Influence of psychological nursing and health education on depression, anxiety and life quality of elderly patients with lung cancer

Educational interventions to reduce depression and anxiety in older adults with cancer in the community: a systematic review, meta-analysis and meta-regression of randomised controlled trials

BACKGROUND

Older adults make up half of those with cancer and are prone to mood disorders, such as depression and severe anxiety, resulting in negative repercussions on their health-related quality-of-life (HRQOL). Educational interventions have been shown to reduce adverse psychological outcomes. We examined the effect of educational interventions on the severity of psychological outcomes in older adults with cancer (OAC) in the community.

METHOD

This PRISMA-adherent systematic review involved a search of PubMed, MedLine, Embase and PsycINFO for randomised controlled trials (RCTs) that evaluated educational interventions impacting the severity of depression, anxiety and HRQOL in OAC. Random effects meta-analyses and meta-regressions were used for the primary analysis.

RESULTS

Fifteen RCTs were included. Meta-analyses showed a statistically insignificant decrease in the severity of depression (SMD = -0.30, 95%CI: -0.69; 0.09), anxiety (SMD = -0.30, 95%CI: -0.73; 0.13) and improvement in overall HRQOL scores (SMD = 0.44, 95%CI: -0.16; 1.04). However, subgroup analyses revealed that these interventions were particularly effective in reducing the severity of depression and anxiety in specific groups, such as OAC aged 60-65, those with early-stage cancer, those with lung cancer and those treated with chemotherapy. A systematic review found that having attained a higher education and income level increased the efficacy of interventions in decreasing the severity of adverse psychological outcomes.

CONCLUSION

Although overall meta-analyses were statistically insignificant, subgroup meta-analyses highlighted a few specific subgroups that the educational interventions were effective for. Future interventions can be implemented to target these vulnerable groups.

Preoperative Physical Dysfunction Characteristics and Influence Factors Among Elderly Patients with Early Lung Cancer: A Latent Class Analysis

Objective

To identify latent classes of preoperative physical dysfunction in elderly patients with early lung cancer. To analyze the differences in demographic characteristics between different classes.

Methods

We invited elderly patients with early lung cancer who were scheduled for surgery at Shanghai Elderly Characteristic Hospital to participate in the study using a convenience sampling method. We took latent class analysis to divide elderly patients with early lung cancer into latent classes based on preoperative physical dysfunction features. Furthermore, we used single-factor analysis and multinomial logistic regression to investigate the influence variables of each latent class.

Results

The characteristics of preoperative physical dysfunction in elderly patients with early lung cancer can be divided into "Anxiety/depression emotion-poor sleep group" "Frailty of physical function group" "Pulmonary hypofunction-low activity tolerance group". The distribution of age, chronic disease history, COPD history, smoking history and perceived social support level of elderly patients with early lung cancer in different potential categories were not the same, and the differences were statistically significant (P<0.05). The elderly lung cancer patients with chronic disease history and age ≥75 years were more likely to be classified as "frailty of physical function group". The elderly lung cancer patients with COPD and smoking history were more likely to be classified into "pulmonary hypofunction-low activity tolerance group". Elderly lung cancer patients with moderate or low degree of perceived social support were more prone to be grouped into "anxiety/depression emotion-poor sleep group".

Conclusion

The variety of preoperative physical dysfunction seen in elderly patients with early lung cancer can be categorized into three latent classes. Medical professionals should create strategies for intervention for multiple patient populations with the goal of further enhancing their general state of life.

Application of IMB model in preventing venous thromboembolism in elderly lung cancer patients

Objective

This study aims to explore the effects of the Information-Motivation-Behavioral (IMB) Skills Model on the prevention of Venous Thromboembolism (VTE) in elderly lung cancer patients.

