 13:2642. [PMID: 34072206 PMCID: PMC8198252 DOI: 10.3390/cancers13112642] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 05/19/2021] [Accepted: 05/25/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Immune checkpoint inhibitors (ICI) provide effective treatment options for advanced melanoma patients. However, they are associated with high rates of immune-related side effects. There are no data on the distress of melanoma patients during their ICI treatment. We, therefore, conducted a prospective longitudinal study to assess distress and the need for psycho-oncological support in these patients. METHODS Questionnaires were completed before initiation of ICI (T0), after 6-8 weeks (T1), and after 12-14 weeks (T2). We furthermore included the Hornheide Screening Instrument (HSI), distress thermometer (DT), and patients' self-assessment. Binary logistic regression was performed to identify factors indicating a need for psychooncological support. RESULTS 36.3%/55.8% (HSI / DT) of the patients were above the threshold, indicating a need for psychooncological support at T0, and 7.8% of the patients reported practical problems. In contrast, at T2, the distress values had decreased to 29.0%/40.2% (HSI/DT), respectively. Female gender and occurrence of side effects significantly correlated to values above the threshold. The strongest factor was the patient's self-assessment. CONCLUSION With the beginning of ICI, psychooncological support should be offered. Furthermore, practical problems should be considered, e.g., transport to therapy. Female patients and patients with side effects should be given special attention, as well as the patient self-assessment.
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Affiliation(s)
- Lisa Wiens
- Department of Dermatology, University Hospital Tübingen, 72076 Tübingen, Germany; (L.W.); (T.E.); (C.G.)
| | - Norbert Schäffeler
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, 72076 Tübingen, Germany;
| | - Thomas Eigentler
- Department of Dermatology, University Hospital Tübingen, 72076 Tübingen, Germany; (L.W.); (T.E.); (C.G.)
| | - Claus Garbe
- Department of Dermatology, University Hospital Tübingen, 72076 Tübingen, Germany; (L.W.); (T.E.); (C.G.)
| | - Andrea Forschner
- Department of Dermatology, University Hospital Tübingen, 72076 Tübingen, Germany; (L.W.); (T.E.); (C.G.)
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22
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Penson A, van Deuren S, Bronkhorst E, Keizer E, Heskes T, Coenen MJH, Rosmalen JGM, Tissing WJE, van der Pal HJH, de Vries ACH, van den Heuvel-Eibrink MM, Neggers S, Versluys BAB, Louwerens M, van der Heiden-van der Loo M, Pluijm SMF, Grootenhuis M, Blijlevens N, Kremer LCM, van Dulmen-den Broeder E, Knoop H, Loonen J. Methodology of the DCCSS later fatigue study: a model to investigate chronic fatigue in long-term survivors of childhood cancer. BMC Med Res Methodol 2021; 21:106. [PMID: 33993873 PMCID: PMC8127233 DOI: 10.1186/s12874-021-01298-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 04/27/2021] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND A debilitating late effect for childhood cancer survivors (CCS) is cancer-related fatigue (CRF). Little is known about the prevalence and risk factors of fatigue in this population. Here we describe the methodology of the Dutch Childhood Cancer Survivor Late Effect Study on fatigue (DCCSS LATER fatigue study). The aim of the DCCSS LATER fatigue study is to examine the prevalence of and factors associated with CRF, proposing a model which discerns predisposing, triggering, maintaining and moderating factors. Triggering factors are related to the cancer diagnosis and treatment during childhood and are thought to trigger fatigue symptoms. Maintaining factors are daily life- and psychosocial factors which may perpetuate fatigue once triggered. Moderating factors might influence the way fatigue symptoms express in individuals. Predisposing factors already existed before the diagnosis, such as genetic factors, and are thought to increase the vulnerability to develop fatigue. Methodology of the participant inclusion, data collection and planned analyses of the DCCSS LATER fatigue study are presented. RESULTS Data of 1955 CCS and 455 siblings was collected. Analysis of the data is planned and we aim to start reporting the first results in 2022. CONCLUSION The DCCSS LATER fatigue study will provide information on the epidemiology of CRF and investigate the role of a broad range of associated factors in CCS. Insight in associated factors for fatigue in survivors experiencing severe and persistent fatigue may help identify individuals at risk for developing CRF and may aid in the development of interventions.
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Affiliation(s)
- Adriaan Penson
- Department of Hematology, Radboud University Medical Center, Nijmegen, The Netherlands.
| | - Sylvia van Deuren
- Department of Hematology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Ewald Bronkhorst
- Department of Dentistry, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Ellen Keizer
- Department of Hematology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Tom Heskes
- Institute for Computing and Information Sciences, Radboud University, Nijmegen, The Netherlands
| | - Marieke J H Coenen
- Department of Human Genetics, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Judith G M Rosmalen
- Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Wim J E Tissing
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
- Department of Pediatric Oncology/Hematology, Beatrix Children's Hospital/University of Groningen/University Medical Center Groningen, Groningen, The Netherlands
| | | | - Andrica C H de Vries
- Department of Pediatric Oncology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Marry M van den Heuvel-Eibrink
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
- Department of Pediatric Oncology, Erasmus Medical Center - Sophia Children's Hospital, Rotterdam, The Netherlands
| | - Sebastian Neggers
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
- Department of Medicine, section Endocrinology, Erasmus Medical Center, Rotterdam, The Netherlands
| | | | - Marloes Louwerens
- Department of Internal Medicine, Leiden University Medical Center, Leiden, The Netherlands
| | | | - Saskia M F Pluijm
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - Martha Grootenhuis
- Department of Psychology, Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - Nicole Blijlevens
- Department of Hematology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Leontien C M Kremer
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
- Department Pediatric Oncology, Emma Children's Hospital, University of Amsterdam, Amsterdam, The Netherlands
| | | | - Hans Knoop
- Department of Medical Psychology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam Public health research institute, Amsterdam, Netherlands
| | - Jacqueline Loonen
- Department of Hematology, Radboud University Medical Center, Nijmegen, The Netherlands
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23
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Fatigue in Cancer Patients in Palliative Care-A Review on Pharmacological Interventions. Cancers (Basel) 2021; 13:cancers13050985. [PMID: 33652866 PMCID: PMC7956665 DOI: 10.3390/cancers13050985] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 02/11/2021] [Accepted: 02/22/2021] [Indexed: 02/07/2023] Open
Abstract
Simple Summary Cancer related fatigue is a common and distressing symptom for patients with cancer during and after primary treatment, and also in the palliative phase of the disease trajectory. This review focuses on the pharmacological treatment of cancer related fatigue in patients with advanced or metastatic cancer. There are few high-quality studies performed in this setting, but both methylphenidate and corticosteroids might be used to relieve fatigue. Abstract Fatigue is one of the most distressing symptoms experienced by cancer patients. The suggested biological mechanism for cancer related fatigue (CRF) includes immune activation triggered by tumor tissue or by anticancer treatment but other mechanisms have also been proposed. Previous large meta-analysis of interventions on fatigue focuses mostly on patients early in the disease trajectory, with only one tenth of included studies performed in palliative cohorts. The aim of this narrative review is therefore to present a background on CRF with focus on the palliative setting. A summary of recent randomized, controlled trials on pharmacological interventions on CRF in palliative care is presented, including studies on psychostimulants, corticosteroids, testosterone and melatonin. Interestingly, in several of these studies there was a positive and similar effect on fatigue in both the intervention and the placebo arm—indicating an important placebo effect for any pharmacological treatment. In addition, studies on dietary supplements and on pharmacological complementary medicines are discussed. To conclude, the evidence is still weak for using pharmacological treatments on CRF in palliative care patients—although methylphenidate and corticosteroids might be considered.
