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Li Y, Jia S, Cao B, Chen L, Shi Z, Zhang H. Network analysis of somatic symptoms in Chinese patients with depressive disorder. Front Public Health 2023; 11:1079873. [PMID: 36992877 PMCID: PMC10040552 DOI: 10.3389/fpubh.2023.1079873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Accepted: 02/23/2023] [Indexed: 03/14/2023] Open
Abstract
IntroductionNetwork theory conceptualizes somatic symptoms as a network of individual symptoms that are interconnected and influenced by each other. In this conceptualization, the network's central symptoms have the strongest effect on other symptoms. Clinical symptoms of patients with depressive disorders are largely determined by their sociocultural context. To our knowledge, no previous study has investigated the network structure of somatic symptoms among Chinese patients with depressive disorders. The aim of this study was to characterize the somatic symptoms network structure in patients with depressive disorders in Shanghai, China.MethodA total of 177 participants were recruited between October 2018 and June 2019. The Chinese version of the Patient Health Questionnaire-15 was used to assess somatic symptoms. In order to quantify the somatic symptom network structure, indicators of “closeness,” “strength,” and “betweenness” were employed as identifiers for network-central symptoms.ResultThe symptoms of “feeling your heart pound or race,” “shortness of breath,” and “back pain” had the highest centrality values, indicating that these symptoms were central to the somatic symptom networks. Feeling tired or mentally ill had the strongest positive correlation with insomnia or other sleep problems (r = 0.419), followed by chest pain and breathlessness (r = 0.334), back pain, and limb or joint pain (r = 0.318).DiscussionPsychological and neurobiological research that offers insights into somatic symptoms may focus on these central symptoms as targets for treatment and future research.
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Affiliation(s)
- Yang Li
- Department of Nursing, Air Force Military Medical University, Xi'an, Shanxi, China
| | - Shoumei Jia
- School of Nursing, Fudan University, Shanghai, China
- *Correspondence: Shoumei Jia
| | - Baohua Cao
- Department of Nursing, Air Force Military Medical University, Xi'an, Shanxi, China
- Baohua Cao
| | - Li Chen
- Department of Nursing, Shanghai Mental Health Center, Shanghai, China
| | - Zhongying Shi
- Department of Nursing, Fudan University Shanghai Cancer Center, Shanghai, China
| | - Hao Zhang
- Medical Department, The Chinese People's Liberation Army 985th Hospital, Taiyuan, Shanxi, China
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Teba PP, Esther MG, Raquel SG. Association between physical activity and patient-reported outcome measures in patients with lung cancer: a systematic review and meta-analysis. Qual Life Res 2022; 31:1963-1976. [DOI: 10.1007/s11136-021-03053-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/23/2021] [Indexed: 01/14/2023]
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Molassiotis A, Vu DV, Ching SSY. The Effectiveness of Qigong in Managing a Cluster of Symptoms (Breathlessness-Fatigue-Anxiety) in Patients with Lung Cancer: A Randomized Controlled Trial. Integr Cancer Ther 2021; 20:15347354211008253. [PMID: 33847150 PMCID: PMC8047940 DOI: 10.1177/15347354211008253] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND AND PURPOSE Qigong is used by cancer patients, but its effect is not adequately evaluated to date. The aim of this study was to investigate the effects of Qigong for the management of a symptom cluster comprising fatigue, dyspnea, and anxiety in patients with lung cancer. METHODOLOGY A total of 156 lung cancer patients participated in this trial, and they were randomized to a Qigong group (6 weeks of intervention) or a waitlist control group receiving usual care. The symptom cluster was assessed at baseline, at the end of treatment (primary outcome), and at 12 weeks, alongside measures of cough and quality of life (QOL). RESULTS There was no significant interaction effect between group and time for the symptom cluster overall and for fatigue and anxiety. However, a significant trend towards improvement was observed on fatigue (P = .004), dyspnea (P = .002), and anxiety (P = .049) in the Qigong group from baseline assessment to the end of intervention at the 6th week (within-group changes). Improvements in dyspnea and in the secondary outcomes of cough, global health status, functional well-being and QOL symptom scales were statistically significant between the 2 groups (P = .001, .014, .021, .001, and .002, respectively). CONCLUSION Qigong did not alleviate the symptom cluster experience. Nevertheless, this intervention was effective in reducing dyspnea and cough, and improving QOL. More than 6 weeks were needed, however, for detecting the effect of Qigong on improving dyspnea. Furthermore, men benefited more than women. It may not be beneficial to use Qigong to manage the symptom cluster consisting of fatigue, dyspnea, and anxiety, but it may be effective in managing respiratory symptoms (secondary outcomes needing further verification in future research). Future studies targeting symptom clusters should ensure the appropriateness of the combination of symptoms. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT02977845. Registered November 30, 2016. https://clinicaltrials.gov/ct2/show/NCT02977845?term=Qigong&cond=Lung+Cancer&draw=2&rank=1.
