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Cramer-Kruit JJJ, Akkerman M, Mouton LJ, Niemeijer AS, Spek B, Scholten-Jaegers SMHJ, van der Woude LHV, Nieuwenhuis MK. Fatigue in children and adolescents after burns: evaluating the problem using longitudinal data. Disabil Rehabil 2024; 46:2828-2838. [PMID: 37723860 DOI: 10.1080/09638288.2023.2232729] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 06/29/2023] [Indexed: 09/20/2023]
Abstract
PURPOSE Describe prevalence and severity of fatigue in children and adolescents with burns during six months after hospital discharge, identify potential explanatory variables, and examine the relationship with exercise capacity. MATERIALS AND METHODS Fatigue was assessed using the Pediatric-Quality-of-Life-Inventory-Multidimensional-Fatigue-Scale (PedsQL-MFS) at discharge, and six weeks, three-, and six months after discharge. PedsQL-MFS scores ≥1 SD below the age-group specific non-burned reference mean were considered to signify fatigue. RESULTS Twenty-two children and adolescents (13 boys/9 girls, age 6-18 years, with burns covering 2-34% of total body surface area) were included. The prevalence of fatigue decreased from 65% (11/17) at discharge to 28% (5/18) six months after discharge. At group level, fatigue severity decreased over time, reaching healthy reference values from six weeks after discharge and beyond. At individual level, the course of fatigue severity varied widely. Fatigue severity at six months after discharge could not be predicted by age, sex, or burn severity (p = 0.51, p = 0.58, p = 0.95, respectively). The association with exercise capacity was weak (r = 0.062-0.538). CONCLUSIONS More than a quarter of pediatric burn patients reported fatigue six months after discharge. Further research in larger populations is required, including also the impact of burn-related fatigue on daily functioning and quality of life.Trial registration number: OND1353942Implications for rehabilitationFatigue should be recognized as a potential consequence of (pediatric) burns, even several months post burnFatigue should be assessed regularly after discharge in all children and adolescents with burns, as it seems not possible to predict its severity from age, sex, or burn severity characteristicsThe weak association between exercise capacity and self-reported fatigue suggests that burn-related fatigue is not simply a consequence of a reduced exercise capacity.
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Affiliation(s)
| | - Moniek Akkerman
- Burn Centre Groningen, Martini Hospital, Groningen, The Netherlands
- Association of Dutch Burn Centres, Burn Centre Groningen, Martini Hospital, Groningen, The Netherlands
| | - Leonora J Mouton
- Center for Human Movement Sciences, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Anuschka S Niemeijer
- Scientific Institute, Martini Hospital, Groningen, The Netherlands
- Burn Centre Groningen, Martini Hospital, Groningen, The Netherlands
- Association of Dutch Burn Centres, Burn Centre Groningen, Martini Hospital, Groningen, The Netherlands
| | - Bea Spek
- Epidemiology and Data Science, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Sonja M H J Scholten-Jaegers
- Burn Centre Groningen, Martini Hospital, Groningen, The Netherlands
- Association of Dutch Burn Centres, Burn Centre Groningen, Martini Hospital, Groningen, The Netherlands
| | - Lucas H V van der Woude
- Center for Human Movement Sciences, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Marianne K Nieuwenhuis
- Association of Dutch Burn Centres, Burn Centre Groningen, Martini Hospital, Groningen, The Netherlands
- Center for Human Movement Sciences, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- Research Group on Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences, Groningen, The Netherlands
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Nunes KZ, Grippa WR, Lopes AB, Gomes KN, Grassi J, Neto LCBS, Marcarini JAC, Felonta SM, Viana KCG, Lopes-Júnior LC. Cancer symptom clusters, cardiovascular risk, and quality of life of patients with cancer undergoing chemotherapy: A longitudinal pilot study. Medicine (Baltimore) 2024; 103:e37819. [PMID: 38640317 PMCID: PMC11029927 DOI: 10.1097/md.0000000000037819] [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: 05/15/2023] [Revised: 03/05/2024] [Accepted: 03/15/2024] [Indexed: 04/21/2024] Open
Abstract
Patients with cancer undergoing chemotherapy may have different cancer symptom clusters (CSC) that negatively impact their quality of life (QoL). These symptoms can sometimes arise from the disease itself or as a result of their cancer treatment. This study aimed to: examine the feasibility of longitudinal testing of CSC pattern and QoL in a sample of adult cancer patients undergoing outpatient chemotherapy; to identify the cardiovascular risk of patients with cancer undergoing outpatient chemotherapy; and to investigate the most prevalent CSC and their impact on the QoL of these patients. A longitudinal pilot study was conducted with eleven participants with a mean age of 56.09 years (range: 27-79) diagnosed with malignant neoplasm and undergoing outpatient chemotherapy treatment were evaluated during 6 cycles of chemotherapy. The CSC, cardiovascular risk, and QoL were assessed using the MSAS, FRS, and EQ-5D-3L™, respectively. Descriptive statistical and non-parametric bivariate analyses were performed. Patients who started chemotherapy treatment generally had a low to moderate cardiovascular risk and were likely to have a family history of hypertension, acute myocardial infarction, and stroke. Cardiovascular risk was found to be correlated with patient age (Rhos = 0.64; P = .033). In addition, the results showed a reduction in the QoL scoring over the 6 chemotherapy sessions. Regarding the most prevalent CSC, 2 clusters were identified: the neuropsychological symptom cluster (difficulty concentrating-sadness-worry) and the fatigue-difficulty sleeping cluster. Between the first and sixth chemotherapy sessions, there was a decrease in the perception of "mild" severity (P = .004) and an increase in the perception of "severe" and "very severe" (P = .003) for all symptoms. Adequate attention to CSC should be the basis for the accurate planning of effective interventions to manage the symptoms experienced by cancer patients.
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Affiliation(s)
- Karolini Zuqui Nunes
- Graduate Program in Nutrition and Health, Health Sciences Center at the Federal University of Espírito Santo (UFES), Vitoria, ES, Brazil
| | - Wesley Rocha Grippa
- Graduate Program in Public Health, Health Sciences Center at the Federal University of Espírito Santo (UFES), Vitoria, ES, Brazil
| | - Andressa Bolsoni Lopes
- Graduate Program in Nutrition and Health, Health Sciences Center at the Federal University of Espírito Santo (UFES), Vitoria, ES, Brazil
| | - Karoline Neumann Gomes
- Graduate Program in Nutrition and Health, Health Sciences Center at the Federal University of Espírito Santo (UFES), Vitoria, ES, Brazil
| | - Jonathan Grassi
- Graduate Program in Public Health, Health Sciences Center at the Federal University of Espírito Santo (UFES), Vitoria, ES, Brazil
| | - Luiz Claudio Barreto Silva Neto
- Graduate Program in Nutrition and Health, Health Sciences Center at the Federal University of Espírito Santo (UFES), Vitoria, ES, Brazil
| | - Julia Anhoque Cavalcanti Marcarini
- Graduate Program in Nutrition and Health, Health Sciences Center at the Federal University of Espírito Santo (UFES), Vitoria, ES, Brazil
| | | | | | - Luís Carlos Lopes-Júnior
- Graduate Program in Nutrition and Health, Health Sciences Center at the Federal University of Espírito Santo (UFES), Vitoria, ES, Brazil
- Graduate Program in Public Health, Health Sciences Center at the Federal University of Espírito Santo (UFES), Vitoria, ES, Brazil
- Nursing Department, Health Sciences Center at UFES, Vitoria, ES, Brazil
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Uluhan C, Akçay Didişen N. Effects of the re-mission video game on fatigue and quality of life levels of adolescents diagnosed with cancer: a randomized controlled trial. PSYCHOL HEALTH MED 2024; 29:603-614. [PMID: 38112283 DOI: 10.1080/13548506.2023.2289471] [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: 04/19/2022] [Accepted: 11/22/2023] [Indexed: 12/21/2023]
Abstract
The aim of this study was to investigate the effects of the Re-Mission video game on the fatigue and quality of life of adolescents diagnosed with cancer. A total of 46 adolescents aged who received inpatient chemotherapy treatment in the pediatric hematology clinic were enrolled in the study. The data were obtained by using the Personal Information Form, Scale for the Assessment of Fatigue in Pediatric Oncology Patients Aged 13-18 and Quality of Life scale. Intergroup comparisons demonstrated that there was a significant difference between the experimental and control groups in terms of their mean scores for the overall Scale for the Assessment of Fatigue and Quality of Life calculated at the baseline of the study and one month and three months. The use of Re-mission video game positively affected levels of fatigue and quality of life of adolescents aged between 13 and 18 diagnosed with cancer.