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You J, He Y, Zhi H, Lee VH, Chan S, Lao L, Liu H, Chen J. Effect of a medicinal and edible decoction YH0618 on chemotherapy-induced dermatologic toxicity: a randomized controlled trial. ANNALS OF TRANSLATIONAL MEDICINE 2021; 9:4. [PMID: 33553297 PMCID: PMC7859827 DOI: 10.21037/atm-20-5181] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Abstract
Background Dermatologic toxicities are the common adverse events (AE) with several chemotherapy agents, but they are usually neglected in the research literature and clinical practice, and there are no clinically safe and effective methods to solve the problem. This study was to determine whether a medicinal and edible decoction YH0618 is effective in accelerating reducing chemotherapy-induced dermatologic toxicity in cancer patients who have completed chemotherapy. Methods This was a prospective randomized controlled trial conducted between 2015 and 2017. Cancer patients who have completed chemotherapy (received taxanes or anthracyclines or fluoropyrimidine) within two weeks were enrolled and then they were randomly divided into YH0618 decoction group (n=104) and wait-list control (n=110). The primary end points were the incidence of protocol-specified grade ≥2 dermatologic toxicities after 6-week intervention assessed using the National Cancer Institute-Common Terminology Criteria for Adverse Events (NCI-CTCAE) Chinese version 4.0, and changes of fingernails color and skin color evaluated by L*a*b after 6 weeks of intervention. Secondary end points included assessment of quality of life (QOL) and fatigue, and some clinical objective indicators associated with myelosuppression, hepatotoxicity and nephrotoxicity. Results The study included 214 participants [mean (SD) age, 52.49 (9.08) years in YH0618 group and 50.44 (9.71) years in wait-list group]. At 6-week, YH0618 significantly reduced the incidence of grade ≥2 in nail discoloration [odds ratio (OR), 0.653; 95% CI, 0.5–0.9; P=0.005] and alopecia (OR, 0.776; 95% CI, 0.6–1.0; P=0.048) compared with control group. Besides, YH0618 increased the L* value and reduced the a* and b* values compared with control group, indicating that YH0618 increased the brightness and reduced hyperpigmentation. YH0618 also significantly reduced chemotherapy-induced fatigue (95% CI, 0.2–4.8; P=0.033). Conclusions YH0618 may be a safe method in ameliorating chemotherapy-induced dermatologic toxicity especially nail discoloration, alopecia and skin hyperpigmentation, and on improving fatigue. Trial registration The trial was registered in the Chinese Clinical Trials Registry, ChiCTR-IOR-15006486.
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Affiliation(s)
- Jieshu You
- School of Chinese Medicine, The University of Hong Kong, Hong Kong, China.,School of Basic Medical Sciences, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Yanhua He
- School of Chinese Medicine, The University of Hong Kong, Hong Kong, China
| | - Hui Zhi
- Department of Social Work & Social Administration, The University of Hong Kong, Hong Kong, China
| | - Victor Hofun Lee
- Department of Clinical Oncology, The University of Hong Kong, Hong Kong, China.,Shenzhen Institute of Research and Innovation, The University of Hong Kong, Shenzhen, China
| | - Suetmui Chan
- Department of Social Work & Social Administration, The University of Hong Kong, Hong Kong, China
| | - Lixing Lao
- School of Chinese Medicine, The University of Hong Kong, Hong Kong, China
| | - Huanlan Liu
- School of Chinese Medicine, The University of Hong Kong, Hong Kong, China
| | - Jianping Chen
- School of Chinese Medicine, The University of Hong Kong, Hong Kong, China.,Shenzhen Institute of Research and Innovation, The University of Hong Kong, Shenzhen, China
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25
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Zhang Y, Huang X, Feng S, Chen C, Guo D, Fang L. Platinum Accumulation and Cancer-Related Fatigue, Correlation With IL-8, TNF-α and Hemocytes. Front Pharmacol 2021; 12:658792. [PMID: 34557089 PMCID: PMC8453147 DOI: 10.3389/fphar.2021.658792] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Accepted: 08/24/2021] [Indexed: 02/05/2023] Open
Abstract
Platinum-based chemotherapy drugs cause platinum accumulation and result in cancer-related fatigue (CRF), which is related to immune response through still ambiguous mechanisms. We aimed to explore the correlation between platinum and CRF from the perspective of platinum accumulation. After allowing for complete metabolism of the administered platinum drugs, we collected blood samples from 135 patients who had at least two platinum chemotherapy rounds, correlated the platinum concentration (C-Pt), pro-inflammatory cytokines IL-8 and TNF-α, hematological index with therapeutic effect, adverse reactions and fatigue. The median platinum concentration was higher in patients treated with cisplatin than oxaliplatin (424.0 vs 211.3 μg/L), and the occurrence of fatigue was 64.4% in all subjects. Separately, the incidence and degree of fatigue were 74.1% and 9.5 in the patients with higher platinum concentration compared to 57.1% and 2.0 in the lower group. C-Pt, IL-8 and TNF-α were positively correlated with the degree of CRF, while erythrocyte count and hemoglobin were negatively correlated with the degree of CRF. Mediating effect analysis showed that increased IL-8 concentration mediated 57.4%, while decreased erythrocyte count mediated 24.1% of the C-Pt effect on CRF. Platinum accumulation may involve increasing IL-8, cause inflammation or aggravate anemia, which in combination lead to CRF.
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Affiliation(s)
- Yuling Zhang
- Department of Pharmacy, Shantou University Medical College, Shantou, China
| | - Xiaoting Huang
- Pharmacy Intravenous Admixture Service, Cancer Hospital of Shantou University Medical College, Shantou, China
| | - Shanna Feng
- Pharmacy Intravenous Admixture Service, Cancer Hospital of Shantou University Medical College, Shantou, China
| | - Chen Chen
- Pharmacy Intravenous Admixture Service, Cancer Hospital of Shantou University Medical College, Shantou, China
| | - Dainian Guo
- Good Clinical Practice, Cancer Hospital of Shantou University Medical College, Shantou, China
- *Correspondence: Ling Fang, , Dainian Guo,
| | - Ling Fang
- Pharmacy Intravenous Admixture Service, Cancer Hospital of Shantou University Medical College, Shantou, China
- *Correspondence: Ling Fang, , Dainian Guo,
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26
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Dolgoy ND, O'Krafka P, McNeely ML. Cancer-related fatigue in head and neck cancer survivors: Energy and functional impacts. Cancer Treat Res Commun 2020; 25:100244. [PMID: 33254042 DOI: 10.1016/j.ctarc.2020.100244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 11/01/2020] [Accepted: 11/20/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Survivors with head and neck cancer (HNC) report cancer-related fatigue (CRF) as a devastating, prevalent health issue that limits activity engagement and adversely influences quality of life. OBJECTIVE To explore HNC survivors' written responses and descriptors regarding CRF, and offer potential healthcare strategies based on findings. METHODOLOGY In written format, similar to responses on intake forms in outpatient-clinics, 25 HNC survivors provided descriptions of their CRF experiences and their perspectives on its impact. An exploratory descriptive research design was utilized, drawing on social theory for content analysis and thematic development. RESULTS Two main themes regarding CRF arose from the data: (1) CRF as a barrier to daily function; and (2) uncontrollable and unpredictable energy fluctuations. CONCLUSIONS To enhance outcomes of CRF symptom management in HNC survivors, a healthcare approach that targets the functional implications of CRF, and utilizes energy cultivation strategies when communicating about the negative impacts of CRF (including limited function and fluctuating energy levels) may be beneficial for HNC survivors. Further research into the effects of CRF on function for HNC survivors is warranted.
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Affiliation(s)
- Naomi D Dolgoy
- University of Alberta, 250 Corbett Hall, Edmonton, AB, T6G 2G4, Canada.
| | - Patricia O'Krafka
- Alberta Health Services, Alberta Children's Hospital 2888 Shaganappi Trail, Calgary, AB, T3B 6A9, Canada
| | - Margaret L McNeely
- University of Alberta and Cross Cancer Institute, 250 Corbett Hall University of Alberta, Edmonton, AB, T6G 2G4, Canada
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27
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Martin E, Zingarello A, Di Meglio A, Baciarello G, Matias M, Charles C, Arvis J, Dumas A, Menvielle G, Vaz-Luis I. A qualitative evaluation of the use of interventions to treat fatigue among cancer survivors: A healthcare provider's view. Eur J Cancer Care (Engl) 2020; 30:e13370. [PMID: 33191520 DOI: 10.1111/ecc.13370] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 09/16/2020] [Accepted: 10/14/2020] [Indexed: 12/20/2022]
Abstract
OBJECTIVE Cancer-related fatigue (CRF) is among the most common and distressing side effects of cancer treatment. Different types of interventions, including physical activity (PA), psychosocial and mind-body interventions, have been shown to reduce CRF. We aimed to explore HCPs' practices and barriers to refer patients towards interventions to reduce CRF. METHODS We performed a qualitative study using key informant interviews among a sample of 20 HCPs including medical, surgical and radiation oncologists, pain specialists, nurses, psychologists, psychiatrists and physiotherapists recruited from breast, prostate and colorectal cancer disease groups from a comprehensive cancer centre. RESULTS Most interviewees reported not to address CRF spontaneously during consultations. When the topic of CRF was brought up by patients, all interviewees acknowledged to recommend PA, whereas few would recommend psychosocial or mind-body interventions. Barriers to recommend interventions to manage CRF included: lack of knowledge about CRF and its treatment, lack of time and complexity of the referral due to their accessibility and cost. CONCLUSION In a diverse sample of HCPs, most acknowledged not to address CRF proactively with their patients, but identified several actionable barriers. Specific training on screening and management of CRF and improving the referral network dedicated to interventions need to be implemented.