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Affiliation(s)
- Alex Molassiotis
- The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hksar, China
| | - Dau Van Vu
- Nam Dinh University of Nursing, Han Thuyen, Nam Dinh, Vietnam
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Lee MK. Interactions of Spiritual Well-Being, Symptoms, and Quality of Life in Patients Undergoing Treatment for Non-Small Cell Lung Cancer: A Cross-Sectional Study. Semin Oncol Nurs 2021; 37:151139. [PMID: 33771405 DOI: 10.1016/j.soncn.2021.151139] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 12/30/2020] [Accepted: 01/15/2021] [Indexed: 01/25/2023]
Abstract
OBJECTIVES To investigate the relationship of spiritual well-being and quality of life (QOL) in patients undergoing treatment for non-small cell lung cancer (NSCLC) and to identify the role of four different symptoms (ie, appetite loss, dyspnea, pain, and fatigue) in mediating this relationship DATA SOURCES: A total of 132 consecutive patients undergoing chemotherapy, radiotherapy, or concurrent chemoradiotherapy for NSCLC from National University Hospital were examined. Symptoms were assessed using the symptom subscale of the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire-C30 (QLQ-C30). Spiritual well-being was assessed using the Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being scale. Global QOL was assessed using the item on global health status from the European Organization for Research and Treatment of Cancer. Data of all self-reported surveys were analyzed using serial multiple mediation analysis. CONCLUSION Spiritual well-being directly affected QOL in patients undergoing treatment for NSCLC. In addition, a serial multiple mediation model showed causal relationships of spiritual well-being on appetite loss, appetite loss on dyspnea, dyspnea on pain, pain on fatigue, and fatigue on QOL. IMPLICATIONS FOR NURSING PRACTICE Providing integrated care that considers spiritual well-being may improve the QOL of patients undergoing treatment for NSCLC. Our findings emphasized the need to conduct routine assessments of spiritual well-being and symptoms when characterizing patient QOL.
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Affiliation(s)
- Myung Kyung Lee
- College of Nursing, Research Institute of Nursing Science, Kyungpook National University, Daegu, South Korea.
