Nurse-led exercise and cognitive-behavioral care against nurse-led usual care between and after chemotherapy cycles in Han Chinese women of ovarian cancer with moderate to severe levels of cancer-related fatigue: A retrospective analysis of the effectiveness

Enhancing Mobility in Oncology: Evidence-Based Practices Across the Care Continuum

OBJECTIVES

Provide an overview of research-derived insights aimed at elucidating best practices for enhancing mobility in patients with cancer throughout the entirety of the care continuum. Highlighting the value of a multidisciplinary approach involving various healthcare professionals to optimize mobility outcomes for patients with cancer and the benefits of different approaches.

METHODS

A literature search was conducted in PubMed/Medline, CINAHL, Scopus, Embase, and on Google Scholar using search terms, mobility, exercise, cancer, nurs*, physical activity, pre-habilitation, rehabilitation, best practices. Systematic reviews, meta-analyses, peer reviewed research studies, exercise, and physical activity recommendations were reviewed to provide a comprehensive overview of strategies aimed at enhancing mobility in patients with cancer.

RESULTS

Twenty-nine references were included in this overview of enhancing mobility in patients with cancer across the care continuum.

CONCLUSIONS

Evidence-based strategies prioritize enhancing mobility for patients with cancer, aiming to boost physical functioning and overall quality of life. Healthcare providers should consider each patient's unique needs and limitations when implementing these evidence-based approaches, emphasizing a multidisciplinary approach involving oncologists, surgeons, nurses, physical therapists, occupational therapists, and other professionals to ensure comprehensive and personalized care focused on improving mobility.

IMPLICATIONS FOR NURSING PRACTICE

Nurses advocate for incorporating exercise into cancer care plans throughout the entire treatment journey, collaborating with healthcare team members to tailor programs to individual patient needs. Working together as an interdisciplinary team, nurses help develop an overall care plan that emphasizes exercise as an important aspect of cancer care, using their expertise to create customized exercise routines to encourage and motivate patients to participate in physical activity.

Systematic Review of the Literature on Multiple Co-occurring Symptoms in Patients Receiving Treatment for Gynecologic Cancers

OBJECTIVE

Patients with gynecologic cancers experience a very high symptom burden that has a negative impact on their quality of life. This systematic review aims to identify the common co-occurring symptoms, the prevalence of common symptoms, common instruments used to measure symptoms, associated risk factors, and the symptom burden in patients with gynecologic cancers.

DATA SOURCES

A search of four databases (ie, PubMed, Embase, Web of Science, and CINAHL) was done from January 1, 2012, through September 5, 2022. A qualitative synthesis of the extant literature was performed using Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines (PRISMA 2020).

CONCLUSION

A total of 118 studies met the prespecified inclusion criteria. Ninety-six symptoms were assessed across these studies. The top six symptoms and their grand mean prevalence rates were lack of energy (64.4%), fatigue (62.1%), abdominal pain (53.3%), depression (52.6%), concentration dysfunction (52.0%), and drowsiness (51.9%). Numerous methodologic challenges were evident across studies. Future research needs to develop a disease-specific symptom assessment measure, evaluate for risk factors associated with a higher symptom burden, and determine the impact of multiple symptoms on patient outcomes.

IMPLICATION FOR NURSING PRACTICE

The results are relevant for oncology clinicians to assess patients with gynecologic cancers for the presence of common symptoms and risk factors for higher symptom burden in the patients and to offer effective management interventions.

Institute-based nurse-led care versus home-based resistance training for patients with acute pancreatitis: Clinical outcomes analysis

Surgeries may have worse clinical outcomes in pancreatitis. In our institute surgical procedure is barely used surgery to treat pancreatitis nowadays. Chinese guidelines recommended regular exercise for severe pancreatitis. The objectives of the current study were to compare nurse-led resistance training at the institute against usual care provided to patients with acute pancreatitis for favorable clinical outcome measures. For acute pancreatitis, patients (≥18 years, of age) received 6 months of resistance training in the garden of the institute under the supervision of registered nurses (NR cohort, n = 102), or received 6 months of resistance training at their home by themselves according to a training manual (HR cohort, n = 120) or received 6 months of usual care only (UC cohort, n = 120). Fewer numbers patients died in the follow-up period in the NR cohort than those of the HR (8 vs 21, P = .0447) and the UC (8 vs 32, P = .0046) cohorts. The frequency of rehospitalization of patients due to any of the reasons in the follow-up period was fewer for patients of the NR cohort than those of the HR and the UC cohorts (P < .05 for both). Hospitalization of patients due to any of the reasons in the follow-up period was fewer for patients of the HR cohort than those of the UC cohort (P < .05). A 52 median score was the quality of life of patients before the start of the non-treatment intervention(s). After 6 months of non-treatment intervention(s), patients of the NR cohort improved their quality of life as compared to their initial quality of life (P < .001), those of HR cohort (P < .05), and those of UC cohort (P < .001). The quality of life of patients with severe pancreatitis after the surgical procedure was worse. Six months of nurse-assisted resistant training at the institute has significant improvement on the quality of life of patients in the follow-up periods of acute pancreatitis. Resistant training at the institute would improve the quality of life of patients with acute pancreatitis (Level of Evidence: IV; Technical Efficacy Stage: 5).

Diverse gut microbiota pattern between mild and severe cancer-related fatigue in lung cancer patients treated with first-line chemotherapy: A pilot study

BACKGROUND

Cancer survivors perceive cancer-related fatigue (CRF) as one of the most common symptoms. However, the potential relationship between CRF and gut microbiota has not been elucidated. Our study aimed to preliminary explore the diverse gut microbiota composition between mild and severe CRF in advanced lung cancer patients undergoing first-line chemotherapy.

METHODS

A total of 20 advanced lung patients treated with first-line chemotherapy were enrolled, 10 with mild CRF and 10 with severe CRF. The self-reported Piper Fatigue Scale and stool samples were collected from all eligible patients. The 16 S ribosomal ribonucleic acid gene was performed to analyze the intestinal microbiome.

RESULTS

We identified the significantly diverse gut microbiota composition among patients with mild and severe CRF. The pattern was characterized by the increasing abundance in short-chain fatty acid-producing taxa for mild CRF patients (genus Lachnospiraceae-UCG-008 and family Lachnospiraceae, p < 0.05), whereas higher abundance in taxa related to inflammation (family Enterobacteriaceae and genus Escherichia-Shigella, p < 0.05) for severe CRF patients. Significantly different Kyoto Encyclopedia of Genes and Genomes pathways between mild and severe CRF patients were evaluated concerning fatty acid metabolism, nucleotide metabolism, brain function, amino acid metabolism, and so on (p < 0.05).

CONCLUSIONS

Our study observed a plausible association between different levels of CRF and the diverse gut microbiota composition, with increasing proinflammation taxa in severe CRF patients and anti-inflammation taxa growing in mild CRF patients. Further studies are warranted to evaluate whether CRF can be improved by modulating the gut microbiota composition.