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Affiliation(s)
- Elise Martin
- Institut Gustave Roussy, Université Paris-Saclay, Inserm, Biomarqueurs Prédictifs et Nouvelles Stratégies Thérapeutiques en Oncologie, Villejuif, France
| | - Anna Zingarello
- Hôpital Saint-Camille, Unité de Soins Médicaux en Oncologie (USMO), Bry-sur-Marne, France
| | - Antonio Di Meglio
- Institut Gustave Roussy, Université Paris-Saclay, Inserm, Biomarqueurs Prédictifs et Nouvelles Stratégies Thérapeutiques en Oncologie, Villejuif, France
| | - Giulia Baciarello
- Medical Oncology Department, Institut Gustave Roussy, Villejuif, France
| | - Margarida Matias
- Medical Oncology Department, Institut Gustave Roussy, Villejuif, France
| | - Cécile Charles
- Psycho-Oncology Unit, Institut Gustave Roussy, Villejuif, France
| | | | - Agnès Dumas
- Inserm Unit 1123, Unité ECEVE, Université de Paris, Paris, France
| | - Gwenn Menvielle
- Sorbonne Université, Inserm, Institut Pierre Louis d'Epidémiologie et Santé Publique (IPLESP), Paris, France
| | - Ines Vaz-Luis
- Institut Gustave Roussy, Université Paris-Saclay, Inserm, Biomarqueurs Prédictifs et Nouvelles Stratégies Thérapeutiques en Oncologie, Villejuif, France.,Medical Oncology Department, Institut Gustave Roussy, Villejuif, France
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28
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Physical exercise during adjuvant chemotherapy for colorectal cancer-a non-randomized feasibility study. Support Care Cancer 2020; 29:2993-3008. [PMID: 33030598 PMCID: PMC8062327 DOI: 10.1007/s00520-020-05789-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Accepted: 09/16/2020] [Indexed: 12/26/2022]
Abstract
Background Colorectal cancer (CRC) is the third most common cancer worldwide, and a large proportion of the patients receive adjuvant oxaliplatin-based chemotherapy. Most of these experience chemotherapy-induced peripheral neuropathy (CIPN), affecting quality of life. Evidence to advise exercise to reduce CIPN is limited. The primary aim of this study was to investigate the feasibility of an exercise intervention and data collection among CRC patients during adjuvant chemotherapy. Material and methods This non-randomized feasibility study included CRC patients admitted to adjuvant chemotherapy to an intervention consisting of supervised aerobic endurance, resistance, and balance exercises twice a week at the hospital in addition to home-based exercise once a week. A physiotherapist supervised the patients, and the intervention lasted throughout the period of adjuvant chemotherapy (12–24 weeks). Participants performed physical tests and filled in questionnaires at baseline, 3, 6, 9, and 12 months. Results and conclusion Nineteen (63%) of 30 invited patients consented. A major barrier to recruit or consent to participation was long travel distance to the hospital. The completion rate of questionnaires and physical tests were near 100%. Seven participants dropped out, five before the intervention started. Median attendance to supervised exercise was 85%. There were no serious adverse events related to the intervention. Except for a planned higher intensity of endurance exercise, we found the intervention feasible and safe. Based on experiences in this study, some adjustments have been made for an upcoming randomized trial, including the supervised exercise taking place close to participants’ homes. Trial registration NCT03885817, March 22, 2019, retrospectively registered.
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29
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Simon H, Ganem G, Touboul C, Lhomel C, Morère J. Patient perspectives on supportive care in cancer: Results of the Calista 2 study. Eur J Cancer Care (Engl) 2020; 29:e13299. [DOI: 10.1111/ecc.13299] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 04/03/2020] [Accepted: 08/07/2020] [Indexed: 12/22/2022]
Affiliation(s)
- Hélène Simon
- Institut de Cancérologie et d’Hématologie Brest France
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30
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Cheng TC, Lee YH, Mar CL, Huang WT, Chang YP. The Health Promoting Mindfulness or Qigong Educational Programs for Beneficial Lifestyle Changes of Cancer Survivors. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2020; 35:743-750. [PMID: 31001740 DOI: 10.1007/s13187-019-01522-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
This study used heart rate variability (HRV) to monitor levels of cancer-related fatigue (CRF) and quality of life (QOL) of cancer survivors subjected to program measures at different psychosomatic or functional levels. A longitudinal study was conducted at a cancer center in Taiwan. Fifty-two cancer survivals were randomly assigned to either the mindfulness group (n = 25) or the Qigong group (n = 27). Both groups received a 12-week mindfulness and Qigong programs, respectively. Improvements in CRF, QOL, and HRV after a 12-week program and at the 3-month follow-up point. For the long-term effects in both mindfulness and Qigong groups, CRF showed a significant downward trend (p < 0.05), but a significant upward trend was observed in HRV (p < 0.001). Mindfulness and Qigong exhibited different effectiveness in individuals, indicating that the mental and physical aspects of health are equally essential and should be addressed in a complementary combination. These findings are worthy of being shared with cancer survivors to benefit their physical and mental well-being. We suggest that healthcare professionals incorporate mindfulness and Qigong in cancer survivors' daily life as means to encourage lifestyle changes for improving their health.
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Affiliation(s)
- Tse-Chou Cheng
- Department of Urology, Chi Mei Medical Center, Liouying, 201, Taikang, Taikang Vil., Liouying Dist., Tainan City, 73657, Taiwan
| | - Yi-Hua Lee
- Department of Administration, National Health Research Institutes, 35 Keyan Road, Zhunan, Miaoli County, 35053, Taiwan
- PhD Program in Management, Da-Yeh University, 168 University Road, Dacun, Changhua, 51591, Taiwan
| | - Chun-Lin Mar
- College of Educational Sciences, Yulin Normal University, 1303 Educational E. Road, Yulin City, Guangxi, 537000, China
| | - Wen-Tsung Huang
- Division of Hematology-Oncology, Department of Internal Medicine, Chi Mei Medical Center, Liouying, 201, Taikang, Taikang Vil., Liouying Dist., Tainan City, 73657, Taiwan
| | - Yuan-Ping Chang
- Nursing Department, Fooyin University, 151 Jinxue Rd., Daliao Dist., Kaohsiung City, 83102, Taiwan.
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31
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Penner C, Zimmerman C, Conboy L, Kaptchuk T, Kerr C. "Honorable Toward Your Whole Self": Experiences of the Body in Fatigued Breast Cancer Survivors. Front Psychol 2020; 11:1502. [PMID: 32719641 PMCID: PMC7350261 DOI: 10.3389/fpsyg.2020.01502] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Accepted: 06/05/2020] [Indexed: 11/13/2022] Open
Abstract
Introduction Cancer Related Fatigue (CRF) is one of the most common and detrimental side effects of cancer treatment. Despite its increasing prevalence and severity CRF remains dismissed by the majority of clinicians. One reason for the apparent gap between clinical need and clinical undertaking is the penchant toward reductionist accounts of the disorder: a tendency to discount the interface between the lived experience of sufferers and the multi-dimensional etiology of CRF as it manifests adversely on a day-to-day basis. Methods In order to better understand the interplay between social, bodily, and emotional components of the disorder we undertook semi-structured interviews with thirteen Breast Cancer survivors suffering from CRF, and then subsequently analyzed their responses using Team Based Qualitative Analysis. Results Our analysis revealed multiple dimensions of the social and bodily underpinnings of fatigue. Most relevantly we found a consistent change in the level and quality of attention to bodily signals. This shift in awareness appeared to be directly connected to the experience of CRF and a newfound, “respect,” for the needs of the body. Furthermore, we found that many of the practices that were described as helpful in alleviating fatigue were oriented around eliciting a sense of embodied awareness, examples being: dance, yoga, and shamanic ritual. This relationship with bodily sensations existed in conjunction with the anxiety and trauma that arose as a result of cancer treatment. Conclusion Our analysis suggests that the quality of awareness and relationship to bodily experience in CRF is a functionally relevant component of the disorder and should be considered as an experiential target moving forward.