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Affiliation(s)
- Canan Uluhan
- Faculty Of Medicine, Department of Pediatric Hematology and Oncology, Ege University, Bornova-İzmir, Turkey
| | - Nurdan Akçay Didişen
- Faculty of Nursing, Department of Pediatric Nursing, Ege University, Bornova-İzmir, Turkey
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Wu WW, Yu TH, Jou ST, Hung GY, Tang CC. Factors associated with walking performance among adolescents undergoing cancer treatment: A correlational study. J Child Health Care 2023; 27:574-586. [PMID: 35337203 DOI: 10.1177/13674935221082400] [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] [Indexed: 11/16/2022]
Abstract
This study aimed to describe and compare the differences in walking performance between adolescent patients in inpatient wards and outpatient units, and to identify factors that influence walking performance among adolescents receiving cancer treatment. The cross-sectional study with correlational research design recruited 32 adolescents with cancer between February 2015 and March 2017 in two teaching hospitals in Taiwan. Descriptive, bivariate, and multivariate regression analyses were used. Participants' age, treatment setting, and symptom distress were significantly associated with number of walking steps. All independent variables in the model together accounted for 82.1% of variance. This study addresses a gap in the existing literature to identify associated factors that affected walking performance among adolescents undergoing cancer treatment. Our findings represent a pathway toward generating knowledge to enhance well-being for this unique population.
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Affiliation(s)
- Wei-Wen Wu
- School of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan
- Department of Nursing, National Taiwan University Hospital, Taipei, Taiwan
| | - Tsung-Hsien Yu
- Department of Health Care Management, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | - Shiann-Tarng Jou
- Department of Medicine, National Taiwan University, Taipei, Taiwan
| | - Giun-Yi Hung
- Department of Pediatrics, Division of Pediatric Hematology and Oncology, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Chia-Chun Tang
- School of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan
- Department of Nursing, National Taiwan University Hospital, Taipei, Taiwan
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Pires LBC, Salaroli LB, Lopes-Júnior LC. Effect of omega-3 supplementation on the nutritional status of patients with pancreatic cancer: A protocol for systematic review of clinical trials. Medicine (Baltimore) 2022; 101:e31262. [PMID: 36550825 PMCID: PMC9771200 DOI: 10.1097/md.0000000000031262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Globally, pancreatic cancer is the seventh most common cause of cancer-related death in both sexes, accounting for 466,003 deaths and 495,773 new cases in 2020. The purpose of this study was to synthesize and evaluate evidence on the effects of omega-3 supplementation on the nutritional status of patients with pancreatic cancer. METHODS This systematic review protocol will be guided by Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols. Five databases will be searched: MEDLINE/PubMed, CENTRAL Cochrane, EMBASE, Web of Science, and SCOPUS, with no restrictions on the publication date nor language. The internal validity and risk of bias of randomized controlled trials will be assessed using the revised Cochrane Risk-Of-Bias tool for randomized trials (RoB 2), whereas the risk of bias in non-randomized studies of interventions will be evaluated using the ROBINS-I. The heterogeneity among the studies will be assessed using the I2 statistic. Based on the results of this test, we will verify whether the meta-analysis would be feasible. If feasibility would be confirmed, a random-effect model analysis will be performed. For data analysis, the calculation of the pooled effect estimates will have a 95% confidence interval, while the alpha will be set to 0.05 using the R statistical software version 4.0.4. All methodological steps of this review will be performed independently by two reviewers and will be conducted and managed in the EPPI-Reviewer Software™. RESULTS This review may be of particular interest to researchers and clinicians, given the low survival and overall burden of patients with pancreatic cancer. Furthermore, the results of this systematic review may contribute to the development of new nutritional interventions in these patients. CONCLUSION To the best of our knowledge, this will be the first study to critically assess the scientific evidence and estimate the effect of omega-3 supplementation on the nutritional status of patients with pancreatic cancer. The review will perform a rigorous approach, adhering to the PRISMA Statement 2020 using a comprehensive and systematic search strategy in five databases and additional sources with no time period nor language restrictions.
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Affiliation(s)
- Luciana Bicalho Cevolani Pires
- Graduate Program in Nutrition and Health, Health Sciences Center at the Federal University of Espírito Santo (UFES), Vitória, Brazil
| | - Luciane Bresciani Salaroli
- Graduate Program in Nutrition and Health, Health Sciences Center at the Federal University of Espírito Santo (UFES), Vitória, Brazil
| | - Luís Carlos Lopes-Júnior
- Graduate Program in Nutrition and Health, Health Sciences Center at the Federal University of Espírito Santo (UFES), Vitória, Brazil
- * Correspondence: Luís Carlos Lopes-Júnior, Graduate Program in Public Health at the Federal University of Espírito Santo (UFES), Av. Marechal Campos, 1468 – Maruípe, Vitória, ES 29.043-900, Brazil (e-mail: )
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Nonpharmacological interventions for treating fatigue in adolescents: A systematic review and narrative synthesis of randomised controlled trials. J Psychosom Res 2022; 163:111070. [PMID: 36327529 DOI: 10.1016/j.jpsychores.2022.111070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 10/19/2022] [Accepted: 10/19/2022] [Indexed: 11/21/2022]
Abstract
OBJECTIVE Fatigue is common in adolescence and can be highly disabling if experienced persistently, with adverse psychosocial outcomes. There is a need to better understand what nonpharmacological treatments are available for adolescents suffering with persistent fatigue. The current review systematically identified, synthesised, and evaluated the evidence regarding nonpharmacological interventions for fatigue in adolescents, focusing on evaluating effectiveness, describing intervention components, and mapping interventions onto the behaviour change technique taxonomy (BCTT). METHODS CENTRAL, EMBASE, PsycINFO, PubMed, and Web of Science were systematically searched for articles including (1) adolescents aged 10-19 years old, (2) fatigue as a primary or secondary outcome, (3) nonpharmacological interventions, and (4) randomised controlled trials. Study screening, data extraction, quality assessment, and BCTT mapping were performed independently by two reviewers. Findings were presented as a narrative synthesis, with interventions ranked by promise. RESULTS 5626 papers were identified and double-screened, resulting in the inclusion of 21 articles reporting 16 trials. Five interventions were classified as likely promising. Interventions often involved psychoeducation, cognitive behavioural therapy, and/or physical activity, incorporating various BCTT domains, most commonly shaping knowledge, repetition and substitution, and goals and planning. However, there did not seem to be any observable differences between fatigue-targeted and non-fatigue-targeted interventions. Overall study quality was mixed, particularly in relation to power and outcome measures. CONCLUSION There are several promising nonpharmacological interventions for adolescent fatigue, although further work is needed to determine effectiveness. Future trials need to ensure design rigour, focusing on adequate powering, validated outcome measures, and adhering to best practice reporting guidelines.
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Van der Looven R, De Vos E, Vandekerckhove K, Coomans I, Laureys G, Dhooge C. Efficacy of interdisciplinary rehabilitation in child cancer survivors: Impact on physical fitness, fatigue and body composition after 1-year follow-up. Eur J Cancer Care (Engl) 2022; 31:e13761. [PMID: 36330596 DOI: 10.1111/ecc.13761] [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: 07/13/2022] [Revised: 09/30/2022] [Accepted: 10/09/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Childhood cancer survivors experience reduced physical activity level, participation as well as health-related quality of life. This prospective, pre-/post-intervention and follow-up cohort study aims to determine the efficacy of an interdisciplinary rehabilitation on improving physical fitness, fatigue and body composition. METHODS A total of 24 childhood cancer survivors (mean age: 12.15 years ± 3.2; 14 females; 10 males) were recruited 6 months after medical treatment and received a 4-month interdisciplinary intervention. Cardiorespiratory fitness (PredVO2peak and PredLoadmax ), body composition (dry lean weight) and quality of life (general fatigue) were assessed at baseline, post-intervention and 1-year follow-up. Linear mixed models were used to analyse data. RESULTS Linear mixed modelling revealed a significant main effect of time on predicted maximal load (F = 13.189, df = 36.179, p < 0.001), dry lean weight (F = 64.813, df = 37.019, p < 0.001) but also significant improvement of general fatigue score (-9.039 ± 4.300, 95% CI -17.741 to -0.336, p = 0.042), indicating a decline in general fatigue. CONCLUSION With emerging evidence that physical activity is safe and feasible, together with increasing numbers of childhood cancer survivors at risk for long-term chronic co-morbidities, this study advocates for better access to interdisciplinary rehabilitation programmes in order to improve their physical condition and their body composition and reduce fatigue.