Methods

A convenience sampling method was used to select study participants who were hospitalized for treatment between November 2022 and August 2023 at a tertiary hospital in Neijiang and met the inclusion and exclusion criteria. The control group (n = 41) received conventional health education, while the intervention group (n = 40) received health education based on the IMB Skills Model over three months. The scores of the Venous Thrombosis Knowledge, Participation in Thrombosis Prevention Willingness and Behavior Questionnaire, and Quality of Life Measurement Scale (QLQ-C30) were compared before the intervention and after three months. After three months of intervention, the hospital satisfaction and VTE incidence rates in both groups were investigated and compared.

Results

After three months of intervention, the scores for the Venous Thrombosis Knowledge, (Participation in Thrombosis Prevention Willingness and Behavior Questionnaire in the intervention group were higher than those in the control group (P < 0.05). The QLQ-C30 scores in the intervention group for physical function, role function, emotional function, insomnia, appetite loss, and overall health status were higher than those in the control group (P < 0.05). The intervention group rated higher in doctor's professional skills, information provision, accessibility; nurse's professional skills, humanistic care, information provision, accessibility; team communication, services of other personnel, overall satisfaction compared to the control group (P < 0.05). The rate of VTE in the intervention group was 2.5%(1/40), and that in the control group was 19.5%(8/41). There was a significant difference (χ2 = 4.336, P = 0.037).

Conclusion

Nursing interventions based on the IMB Skills Model for elderly lung cancer patients can enhance patients' understanding of venous thrombosis, increase willingness and active participation in thrombosis prevention, improve quality of life, increase hospital satisfaction, and reduce the incidence of VTE.

The effect of multimodal care based on Peplau's interpersonal relationship theory on postoperative recovery in lung cancer surgery: a retrospective analysis

BACKGROUND

Lung cancer remains a major global health concern due to its high incidence and mortality rates. With advancements in medical treatments, an increasing number of early-stage lung cancer cases are being detected, making surgical treatment the primary option for such cases. However, this presents challenges to the physical and mental recovery of patients. Peplau known as the "mother of psychiatric associations" has formulated a theory of interpersonal relationships in nursing. Through effective communication between nurses and patients over four periods, she has established a good therapeutic nurse-patient relationship. Therefore, this study aimed to explore the effect of perioperative multimodal nursing based on Peplau's interpersonal relationship theory on the rehabilitation of patients with surgical lung cancer.

METHODS

We retrospectively analyzed 106 patients with non-small cell lung cancer who underwent thoracoscopic lobectomy at our department between June 2021 and April 2022. Patients were categorized into two groups according to the different nursing intervention techniques. The Peplau's group comprised 53 patients who received targeted nursing interventions, and the control group comprised 53 patients who received conventional nursing care. We observed the patients' illness uncertainty, quality of life, and clinical symptoms in both groups.

RESULTS

Patients in the Peplau's group had significantly lower illness uncertainty scores and a significantly higher quality of recovery than those in the control group. However, there were no significant differences in length of post-anesthesia care unit stay, complication rates, and visual analog scores between both groups.

CONCLUSION

The multimodal perioperative nursing based on Peplau's interpersonal relationship theory not only reduces the illness uncertainty of patients with lung cancer surgery and improves their QoR but also expands the application of this theory in clinical practice, guiding perioperative nursing of patients with lung cancer.

IMPLICATIONS

These findings provide practical information for standardized care in a hectic anesthetic care setting.

IMPACT

The assessed anesthesia nursing model helps reduce uncertainty and promote early recovery in patients with cancer at various stages of their disease, which expands the scope of therapeutic practice and existing theories. It also serves as a guide for care in the anesthesia recovery room.

REPORTING METHOD

We adhered to the relevant Equator guidelines and the checklist of items in the case-control study report.

PATIENT OR PUBLIC CONTRIBUTION

Patients cooperated with medical staff to complete relevant scales.

Application effect of diversified health-promoting models on rehabilitation exercises for cervical spondylotic myelopathy

BACKGROUND

With improving living standards, the incidence of cervical spondylotic myelopathy (CSM) has become increasingly high.

OBJECTIVE

The study aims to explore the effect of diversified health-promoting models on rehabilitation exercises in patients with CSM after an operation.