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Affiliation(s)
- Cooper Penner
- Department of Neuroscience, Brown University, Providence, RI, United States.,Department of Neurosurgery, Cedars Sinai Medical Center, Los Angeles, CA, United States
| | - Chloe Zimmerman
- Department of Neuroscience, Brown University, Providence, RI, United States.,Warren Alpert Medical School, Brown University, Providence, RI, United States.,Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States
| | - Lisa Conboy
- Warren Alpert Medical School, Brown University, Providence, RI, United States.,Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States.,New England School of Acupuncture, Newton, MA, United States
| | - Ted Kaptchuk
- Warren Alpert Medical School, Brown University, Providence, RI, United States.,Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States
| | - Catherine Kerr
- Department of Contemplative Studies, Brown University, Providence, RI, United States
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Pethybridge R, Teleni L, Chan RJ. How do family-caregivers of patients with advanced cancer provide symptom self-management support? A qualitative study. Eur J Oncol Nurs 2020; 48:101795. [PMID: 32763841 DOI: 10.1016/j.ejon.2020.101795] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Revised: 06/23/2020] [Accepted: 06/24/2020] [Indexed: 01/22/2023]
Abstract
PURPOSE The family-caregiver role is of critical importance to the success of symptom-related self-management of patients with advanced cancer. This study examined the perspectives of patients and family-caregivers regarding the role of the family-caregiver in symptom-related self-management support ( SMS). METHODS Semi-structured interviews were conducted in patients with advanced cancer experiencing significant symptom burden and their family-caregivers. An inductive content analysis approach was used to analyse data. RESULTS Eleven patients and ten family caregivers were included. Identified themes were 1) engaging in specific symptom-related SMS; 2) interacting with health care professionals; and 3) balancing patient need versus expectation. These themes were applicable to both the family-caregiver and patient cohorts, regardless of the individual symptom profile of each patient. CONCLUSIONS The role of family-caregivers of patients with advanced cancer is complex and varied in providing symptom-related SMS at home; often requiring family-caregivers to have diverse knowledge and skills in the management of a range of cancer-related symptoms. Health care professionals can support family-caregivers by anticipating needs, tailoring evidence-based information to those needs, and ensuring family-caregivers have an appropriate contact point for advice or help.
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Affiliation(s)
- Ruth Pethybridge
- School of Nursing and Cancer and Palliative Care Outcomes Centre, Queensland University of Technology, Brisbane, Australia; Princess Alexandra Hospital, Metro South Hospital and Health Services, Brisbane, Australia.
| | - Laisa Teleni
- School of Nursing and Cancer and Palliative Care Outcomes Centre, Queensland University of Technology, Brisbane, Australia.
| | - Raymond Javan Chan
- School of Nursing and Cancer and Palliative Care Outcomes Centre, Queensland University of Technology, Brisbane, Australia; Princess Alexandra Hospital, Metro South Hospital and Health Services, Brisbane, Australia.
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Al Maqbali M, Gracey J, Dunwoody L, Rankin J, Hacker E, Hughes C. Healthcare professionals knowledge on cancer-related fatigue: A cross-sectional survey in Oman. Nurs Health Sci 2020; 22:732-740. [PMID: 32270899 DOI: 10.1111/nhs.12720] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Revised: 03/26/2020] [Accepted: 04/01/2020] [Indexed: 11/27/2022]
Abstract
Cancer-related fatigue is a common and distressing cancer symptom that negatively affects quality of life. The main objective of this study was to determine health professionals' knowledge relating to cancer patients' fatigue in Oman and identify current management practices of cancer-related fatigue. A cross-sectional survey design using Qualtrics® software was performed. The survey had five sections and comprised 32 items. A total of 138 healthcare professionals working in Oman participated in the study (response rate 63.9%). Nearly three quarters of the participants were nurses (74.6%, n = 103). The mean level of knowledge of cancer-related fatigue was 16.6/23, with 50% of participants having the expected level of knowledge above 12. The result indicated that professional discipline and work experience each were significantly associated with overall level of knowledge. Participants identified the need for guidelines, assessment tools, and training for the oncology staff to help improve the quality of life of patients with cancer-related fatigue.
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Affiliation(s)
- Mohammed Al Maqbali
- Institute of Nursing and Health Research, Ulster University, Newtownabbey, UK
| | - Jackie Gracey
- Institute of Nursing and Health Research, Ulster University, Newtownabbey, UK
| | - Lynn Dunwoody
- Psychology Research Institute, Ulster University, Coleraine, UK
| | - Jane Rankin
- Physiotherapy Department, Cancer Centre, Belfast Health and Social Care Trust, Belfast, UK
| | | | - Ciara Hughes
- Institute of Nursing and Health Research, Ulster University, Newtownabbey, UK
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Spahrkäs SS, Looijmans A, Sanderman R, Hagedoorn M. Beating Cancer-Related Fatigue With the Untire Mobile App: Protocol for a Waiting List Randomized Controlled Trial. JMIR Res Protoc 2020; 9:e15969. [PMID: 32130185 PMCID: PMC7055831 DOI: 10.2196/15969] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Revised: 11/20/2019] [Accepted: 11/26/2019] [Indexed: 01/19/2023] Open
Abstract
Background Many cancer patients and survivors worldwide experience disabling fatigue as the main side effect of their illness and the treatments involved. Face-to-face therapy is effective in treating cancer-related fatigue (CRF), but it is also resource-intensive. Offering a self-management program via a mobile phone app (ie, the Untire app), based on elements of effective face-to-face treatments, might increase the number of patients receiving adequate support for fatigue and decrease care costs. Objective The aim of this protocol is to describe a randomized controlled trial (RCT) to assess the effectiveness of the Untire app in reducing fatigue in cancer patients and survivors after 12 weeks of app use as compared with a waiting list control group. Substudies nested within this trial include questions concerning the reach and costs of online recruitment and uptake and usage of the Untire app. Methods The Untire app study is a waiting list RCT targeting cancer patients and survivors who experience moderate to severe fatigue via social media (Facebook and Instagram) across 4 English-speaking countries (Australia, Canada, the United Kingdom, and the United States). The Untire app includes psychoeducation and exercises concerning energy conservation, activity management, optimizing restful sleep, mindfulness-based stress reduction, psychosocial support, cognitive behavioral therapy, and physical activity. After randomization, participants in the intervention group could access the Untire app immediately, whereas control participants had no access to the Untire app until the primary follow-up assessment at 12 weeks. Participants completed questionnaires at baseline before randomization and after 4, 8, 12, and 24 weeks. The study outcomes are fatigue (primary) and quality of life (QoL; secondary). Potential moderators and mediators of the hypothesized treatment effect on levels of fatigue and QoL were also assessed. Link clicks and app activation are used to assess reach and uptake, respectively. Log data are used to explore the characteristics of app use. Sample size calculations for the primary outcome showed that we needed to include 164 participants with complete 12-week measures both in the intervention and the control groups. The intention-to-treat approach is used in the primary analyses, which refers to analyzing all participants regardless of their app use. Results Participants were recruited from March to October 2018. The last participant completed the 24-week assessment in March 2019. Conclusions This mobile health (mHealth) RCT recruited participants online in multiple countries to examine the uptake and effectiveness of the Untire self-management app to reduce CRF. Many advantages of mHealth apps are assumed, such as the immediate access to the app, the low thresholds to seek support, and the absence of contact with care professionals that will reduce costs. If found effective, this app can easily be offered worldwide to patients experiencing CRF. Trial Registration Netherlands Trial Register NL6642; https://www.trialregister.nl/trial/6642. International Registered Report Identifier (IRRID) DERR1-10.2196/15969
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Affiliation(s)
- Simon S Spahrkäs
- Department of Health Psychology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Anne Looijmans
- Department of Health Psychology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Robbert Sanderman
- Department of Health Psychology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands.,Department of Psychology, Health & Technology, University of Twente, Enschede, Netherlands
| | - Mariët Hagedoorn
- Department of Health Psychology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
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Abu-Taha OM, Al Qadire MI, Maharmeh M, Alyami MS. Assessment of cancer-related fatigue among Jordanian patients: a cross-sectional survey. BRITISH JOURNAL OF NURSING (MARK ALLEN PUBLISHING) 2020; 29:111-117. [PMID: 31972112 DOI: 10.12968/bjon.2020.29.2.111] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND Cancer-related fatigue (CRF) is considered to be one of the most common symptoms reported by cancer patients. However, little information is available regarding the variables associated with CRF among Jordanian patients. AIMS To assess the prevalence of CRF and explore its predictors among Jordanian patients. METHODS A cross-sectional survey design was used. FINDINGS Of the 240 patients surveyed, 210 (87.5%) had fatigue at the time of the survey. The total mean fatigue score was 6.2 (SD=1.7) out of a maximum possible score of 10. The results also showed that being unemployed, with longer hospitalisation, low haemoglobin, and having lung cancer seem to predict higher levels of CRF. CONCLUSION Several variables and factors associated with CRF were identified. In response to these results, healthcare providers should pay more attention to CRF, which needs to be assessed on a regular basis and to be managed with the available pharmacological and non-pharmacological interventions.