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Affiliation(s)
- Ruth Van der Looven
- Child Rehabilitation Centre, Department of Physical and Rehabilitation Medicine, Ghent University Hospital, Ghent, Belgium
| | - Elise De Vos
- Child Rehabilitation Centre, Department of Physical and Rehabilitation Medicine, Ghent University Hospital, Ghent, Belgium
| | | | - Ilse Coomans
- Department of Pediatric Cardiology, Ghent University Hospital, Ghent, Belgium
| | - Geneviève Laureys
- Department of Pediatric Hematology, Oncology and Hematopoietic Stem Cell Transplantation, Ghent University Hospital, Ghent, Belgium
| | - Catharina Dhooge
- Department of Pediatric Hematology, Oncology and Hematopoietic Stem Cell Transplantation, Ghent University Hospital, Ghent, Belgium
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Levesque A, Caru M, Duval M, Laverdière C, Marjerrison S, Sultan S. Cancer-related fatigue in childhood cancer survivors: A systematic scoping review on contributors of fatigue and how they are targeted by non-pharmacological interventions. Crit Rev Oncol Hematol 2022; 179:103804. [PMID: 36087854 DOI: 10.1016/j.critrevonc.2022.103804] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 08/24/2022] [Accepted: 09/05/2022] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES We aimed to identify contributors to cancer-related fatigue (CRF), explore non-pharmacological interventions addressing CRF, and highlight which contributors were targeted by these interventions in childhood cancer survivors. METHODS We performed a search in various databases and used the PRISMA-ScR checklist. Findings were synthesized in various different tables and figures in accordance with our objectives. RESULTS We included 49 articles in this systematic scoping review. We identified 59 significant contributors. Depression and physical activity level were some of the most studied significant contributors. Ten interventional studies were identified (e.g., yoga, physical activity intervention) that addressed 6 contributors (e.g., physical activity level). DISCUSSION This review is the first to describe and relate contributors and non-pharmacological interventions targeting CRF in childhood cancer survivors. Important clinical implications could be derived from the variety of factors explaining CRF and how it is currently addressed.
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Affiliation(s)
- Ariane Levesque
- Department of Psychology, Université de Montreal, Montreal, Canada; Research Center, Sainte-Justine University Health Center, Montreal, Canada.
| | - Maxime Caru
- Department of Pediatric Hematology and Oncology, and Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA, USA
| | - Michel Duval
- Research Center, Sainte-Justine University Health Center, Montreal, Canada; Charles-Bruneau Cancer Care Center, Sainte-Justine University Health Center, Montreal, Canada; Department of Pediatrics, Université de Montreal, Montreal, Canada
| | - Caroline Laverdière
- Research Center, Sainte-Justine University Health Center, Montreal, Canada; Charles-Bruneau Cancer Care Center, Sainte-Justine University Health Center, Montreal, Canada; Department of Pediatrics, Université de Montreal, Montreal, Canada
| | - Stacey Marjerrison
- Department of Pediatrics, McMaster University Children's Hospital, Hamilton, Ontario, Canada
| | - Serge Sultan
- Department of Psychology, Université de Montreal, Montreal, Canada; Research Center, Sainte-Justine University Health Center, Montreal, Canada; Charles-Bruneau Cancer Care Center, Sainte-Justine University Health Center, Montreal, Canada; Department of Pediatrics, Université de Montreal, Montreal, Canada
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Karst JS, Hoag JA, Anderson LJ, Schmidt DJ, Schroedl RL, Bingen KM. Evaluation of fatigue and related factors in survivors of pediatric cancer and hematopoietic stem cell transplant. J Child Health Care 2022; 26:383-393. [PMID: 33913779 DOI: 10.1177/13674935211014748] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This study sought to better understand specific factors contributing to fatigue in survivors of pediatric cancer and hematopoietic stem cell transplant (HSCT). As part of a larger study evaluating long-term psychosocial functioning of pediatric cancer survivors, N = 87 participants completed measures assessing fatigue and emotional and behavioral functioning. Chart abstraction was used to catalog diagnosis, treatments received, treatment intensity, and late effects. Results suggest clinically significant fatigue in n = 4 (4.6%) of survivors participating in this study. Fatigue was greater for participants with more recent diagnoses and who were more recently off treatment and was positively associated with parent and self-report of internalizing (emotional) and externalizing (behavioral) symptoms. Participants with more severe late effects suffered greater fatigue; however, fatigue was not associated with treatment intensity or therapy type. Fatigue is an important variable to consider in evaluating the social, emotional, behavioral, and physical well-being of cancer and HSCT survivors. Interventions are needed to address fatigue directly, while also addressing both contributing factors to fatigue and potential negative outcomes that result from fatigue in survivorship.
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Affiliation(s)
- Jeffrey S Karst
- 5506Medical College of Wisconsin, Milwaukee, WI, USA.,Children's Hospital of Wisconsin, Milwaukee, WI, USA
| | - Jennifer A Hoag
- 5506Medical College of Wisconsin, Milwaukee, WI, USA.,Children's Hospital of Wisconsin, Milwaukee, WI, USA
| | - Lynnette J Anderson
- 5506Medical College of Wisconsin, Milwaukee, WI, USA.,Children's Hospital of Wisconsin, Milwaukee, WI, USA
| | - Debra J Schmidt
- 5506Medical College of Wisconsin, Milwaukee, WI, USA.,Children's Hospital of Wisconsin, Milwaukee, WI, USA
| | | | - Kristin M Bingen
- 5506Medical College of Wisconsin, Milwaukee, WI, USA.,Children's Hospital of Wisconsin, Milwaukee, WI, USA
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COVID-19 associated cognitive impairment: A systematic review. Cortex 2022; 152:77-97. [PMID: 35537236 PMCID: PMC9014565 DOI: 10.1016/j.cortex.2022.04.006] [Citation(s) in RCA: 75] [Impact Index Per Article: 37.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 03/07/2022] [Accepted: 04/09/2022] [Indexed: 01/25/2023]
Abstract
INTRODUCTION COVID-19 has a wide range of clinical manifestations. Neurological manifestations in COVID-19 patients were demonstrated during the pandemic, including cognitive impairment. This study aimed to determine any relationship between COVID-19 and cognitive complaints, such as dementia, mild cognitive impairment (MCI), or subjective cognitive decline (SCD). METHODS We performed a systematic review of MEDLINE via Ebsco, Cochrane EMBASE, SCOPUS, and LILACS electronic databases of observational studies with COVID-19 patients confirmed by serology or PCR who developed new cognitive impairment or deteriorated from previous cognitive impairment after infection. This review protocol was recorded on PROSPERO with registration number CRD 42021241590. RESULTS A total of 3.520 articles were retrieved and read. Twenty-two studies were selected for our review. A wide range of cognitive assessment tools (n = 25) was used. The most described affected domains in these studies were executive functions, attention, and episodic memory. Thirteen studies showed a pattern of cognitive impairment in processing speed, inattention, or executive dysfunction assessed through working memory. CONCLUSION This review highlights the high frequency of cognitive impairment after COVID-19 infection. However, we were unable to differentiate whether the cognitive impairment found corresponded to mild cognitive impairment or dementia through data from selected studies, and this issue serves as one objective of future studies to be addressed on this topic.
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Qualidade de vida da população infantojuvenil oncológica com e sem fadiga. ACTA PAUL ENFERM 2022. [DOI: 10.37689/acta-ape/2022ao0288345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Delgado-Bustamante RI, Rodríguez-Santillán E. Evidencia del ejercicio en el tratamiento de la fatiga relacionada al cáncer infantil. Revisión temática. Rev Salud Publica (Bogota) 2022. [DOI: 10.15446/rsap.v24n3.99217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Objetivo Recopilar la evidencia más reciente que soporte el uso del ejercicio y la actividad física para disminuir la fatiga relacionada al cáncer infantil.
Métodos Se llevó a cabo una búsqueda electrónica de literatura no mayor a cinco años. Posteriormente, los artículos se agruparon en categorías por tipo de estudio y se analizaron sus resultados de acuerdo con el objetivo planteado.
Resultados Fueron incluidos 16 artículos de diferentes diseños, incluyendo estudios clínicos y revisiones sistemáticas. De manera general, se muestran diferencias significativas en favor del ejercicio para disminuir la fatiga; también se reportan efectos positivos en otros aspectos como la movilidad funcional y la calidad de vida.
Conclusión Se respalda la idea de continuar generando evidencias para conocer de manera más puntual la dosificación del ejercicio dependiendo de todas las variables que se pueden presentar en el pediátrico oncológico.
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Ibiapina ARDS, Lopes-Junior LC, Veloso LUP, Costa APC, Silva FJGD, Sales JCES, Monteiro CFDS. Efeitos da musicoterapia sobre os sintomas de ansiedade e depressão em adultos com diagnóstico de transtornos mentais: revisão sistemática. ACTA PAUL ENFERM 2022; 35. [DOI: 10.37689/acta-ape/2022ar02212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/13/2023] Open
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Mora DC, Kristoffersen AE, Overvåg G, Jong MC, Mentink M, Liu J, Stub T. Safety of Complementary and Alternative Medicine (CAM) treatment among children and young adults who suffer from adverse effects of conventional cancer treatment: A systematic review. Integr Cancer Ther 2022; 21:15347354221105563. [PMID: 35726681 PMCID: PMC9218455 DOI: 10.1177/15347354221105563] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Background: Complementary and Alternative Medicine (CAM) is widely used around the world to treat adverse effects derived from cancer treatment among children and young adults. Parents often seek CAM to restore and maintain the child’s physical and emotional condition during and after cancer treatment. Objectives: The objectives of this review were (i) to identify literature that investigates CAM use for treating adverse effects of conventional cancer treatment, (ii) to investigate the safety of the included CAM modalities, and (iii) to evaluate the quality of included studies. Methods: Five scientific research databases were used to identify observational, quasi-experimental, and qualitative studies from January 1990 to May 2021. Included studies investigated the use of CAM to treat adverse effects of cancer treatment in childhood cancer. Results: Fifteen studies were included in this review. Ten quasi-experimental, 3 observational studies (longitudinal/prospective), 2 qualitative studies, and 1 study with a quasi-experimental and qualitative arm were identified. Less than half (n = 6; 40%) of the studies included reported adverse effects for the CAM modality being studied. Among the studies that reported adverse effects, they were mostly considered as direct risk, as 13% reported mainly bleeding and bruising upon acupuncture treatment, and dizziness with yoga treatment. All adverse effects were assessed as minor and transient. CAM modalities identified for treating adverse effects of cancer treatment were alternative medical systems, manipulative and body-based therapies, biologically-based therapies, and mind-body therapies. CAM modalities were used to alleviate anxiety, pain, toxicity, prevent trauma, and improve health-related quality of life, functional mobility, and physical activity levels. All studies assessed scored 70% or above according to the Joanna Briggs Institute critical appraisal for study quality checklists. Conclusion: Most of the studies (58.3%) included in this review did not report adverse effects from CAM modalities used to treat adverse effects of cancer treatment in children and young adults. This lack of safety information is of concern because parents need to know whether the modality represents an extra burden or harm to the child. To improve awareness about safety in the field, a universal and uniform reporting system for adverse effects in CAM research is needed.