METHOD

This was a randomized controlled trial, wherein 107 patients with CSM treated by neurosurgery were selected as the subjects. Of those, 52 patients in the control group adopted the conventional health-promoting model, while the remaining 55 patients in the intervention group adopted diversified health-promoting models. The effect of rehabilitation exercises in the two groups was evaluated according to the self-efficacy rehabilitation outcome scale, grip strength measurement of the affected limb, and Barthel index.

RESULTS

At Day 3 post-operation and before discharge, the self-efficacy management of rehabilitation exercises in the intervention group was better than that of the control group (P< 0.05). The grip strength measurement of the affected limb, Japanese Orthopedic Association score of the cervical vertebra, and Barthel index of the two groups at Day 3 post-operation were lower than before the intervention and were not statistically significant (P> 0.05). However, these three items before discharge were improved when compared with those of before intervention and were statistically significant (P< 0.05).

CONCLUSION

Postoperative rehabilitation exercises guided by the diversified health-promoting models for patients with CSM can improve the patients' self-efficacy management ability in rehabilitation exercises, help improve grip strength, and promote the recovery of cervical vertebra function, thereby improving the patients' quality of life.

Primary-level and community worker interventions for the prevention of mental disorders and the promotion of well-being in low- and middle-income countries

BACKGROUND

There is a significant research gap in the field of universal, selective, and indicated prevention interventions for mental health promotion and the prevention of mental disorders. Barriers to closing the research gap include scarcity of skilled human resources, large inequities in resource distribution and utilization, and stigma.

OBJECTIVES

To assess the effectiveness of delivery by primary workers of interventions for the promotion of mental health and universal prevention, and for the selective and indicated prevention of mental disorders or symptoms of mental illness in low- and middle-income countries (LMICs). To examine the impact of intervention delivery by primary workers on resource use and costs.

SEARCH METHODS

We searched CENTRAL, MEDLINE, Embase, CINAHL, Global Index Medicus, PsycInfo, WHO ICTRP, and ClinicalTrials.gov from inception to 29 November 2021.

SELECTION CRITERIA

Randomized controlled trials (RCTs) of primary-level and/or community health worker interventions for promoting mental health and/or preventing mental disorders versus any control conditions in adults and children in LMICs.

DATA COLLECTION AND ANALYSIS

Standardized mean differences (SMD) or mean differences (MD) were used for continuous outcomes, and risk ratios (RR) for dichotomous data, using a random-effects model. We analyzed data at 0 to 1, 1 to 6, and 7 to 24 months post-intervention. For SMDs, 0.20 to 0.49 represented small, 0.50 to 0.79 moderate, and ≥ 0.80 large clinical effects. We evaluated the risk of bias (RoB) using Cochrane RoB2.