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Affiliation(s)
| | | | - Mahmoud Maharmeh
- Associate Professor, Faculty of Nursing, Head of Clinical Nursing Department, University of Jordan, Amman, Jordan
| | - Mansour Saleh Alyami
- General Director, General Directorate of Academic Affairs and Training, Ministry of Health, Saudi Arabia
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Huang J, Han Y, Wei J, Liu X, Du Y, Yang L, Li Y, Yao W, Wang R. The effectiveness of the Internet-based self-management program for cancer-related fatigue patients: a systematic review and meta-analysis. Clin Rehabil 2019; 34:287-298. [PMID: 31793340 DOI: 10.1177/0269215519889394] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Objective: To systematically investigate how fatigue, depression, anxiety, sleep quality, and life quality are influenced by the Internet-based self-management program (IBSMP) among cancer patients. Data sources: Eight databases (Cochrane Library, Ovid, Web of Science, Medline, Embase, Chinese biomedical database (CBM), China National Knowledge Infrastructure (CNKI), and Wanfang) were systematically searched from inception to January 2019. Methods: The aim of this study is to identify randomized controlled trials (RCTs) associated with the IBSMP among cancer-related fatigue (CRF) patients. Two reviewers independently screened 1128 records and selected 13 articles, including 1603 patients for inclusion. The quality of the evidence was assessed at the study level and at the outcome level. Results: The meta-analysis showed that the IBSMP was effective for ameliorating fatigue and related symptoms among cancer survivors (the Brief Fatigue Index, relative risk = 0.74, 95% confidence interval (CI; 0.69, 0.79), P < 0.01; the Cancer Fatigue Scale or the Multidimension Fatigue Scale, weighted mean difference = −10.15, 95% CI (−11.42, −8.89), P < 0.01; the Self-rating Anxiety scale, relative risk = 1.07, 95% CI (0.55, 2.05), P < 0.01; the Self-rating Depression scale, relative risk = 0.70, 95% CI (0.60, 0.81), P < 0.01; the Pittsburgh Sleep Quality Index, relative risk = 0.46, 95% CI (0.33, 0.62), P < 0.01; and the Function Assessment of Cancer Therapy—General scale or the Function Assessment of Cancer Therapy—Breast, weighted mean difference = 13.76, 95% CI (3.38, 24.14), P < 0.01.) Conclusion: This meta-analysis demonstrates that the IBSMP, as one of the rehabilitation forms, can reduce the incidence of fatigue, depression, and anxiety and improve sleep quality and life quality among CRF patients.
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Affiliation(s)
- Junting Huang
- The Information Management Office, The First Affiliated Hospital, Xi’an Jiaotong University, Xi’an City, Shaanxi Province, China
| | - Yang Han
- The Health Management Department, Shenzhen Samii Medical Center, Shenzhen City, China
| | - Jiejie Wei
- The Hospital of Traditional Chinese Medicine, Zhuzhou City, China
| | - Xiaobo Liu
- The Medical School, Yan’an University, Yan’an City, China
| | - Yanying Du
- The Nursing School, Health Science Center, Xi’an Jiaotong University, Xi’an City, China
| | - Linqing Yang
- The Nursing School, Health Science Center, Xi’an Jiaotong University, Xi’an City, China
| | - Ying Li
- The Medical College, Xi’an Peihua University, Xi’an City, China
| | - Wanxia Yao
- The Information Management Office, The First Affiliated Hospital, Xi’an Jiaotong University, Xi’an City, Shaanxi Province, China
- The Medical College, Xi’an Peihua University, Xi’an City, China
- The Nursing Department, Shenzhen Samii Medical Center, Shenzhen City, China
| | - Ruijun Wang
- The Outpatient Department, The First Affiliated Hospital, Xi’an Jiaotong University, Xi’an City, China
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Avelar JMDP, Nicolussi AC, Toneti BF, Sonobe HM, Sawada NO. Fatigue in patients with head and neck cancer undergoing radiation therapy: a prospective study. Rev Lat Am Enfermagem 2019; 27:e3168. [PMID: 31432921 PMCID: PMC6703102 DOI: 10.1590/1518-8345.2813-3168] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Accepted: 03/12/2019] [Indexed: 12/14/2022] Open
Abstract
Objective to identify the frequency of fatigue and domains affected in patients with
head and neck cancer undergoing radiation therapy, at the beginning, middle
and end of treatment. Method longitudinal and prospective study of quasi-experimental design, involving
60 patients with head and neck cancer. It should be highlighted that this
article will address only the data of the Control Group. The dependent
variables were collected through interview, using the revised Piper Fatigue
Scale, which is a multidimensional instrument that assesses global,
behavioral, affective and sensory/psychological domains. Data analysis was
based on absolute and relative frequencies. Results there was a predominance of males, age group between 41-60 years, low level
of education and in regular use of alcohol and cigarettes. All domains in
the fatigue scale had their scores increased, presenting median values of
greater magnitude in Time 2 and Time 3, when compared to the Time 1 values,
indicating an increase in fatigue levels during radiation therapy. Conclusion fatigue increased in the course of the radiation therapy, having all domains
affected. Therefore, its evaluation throughout the treatment is important,
as fatigue is a common and debilitating symptom on cancer patients.
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Affiliation(s)
- Juliana Maria de Paula Avelar
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, Centro Colaborador da OPAS/OMS para o Desenvolvimento da Pesquisa em Enfermagem, Ribeirão Preto, SP, Brasil.,Estácio, Centro Universitário Estácio de Ribeirão Preto, Ribeirão Preto, SP, Brasil
| | | | - Bruna Francielle Toneti
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, Centro Colaborador da OPAS/OMS para o Desenvolvimento da Pesquisa em Enfermagem, Ribeirão Preto, SP, Brasil
| | - Helena Megumi Sonobe
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, Centro Colaborador da OPAS/OMS para o Desenvolvimento da Pesquisa em Enfermagem, Ribeirão Preto, SP, Brasil
| | - Namie Okino Sawada
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, Centro Colaborador da OPAS/OMS para o Desenvolvimento da Pesquisa em Enfermagem, Ribeirão Preto, SP, Brasil
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The effect of a 12-week home-based walking program on reducing fatigue in women with breast cancer undergoing chemotherapy: A randomized controlled study. Int J Nurs Stud 2019; 99:103376. [PMID: 31442785 DOI: 10.1016/j.ijnurstu.2019.06.007] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Revised: 05/19/2019] [Accepted: 06/16/2019] [Indexed: 12/13/2022]
Abstract
BACKGROUND Fatigue is the most common symptom experienced by cancer patients during treatment and can last long after completing treatment. Fatigue in cancer patients who have completed treatment is well known to be reduced by exercise, but the effect of exercise on reducing fatigue in patients under treatment has been inconsistent. OBJECTIVES The purposes of this study were to examine short-term and long-term effects of an individually tailored, home-based brisk walking program on reducing fatigue in breast cancer patients under chemotherapy. DESIGN, SETTING, PARTICIPANTS For this randomized controlled trial, women were recruited from a medical center in northern Taiwan if they were diagnosed with stages I-III breast cancer and experienced insomnia, fatigue, pain, or depressive symptoms after their first cycle of chemotherapy. Consenting participants (N = 159) were randomly assigned to either an exercise (12-week home-based walking program) group (n = 81) or an attention-control group (n = 78). METHODS The 12-week, home-based brisk walking program started on the first day of the third chemotherapy cycle. Fatigue was measured by the Brief Fatigue Inventory. Covariates, i.e., functional performance, sleep disturbance, anxiety, depression, and exercise-related variables, were also measured. Data were collected at baseline, two times during the exercise intervention, and five times after the exercise intervention (eight times in total). The effects of time-varying and time-invariant predictors on fatigue were analyzed by multilevel modeling. RESULTS Fatigue levels increased over time for both groups, even after completing treatment. At the end of the 12-week exercise program, the exercise group had less fatigue than the attention-control group, and this group difference was maintained for the whole study period. At the end of exercise program, women who had spent more time exercising before diagnosis had less fatigue than those who had exercised less often. In addition, patients' fatigue levels at various time points fluctuated along with their functional performance, sleep disturbance, and depression. CONCLUSIONS Our tailored, home-based brisk walking program effectively reduced fatigue in breast cancer patients under chemotherapy, and this effect lasted after completing treatment.