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Seppälä S, Rajala K, Lehto JT, Sutinen E, Mäkitalo L, Kautiainen H, Kankaanranta H, Ainola M, Saarto T, Myllärniemi M. Factor analysis identifies three separate symptom clusters in idiopathic pulmonary fibrosis. ERJ Open Res 2020; 6:00347-2020. [PMID: 33043051 PMCID: PMC7533377 DOI: 10.1183/23120541.00347-2020] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Accepted: 06/26/2020] [Indexed: 12/24/2022] Open
Abstract
Idiopathic pulmonary fibrosis (IPF) is a severe and progressive lung disease with a poor prognosis. Patients with IPF suffer from a high symptom burden, which impairs their health-related quality of life (HRQoL). Lack of research on IPF symptoms and their clustering, however, makes symptom-centred care challenging. There are three distinct symptom factors (respiratory, emotional and pain) in IPF patients. The symptom factors are associated with impairment in different domains of quality of life, with the respiratory and emotional factors having a widespread impact.https://bit.ly/3inDezm
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Affiliation(s)
- Severi Seppälä
- INDIVIDRUG Research Program, Research Programs Unit, Faculty of Medicine, University of Helsinki, Helsinki, Finland.,Päijät-Häme Central Hospital, Dept of Respiratory Medicine, Lahti, Finland
| | - Kaisa Rajala
- INDIVIDRUG Research Program, Research Programs Unit, Faculty of Medicine, University of Helsinki, Helsinki, Finland.,Joint Municipal Authority for Health Care and Social Services in Keski-Uusimaa, Uusimaa, Finland
| | - Juho Tuomas Lehto
- Palliative Care Centre and Dept of Oncology, Tampere University Hospital and Faculty of Medicine and Health Technology, University of Tampere, Tampere, Finland
| | - Eva Sutinen
- INDIVIDRUG Research Program, Research Programs Unit, Faculty of Medicine, University of Helsinki, Helsinki, Finland.,Helsinki University Hospital, Heart and Lung Center, Helsinki, Finland
| | - Laura Mäkitalo
- INDIVIDRUG Research Program, Research Programs Unit, Faculty of Medicine, University of Helsinki, Helsinki, Finland.,Helsinki University Hospital, Heart and Lung Center, Helsinki, Finland
| | - Hannu Kautiainen
- Primary Health Care Unit, Kuopio University Hospital, Finland.,Folkhälsan Research Center, Helsinki, Finland
| | - Hannu Kankaanranta
- Faculty of Medicine and Health Technology, University of Tampere, Tampere, Finland.,Dept of Respiratory Medicine, Seinäjoki Central Hospital, Seinäjoki, Finland
| | - Mari Ainola
- INDIVIDRUG Research Program, Research Programs Unit, Faculty of Medicine, University of Helsinki, Helsinki, Finland.,Helsinki University Hospital, Heart and Lung Center, Helsinki, Finland
| | - Tiina Saarto
- Helsinki University Hospital, Comprehensive Cancer Center, Dept of Palliative Care and Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Marjukka Myllärniemi
- INDIVIDRUG Research Program, Research Programs Unit, Faculty of Medicine, University of Helsinki, Helsinki, Finland.,Helsinki University Hospital, Heart and Lung Center, Helsinki, Finland
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Kwon CY, Lee B, Kong M, Lee SH, Jung HJ, Kim KI, Lee BJ. Effectiveness and safety of herbal medicine for cancer-related fatigue in lung cancer survivors: A systematic review and meta-analysis. Phytother Res 2020; 35:751-770. [PMID: 32929824 DOI: 10.1002/ptr.6860] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Revised: 06/04/2020] [Accepted: 08/10/2020] [Indexed: 12/17/2022]
Abstract
Approximately half of lung cancer patients (LCP) receiving chemotherapy are experiencing cancer-related fatigue (CRF). In East Asia, herbal medicines (HMs) have been used as tonics due to their anti-fatigue effect. This systematic review evaluated the effectiveness and safety of HMs for CRF in LCP. We comprehensively searched 12 electronic medical databases to search randomized controlled trials (RCTs) and quasi-RCTs investigating HMs for CRF in LCP, published up to September 2019. The primary outcome was the fatigue severity. Secondary outcomes included patients' quality of life (QOL), activities of daily life (ADL), and incidence of adverse events. Cochrane's risk of bias tool assessed the methodological quality of included RCTs. The risk ratio or mean difference was estimated with 95% confidence intervals by performing a meta-analysis. Twelve RCTs with 861 participants were included. Compared to conventional medicine alone, HM combined with conventional medicine significantly improved fatigue level, QOL, and ADL. As monotherapy, HM significantly improved ADL compared with megestrol. No serious HM-related adverse events were reported. Limited evidence suggests that HM could be effective and safe for CRF in LCP. However, further high-quality RCTs are needed to confirm these findings owing to the small number and low methodological quality of the included studies.