MAIN RESULTS

Description of studies We identified 113 studies with 32,992 participants (97 RCTs, 19,570 participants in meta-analyses) for inclusion. Nineteen RCTs were conducted in low-income countries, 27 in low-middle-income countries, 2 in middle-income countries, 58 in upper-middle-income countries and 7 in mixed settings. Eighty-three RCTs included adults and 30 RCTs included children. Cadres of primary-level workers employed primary care health workers (38 studies), community workers (71 studies), both (2 studies), and not reported (2 studies). Interventions were universal prevention/promotion in 22 studies, selective in 36, and indicated prevention in 55 RCTs. Risk of bias The most common concerns over risk of bias were performance bias, attrition bias, and reporting bias. Intervention effects 'Probably', 'may', or 'uncertain' indicates 'moderate-', 'low-', or 'very low-'certainty evidence. *Certainty of the evidence (using GRADE) was assessed at 0 to 1 month post-intervention as specified in the review protocol. In the abstract, we did not report results for outcomes for which evidence was missing or very uncertain. Adults Promotion/universal prevention, compared to usual care: - probably slightly reduced anxiety symptoms (MD -0.14, 95% confidence interval (CI) -0.27 to -0.01; 1 trial, 158 participants) - may slightly reduce distress/PTSD symptoms (SMD -0.24, 95% CI -0.41 to -0.08; 4 trials, 722 participants) Selective prevention, compared to usual care: - probably slightly reduced depressive symptoms (SMD -0.69, 95% CI -1.08 to -0.30; 4 trials, 223 participants) Indicated prevention, compared to usual care: - may reduce adverse events (1 trial, 547 participants) - probably slightly reduced functional impairment (SMD -0.12, 95% CI -0.39 to -0.15; 4 trials, 663 participants) Children Promotion/universal prevention, compared to usual care: - may improve the quality of life (SMD -0.25, 95% CI -0.39 to -0.11; 2 trials, 803 participants) - may reduce adverse events (1 trial, 694 participants) - may slightly reduce depressive symptoms (MD -3.04, 95% CI -6 to -0.08; 1 trial, 160 participants) - may slightly reduce anxiety symptoms (MD -2.27, 95% CI -3.13 to -1.41; 1 trial, 183 participants) Selective prevention, compared to usual care: - probably slightly reduced depressive symptoms (SMD 0, 95% CI -0.16 to -0.15; 2 trials, 638 participants) - may slightly reduce anxiety symptoms (MD 4.50, 95% CI -12.05 to 21.05; 1 trial, 28 participants) - probably slightly reduced distress/PTSD symptoms (MD -2.14, 95% CI -3.77 to -0.51; 1 trial, 159 participants) Indicated prevention, compared to usual care: - decreased slightly functional impairment (SMD -0.29, 95% CI -0.47 to -0.10; 2 trials, 448 participants) - decreased slightly depressive symptoms (SMD -0.18, 95% CI -0.32 to -0.04; 4 trials, 771 participants) - may slightly reduce distress/PTSD symptoms (SMD 0.24, 95% CI -1.28 to 1.76; 2 trials, 448 participants).

AUTHORS' CONCLUSIONS

The evidence indicated that prevention interventions delivered through primary workers - a form of task-shifting - may improve mental health outcomes. Certainty in the evidence was influenced by the risk of bias and by substantial levels of heterogeneity. A supportive network of infrastructure and research would enhance and reinforce this delivery modality across LMICs.

Depression and anxiety in cancer patient enrolled in clinical trials with serious adverse events

OBJECTIVE

Drug-induced side effects, particularly serious adverse events (SAEs), often affect cancer patients enrolled in clinical trials. However, little is known about anxiety and depression in cancer patients who experienced SAEs. This study evaluated the prevalence of anxiety and depression in cancer patients enrolled in clinical trials who experienced SAEs and explored the risk factors.

METHODS

A multi-center, cross-sectional survey was conducted in hospitals affiliated with the University of Science and Technology of China from December 2021 to November 2022. A total of 112 cancer patients who experienced SAEs while enrolled in clinical trials, and who completed the informed consent process and study questionnaires, were included in the final analysis.

RESULTS

The rate of moderate-severe depression in cancer patients was 38.4% and that of moderate-severe anxiety was 13.4%. Among the patients who had moderate-severe anxiety, 93.3% had concurrent moderate-severe depression. Lower cognitive function and lower global quality of life were risk factors for depression in cancer patients who experienced SAEs. Pain, low emotional function, low global quality of life, and a high Impact of Events Scale score were risk factors for anxiety.

CONCLUSIONS

Cancer patients enrolled in a clinical trial who experienced SAEs tended to be anxious and depressed, particularly the latter. These results indicate the need to evaluate anxiety and depression, and mental health treatment among cancer patients with SAEs in clinical trials.

Effectiveness of healthy lifestyle-based interventions in lung cancer survivors: a systematic review and meta-analysis

PURPOSE

To assess the effectiveness of healthy lifestyle-based interventions in lung cancer survivors.