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Affiliation(s)
- Dana C Mora
- UiT The Arctic University of Norway, Tromsø, Norway
| | | | | | - Miek C Jong
- UiT The Arctic University of Norway, Tromsø, Norway
| | - Marit Mentink
- Netherlands Institute for Health Services Research, Utrecht, The Netherlands
| | - Jianping Liu
- Beijing University of Chinese Medicine and Pharmacology, Beijing, China
| | - Trine Stub
- UiT The Arctic University of Norway, Tromsø, Norway
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15
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Lopes-Júnior LC, Veronez LC. Circadian rhythms disruption in cancer. BIOL RHYTHM RES 2021. [DOI: 10.1080/09291016.2021.1951470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Luís Carlos Lopes-Júnior
- Postgraduate Program in Nutrition and Health in Sciences. Health Sciences Center at the Universidade Federal Do Espírito Santo (UFES), Vitória, ES, Brazil
| | - Luciana Chain Veronez
- BSc in Biology., Ph.D. In Immunology. Post-doctoral Fellow at the Department of Childcare and Pediatrics at the Ribeirão PretoMedical School at the University of São Paulo (USP). (FMRP-USP)., Ribeirão Preto, SP, Brazil
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Kant-Smits K, Van Brussel M, Nijhof S, Van der Net J. Reducing fatigue in pediatric rheumatic conditions: a systematic review. Pediatr Rheumatol Online J 2021; 19:111. [PMID: 34238314 PMCID: PMC8268602 DOI: 10.1186/s12969-021-00580-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Accepted: 05/25/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Although fatigue is a prevalent distressing symptom in children and adolescents with Pediatric Rheumatic Conditions (PRCs), intervention studies designed for reducing fatigue in PRCs are limited. AIM To systematically review evidence regarding the efficacy of interventions intended to reduce fatigue in patients with PRCs. METHODS Comprehensive electronic searches were performed in PubMed/ MEDLINE, Embase, Web of Science and Cinahl. The risk of bias was assessed using the 'Revised Cochrane risk-of-bias tool for randomized trials' and 'Quality Assessment Tool for Before-After Studies With No Control Group' for respectively studies with and without a control group. RESULTS Ten out of 418 studies were included with a total of 240 participants (age range 5-23 years). Interventions included land-based and aquatic-based exercise therapy, prednisolone, vitamin-D and creatine supplementation, psychological therapy and a transition program into an adult rheumatology program. Fatigue was assessed with self-reported questionnaires in all included studies. Land-based exercise therapy was effective in one pre-post intervention study, whereas not effective in two randomized controlled trials. Aquatic-based exercise therapy was found more effective than land-based exercise therapy. Two placebo-controlled studies showed a significant positive effect in reducing subjective fatigue with prednisolone and vitamin-D. Creatine was not found effective. Cognitive therapy was effective in one pre-post intervention study, while one RCT did not show an effect in reducing fatigue. A transition program based on health education showed a small reducing effect, however, it was not clear if this was a significant effect. Six studies showed a high risk of bias, three studies a moderate risk, and one study had a low risk of bias. CONCLUSIONS Insufficient evidence is provided to substantiate the efficacy of current interventions to reduce fatigue in PRCs. The low number of studies, non-comparable interventions, risk of bias, and inconclusive outcomes of the included studies denote future research should focus on intervention studies aimed at the treatment of fatigue in children and adolescents with PRCs. Identification of possible underlying biological and psychosocial mechanisms as possible treatment targets to reduce complaints of fatigue in children and adolescents with PRCs is warranted.
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Affiliation(s)
- K Kant-Smits
- Department of Pediatrics, Wilhelmina Children's Hospital, Center for Child Development Exercise and Physical Literacy, University Medical Center Utrecht, Utrecht University, Suite KB.02.055.1, Internal mail KB.02.056.0, PO Box 85090, 3508, AB, Utrecht, The Netherlands
| | - M Van Brussel
- Department of Pediatrics, Wilhelmina Children's Hospital, Center for Child Development Exercise and Physical Literacy, University Medical Center Utrecht, Utrecht University, Suite KB.02.055.1, Internal mail KB.02.056.0, PO Box 85090, 3508, AB, Utrecht, The Netherlands
| | - S Nijhof
- Department of Pediatrics, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - J Van der Net
- Department of Pediatrics, Wilhelmina Children's Hospital, Center for Child Development Exercise and Physical Literacy, University Medical Center Utrecht, Utrecht University, Suite KB.02.055.1, Internal mail KB.02.056.0, PO Box 85090, 3508, AB, Utrecht, The Netherlands.
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Lopes-Júnior LC, Urbano IR, Schuab SIPDC, Pessanha RM, Rosa GS, Lima RAGD. Effectiveness of complementary therapies for the management of symptom clusters in palliative care in pediatric oncology: a systematic review. Rev Esc Enferm USP 2021; 55:03709. [PMID: 34037196 DOI: 10.1590/s1980-220x2020025103709] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Accepted: 09/22/2020] [Indexed: 12/29/2022] Open
Abstract
OBJECTIVE To evaluate the effectiveness of complementary therapies in the management of symptom clusters in children and adolescents with cancer undergoing palliative care. METHOD Systematic review guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses, resorting to the databases MEDLINE, Web of Science, Central Cochrane, and PsycINFO. The identification, selection, inclusion, extraction, and methodological assessment were conducted by two independent reviewers. RESULTS Five quasi-experiments met the eligibility criteria. The heterogeneous characteristics of the studies made meta-analysis impossible. Two studies used therapeutic massage, one used Reiki, one used boswellic acid, and one used Cannabis sativa; three of them (therapeutic massage and Reiki) presented statistically significant results for the management of the cluster pain-anxiety-worry-dyspnea. Most studies presented a moderate risk of bias as per ROBINS-I tool. CONCLUSION Therapeutic massage and Reiki may be effective for the symptom clusters management, especially the pain-anxiety-worry-dyspnea cluster in children and adolescents undergoing palliative care.
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Affiliation(s)
- Luís Carlos Lopes-Júnior
- Universidade Federal do Espírito Santo, Centro de Ciências da Saúde, Departamento de Enfermagem, Vitória, ES, Brazil
| | - Isadora Rangel Urbano
- Universidade Federal do Espírito Santo, Centro de Ciências da Saúde, Departamento de Enfermagem, Vitória, ES, Brazil
| | | | - Raphael Manhães Pessanha
- Universidade Federal do Espírito Santo, Centro de Ciências da Saúde, Departamento de Enfermagem, Vitória, ES, Brazil
| | - Gabriela Sylvestre Rosa
- Universidade Federal do Espírito Santo, Centro de Ciências da Saúde, Departamento de Enfermagem, Vitória, ES, Brazil
| | - Regina Aparecida Garcia de Lima
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, Departamento de Enfermagem Materno Infantil e Saúde Pública, Ribeirão Preto, SP, Brazil
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Cheng KKF, Tan LML. A pilot study of the effect of a home-based multimodal symptom-management program in children and adolescents undergoing chemotherapy. Cancer Rep (Hoboken) 2021; 4:e1336. [PMID: 33586920 PMCID: PMC8222554 DOI: 10.1002/cnr2.1336] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 12/28/2020] [Accepted: 01/04/2021] [Indexed: 12/12/2022] Open
Abstract
Background Prevalent symptoms that affect children and adolescents throughout the process of cancer diagnosis and treatment include nausea and vomiting, fatigue, pain, mucositis, and anxiety. Aim To examine the effect of a home‐based multimodal symptom‐management program for alleviation of nausea and vomiting, fatigue, pain, mucositis, and anxiety in children and adolescents undergoing chemotherapy for hematological malignancies or solid tumors. Methods In an exploratory pilot randomized study with qualitative interview, patients between 10 and 18 years of age were randomly assigned to either the symptom‐management program plus usual care (intervention group) or usual care (control group). The program consisted of multiple nonpharmacological interventional components. The targeted symptoms were measured at baseline (after diagnosis), at the first 2 weeks of each cycle of chemotherapy, and at 6 months after baseline, using the Memorial Symptom Assessment Scale 10‐18 and the State Anxiety Scale for Children. Results Fifty children (31 boys; mean age, 13.7 years) were randomized either to the intervention group or the control group (25 each) and underwent baseline assessment. A comparison between the groups showed that the intervention group had a significant less fatigue over time (P < .05). However, no differences were found with respect to nausea and vomiting, pain, mucositis, and anxiety between groups. Both children and parents reported a positive experience with the symptom‐management program. Conclusion The home‐based symptom‐management program may have helped to reduce fatigue in children and adolescents undergoing chemotherapy. In addition, qualitative data support the importance of improving children and parents' knowledge, coping skills, and psychological preparation for symptoms associated with chemotherapy.