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Affiliation(s)
- Chan-Young Kwon
- Department of Oriental Neuropsychiatry, Dong-eui University College of Korean Medicine, Busan, Republic of Korea
| | - Boram Lee
- Clinical Medicine Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - Moonkyo Kong
- Division of Lung & Head and Neck Oncology, Department of Radiation Oncology, Kyung Hee University Medical Center, Kyung Hee University School of Medicine, Seoul, Republic of Korea
| | - Seung Hyeun Lee
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kyung Hee University Medical Center, Kyung Hee University School of Medicine, Seoul, Republic of Korea
| | - Hee-Jae Jung
- Division of Allergy, Immune and Respiratory System, Department of Internal Medicine, College of Korean Medicine, Kyunghee University, Seoul, Republic of Korea
| | - Kwan-Il Kim
- Division of Allergy, Immune and Respiratory System, Department of Internal Medicine, College of Korean Medicine, Kyunghee University, Seoul, Republic of Korea
| | - Beom-Joon Lee
- Division of Allergy, Immune and Respiratory System, Department of Internal Medicine, College of Korean Medicine, Kyunghee University, Seoul, Republic of Korea
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Kwon CY, Lee B, Kim KI, Lee BJ. Herbal medicine on cancer-related fatigue of lung cancer survivors: Protocol for a systematic review. Medicine (Baltimore) 2020; 99:e18968. [PMID: 32000424 PMCID: PMC7004586 DOI: 10.1097/md.0000000000018968] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Lung cancer is one of the most common cancers worldwide, and approximately half of the patients with lung cancer receiving chemotherapy suffer from cancer-related fatigue (CRF). Herbal medicines (HMs) have been used in Oriental countries for centuries as tonics. Various beneficial effects of HM on fatigue and cancer have been reported. However, the effectiveness and safety of HM for CRF in lung cancer patients have not been synthesized. The purpose of this systematic review is to evaluate the effectiveness and safety of HM for CRF in patients with lung cancer, regardless of their cancer type or stage. METHODS AND ANALYSIS A comprehensive search will be conducted in 12 electronic medical databases including 5 English-language databases (Medline via PubMed, EMBASE via Elsevier, the Cochrane Central Register of Controlled Trials [CENTRAL], the Allied and Complementary Medicine Database [AMED] via EBSCO, and the Cumulative Index to Nursing and Allied Health Literature [CINAHL] via EBSCO), 4 Korean-language databases (Oriental Medicine Advanced Searching Integrated System [OASIS], Koreanstudies Information Service System [KISS], Research Information Service System [RISS], and Korea Citation Index [KCI]), 2 Chinese-language databases (China National Knowledge Infrastructure [CNKI] and Wanfang Data), and 1 Japanese-language database (CiNii). Only randomized controlled trials (RCTs) and quasi-RCTs on HM for CRF will be allowed. The severity of fatigue assessed using a validated tool will be considered as theprimary outcome. The secondary outcomes will include the patients' quality of life, activities of daily life, incidence of adverse events, and total effective rate. Two independent researchers will perform the study selection, data extraction, and quality assessment. RevMan version 5.3 will be used for data synthesis. The methodological quality of the included RCTs will be assessed using the Cochrane Collaboration's risk of bias tool. In the meta-analysis, for dichotomous data and continuous data, risk ratio and mean difference, respectively, will be estimated with their 95% confidence intervals. According to the heterogeneity, either a fixed-effects or a random-effects model will be used. ETHICS AND DISSEMINATION Ethical approval is not required because individual patient data are not included. The findings of this systematic review will be disseminated through a peer-reviewed publication or conference presentation. PROSPERO REGISTRATION NUMBER CRD42019141660.
