The impact of anxiety and depression in the quality of life and psychological well-being of Greek hematological cancer patients on chemotherapy

Health-related quality of life in older hematological cancer survivors (70+) compared to older general population-A German cancer-register-based cross-sectional comparative study

OBJECTIVES

The extent of health-related quality of life (HRQOL) impairments in older hematological cancer survivors (HCS) has not been sufficiently studied. We therefore examined HRQOL in older HCS compared to a community sample (CS) and investigated sociodemographic, disease- and treatment-specific, geriatric, and psychosocial factors associated with reduced HRQOL.

MATERIALS AND METHODS

In this cancer-register-based cross-sectional comparative study 200 HCS, aged ≥70 years, and 252 persons of an age- and gender-matched CS completed validated questionnaires including the EORTC QLQ-C30 and EORTC QLQ-ELD14.

RESULTS

Older HCS reported a reduced HRQOL in the dimensions of global QOL, physical, role, and social functioning (small clinical significance) and higher symptom burden of fatigue, nausea and vomiting, appetite loss, and poorer mobility compared to the CS (fatigue and mobility with medium, the others with small clinical significance). Perceived disease burden of comorbidities, functional disabilities, psychological distress, and depression showed statistical significance for reduced HRQOL in older HCS in multiple linear regression analysis (R2 = .602, p < .001).

DISCUSSION

The screening and treatment of functional limitations and individual symptoms and the integration of a geriatric assessment into oncological practice can help to identify supportive care needs, to implement individualized, patient-centered cancer survivorship care programs and to improve older HCS's HRQOL.

The impact of a continuous care model utilizing a smartphone application on quality of life and anxiety levels among gynecologic cancer patients: a randomized controlled trial

BACKGROUND

Patients diagnosed with gynecological cancers often face a range of complications that can impact their quality of life and increase their anxiety. Nursing models combined with mobile phone applications have the potential to improve outcomes for these patients. This study aimed to assess the impact of a continuous care model utilizing a smartphone application on quality of life and anxiety levels among gynecologic cancer patients.

METHODS

This study involved two phases: (1) mobile App development and (2) implementation of the intervention. The two-group randomized controlled trial included 70 participants with gynecological cancers referred to medical centers affiliated with Shahrekord University of Medical Sciences in 2023. The participants were randomized into control or intervention groups (n = 35 per group). Finally, 68 patients completed the trial. The intervention group received an 8-week intervention incorporating the continuous care model, whereas the control group received routine care (the standard support provided by nurses both during and after hospitalization). The participants completed the Spielberger state-trait anxiety and quality of life (QLQ-C30) questionnaires before, immediately after, and two months after the intervention. The data were analyzed via the chi-square test, independent samples t test, analysis of covariance, and repeated-measures ANOVA.

RESULTS

There were no significant differences in the baseline data between the two groups. However, after the intervention, the intervention group reported a significant increase in quality of life, with mean scores rising from 68.90 ± 17.50 to 73.78 ± 16.79 immediately after the intervention and to 80.61 ± 9.90 at the two-month follow-up. In contrast, the control group showed no significant improvement. Additionally, state anxiety significantly decreased in the intervention group from 51.64 ± 14.97 to 40.20 ± 11.70 at the follow-up, and trait anxiety scores in the intervention group decreased significantly from 49.91 ± 14.96 to 39.82 ± 10.28 at the follow-up, whereas the scores of the control group worsened.

CONCLUSION

The intervention improved quality of life and reduced anxiety in patients with gynecological cancers. Given the scant attention given to mobile application-based follow-up in gynecologic cancer patients in previous studies, this approach can be incorporated into routine care to support patients, and it is recommended for nurses, health care providers, and physicians.

TRIAL REGISTRATION

The study was registered as a randomized controlled trial in the Clinical Trial Registration Center of Iran. Registration Date: 2024-02-14, Registration Number: IRCT20231107059977N1.

Review of Baduanjin and resistance exercise for the mental health of patients with hematologic malignancies

Patients with hematological tumors experience physical and psychological stress, and negative psychological states. Baduanjin, an emerging psychological rehabilitation method combined with resistance exercise, has received widespread attention. This study reviews the current status of the application of Baduanjin combined with resistance exercise in improving the negative psychological state of patients with hematological tumors and discusses its problems and prospects. Through a literature review and comprehensive analysis, the application of Baduanjin and resistance exercise in the psychological rehabilitation of patients with hematological tumors was identified and evaluated. The results showed that Baduanjin with resistance exercise had a positive effect on improving negative psychological states of patients with hematological tumors, which can alleviate anxiety, depression, and other adverse emotions, and improve quality of life. However, there is a lack of unified and standardized exercise intervention programs for practical application, and patient participation and compliance must be improved. Baduanjin combined with resistance exercise can potentially improve the negative psychological status of patients with hematological tumors; however, it is still necessary to further standardize and improve the exercise program improving patient participation and compliance. Future studies should strengthen theoretical exploration and empirical research, providing more effective psychological rehabilitation strategies for patients with hematological tumors.