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Abstract
PURPOSE OF REVIEW Cancer-related fatigue (CRF) is a frequent and distressing symptom present at any stage of the disease. However, it is still underreported, rarely properly assessed and undertreated. RECENT FINDINGS There are international guidelines available, but also several barriers to their implementation into clinical practice. SUMMARY According to guidelines, all patients should be clinically screened for CRF on regular basis, at the initial cancer visit and at intervals during every clinic visit, also at posttreatment follow-up visits. Generally, any treatable contributing factors should be identified and possibly treated. After the concomitant factors have been improved or removed, pharmacological and or nonpharmacological treatments of CRF can be considered.Further research is needed to better understand the causes, the better treatments, the easier assessment tool for CRF for clinical practice and to identify barriers and facilitators to implementing CRF guidelines.
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Zhang L, Hall M, Bastola D. Utilizing Twitter data for analysis of chemotherapy. Int J Med Inform 2018; 120:92-100. [DOI: 10.1016/j.ijmedinf.2018.10.002] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Revised: 09/24/2018] [Accepted: 10/07/2018] [Indexed: 01/05/2023]
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Trotter P, Hill QA. Immune thrombocytopenia: improving quality of life and patient outcomes. PATIENT-RELATED OUTCOME MEASURES 2018; 9:369-384. [PMID: 30568522 PMCID: PMC6267629 DOI: 10.2147/prom.s140932] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Immune thrombocytopenia (ITP) is an immune-mediated disorder characterized by a reduced platelet count and patients may develop bruising or mucosal bleeding. Since 2003, generic health-related quality of life (HRQoL) measures have been applied and ITP-specific measures developed, alongside trials of novel therapeutic agents. These have identified significant morbidity in patients with ITP, including fatigue, fear of bleeding and a negative impact on role, social and work activities. This review critically evaluates HRQoL data in adults and children with ITP. It also considers the impact of treatment and how patient-reported outcomes might be applied to care to optimize patients' quality of life.
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Affiliation(s)
- Patrick Trotter
- Department of Surgery, University of Cambridge, Cambridge, UK.,National Health Service Blood and Transplant, Organ Donation and Transplant Directorate, Bristol, UK
| | - Quentin A Hill
- Department of Haematology, St James's University Hospital, Leeds, UK,
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Lee YH, Lai GM, Lee DC, Tsai Lai LJ, Chang YP. Promoting Physical and Psychological Rehabilitation Activities and Evaluating Potential Links Among Cancer-Related Fatigue, Fear of Recurrence, Quality of Life, and Physiological Indicators in Cancer Survivors. Integr Cancer Ther 2018; 17:1183-1194. [PMID: 30354701 PMCID: PMC6247550 DOI: 10.1177/1534735418805149] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Objectives: Cancer-related fatigue and fear of recurrence (FOR) are
the most common symptoms in cancer survivors and severely affect quality of life
(QOL). This study aims to promote and evaluate the effectiveness of physical and
psychological rehabilitation activities for cancer survivors.
Methods: A longitudinal study with an interventional research
design was conducted. A total of 80 participants were randomly assigned to
experimental groups E1 (Qigong exercise [QE]) or E2 (stress management [SM]) or
the control group. The E1 and E2 groups received QE and SM, respectively, as
interventions once a week for 12 weeks, and effects were assessed.
Cancer-related fatigue, FOR, QOL, and heart rate variability (HRV) were
evaluated at baseline (T0), after 12 weeks (T1), and at the 3-month follow-up
(T2). Results: QE and SM effectively strengthened the physical and
psychological functions of cancer survivors at the T1 phase. Although
differences in FOR and QOL were not statistically significant, the scores were
decreased and increased, respectively. Although the effects during the T2 phase
were not as significant as those during T1, the score progress was maintained.
The effects on HRV were significantly different among the E1, E2, and control
groups at T1, which shows that the performance of both experimental groups was
better than that of the control group. Conclusions: Physical and
psychological rehabilitation activities should be practiced periodically and
should be led by professional staff. Long-term educational resources and care
should also be provided. HRV can be used to efficiently monitor the status of
the mind-body balance and is a more suitable index than questionnaires for
physical and psychological function evaluation in cancer survivors.
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Affiliation(s)
- Yi-Hua Lee
- 1 National Health Research Institutes, Zhunan, Miaoli County, Taiwan.,2 Da-Yeh University, Dacun, Changhua, Taiwan
| | - Gi-Ming Lai
- 3 Taipei Municipal Wanfang Hospital, Wenshan District, Taipei City, Taiwan.,4 Taipei Medical University, Taipei, Taiwan
| | - De-Chih Lee
- 2 Da-Yeh University, Dacun, Changhua, Taiwan
| | | | - Yuan-Ping Chang
- 6 Fooyin University, Daliao District, Kaohsiung City, Taiwan
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Prevalence, characteristics, and treatment of fatigue in oncological cancer patients in Italy: a cross-sectional study of the Italian Network for Supportive Care in Cancer (NICSO). Support Care Cancer 2018; 27:1041-1047. [DOI: 10.1007/s00520-018-4393-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Accepted: 07/31/2018] [Indexed: 10/28/2022]
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Ben-Arye E, Dahan O, Shalom-Sharabi I, Samuels N. Inverse relationship between reduced fatigue and severity of anemia in oncology patients treated with integrative medicine: understanding the paradox. Support Care Cancer 2018; 26:4039-4048. [PMID: 29882024 DOI: 10.1007/s00520-018-4271-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Accepted: 05/14/2018] [Indexed: 02/06/2023]
Abstract
OBJECTIVE To assess the impact of integrative medicine (IM) on cancer-related fatigue in patients undergoing chemotherapy for early and advanced breast and gynecological (ovarian, endometrial, and cervical) cancer. METHODS Patients reporting significant levels of fatigue (on the Edmonton Symptom Assessment Scale (ESAS), European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30), or Measure Yourself Concerns and Wellbeing questionnaire (MYCAW)) were offered complementary and integrative medicine (CIM) treatments in addition to standard supportive care. Patients who did not undergo IM treatments were designated as controls. Attending at least five CIM treatments less than 30 days between each session was considered as high adherence to integrative care (AIC). RESULTS Of 258 eligible patients reporting significant fatigue, follow-up assessment at 6 and 12 weeks was considered optimal for 120 patients in the intervention group and for 64 controls; 88 of treated patients found to be adherent to the IM intervention. At 12 weeks, ESAS (P < 0.001) and EORTC (p = 0.001) scores for fatigue improved more significantly in treated patients, with a higher percent with optimal relative dose intensity in the AIC subgroup, both at 6 weeks (P = 0.002) and at 12 weeks (P < 0.001). IM treatment was paradoxically associated with a greater decrease in hemoglobin levels at 12 weeks (P = 0.016), more so in the AIC subgroup (P = 0.024). CONCLUSION Integrative medicine program may alleviate cancer-related fatigue in patients with breast and gynecological cancer undergoing chemotherapy.
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Affiliation(s)
- Eran Ben-Arye
- Integrative Oncology Program, Lin and Carmel Medical Centers, Clalit Health Services, Haifa, Israel.