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Affiliation(s)
- Chan-Young Kwon
- Department of Clinical Korean Medicine, Graduate School, Kyung Hee University, Seoul
| | - Boram Lee
- Department of Clinical Korean Medicine, Graduate School, Kyung Hee University, Seoul
- Clinical Medicine Division, Korea Institute of Oriental Medicine, Daejeon
| | - Kwan-Il Kim
- Department of Internal Medicine, Division of Allergy, Immune and Respiratory System, College of Korean Medicine, Kyunghee University, Seoul, Republic of Korea
| | - Beom-Joon Lee
- Department of Internal Medicine, Division of Allergy, Immune and Respiratory System, College of Korean Medicine, Kyunghee University, Seoul, Republic of Korea
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Hugoy T, Lerdal A, Rustoen T, Oksholm T. Predicting postoperative fatigue in surgically treated lung cancer patients in Norway: a longitudinal 5-month follow-up study. BMJ Open 2019; 9:e028192. [PMID: 31562144 PMCID: PMC6773303 DOI: 10.1136/bmjopen-2018-028192] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES Despite the negative influence of fatigue on quality of life in patients who undergo lung cancer surgery, little is known about the possible predictors of postoperative fatigue. The aim of this study was to examine demographic and clinical characteristics that might predict postoperative fatigue 5 months after lung cancer surgery. DESIGN A prospective longitudinal follow-up study comprising preoperative and postoperative questionnaires, including Lee Fatigue Scale, and sociodemographic and clinical data. SETTING Three university hospitals in Norway (eg, Oslo University Hospital, St. Olav University Hospital and Haukeland University Hospital). PARTICIPANTS In total, 196 surgically treated patients who answered the questionnaires both preoperatively and at 5-month follow-up with valid fatigue scores. RESULTS Bivariate analyses showed that preoperative fatigue was associated with comorbidities and the symptoms of shortness of breath, cough, depression, anxiety, sleep disturbance and pain. Only cough was directly associated with preoperative fatigue in a regression model. Comorbidities and the symptoms of shortness of breath, cough, depression and sleep disturbance were associated with postoperative fatigue in the bivariate analyses, but only shortness of breath was associated with postoperative fatigue in the regression model. We did not find any significant correlations between fatigue and any treatment variable. CONCLUSION Clinicians should pay special attention to lung symptoms and be aware that these may lead to long-term postoperative fatigue. Further research should examine whether interventions reducing lung symptoms, such as shortness of breath and coughing, may prevent development of fatigue in patients undergoing lung cancer surgery.
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Affiliation(s)
- Therese Hugoy
- Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway
- Lovisenberg Diakonale Hogskole, Oslo, Norway
| | - Anners Lerdal
- Department of Interdisciplinary Health Sciences, Institute of Health and Society, University of Oslo, Oslo, Norway
- Department of Research, Lovisenberg Diakonale Hospital, Oslo, Norway
| | - Tone Rustoen
- Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway
- Department of Research and Development, Division of Emergencies and Critical Care, Oslo universitetssykehus Ulleval, Oslo, Norway
| | - Trine Oksholm
- Faculty of Health Studies, Campus Haraldsplass, VID Vitenskapelige Hogskole, Bergen, Norway
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Hoang HTX, Molassiotis A, Chan CW, Nguyen TH, Liep Nguyen V. New-onset insomnia among cancer patients undergoing chemotherapy: prevalence, risk factors, and its correlation with other symptoms. Sleep Breath 2019; 24:241-251. [PMID: 31016572 DOI: 10.1007/s11325-019-01839-x] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Revised: 03/26/2019] [Accepted: 03/30/2019] [Indexed: 12/19/2022]
Abstract