Health-related quality of life in hemato-oncology patients: role of informativeness and doctor-patient communication

Background

The patient's information about the disease and doctor-patient communication are both constructs whose importance is emphasized in the theory, but much less frequently researched and used in the practice.

Objective

This study aimed to determine whether certain facets of health-related quality of life of hemato-oncology patients in Croatia could be predicted based on patients' sociodemographic data, the disease's determinants, the patients' information about their disease and the quality of doctor-patient communication.

Methods

60 women and 54 men with diagnoses of both leukemia and lymphoma have participated in filling out questionnaires. The survey consisted of a sociodemographic questionnaire, EORTC QLQ-C30(version 3), EORTC QLQ-INFO25 and the Doctor-Patient Communication Questionnaire.

Results

Patients' sociodemographic data, the disease's determinants, the patients' information about their disease and the quality of doctor-patient communication predicted 26.8 % variance of global health status (F = 2.756, p \< .01), 35.7% variance of physical functioning (F = 4.196, p \< .01), 23.3% variance of role functioning (F = 2.291, p \< .05), 29.9% variance of emotional functioning (F = 3.215, p \< .01) and 27.9% of social functioning (F = 2.881, p \< .01). Predictors that significantly contributed to the change in variance of health-related quality of life were age, duration of diagnosis, the existence of comorbidity, frequency of hospitalization, talking with the psychologist after getting the diagnosis and information.

Conclusion

The study offers valuable insights into an under-researched patient population and a better understanding of their health-related quality of life. The results indicate the importance of information that can be implemented in everyday clinical practice, and pave the way for further research on doctor-patient communication.

Professional quality of life, psychological well-being, and work engagement of healthcare professionals in two Greek hospitals during COVID-19: A cross-sectional study

BACKGROUND

During the COVID-19 pandemic, the mental health of healthcare professionals has emerged as an issue of great concern.

OBJECTIVE

To investigate the levels of professional quality of life, psychological well-being, and work engagement among healthcare professionals in two Greek hospitals during the COVID-19 pandemic.

METHODS

A cross-sectional study was conducted in December 2021 in two public hospitals in Greece. To assess the levels of professional quality of life, psychological well-being, and work engagement, respondents completed the Professional Quality of Life Scale Version 5 (ProQOL-V), the Psychological Well-being (PWB) scale, and the Utrecht Work Engagement Scale (UWES-17).

RESULTS

A total of 150 questionnaires were distributed, and 102 were returned (response rate: 68%). It was found that as burnout levels increased, the levels of work engagement decreased (rho = -0.36, p-value < 0.01). Higher levels of compassion satisfaction were associated with higher work engagement (rho = 0.48, p-value < 0.01). Multivariable analysis revealed that healthcare personnel's contact with patients or service users exposed to or who have experienced traumatic events was associated with less positive relationships with others (and, consequently, lower levels of psychological well-being) (p-value = 0.035).

CONCLUSIONS

Healthcare professionals in the two public hospitals in Greece, experienced moderate levels of compassion satisfaction, burnout, and secondary traumatic stress during the COVID-19 pandemic. Their psychological well-being was also found to be moderate, and their levels of work engagement were moderate to high. Supporting the physical and psychological well-being of healthcare professionals is essential for their ability to provide high-quality care in times of crisis, such as during the COVID-19 pandemic.

Psychological Distress and Concerns of In-Home Older People Living with Cancer and Their Impact on Supportive Care Needs: An Observational Survey

(1) Background: Cancer patients are experiencing psychological problems after diagnosis, such as emotional distress and social anxiety, which may increase their demands for emotional and supportive care. This study aimed to assess the influence of both emotional distress and concerns on the supportive care needs of cancer patients receiving home-based healthcare. (2) Methods: In this door-to-door screening program, 97 cancer patients were approached, with a mean age of 73 years old (mean = 73.43; SD = 6.60). (3) Results: As expected, 42.3% of patients highlighted their treatment as their main psychological priority, with 20.6% identifying concerns about the future of their family in this regard. No significant associations with respect to sex were identified in terms of focus, though females reported the need for more frequent psychological support (58.7% vs. 37.3%, respectively, p = 0.035) compared to males. Patients who had experienced an increased number of concerns during the last weeks (IRR = 1.02; 95% CI: 1.00-1.03, p = 0.007) had a significantly greater risk of presenting an increased rate of supportive care needs. Notably, male patients with bone cancer presented a significantly greater number of supportive care needs (mean rank 45.5 vs. 9.0, p = 0.031) respectively, in comparison to those with other types of cancer. (4) Conclusions: Supportive care needs arise from a greater concern and specific type of cancer, highlighting the need for supportive care, such as psychosocial and psychological support. This may have significant implications for treatment and patient outcomes in home care settings.