METHODS

We performed a literature search using PubMed, Web of Science, and Science Direct (last search March 2022). Quality assessment and risk of bias were assessed using the Downs and Black scale and the Cochrane tool. A systematic review and meta-analysis of randomized controlled trials were performed. We included controlled trials testing the effect of healthy lifestyle-based interventions in lung cancer survivors versus a control intervention where lung cancer patients had no treatment, were receiving the usual care, or had not an active role in the intervention. The data were pooled and a meta-analysis was completed for quality of life, psychological distress, and cancer-related symptoms.

RESULTS

We selected 14 studies, which included 1519 patients with lung cancer. The treatment status of these patients was heterogeneous. Healthy lifestyle programs were applied isolated or in combination with usual care in most of the studies. The components of the healthy lifestyle programs were also heterogeneous. Results showed significant differences in favor of healthy lifestyle-based interventions in comparison to the control group for quality of life (p = 0.01), psychological distress (p = 0.05), and cancer-related symptoms (p = 0.03).

CONCLUSIONS

The findings indicated a beneficial effect of healthy lifestyle-based interventions for improving quality of life, psychological distress, and cancer-related symptoms in lung cancer patients. However, this review could not show any conclusion about the better treatment moment to apply healthy lifestyle-based interventions.

REVIEW REGISTRATION

PROSPERO Identifier: CRD42021292152.

REVIEW REGISTRATION DATE

19/12/2021.

What should nurses do on post-stroke depression? A global systematic assessment of clinical practice guidelines

OBJECTIVES

Post-stroke depression (PSD) is the most common mental disorder in post-stroke patients. Yet, the recommendations related to nursing in clinical practice guidelines (CPGs) have not been systematically sorted out. This study aimed to assess the methodological quality of current CPGs related to PSD and develop an algorithm using nursing process as a framework for nurses.

DESIGN

A systematic assessment of CPGs.

INTERVENTIONS

A systematic search for relevant CPGs published between 2017 and 2022 was conducted. Appraisal of Guidelines for Research and Evaluation Ⅱ instrument was used to assess methodological quality. Recommendations related to nursing practice from high-quality CPGs were summarised and developed into an algorithm to provide reference for the standardised construction of nursing practice scheme.

RESULTS

497 records were initially identified from database searches and other sources. Finally, 12 CPGs were included, of which 6 were rated as high quality. A total of 35 recommendations from the 6 highest-scoring CPGs were summarised and used to develop an algorithm.

CONCLUSIONS

This study indicated deficiencies and variability in current available CPGs. Based on six high-quality CPGs, we developed an algorithm to facilitate nurses' adherence to CPGs and contribute to evidence-based nursing. In the future, more nursing specialists should participate in the formulation of the CPGs to provide nursing insights.

Influence of Psychological Nursing Procedure on Negative Emotion, Stress State, Quality of Life and Nursing Satisfaction in Patients with Lung Cancer Radical Operation

Objective

To discuss the influence of psychological nursing procedure on negative emotion, stress state, quality of life and nursing satisfaction in patients with lung cancer radical operation.

Methods

106 patients with lung cancer who underwent radical resection in our hospital from September 2019 to September 2021 were selected. According to the intervention time, patients were divided into Group A and Group B, with 53 cases in each group. Group A received routine nursing, Group B used psychological nursing procedure on the basis of Group A. The negative emotions, stress state, quality of life and nursing satisfaction of patient were observed.

Results

Self-rating anxiety scale and self-rating depression scale scores of Group B were lower than Group A (P &lt; 0.05). The levels of norepinephrine, epinephrine and cortisol in Group B were lower than Group A (P &lt; 0.05). Generic quality of life inventory-74 scores of Group B were higher than Group A (P &lt; 0.05). The nursing satisfaction of Group B (88.68%) was higher than Group A (73.58%) (P &lt; 0.05).

Conclusion

Psychological nursing procedure is conducive to reducing the negative emotion, relieving stress reaction, improving the quality of life, increasing nursing satisfaction of patients with lung cancer radical operation.