STUDY OBJECTIVES Although insomnia is common among cancer patients, its prevalence remains variable, and its risk factors and correlation with other cancer-related symptoms are not fully explored in the literature. This study aims to determine the prevalence and severity of insomnia as well as risk factors and sleep-related symptom clusters in a sample of cancer patients. METHODS A cross-sectional survey was conducted collecting data from 213 cancer patients undergoing chemotherapy (age = 53.1 ± 11.3 years, 60% female). Insomnia was measured using the Insomnia Severity Index, a sleep log, and Actigraph, while symptoms were assessed using the Memorial Symptom Assessment Scale and the Hospital Anxiety and Depression Scale. Quality of life was measured with the Functional Assessment of Cancer Therapy-General. RESULTS Of the participants, 42.8% reported insomnia, with 31.9% of those with insomnia reporting severe insomnia. Insomnia occurrence and severity were not correlated with the participants' characteristics, cancer-related or treatment-related factors, only with the participants' anxiety/depression scores. Principal component analysis showed that insomnia, depression, and anxiety formed a symptom cluster (p < 0.001). There was no difference between sleep parameters measured by Actigraphy in insomnia and non-insomnia participants. CONCLUSION This study demonstrated that the prevalence of insomnia was high and indicated a symptom cluster of insomnia, depression, and anxiety. Therefore, interventions to reduce this symptom cluster may benefit cancer patients who are trying to manage these symptoms.
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Affiliation(s)
- Huong Thi Xuan Hoang
- School of Nursing, The Hong Kong Polytechnic University, 11 Yuk Choi Rd, Hung Hom, Kowloon, Hong Kong SAR.,Faculty of Nursing, Phenikaa University, Hanoi, Vietnam
| | - Alex Molassiotis
- School of Nursing, The Hong Kong Polytechnic University, 11 Yuk Choi Rd, Hung Hom, Kowloon, Hong Kong SAR.
| | - Choi Wan Chan
- School of Nursing, The Hong Kong Polytechnic University, 11 Yuk Choi Rd, Hung Hom, Kowloon, Hong Kong SAR
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Pham T, Bui L, Kim G, Hoang D, Tran T, Hoang M. Cancers in Vietnam-Burden and Control Efforts: A Narrative Scoping Review. Cancer Control 2019; 26:1073274819863802. [PMID: 31319695 PMCID: PMC6643189 DOI: 10.1177/1073274819863802] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Revised: 06/04/2019] [Accepted: 06/18/2019] [Indexed: 01/19/2023] Open
Abstract
Although the burden of cancer is rapidly growing in Vietnam, there was no up-to-date review that describes cancer burden and control in Vietnam throughout the literature. By identifying various risk factors, means of prevention, and methods for early detection, this review seeks to systematically summarize the evidence for the future planning and management of cancer occurrence in Vietnam. Additionally, this report aims to identify improvements which are necessary for the treatment and palliative care of patients with cancer in Vietnam. We employed a hybrid approach including both a scoping review and narrative synthesis for this study. Information was identified, extracted, and charted from various sources, which include international and domestically published studies, in addition to gray literature. Our results illustrate that the burden of cancer in Vietnam has tripled in the past 30 years, and this situation could be partly explained by the growing prevalence of both old and new risk factors. Besides hepatitis B virus, various other important risk factors such as human papilloma virus, tobacco usage, physical inactivity, and improper diets are still not under control in Vietnam. There is presently a lack of national cancer screening programs, and the capacity of cancer care services could not maintain pace with the demands of a rapidly increasing Vietnamese population. Overall, policy frameworks for cancer control in Vietnam are in place, but there is still a lack of proper financing and governing models necessary to support a sustainable program. In conclusion, Cancer and its associated consequences are both persistent and emerging problems in Vietnam, and the results of cancer control programs are limited. A comprehensive and evidence-based approach toward the prevention and treatment of cancer should be the future direction for Vietnam.