Covalent CES2 Inhibitors Protect against Reduced Formation of Intestinal Organoids by the Anticancer Drug Irinotecan

BACKGROUND

Irinotecan is widely used to treat various types of solid and metastatic cancer. It is an ester prodrug and its hydrolytic metabolite (SN-38) exerts potent anticancer activity. Irinotecan is hydrolyzed primarily by carboxylesterase-2 (CES2), a hydrolase abundantly present in the intestine such as the duodenum. We have identified several potent and covalent CES2 inhibi¬tors such as remdesivir and sofosbuvir. Remdesivir is the first small molecule drug approved for COVID-19, whereas sofosbuvir is a paradigm-shift medicine for hepatitis C viral infection. Irinotecan is generally well-tolerated but associated with severe/life-threatening diarrhea due to intestinal accu¬¬mula¬tion of SN-38.

OBJECTIVE

This study was to test the hypothesis that remdesivir and sofosbuvir protect against irinotecan-induced epithelial injury associated with gastrointestinal toxicity.

METHODS

To test this hypothesis, formation of organoids derived from mouse duodenal crypts, a robust cellular model for intestinal regeneration, was induced in the presence or absence of irinotecan +/- pretreatment with a CES2 drug inhibitor.

RESULTS

Irinotecan profoundly inhibited the formation of intestinal organoids and the magnitude of the inhibition was greater with female crypts than their male counterparts. Consistently, crypts from female mice had significantly higher hydrolytic activity toward irinotecan. Critically, remdesivir and sofosbuvir both reduced irinotecan hydrolysis and reversed irinotecan-reduced formation of organoids. Human duodenal samples robustly hydrolyzed irinotecan, stable CES2 transfection induced cytotoxicity and the cytotoxicity was reduced by CES2 drug inhibitor.

CONCLUSION

These findings establish a therapeutic rationale to reduce irinotecan-gastrointestinal injury and serve as a cellular foundation to develop oral formulations of irinotecan with high safety.

Examining anxiety and depression in haematology cancer patients in ongoing treatment and under watchful waiting: A systematic review and meta-analysis

INTRODUCTION

The present review aimed to establish prevalence rates of anxiety and depression in adults with haematology cancer, with a focus on the differences between patients under treatment and patients under watchful waiting.

METHOD

Five databases (Scopus, Medline, PsycINFO, EThOS, CINAHL) were searched throughout June 2021. Key search terms included haematology cancer, anxiety, depression, in treatment and watchful waiting. Study and sample characteristics, prevalence rates and mean self-reported scores of anxiety and depression data were extracted.

RESULTS

A total of 18 eligible papers were included in the review. Quality appraisal indicated papers were of adequate standard. Depression data from 2720 participants (14.5% under watchful waiting) and anxiety data from 2520 participants (15.9% under watchful waiting) were analysed through subgroup meta-analyses. The prevalence of anxiety was 34% amongst adults receiving treatment and 24.5% amongst those under watchful waiting. The prevalence of depression amongst adults receiving treatment was 31.3%, significantly higher than 16.1% of adults under watchful waiting.

CONCLUSION

Overall, adults with haematology cancer were at greater risk of experiencing anxiety and depression than the general population, with greatest risk in those under treatment. The findings indicate the need for future research to examine availability and effectiveness of targeted psychological interventions.

The impact of COVID-19 on patients with hematological malignancies: the mixed-method analysis of an Israeli national survey

Background

The COVID-19 pandemic required reevaluation of the therapeutic approach and added emotional stress for patients with hematological malignancies at high risk of contracting the virus. We aimed to evaluate how it affected such patients during the second lockdown in Israel.

Methods

This national survey included Hebrew-speaking patients with hematological malignancy. This included three tools with 28 items of sociodemographic and medical baseline characteristics, management of hematological disease, and evaluation of emotional coping during COVID-19 pandemic; the Hebrew version of the Patient Health Questionnaire 9; and 3 qualitative open-ended questions. Data was analyzed by mixed methods which combined both quantitative and qualitative thematic analyses.