| | - Ofer Dahan
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Ilanit Shalom-Sharabi
- Integrative Oncology Program, Lin and Carmel Medical Centers, Clalit Health Services, Haifa, Israel
| | - Noah Samuels
- Tal Center for Integrative Oncology, Institute of Oncology, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel
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Johansson AC, Brink E, Cliffordson C, Axelsson M. The function of fatigue and illness perceptions as mediators between self-efficacy and health-related quality of life during the first year after surgery in persons treated for colorectal cancer. J Clin Nurs 2018; 27:e1537-e1548. [PMID: 29399917 DOI: 10.1111/jocn.14300] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/21/2018] [Indexed: 12/20/2022]
Abstract
AIMS AND OBJECTIVES To measure changes in health-related quality of life, two dimensions of illness perceptions (i.e., consequences and emotional representations), fatigue and self-efficacy in persons treated for colorectal cancer during the first year after surgical treatment, and to study how fatigue, illness perceptions and self-efficacy measured at 3 months affect health-related quality of life at 12 months postsurgery. BACKGROUND There are fluctuations in health-related quality of life during the first year after treatment for colorectal cancer, and fatigue may negatively influence health-related quality of life. Illness perceptions (consequences and emotional representations) and self-efficacy have been shown to be associated with health-related quality of life in other cancer diagnoses. Concerning colorectal cancer, there is a lack of knowledge concerning how illness perceptions and self-efficacy change during recovery, and how these variables and fatigue at 3 months relate to health-related quality of life at 12 months. DESIGN A prospective longitudinal design. METHODS Thirty-nine persons surgically treated for colorectal cancer, of whom 17 had a colostomy, participated. Health-related quality of life, fatigue, illness perceptions and self-efficacy were assessed using QLQ-C30, the Revised Illness Perception Questionnaire and the Maintain Function Scale. Descriptive and analytical statistics were used. RESULTS No changes were reported in levels of health-related quality of life, fatigue or illness perceptions. Self-efficacy was lower at 12 months compared to 3 months. Fatigue and one dimension of illness perceptions mediated the effect of self-efficacy at 3 months on health-related quality of life at 12 months. CONCLUSION Persons treated for colorectal cancer who have lower self-efficacy 3 months postsurgery are inclined to have more negative illness perceptions concerning emotions and to experience more fatigue. RELEVANCE TO CLINICAL PRACTICE Nurses need to support persons with fatigue and negative illness perceptions concerning emotions and to bolster their self-efficacy, that is carry out follow-up consultations focusing on illness management, symptoms, emotions and information on ways to increase self-efficacy.
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Affiliation(s)
- Ann-Caroline Johansson
- Department of Health Sciences, University West, Trollhättan, Sweden.,Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Eva Brink
- Department of Health Sciences, University West, Trollhättan, Sweden.,Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | | | - Malin Axelsson
- Department of Care Science, Faculty of Health and Society, Malmö University, Malmö, Sweden
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Kalter J, Verdonck-de Leeuw IM, Sweegers MG, Aaronson NK, Jacobsen PB, Newton RU, Courneya KS, Aitken JF, Armes J, Arving C, Boersma LJ, Braamse AMJ, Brandberg Y, Chambers SK, Dekker J, Ell K, Ferguson RJ, Gielissen MFM, Glimelius B, Goedendorp MM, Graves KD, Heiney SP, Horne R, Hunter MS, Johansson B, Kimman ML, Knoop H, Meneses K, Northouse LL, Oldenburg HS, Prins JB, Savard J, van Beurden M, van den Berg SW, Brug J, Buffart LM. Effects and moderators of psychosocial interventions on quality of life, and emotional and social function in patients with cancer: An individual patient data meta-analysis of 22 RCTs. Psychooncology 2018; 27:1150-1161. [PMID: 29361206 PMCID: PMC5947559 DOI: 10.1002/pon.4648] [Citation(s) in RCA: 64] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2017] [Revised: 01/02/2018] [Accepted: 01/10/2018] [Indexed: 01/25/2023]
Abstract
Objective This individual patient data (IPD) meta‐analysis aimed to evaluate the effects of psychosocial interventions (PSI) on quality of life (QoL), emotional function (EF), and social function (SF) in patients with cancer, and to study moderator effects of demographic, clinical, personal, and intervention‐related characteristics. Methods Relevant studies were identified via literature searches in 4 databases. We pooled IPD from 22 (n = 4217) of 61 eligible randomized controlled trials. Linear mixed‐effect model analyses were used to study intervention effects on the post‐intervention values of QoL, EF, and SF (z‐scores), adjusting for baseline values, age, and cancer type. We studied moderator effects by testing interactions with the intervention for demographic, clinical, personal, and intervention‐related characteristics, and conducted subsequent stratified analyses for significant moderator variables.Results: PSI significantly improved QoL (β = 0.14,95%CI = 0.06;0.21), EF (β = 0.13,95%CI = 0.05;0.20), and SF (β = 0.10,95%CI = 0.03;0.18). Significant differences in effects of different types of PSI were found, with largest effects of psychotherapy. The effects of coping skills training were moderated by age, treatment type, and targeted interventions. Effects of psychotherapy on EF may be moderated by cancer type, but these analyses were based on 2 randomized controlled trials with small sample sizes of some cancer types. Conclusions PSI significantly improved QoL, EF, and SF, with small overall effects. However, the effects differed by several demographic, clinical, personal, and intervention‐related characteristics. Our study highlights the beneficial effects of coping skills training in patients treated with chemotherapy, the importance of targeted interventions, and the need of developing interventions tailored to the specific needs of elderly patients.
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Affiliation(s)
- J Kalter
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, The Netherlands
| | - I M Verdonck-de Leeuw
- Department of Clinical Psychology, VU University Amsterdam, The Netherlands.,Department of Otolaryngology-Head and Neck Surgery, Amsterdam Public Health research institute and Cancer Center Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - M G Sweegers
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, The Netherlands
| | - N K Aaronson
- Division of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - P B Jacobsen
- Division of Cancer Control and Population Science, National Cancer Institute, Bethesda, Maryland, FL, USA
| | - R U Newton
- Exercise Medicine Research Institute, Edith Cowan University, Joondalup, WA, Australia
| | - K S Courneya
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, AB, Canada
| | - J F Aitken
- Menzies Health Institute Queensland, Griffith University, Southport, Australia.,Cancer Council Queensland, Brisbane, Australia.,Institute for Resilient Regions, University of Southern Queensland, Brisbane, Australia
| | - J Armes
- Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK
| | - C Arving
- Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden
| | - L J Boersma
- Department of Radiation Oncology, Maastricht University Medical Center (MAASTRO clinic), Maastricht, The Netherlands.,GROW-School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, The Netherlands
| | - A M J Braamse
- Department of Medical Psychology, Academic Medical Center, Amsterdam, The Netherlands
| | - Y Brandberg
- Department of Oncology-Pathology, Karolinska Institute, Stockholm, Sweden
| | - S K Chambers
- Menzies Health Institute Queensland, Griffith University, Southport, Australia.,Cancer Council Queensland, Brisbane, Australia.,Prostate Cancer Foundation of Australia, Sydney, NSW, Australia
| | - J Dekker
- Department of Rehabilitation Medicine, VU University Medical Center, Amsterdam, The Netherlands.,Department of Psychiatry, VU University Medical Center, Amsterdam, The Netherlands
| | - K Ell
- Department of Adults and Healthy Aging, University of Southern California, Los Angeles, CA, USA
| | - R J Ferguson
- Division of Hematology-Oncology, University of Pittsburgh Cancer Institute, Pittsburgh, PA, USA
| | - M F M Gielissen
- Department of Medical Psychology, Academic Medical Center, Amsterdam, The Netherlands
| | - B Glimelius
- Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden
| | - M M Goedendorp
- Department of Health Psychology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - K D Graves
- Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC, USA
| | - S P Heiney
- College of Nursing, University of South Carolina, Columbia, SC, USA
| | - R Horne
- UCL School of Pharmacy, University College London, London, UK
| | - M S Hunter
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - B Johansson
- Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden
| | - M L Kimman
- Department of Clinical Epidemiology and Medical Technology Assessment, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - H Knoop
- Department of Medical Psychology, Academic Medical Center, Amsterdam, The Netherlands
| | - K Meneses
- University of Alabama at Birmingham, School of Nursing, Birmingham, AL, USA
| | - L L Northouse
- University of Michigan School of Nursing, Ann Arbor, MI, USA
| | - H S Oldenburg
- Department of Surgical Oncology, Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - J B Prins
- Department of Medical Psychology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - J Savard
- School of Psychology, Université Laval and Laval University Cancer Research Center, Québec, QC, Canada
| | - M van Beurden
- Department of Gynecology, Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - S W van den Berg
- Department of Medical Psychology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - J Brug
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, The Netherlands.,Amsterdam School of Communication Research (ASCoR), University of Amsterdam, Amsterdam, The Netherlands
| | - L M Buffart
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, The Netherlands.,Exercise Medicine Research Institute, Edith Cowan University, Joondalup, WA, Australia.,Department of Medical Oncology, Cancer Center Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
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Zhou W, Wan YH, Chen Q, Qiu YR, Luo XM. Effects of Tai Chi Exercise on Cancer-Related Fatigue in Patients With Nasopharyngeal Carcinoma Undergoing Chemoradiotherapy: A Randomized Controlled Trial. J Pain Symptom Manage 2018; 55:737-744. [PMID: 29122618 DOI: 10.1016/j.jpainsymman.2017.10.021] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2016] [Revised: 10/29/2017] [Accepted: 10/30/2017] [Indexed: 11/25/2022]
Abstract
CONTEXT Tai Chi exercise has been shown to improve cancer-related fatigue (CRF) and autonomic nervous system (ANS) balance in some cancer patients or survivors; however, such effects are yet to be verified in nasopharyngeal carcinoma (NPC) patients undergoing chemoradiotherapy. OBJECTIVES To explore the effects of Tai Chi exercise on CRF in NPC patients undergoing chemoradiotherapy and then to evaluate ANS information indicated by heart rate variability parameters and their association with CRF. METHODS A randomized controlled trial of Tai Chi exercise was conducted from January 2014 to August 2015. Participants in the Tai Chi group practiced Tai Chi a one-hour session, five sessions/week during chemoradiotherapy. Participants in the control group received usual care. The primary end points were scores of the multidimensional fatigue symptom inventory-short form (MFSI-SF). Secondary end points were heart rate variability parameters, including normalized low-frequency (nLF) power, normalized high-frequency (nHF) power, and the nLF/nHF ratio, and their association with CRF. RESULTS One hundred fourteen patients were recruited in this study, and 83 patients completed the trial. The Tai Chi group and the control group had comparable baseline characteristics. After chemoradiotherapy, the Tai Chi group exhibited lower MFSI-SF total score and three negative subscale (general, physical, and emotional fatigue) scores and higher vigor score compared with the control group (P < 0.01 for all). The nLF/nHF ratio was significantly lower in the Tai Chi group compared to the control group after chemoradiotherapy. The MFSI-SF total score was markedly correlated with the nLF/nHF ratio. CONCLUSION Tai Chi exercise is conducive to alleviate CRF in NPC patients undergoing chemoradiotherapy. The improvement in ANS balance might fit into the process of Tai Chi for CRF management in this population.