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Affiliation(s)
- Karis Kin-Fong Cheng
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Laura Mei Lian Tan
- Paediatric Oncology, Department of Paediatrics, Khoo Teck Puat National University Children's Medical Institute, Singapore, Singapore
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Franco JHM, Evangelista CB, Rodrigues MDSD, Cruz RADO, Franco IDSMF, Freire ML. A musicoterapia em oncologia: percepções de crianças e adolescentes em cuidados paliativos. ESCOLA ANNA NERY 2021. [DOI: 10.1590/2177-9465-ean-2021-0012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Resumo Objetivo analisar as percepções de crianças e adolescentes com câncer em cuidados paliativos sobre a musicoterapia. Método pesquisa de campo, com abordagem qualitativa, realizada com sete crianças e adolescentes hospitalizadas. A técnica de desenho-estória foi realizada inicialmente a partir do desenho sobre os sentimentos diante da hospitalização e a estória do desenho. Em seguida, houve a interação musical, desenho sobre o significado da música diante do processo de hospitalização, e a estória do desenho. Para análise, utilizou-se a técnica de análise de conteúdo. Resultados antes da musicoterapia, crianças e adolescentes expressaram sentimentos de tristeza, medo e saudade relacionados ao rompimento do vínculo familiar durante o processo de hospitalização. Após receberem a musicoterapia, elas expressaram as sensações de prazer e bem-estar que essa vivência pode proporcionar, permitindo-lhes a expressão dos sentimentos mais profundos. Conclusão a musicoterapia pode beneficiar a criança e o adolescente com câncer uma vez que permite a expressão de sentimentos, possibilita o resgate de lembranças e proporciona esperança diante da situação vivenciada, além do alívio da dor. Implicações para a prática a musicoterapia contribui no processo paliativista, podendo conferir uma melhor qualidade de vida às crianças e adolescentes com câncer.
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Kolit Z, Şahin S, Davutoğlu C, Huri M. Effectiveness of a task-oriented training on occupational performance, functional independence, and fatigue in children with childhood cancer: a randomized-controlled trial. CADERNOS BRASILEIROS DE TERAPIA OCUPACIONAL 2021. [DOI: 10.1590/2526-8910.ctoao2129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Abstract Objective The objective of the study is to explore the effectiveness of task-oriented training (TOT) on occupational performance, functional independence, and fatigue of children with cancer. Method Two hundred and thirteen children (101 females, 112 males) with cancer were randomized to experimental (n = 112; 9.53±2.23 years) or control (n = 101; 7.93±1.98 years) groups. The experimental group received a TOT together with a conventional occupational therapy (COT), while the control group received only a COT. Both groups received 20 sessions of therapy. The outcomes regarding occupational performance via the Canadian Occupational Performance Measure, functional independence via the Functional Independence Measure for Children and fatigue via the Visual Analog Scale were evaluated by the blind evaluators before and after the interventions in the hospital setting. Results The occupational performance and satisfaction (p<0.001) scores showed statistically significant differences in the experimental group compared to the control group (p<0.01). A statistically significant improvement was determined in functional independence for both groups (p< 0.001). The experimental group indicated a significant reduction in fatigue (p values for fatigue before, during, after activity, morning and evening: p< 0.001) and in the control group (P values for fatigue all situation: p< 0.05). Conclusion The TOT seems to ensure more beneficial effects in increasing occupational performance, improving functional independence in daily activities, and decreasing fatigue at the early phases of inpatient treatment of childhood cancer.
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21
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Lopes-Júnior LC, Bomfim E, Olson K, Neves ET, Silveira DSC, Nunes MDR, Nascimento LC, Pereira-da-Silva G, Lima RAG. Effectiveness of hospital clowns for symptom management in paediatrics: systematic review of randomised and non-randomised controlled trials. BMJ 2020; 371:m4290. [PMID: 33328164 PMCID: PMC7737653 DOI: 10.1136/bmj.m4290] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/13/2020] [Indexed: 12/21/2022]
Abstract
OBJECTIVE To evaluate evidence from randomised controlled trials and non-randomised controlled trials on the effectiveness of hospital clowns for a range of symptom clusters in children and adolescents admitted to hospital with acute and chronic conditions. DESIGN Systematic review of randomised and non-randomised controlled trials. DATA SOURCES Medline, ISI of Knowledge, Cochrane Central Register of Controlled Trials, Science Direct, Scopus, American Psychological Association PsycINFO, Cumulative Index to Nursing and Allied Health Literature, and Latin American and Caribbean Health Sciences Literature. STUDY SELECTION Randomised and non-randomised controlled trials were peer reviewed using the following eligibility criteria: children and adolescents who were admitted to hospital for acute conditions or chronic disorders, studies comparing use of hospital clowns with standard care, and studies evaluating the effect of hospital clowns on symptom management of inpatient children and adolescents as a primary outcome. DATA EXTRACTION AND SYNTHESIS Two investigators independently screened studies, extracted data, and appraised the risk of bias. Methodological appraisal was assessed by two investigators independently using the Jadad scale, the revised Cochrane risk-of-bias tool for randomised controlled trials (RoB 2), and the risk of bias in non-randomised studies (ROBINS-I) tool for non-randomised controlled trials. RESULTS 24 studies (n=1612) met the inclusion criteria for data extraction and analysis. Most studies were randomised controlled trials (n=13). Anxiety was the most frequently analysed symptom (n=13), followed by pain (n=9), psychological and emotional responses and perceived wellbeing (n=4), stress (n=4), cancer related fatigue (n=3), and crying (n=2). Five studies used biomarkers, mainly cortisol, to assess stress or fatigue outcome following hospital clowns. Most of the randomised controlled trials (n=11; 85%) were rated as showing some concerns, and two trials were rated with a high risk of bias. Most non-randomised controlled trials (n=6; 55%) were rated with a moderate risk of bias according to ROBINS-I tool. Studies showed that children and adolescents who were in the presence of hospital clowns, either with or without a parent present, reported significantly less anxiety during a range of medical procedures, as well as improved psychological adjustment (P<0.05). Three studies that evaluated chronic conditions showed favourable results for the intervention of hospital clowns with significant reduction in stress, fatigue, pain, and distress (P<0.05). CONCLUSIONS These findings suggest that the presence of hospital clowns during medical procedures, induction of anaesthesia in the preoperative room, and as part of routine care for chronic conditions might be a beneficial strategy to manage some symptom clusters. Furthermore, hospital clowns might help improve psychological wellbeing in admitted children and adolescents with acute and chronic disorders, compared with those who received only standard care. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42018107099.
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Affiliation(s)
- Luís Carlos Lopes-Júnior
- Federal University of Espírito Santo, Avenida Marechal Campus, 1468 Maruípe, Vitória, 29.043-900, ES, Brazil
| | - Emiliana Bomfim
- University of Saskatchewan, College of Medicine, Saskatoon, SK, Canada
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Young adult cancer survivors' experience of taking part in a 12-week exercise referral programme: a qualitative study of the Trekstock RENEW initiative. Support Care Cancer 2020; 29:2613-2620. [PMID: 32964260 PMCID: PMC7981325 DOI: 10.1007/s00520-020-05746-w] [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: 04/16/2020] [Accepted: 09/04/2020] [Indexed: 01/03/2023]
Abstract
Purpose There is emerging evidence that physical activity interventions have the potential to improve the physical function and psychosocial well-being of young adult cancer survivors. However, most existing interventions for young adult cancer survivors have been delivered in an in-patient hospital setting. The purpose of this study is to explore young adult cancer survivors’ (YACS) experiences of the RENEW programme, a 12-week community-based exercise referral scheme delivered by Trekstock, a UK-based cancer charity. Methods Sixteen semi-structured interviews were conducted with YACS (mean age, 33 years; 87.5% female) who participated in the RENEW exercise referral programme. Each interview followed the same semi-structured interview guide which asked participants about their experiences of the RENEW programme and their ideas for the future development of the scheme. Data was audio-recorded, transcribed full verbatim and analysed using framework analysis. Results YACs predominantly chose to take part in the RENEW programme as a means to improve their health and overcome cancer related impairments (e.g. fatigue, loss of strength, low body confidence). The offer of one-to-one tailored support and unlimited gym access was often cited as a factor which motivated enrolment. Overall, YACS experience of the programme was positive with many describing improvements in physical function and general well-being. Barriers to participating in the programme included sign-off from clinicians prior to enrolment, travelling to the gym and fear of exercising alone. Conclusions Exercise referral schemes are acceptable to YACS and provide a promising opportunity for young people with cancer to improve their physical and psychosocial health through physical activity. Electronic supplementary material The online version of this article (10.1007/s00520-020-05746-w) contains supplementary material, which is available to authorized users.