Results

Four hundred eight patients responded to the survey. The management of their hematological disease included a decrease in the number of visits to the hematology clinic (37.0%), delay of some treatment schedules (9.1%), and prescription of replacement therapies permitting less visits to the clinic (2.2%). The frequency and intensity of “feeling afraid” regarding COVID-19 infection was increased (mean ± SD: 4 ± 1 to 5 ± 2 in a 1–7 Likert scale), and a high rate of depression was recorded, which appeared to be more evident in patients with chronic myeloid leukemia (CML) (p < 0.001).

Conclusion

The management of hematological malignancies during pandemics should always take into consideration patients’ fears, as well as the development of depression related to isolation and loneliness, in addition to the high risk of severe disease. Patients with CML had a high rate of depression which obviously needs to be managed very carefully during and after the COVID-19 pandemic.

Prevalence and factors associated with anxiety and depressive symptoms among patients hospitalized with hematological malignancies after chimeric antigen receptor T-cell (CAR-T) therapy: A cross-sectional study

BACKGROUND

We conducted a survey to investigate the prevalence and factors associated with anxiety and depressive symptoms among patients hospitalized with hematological malignancies after chimeric antigen receptor T-cell (CAR-T) therapy.

METHODS

In total, 130 eligible patients completed the Self-Rating Anxiety Scale and Self-Rating Depression Scale at week 4 after CAR-T cell infusion. We collected sociodemographic information during the same period. We studied factors associated with anxiety and depressive symptoms using logistic regression analysis.

RESULTS

The prevalence of anxiety and depressive symptoms at week 4 after infusion were 13.8% and 40.0%, respectively. A cutoff value of 50 or above indicates significantly anxiety and depressive symptoms. Binary logistic regression analysis showed that high school education and above (OR = 0.22, 95% CI = 0.06-0.78) and middle age (OR = 0.16, 95% CI = 0.03-0.90) were associated with lower risk of anxiety symptoms, and increased odds of depressive symptoms was associated with old age (OR = 11.39, 95% CI = 2.50-51.88), non-manual occupations before illness (OR = 3.72, 95% CI = 1.20-11.58), and higher healthcare expenditure (OR = 3.93, 95% CI = 1.50-10.33), while lower risk of depressive symptoms was associated with rural household location (OR = 0.25, 95% CI = 0.08-0.76) and being cared for by spouse (OR = 0.12, 95% CI = 0.02-0.63).

CONCLUSIONS

Patients receiving CAR-T therapy with lower education background, old ages, urban household location, or who used to work as non-manual workers require more attention and psychological care. Support from a spouse and medical expense deductions from the government may help patients develop positive attitudes.

Patient-Reported Outcomes of Regular Aerobic Exercise in Gastric Cancer

Simple Summary

The benefits of exercise for health-related quality of life (HRQOL) and depression in patients with gastric cancer remain unclear. Thus this research was suggested to examine the association between maintenance of regular aerobic exercise at a recommended level and depression and HRQOL in patients with gastric cancer during or after treatment. The findings indicated that exercise can have a synergistic effect on improvement in HRQOL via indirect positive effects on depression and direct effects on HRQOL in patients with gastric cancer. The findings of this research may add the evidence on the benefits of exercise for HRQOL and depression in patients with gastric cancer to the research community.

Abstract

The benefits of exercise for health-related quality of life (HRQOL) and depression in patients with gastrointestinal disease remain unclear, and studies on gastric cancer are scant. This study examines the association between the maintenance of regular aerobic exercise at a recommended level and depression and HRQOL in patients with gastric cancer during or after treatment. In this cross-sectional study, a face-to-face survey was used to collect data from 126 patients with primary gastric cancer during or after treatment in a tertiary acute-care hospital in Korea. Regular exercise was defined as regularly maintained aerobic exercise of at least moderate intensity consuming ≥4 metabolic equivalents for ≥150 min/wk for at least 6 months. Depression was measured using the 9-item version of the Patient Health Questionnaire, and HRQOL was assessed using the EORTC QLQ-C30. Patients who maintained aerobic exercise at a recommended level were less likely to have depression and more likely to have improved global QOL, as well as physical, role, and emotional functioning. Patients with depression were less likely to report improved global QOL and functioning. Thus, exercise can have a synergistic effect on improvement in HRQOL via indirect positive effects on depression and direct effects on HRQOL in patients with gastric cancer. Oncology nurses should encourage patients with gastric cancer who suffer from a depressive mood to set up and implement specific plans for practicing regular exercise, which can lead to an improvement in both depression and HRQOL.