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Affiliation(s)
- Tung Pham
- Department of Physiology, Hanoi Medical University, Hanoi,
Vietnam
- Center for Population Health Science, Hanoi University of Public
Health, Hanoi, Vietnam
| | - Linh Bui
- Center for Population Health Science, Hanoi University of Public
Health, Hanoi, Vietnam
| | - Giang Kim
- Department of Health Education, Hanoi Medical University, Hanoi,
Vietnam
| | - Dong Hoang
- Vietnam National Cancer Institute, National Cancer Hospital, Hanoi,
Vietnam
| | - Thuan Tran
- Vietnam National Cancer Institute, National Cancer Hospital, Hanoi,
Vietnam
| | - Minh Hoang
- Department of Health Economics, Hanoi University of Public Health,
Hanoi, Vietnam
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The impact of surgical complications on health-related quality of life in women undergoing gynecologic and gynecologic oncology procedures: a prospective longitudinal cohort study. Am J Obstet Gynecol 2016; 215:457.e1-457.e13. [PMID: 27131589 DOI: 10.1016/j.ajog.2016.04.025] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2016] [Revised: 03/23/2016] [Accepted: 04/19/2016] [Indexed: 01/10/2023]
Abstract
BACKGROUND There are currently no assessments of the impact of surgical complications on health-related quality of life in gynecology and gynecologic oncology. This is despite complications being a central focus of surgical outcome measurement, and an increasing awareness of the need for patient-reported data when measuring surgical quality. OBJECTIVE We sought to measure the impact of surgical complications on health-related quality of life at 1 month postoperatively, in women undergoing gynecologic and gynecologic oncology procedures. STUDY DESIGN This is a prospective cohort study of women undergoing surgery by gynecologic oncologists at a tertiary care academic center from October 2013 through October 2014. Patients were enrolled preoperatively and interviewed at baseline and 1, 3, and 6 months postoperatively. Health-related quality of life measures included validated general and disease-specific instruments, measuring multiple aspects of health-related quality of life, including anxiety and depression. The medical record was abstracted for clinical data and surgical complications were graded using validated Clavien-Dindo criteria, and women grouped into those with and without postoperative complications. Bivariate statistics, analysis of covariance, responder analysis, and multivariate modeling was used to analyze the relationship of postoperative complications to change health-related quality of life from baseline to 1 month. Plots of mean scores and change over time were constructed. RESULTS Of 281 women enrolled, response rates were 80% (n = 231/281) at baseline, and from that cohort, 81% (n = 187/231), 74% (n = 170/231), and 75% (n = 174/231) at 1, 3, and 6 months, respectively. The primary analytic cohort comprised 185 women with completed baseline and 1-month interviews, and abstracted clinical data. Uterine (n = 84, 45%), ovarian (n = 23, 12%), cervical (n = 17, 9%), vulvar (n = 3, 2%), and other (n = 4, 2%) cancers were represented, along with 53 (30%) cases of benign disease. There were 42 (24%) racial/ethnic minority women. Minimally invasive (n = 115, 63%) and laparotomy (n = 60, 32%) procedures were performed. Postoperative complications occurred in 47 (26%) of patients who experienced grade 1 (n = 12), grade 2 (n = 29), and grade 3 (n = 6) complications. At 1 month, physical (20.6 vs 22.5, P = .04) and functional (15.4 vs 18.3, P = .02) well-being, global physical health (43.1 vs 46.3, P = .02), and work ability (3 vs 7.2, P = .001) were lower in postoperative complication vs non-postoperative complication women. Relative change, however, in most health-related quality of life domains from baseline to 1 month did not differ between postoperative complication and nonpostoperative complication groups. Postoperative complication patients did have increased odds of sustained or worsened anxiety at 1 month vs baseline (odds ratio, 2.5; 95% confidence interval, 1.2-5.0) compared to nonpostoperative complication patients. CONCLUSION Collectively, women who experienced postoperative complications after gynecologic and gynecologic oncology procedures did not appear to have differences in most health-related quality of life trends over time compared to those who did not. An exception was anxiety, where postoperative complications were associated with sustained or worsened levels of high anxiety after surgery.
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