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Lopes-Júnior LC, Bomfim E, Silveira DSCD, Pessanha RM, Schuab SIPC, Lima RAG. Effectiveness of mass testing for control of COVID-19: a systematic review protocol. BMJ Open 2020; 10:e040413. [PMID: 32847926 PMCID: PMC7451293 DOI: 10.1136/bmjopen-2020-040413] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 07/17/2020] [Accepted: 07/21/2020] [Indexed: 12/13/2022] Open
Abstract
INTRODUCTION Since March 2020, when the COVID-19 outbreak has been deemed a pandemic by the WHO, the SARS-CoV-2 spreading has been the focus of attention of scientists, authorities, public health agencies and communities around the world. One of the great concerns and challenges, mainly in low-income and middle-income countries, is the identification and monitoring of COVID-19 cases. The large-scale availability of testing is a fundamental aspect of COVID-19 control, but it is currently the biggest challenge faced by many countries around the world. We aimed to synthesise and critically evaluate the scientific evidence on the influence of the testing capacity for symptomatic individuals in the control of COVID-19. METHODS AND ANALYSIS A systematic review will be conducted in eight databases, such as Medical Literature Analysis and Retrieval System Online, ISI-of-Knowledge, Cochrane Central Register of Controlled Trials, Embase, SCOPUS, Latin American and Caribbean Health Sciences Literature, PsycINFO and Chinese National Knowledge Infrastructure, from inception to 30 July 2020. No restriction regarding the language, publication date or setting will be employed. Primary outcomes will include the sensitivity as well as the specificity of the tests for COVID-19. Study selection will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist. Methodological assessment of the studies will be evaluated by the Cochrane Risk-of-Bias tool for randomised controlled trials, the MINORS for non-randomised studies and the Newcastle-Ottawa Scale for cohort or case-control studies. Findings will be structured according to the test type and target population characteristics and focused on the primary outcomes (sensitivity and specificity). Moreover, if sufficient data are available, a meta-analysis will be performed. Pooled standardised mean differences and 95% CIs will be calculated. Heterogeneity between the studies will be determined by I2 statistics. Subgroup analyses will also be conducted. Publication bias will be assessed with funnel plots and Egger's test. Heterogeneity will be explored by random effects analysis. ETHICS AND DISSEMINATION Ethical approval is not required. The results will be disseminated widely via peer-reviewed publication and presentations at conferences related to this field. PROSPERO REGISTRATION NUMBER CRD42020182724.
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Affiliation(s)
- Luís Carlos Lopes-Júnior
- Nursing Department, Health Sciences Center, Universidade Federal do Espirito Santo (UFES), Vitoria, Brazil
| | - Emiliana Bomfim
- Department of Medicine, University of Saskatchewan College of Medicine, Saskatoon, Saskatchewan, Canada
| | | | - Raphael Manhães Pessanha
- Nursing Department, Health Sciences Center, Universidade Federal do Espirito Santo (UFES), Vitoria, Brazil
| | | | - Regina Aparecida Garcia Lima
- Maternal-Infant and Public Health Nursing Department, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirao Preto, Brazil
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Recommendations for the surveillance of cancer-related fatigue in childhood, adolescent, and young adult cancer survivors: a report from the International Late Effects of Childhood Cancer Guideline Harmonization Group. J Cancer Surviv 2020; 14:923-938. [PMID: 32839902 PMCID: PMC7572340 DOI: 10.1007/s11764-020-00904-9] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Accepted: 06/03/2020] [Indexed: 02/07/2023]
Abstract
PURPOSE Cancer-related fatigue (CRF) negatively affects the lives of childhood, adolescent, and young adult (CAYA) cancer survivors. We aimed to provide an evidence-based clinical practice guideline (CPG) with internationally harmonized CRF surveillance recommendations for CAYA cancer survivors diagnosed < 30 years. METHODS This CPG was developed by a multidisciplinary panel under the umbrella of the International Late Effects of Childhood Cancer Guideline Harmonization Group. After evaluating concordances and discordances of four existing CPGs, we performed systematic literature searches. We screened articles for eligibility, assessed quality, extracted, and summarized the data from included articles. We formulated recommendations based on the evidence and clinical judgment. RESULTS Of 3647 articles identified, 70 articles from 14 countries were included. The prevalence of CRF in CAYA cancer survivors ranged from 10-85%. We recommend that healthcare providers are aware of the risk of CRF, implement regular screening with validated measures, and recommend effective interventions to fatigued survivors. CONCLUSIONS A considerable proportion of CAYA cancer survivors suffers from CRF even years after the end of treatment. IMPLICATIONS FOR CANCER SURVIVORS We recommend that healthcare providers adopt regular screening to detect and treat CRF early and positively influence survivors' health and quality of life.
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Silva Junior FJGD, Sales JCES, Monteiro CFDS, Costa APC, Campos LRB, Miranda PIG, Monteiro TADS, Lima RAG, Lopes-Junior LC. Impact of COVID-19 pandemic on mental health of young people and adults: a systematic review protocol of observational studies. BMJ Open 2020; 10:e039426. [PMID: 32611746 PMCID: PMC7358102 DOI: 10.1136/bmjopen-2020-039426] [Citation(s) in RCA: 61] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
INTRODUCTION Since the WHO declared COVID-19 as a pandemic, the spread of the new coronavirus has been the focus of attention of scientists, governments and populations. One of the main concerns is the impact of this pandemic on health outcomes, mainly on mental health. Even though there are a few empirical studies on COVID-19 and mental health, so far, there is no systematic review about the impact of COVID-19 on mental health of young people and adults yet. We aim to critically synthesise the scientific evidence about the impact of the COVID-19 pandemic on the mental health of young people and adults. METHODS AND ANALYSIS A systematic review will be performed through eight databases: MEDLINE (Medical Literature Analysis and Retrieval System Online), ISI-of-Knowledge, CENTRAL (Cochrane Central Register of Controlled Trials), EMBASE (Excerpta Medica Database), SCOPUS, LILACS (Latin American and Caribbean Health Sciences Literature), PsycINFO (Psychology Information) and CNKI (Chinese National Knowledge Infrastructure), from inception until 30 June 2020. No restriction regarding the publication date, setting or languages will be considered. Preliminary search strategies were carried out on 29 March 2020 and will be updated in June 2020. The primary outcomes will be the prevalence and the severity of psychological symptoms in young people and adults (>18 years old) resulting from the impact of COVID-19 pandemic. Study selection will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist. Pooled standardised mean differences and 95% CIs will be calculated. The risk of bias of the observational studies will be assessed through the Methodological Index for Non-Randomised Studies (MINORS). Additionally, if sufficient data are available, a meta-analysis will be conducted. Heterogeneity between the studies will be determined by the I2 statistics. Subgroup analyses will also be performed. Publication bias will be checked with funnel plots and Egger's test. Heterogeneity will be explored by random-effects analysis. ETHICS AND DISSEMINATION Ethical assessment was not required. Findings will be disseminated through peer-reviewed publication and will be presented at conferences related to this field. PROSPERO REGISTRATION NUMBER CRD42020177366.
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Affiliation(s)
| | | | | | | | | | | | | | - Regina Aparecida Garcia Lima
- Maternal-Infant and Public Health Nursing Department, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirao Preto, São Paulo, Brazil
| | - Luis Carlos Lopes-Junior
- Health Sciences Center, Nursing Department, Universidade Federal do Espirito Santo, Vitoria, Espírito Santo, Brazil
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Casellas-Grau A, Ochoa C, Lleras De Frutos M, Flix-Valle A, Rosales A, Gil F. Perceived changes in psychological and physical symptoms after hospital clown performances in a cancer setting. Arts Health 2020; 13:189-203. [PMID: 32223531 DOI: 10.1080/17533015.2020.1744172] [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: 10/24/2022]
Abstract
Background: The therapeutic role of humor and hospital clowns has become a focus of interest in recent decades. Most of the research in the area has focused on children; here, we explore the influence of clown performances on adult cancer patients, their companions, and health-care staff.Methods: Ninety-nine cancer patients and 113 companions were assessed pre- and post-interventions performed by professional clowns; 31 health professionals were asked about the possible influence of the presence of clowns in hospital on their work.Results: Patients felt that clowning performances helped to reduce their level of psychological symptoms, but not their physical symptoms. Companions reported improvements in all the psychological symptoms explored. Health professionals reported that the presence of clowns in the workplace improved their well-being.Conclusions: Clowning performances helped to improve psychological functioning in all the populations studied, especially in companions. Adult hospitals should consider promoting clowning interventions to improve general well-being.