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Affiliation(s)
- Wei Zhou
- Cancer Center, Renmin Hospital of Wuhan University, Wuhan, Hubei, China
| | - Yong-Hui Wan
- Cancer Center, Renmin Hospital of Wuhan University, Wuhan, Hubei, China
| | - Qian Chen
- Cancer Center, Renmin Hospital of Wuhan University, Wuhan, Hubei, China
| | - Yan-Ru Qiu
- Cancer Center, Renmin Hospital of Wuhan University, Wuhan, Hubei, China
| | - Xiao-Min Luo
- Emergency Department, Renmin Hospital of Wuhan University, Wuhan, Hubei, China.
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Johansson AC, Axelsson M, Grankvist G, Berndtsson I, Brink E. Symptoms, Illness Perceptions, Self-Efficacy and Health-Related Quality of Life Following Colorectal Cancer Treatment. ACTA ACUST UNITED AC 2018. [DOI: 10.4236/ojn.2018.89044] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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49
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Bruggeman-Everts FZ, Wolvers MDJ, van de Schoot R, Vollenbroek-Hutten MMR, Van der Lee ML. Effectiveness of Two Web-Based Interventions for Chronic Cancer-Related Fatigue Compared to an Active Control Condition: Results of the "Fitter na kanker" Randomized Controlled Trial. J Med Internet Res 2017; 19:e336. [PMID: 29051138 PMCID: PMC5668634 DOI: 10.2196/jmir.7180] [Citation(s) in RCA: 60] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2016] [Revised: 05/05/2017] [Accepted: 07/06/2017] [Indexed: 12/19/2022] Open
Abstract
Background Approximately one third of all patients who have been successfully treated for cancer suffer from chronic cancer-related fatigue (CCRF). Effective and easily accessible interventions are needed for these patients. Objective The current paper reports on the results of a 3-armed randomized controlled trial investigating the clinical effectiveness of two different guided Web-based interventions for reducing CCRF compared to an active control condition. Methods Severely fatigued cancer survivors were recruited via online and offline channels, and self-registered on an open-access website. After eligibility checks, 167 participants were randomized via an embedded automated randomization function into: (1) physiotherapist-guided Ambulant Activity Feedback (AAF) therapy encompassing the use of an accelerometer (n=62); (2) psychologist-guided Web-based mindfulness-based cognitive therapy (eMBCT; n=55); or (3) an unguided active control condition receiving psycho-educational emails (n=50). All interventions lasted nine weeks. Fatigue severity was self-assessed using the Checklist Individual Strength - Fatigue Severity subscale (primary outcome) six times from baseline (T0b) to six months (T2). Mental health was self-assessed three times using the Hospital Anxiety and Depression Scale and Positive and Negative Affect Schedule (secondary outcome). Treatment dropout was investigated. Results Multiple group latent growth curve analysis, corrected for individual time between assessments, showed that fatigue severity decreased significantly more in the AAF and eMBCT groups compared to the psycho-educational group. The analyses were checked by a researcher who was blind to allocation. Clinically relevant changes in fatigue severity were observed in 66% (41/62) of patients in AAF, 49% (27/55) of patients in eMBCT, and 12% (6/50) of patients in psycho-education. Dropout was 18% (11/62) in AAF, mainly due to technical problems and poor usability of the accelerometer, and 38% (21/55) in eMBCT, mainly due to the perceived high intensity of the program. Conclusions Both the AAF and eMBCT interventions are effective for managing fatigue severity compared to receiving psycho-educational emails. Trial Registration Trialregister.nl NTR3483; http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=3483 (Archived by WebCite at http://www.webcitation.org/6NWZqon3o)
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Affiliation(s)
- Fieke Z Bruggeman-Everts
- Helen Dowling Instituut, Scientific Research Department, Bilthoven, Netherlands.,Telemedicine Group, Faculty of Electrical Engineering, Mathematics, and Computer Science, University of Twente, Enschede, Netherlands
| | - Marije D J Wolvers
- Roessingh Research and Development, Telemedicine Group, Enschede, Netherlands.,Telemedicine Group, Faculty of Electrical Engineering Mathematics and Computer Science, University of Twente, Enschede, Netherlands
| | - Rens van de Schoot
- Department of Methods and Statistics, Utrecht University, Utrecht, Netherlands.,North-West University, Vanderbijlpark, South Africa
| | - Miriam M R Vollenbroek-Hutten
- Telemedicine Group, Faculty of Electrical Engineering, Mathematics, and Computer Science, University of Twente, Enschede, Netherlands.,Roessingh Research and Development, Telemedicine Group, Enschede, Netherlands
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50
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Hou L, Zhou C, Wu Y, Yu Y, Hu Y. Transcutaneous electrical acupoint stimulation (TEAS) relieved cancer-related fatigue in non-small cell lung cancer (NSCLC) patients after chemotherapy. J Thorac Dis 2017; 9:1959-1966. [PMID: 28839994 DOI: 10.21037/jtd.2017.06.05] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND To explore the effectiveness of transcutaneous electrical acupoint stimulation (TEAS) approach on cancer-related fatigue (CRF) in non-small cell lung cancer (NSCLC) chemotherapy patients. METHODS A total of 162 participants who treated with gemcitabine combined with platinum-based drugs (GP chemotherapy) were randomly assigned to three groups: Control (Group A, n=56), Sham TEAS (Group B, n=49), and TEAS (Group C, n=57). The following acupoints were used in this study: Qihai (CV6), Keshu (UB17), and Zusanli (ST36). The Revised Piper Fatigue Scale (RPFS) were used to measure CRF on the day before chemotherapy (P1), days 8 (P2) and 28 (P3) separately. The Differences among three groups were analyzed. RESULTS At the 28th day, the outcomes of the fatigue scores for Group C, Group B and Group A were 2.06±0.90, 2.80±1.34, 3.00±1.29 respectively. There were significantly different among three groups (F=9.784, P<0.01). At the 28th day, the outcomes of the affective fatigue (F=8.161, P<0.01), sensory fatigue (F=3.06, P=0.05) and cognitive fatigue (F=8.06, P<0.01) for Group C, Group B and Group A were significantly different among three groups. CONCLUSIONS Chemotherapy may increase the fatigue from P1 to P2 and P3 in NSCLC patients. And TEAS could help to relived CRF, especially at P3.
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Affiliation(s)
- Lili Hou
- Department of Nursing, Shanghai Pulmonary Hospital, Tongji University, Shanghai 200433, China
| | - Caicun Zhou
- Department of Oncology and Cancer Institute, Shanghai Pulmonary Hospital, Tongji University, Shanghai 200433, China
| | - Yifan Wu
- Department of Nursing, Shanghai Pulmonary Hospital, Tongji University, Shanghai 200433, China
| | - Ying Yu
- Department of Nursing, Shanghai Pulmonary Hospital, Tongji University, Shanghai 200433, China
| | - Yinqing Hu
- Department of Nursing, Shanghai Pulmonary Hospital, Tongji University, Shanghai 200433, China
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