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Affiliation(s)
- A Casellas-Grau
- Institut Català d'Oncologia, L'Hospitalet de Llobregat, Spain.,Psychosocial Observatory in Cancer, L'Hospitalet de Llobregat, Spain.,Universitat De Vic - Universitat Central De Catalunya, Vic, Spain.,Universitat Autònoma De Barcelona, Cerdanyola del Vallès, Spain
| | - C Ochoa
- Institut Català d'Oncologia, L'Hospitalet de Llobregat, Spain.,Institut d'Investigació Biomèdica De Bellvitge, L'Hospitalet de Llobregat, Spain.,Universitat De Barcelona, Barcelona, Spain
| | - M Lleras De Frutos
- Institut Català d'Oncologia, L'Hospitalet de Llobregat, Spain.,Universitat De Barcelona, Barcelona, Spain
| | - A Flix-Valle
- Institut Català d'Oncologia, L'Hospitalet de Llobregat, Spain.,Institut d'Investigació Biomèdica De Bellvitge, L'Hospitalet de Llobregat, Spain
| | | | - F Gil
- Institut Català d'Oncologia, L'Hospitalet de Llobregat, Spain.,Psychosocial Observatory in Cancer, L'Hospitalet de Llobregat, Spain.,Universitat Autònoma De Barcelona, Cerdanyola del Vallès, Spain.,Escola Superior De Ciències De La Salut, Tecnocampus-Mataró, Universitat Pompeu Fabra, Mataró, Spain
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Xavier WDS, Pacheco STDA, Silva LFD, Nascimento LC, Lopes LC, Araújo BBMD, Nunes MDR. Intervenções não farmacológicas na melhoria da qualidade de vida de crianças/adolescentes oncológicos. ACTA PAUL ENFERM 2020; 33. [DOI: 10.37689/acta-ape/2020ar0022] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/13/2023] Open
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Swartz MC, Allen K, Deer RR, Lyons EJ, Swartz MD, Clifford T. A Narrative Review on the Potential of Red Beetroot as an Adjuvant Strategy to Counter Fatigue in Children with Cancer. Nutrients 2019; 11:E3003. [PMID: 31817919 PMCID: PMC6949985 DOI: 10.3390/nu11123003] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Revised: 12/04/2019] [Accepted: 12/06/2019] [Indexed: 01/04/2023] Open
Abstract
Cancer-related fatigue (CRF) is a debilitating adverse effect among children with cancer and a significant barrier to physical activity (PA) participation. PA interventions are effective at reducing fatigue and improving both quality of life (QOL) and functional outcomes in children with cancer. However, 50-70% of children with cancer do not meet PA guidelines. Thus, adjuvant methods are needed to increase PA participation. Given the growing interest in the use of beetroot juice to reduce exercise-induced fatigue, our narrative review evaluated the potential use of beetroot to improve PA participation to counter CRF and improve QOL. Our review of 249 articles showed a lack of published clinical trials of beetroot in children and adults with cancer. Trials of beetroot use had been conducted in a noncancer population (n = 198), and anticancer studies were primarily in the preclinical phase (n = 40). Although results are promising, with beetroot juice shown to counter exercise-induced fatigue in a variety of athletic and patient populations, its use to counter CRF in children with cancer is inconclusive. Pilot and feasibility studies are needed to examine the potential benefits of beetroot to counter CRF, increase PA participation, and improve QOL in children with cancer.
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Affiliation(s)
- Maria C. Swartz
- Department of Pediatrics-Research, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd., Houston, TX 77030-4009, USA
| | - Kaitlyn Allen
- Department of Nutrition and Metabolism, The University of Texas Medical Branch, 301 University Blvd., Galveston, TX 77555-1124, USA; (K.A.); (E.J.L.)
| | - Rachel R. Deer
- Division of Rehabilitation Sciences, The University of Texas Medical Branch, 301 University Blvd., Galveston, TX 77555-1137, USA;
| | - Elizabeth J. Lyons
- Department of Nutrition and Metabolism, The University of Texas Medical Branch, 301 University Blvd., Galveston, TX 77555-1124, USA; (K.A.); (E.J.L.)
| | - Michael D. Swartz
- Department of Biostatistics and Data Science, The University of Texas Health Science Center, School of Public Health, 1200 Pressler St., Houston, TX 77030, USA;
| | - Tom Clifford
- School of Sport, Exercise and Health Sciences, Loughborough University, Leicestershire LE11 3TU, UK;
- School of Biomedical, Nutritional and Sport Sciences, Newcastle University, Newcastle NE2 4HH, UK
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Wu WW, Yu TH, Jou ST, Hung GY. Physical activity self-efficacy mediates the effect of symptom distress on exercise involvement among adolescents undergoing cancer treatment. Eur J Cancer Care (Engl) 2019; 28:e13045. [PMID: 30993778 DOI: 10.1111/ecc.13045] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Revised: 02/11/2019] [Accepted: 03/25/2019] [Indexed: 11/29/2022]
Abstract
The objective of this study was to examine whether physical activity self-efficacy mediated the adverse effect of symptom distress on exercise involvement among adolescents undergoing cancer treatment. A secondary data analysis approach was used to analyse a pooled sample of 97 adolescents who were undergoing cancer treatment in paediatric oncology/haematology wards and ambulatory settings in northern Taiwan. Mediation analysis was performed to examine the mediation relationship among physical activity self-efficacy, symptom distress and exercise involvement. The total effect (path c) (p < 0.001), the indirect effect (paths a and b) (p < 0.05 and p < 0.01) and the direct effect (path c') (p < 0.001) were significant. The bootstrapping test was significant (95% CI: -0.356 to -0.016), indicating that physical activity self-efficacy partially mediated the adverse effect of symptom distress on exercise involvement after adjusting for age, gender and cancer diagnosis. Physical activity self-efficacy partially mediates the relationship between symptom distress and exercise involvement for adolescents undergoing cancer treatment. There is an imperative need for healthcare professionals to design interventions to enhance these adolescents' physical activity self-efficacy, increase their exercise involvement and thus improve their quality of life.
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Affiliation(s)
- Wei-Wen Wu
- School of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Tsung-Hsien Yu
- Department of Health Care Management, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | - Shiann-Tarng Jou
- Department of Medicine, National Taiwan University, Taipei, Taiwan
| | - Giun-Yi Hung
- Department of Pediatrics, Taipei Veterans General Hospital, Taipei, Taiwan
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30
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Rodgers CC, Hooke MC, Taylor OA, Koerner KM, Mitby PA, Moore IM, Scheurer ME, Hockenberry MJ, Pan W. Childhood Cancer Symptom Cluster: Leukemia and Health-Related Quality of Life. Oncol Nurs Forum 2019; 46:228-237. [PMID: 30767969 DOI: 10.1188/19.onf.228-237] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVES To examine the relationship of the Childhood Cancer Symptom Cluster-Leukemia (CCSC-L) with health-related quality of life (HRQOL). SAMPLE & SETTING 327 children receiving treatment for acute lymphoblastic leukemia from four pediatric oncology programs across the United States. METHODS & VARIABLES Participants completed fatigue, sleep disturbance, pain, nausea, and depression symptom questionnaires at four time points; these symptoms comprised the CCSC-L. HRQOL was measured at the start of postinduction therapy and then at the start of maintenance therapy. Relationships between the CCSC-L and HRQOL scores were examined with longitudinal parallel-process modeling. RESULTS The mean HRQOL significantly increased over time (p < 0.001). The CCSC-L had a significant negative association with HRQOL scores at the start of postinduction therapy (beta = -0.53, p < 0.005) and the start of maintenance therapy (beta = -0.33, p < 0.015). Participants with more severe symptoms in the CCSC-L over time had significantly lower HRQOL at the start of maintenance therapy (beta = -0.42, p < 0.005). IMPLICATIONS FOR NURSING Nurses are pivotal in providing management strategies to minimize symptom severity that may improve HRQOL.
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31
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Lopes-Junior LC, Silveira DSC, Olson K, Bomfim EO, Veronez LC, Santos JC, Alonso JB, Nascimento LC, Pereira-da-Silva G, Lima RAG. Clown Intervention on Psychological Stress and Fatigue in Pediatric Patients With Cancer Undergoing Chemotherapy. Cancer Nurs 2019; 43:290-299. [PMID: 30801267 DOI: 10.1097/ncc.0000000000000690] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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Lopes-Júnior LC, Lima RAG, Olson K, Bomfim E, Neves ET, Silveira DSCD, Nunes MDR, Nascimento LC, Pereira-da-Silva G. Systematic review protocol examining the effectiveness of hospital clowns for symptom cluster management in paediatrics. BMJ Open 2019; 9:e026524. [PMID: 30670530 PMCID: PMC6347896 DOI: 10.1136/bmjopen-2018-026524] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Revised: 11/19/2018] [Accepted: 12/03/2018] [Indexed: 12/31/2022] Open
Abstract
INTRODUCTION Clown intervention may playing an important complementary role in paediatric care and recovery. However, data on its utility for symptom cluster management of hospitalised children and adolescents in acute and chronic disorders are yet to be critically evaluated. As clinicians strive to minimise the psychological burden during hospitalisation, it is important that they are aware of the scientific evidences available regarding clown intervention for symptom management. We aim to provide quality evidence for the effectiveness of clown intervention on symptom cluster management in paediatric inpatients, both in acute and chronic conditions. METHODS AND ANALYSIS A systematic review of randomised controlled trials (RCTs) and non-randomised controlled trials (NRCTs) will be conducted. MEDLINE, Web of Science, Cochrane Library, Science Direct, PsycINFO, CINAHL, LILACS and SciELO databases will be searched from January 2000 to December 2018. Primary outcomes will include measures related with the effect of clown intervention on symptom cluster of paediatric inpatients (anxiety, depression, pain, fatigue, stress and psychological, emotional responses and perceived well-being). Study selection will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, and the methodological appraisal of the studies will be assessed by the Jadad Scale as well as Cochrane Risk-of-Bias Tool for RCTs, and Risk-of-Bias In Non-Randomized Studies Tool for NRCTs. A narrative synthesis will be conducted for all included studies. Also, if sufficient data are available, a meta-analysis will be conducted. The effect sizes will be generated using Hedges' g score for both fixed and random effect models. I 2 statistics will be used to assess heterogeneity and identify their potential sources. ETHICS AND DISSEMINATION As it will be a systematic review, without human beings involvement, there will be no requirement for ethical approval. Findings will be disseminated widely through peer-reviewed publication and in various media, for example, conferences, congresses or symposia. TRIAL REGISTRATION NUMBER CRD42018107099.
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Affiliation(s)
- Luís Carlos Lopes-Júnior
- WHO Collaborating Centre for Nursing Research Development. Ribeirão Preto, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirao Preto, Brazil
| | - Regina Aparecida Garcia Lima
- WHO Collaborating Centre for Nursing Research Development. Ribeirão Preto, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirao Preto, Brazil
| | - Karin Olson
- Faculty of Nursing, University of Alberta, Edmonton, Canada
| | - Emiliana Bomfim
- Department of Medicine, University of Saskatchewan, College of Medicine, Saskatoon, Canada
| | | | | | | | - Lucila Castanheira Nascimento
- WHO Collaborating Centre for Nursing Research Development. Ribeirão Preto, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirao Preto, Brazil
| | - Gabriela Pereira-da-Silva
- WHO Collaborating Centre for Nursing Research Development. Ribeirão Preto, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirao Preto, Brazil
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Carroll S, Chalder T, Hemingway C, Heyman I, Bear H, Sweeney L, Moss-Morris R. Adolescent and parent factors related to fatigue in paediatric multiple sclerosis and chronic fatigue syndrome: A comparative study. Eur J Paediatr Neurol 2019; 23:70-80. [PMID: 30455131 DOI: 10.1016/j.ejpn.2018.10.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Revised: 08/03/2018] [Accepted: 10/28/2018] [Indexed: 11/27/2022]
Abstract
BACKGROUND Fatigue is a disabling, poorly understood symptom in children and adolescents with multiple sclerosis (caMS), for which effective treatments are lacking. In paediatric Chronic Fatigue Syndrome (CFS), effective psychological interventions have been developed based on psychosocial factors associated with fatigue. This study aimed to identify potentially modifiable factors of fatigue in caMS by comparing caMS, adolescents with CFS, healthy adolescents and their parents on measures of fatigue, psychosocial factors, and neurocognitive functioning. METHODS 175 participants including 30 caMS (15 fatigued, 15 non-fatigued), 30 adolescents with CFS, 30 healthy controls, and their parents were compared on measures of self- and parent-reported fatigue, adolescent and parent cognitive behavioural responses to symptoms, sleep, psychological difficulties, parental distress and objectively measured neurocognitive functioning. RESULTS Fatigue severity, functional impairment and cognitive behavioural responses to symptoms were equivalent in fatigued caMS and adolescents with CFS, and were significantly higher than in healthy controls and non-fatigued caMS. Neurocognitive functioning was impaired in both caMS groups, but was normal in adolescents with CFS and healthy controls. No between-group differences were identified in adolescent sleep behaviour or psychological difficulties. Parents of all illness groups had more unhelpful cognitions than parents of healthy controls. Psychological distress was elevated in parents of both fatigued groups. CONCLUSIONS Fifty percent of caMS reported clinically significant fatigue. Similarities between adolescent and parent cognitive behavioural factors in fatigued caMS and adolescents with CFS suggest important potential targets for intervention. Both fatigued and non-fatigued caMS had cognitive difficulties, suggesting that fatigue may need targeted intervention.
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Affiliation(s)
- Susan Carroll
- Health Psychology Section, Institute of Psychiatry, Psychology & Neuroscience at King's College London, UK
| | - Trudie Chalder
- Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience at King's College London, UK
| | - Cheryl Hemingway
- Department of Neurology, Great Ormond Street Hospital for Children, London, UK; UCL, Institute of Child Health, Guildford Street, London, UK
| | - Isobel Heyman
- Department of Psychological Medicine, Great Ormond Street Hospital for Children, London, UK; UCL, Institute of Child Health, Guildford Street, London, UK
| | - Holly Bear
- Health Psychology Section, Institute of Psychiatry, Psychology & Neuroscience at King's College London, UK
| | - Louise Sweeney
- Health Psychology Section, Institute of Psychiatry, Psychology & Neuroscience at King's College London, UK
| | - Rona Moss-Morris
- Health Psychology Section, Institute of Psychiatry, Psychology & Neuroscience at King's College London, UK.
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Lopes-Júnior LC, Pereira-da-Silva G, Silveira DSC, Veronez LC, Santos JC, Alonso JB, Lima RAG. The Effect of Clown Intervention on Self-Report and Biomarker Measures of Stress and Fatigue in Pediatric Osteosarcoma Inpatients: A Pilot Study. Integr Cancer Ther 2018; 17:928-940. [PMID: 29900751 PMCID: PMC6142113 DOI: 10.1177/1534735418781725] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND Pediatric cancer patients experience different psychological processes during hospitalization that may regulate the immune response and affect recovery and response to cancer treatment. In this study, we aimed to examine the feasibility of longitudinal testing of psychophysiological parameters of stress and fatigue in pediatric osteosarcoma patients hospitalized for chemotherapy submitted to clown intervention; and to investigate whether changes in the levels of biomarkers are associated with psychological stress and fatigue levels in these patients after the clown intervention. METHODS A pretest-posttest quasi-experimental pilot study was conducted at the pediatric oncology inpatient unit in a comprehensive cancer care center in Brazil including children and adolescents with osteosarcoma hospitalized for chemotherapy. Eight saliva samples were collected, comprising 4 at baseline (pre-intervention) and 4 after the clown intervention (+1, +4, +9, and +13 hours post-awakening). Salivary cortisol, α-amylase (sAA), cytokines, and matrix metalloproteinase-9 (MMP-9) levels were determined using high-sensitivity enzyme-linked immunosorbent assay (ELISA) kits. Stress and fatigue were measured by Child Stress Scale-ESI and PedsQL Multidimensional Fatigue Scale respectively. Bivariate association analysis between stress and fatigue scores and biomarker levels were investigated using nonparametric statistics. Effect sizes were calculated for each outcome variable. RESULTS Six pediatric osteosarcoma patients were enrolled with no missing data. No significant effects sizes were observed for psychophysiological outcomes. Effect sizes ranged from 0.54 (cortisol) to 0 (interleukin-1β [IL-1β]). Decreasing overall trends were observed for cortisol levels for all 6 pediatric osteosarcoma patients over time. In addition, a similar pattern of tumor necrosis factor-α (TNF-α) levels over time was found for all 6 patients. Patients with metastatic osteosarcoma showed a linear trend for a decrease in MMP-9 levels between 1 and 9 hours after the clown intervention and restoration to basal levels after 13 hours. CONCLUSIONS The results of this pilot study suggest that it is feasible longitudinally measure psychophysiological outcomes in the pediatric osteosarcoma inpatients for chemotherapy. Clown intervention merits further study as a way to reduce stress as well as fatigue, since that the stress and cytokines measurements are feasible based on our work.
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Affiliation(s)
- Luis C Lopes-Júnior
- 1 University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, São Paulo, Brazil
| | - Gabriela Pereira-da-Silva
- 1 University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, São Paulo, Brazil.,2 University of São Paulo at Ribeirão Preto Medical School, Ribeirão Preto, São Paulo, Brazil
| | - Denise S C Silveira
- 2 University of São Paulo at Ribeirão Preto Medical School, Ribeirão Preto, São Paulo, Brazil
| | - Luciana C Veronez
- 2 University of São Paulo at Ribeirão Preto Medical School, Ribeirão Preto, São Paulo, Brazil
| | - Jéssica C Santos
- 2 University of São Paulo at Ribeirão Preto Medical School, Ribeirão Preto, São Paulo, Brazil
| | - Jonas B Alonso
- 1 University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, São Paulo, Brazil
| | - Regina A G Lima
- 1 University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, São Paulo, Brazil
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