Mood disorders and risk of lung cancer in the EAGLE case-control study and in the U.S. Veterans Affairs inpatient cohort

Flexible nursing in patients with lung cancer who received chemotherapy

OBJECTIVE

Flexible nursing refers to the implementation of individualized nursing according to the patient's condition and characteristics, which can greatly alleviate patients' anxiety, depression and other adverse emotions and improve patients' nursing satisfaction. This experiment studies the effect of the implementation of flexible nursing model for patients with lung cancer chemotherapy.

METHODS

We enrolled a total of 107 patients with lung cancer who were admitted to Respiratory and Critical Care Medicine Department (East District) of Anqing Municipal Hospital from November 2020 to May 2022 in the study. Patients were selected as per inclusion and exclusion criteria. We randomly divided the patients into the test group and control group using a random number table. Patients in the test group were given flexible nursing, while those in the control group received routine care. All patients completed the self-rating Anxiety Scale (SAS) score and Self-rating Depression Scale (SDS) score and calculated standard score before admission for chemotherapy, and completed the self-rating Anxiety Scale (SAS) score and self-rating Depression Scale (SDS) score and the Nursing Satisfaction Questionnaire of the Eastern Department of Respiratory and Critical Care Medicine of our hospital again at the time of discharge. The anxiety, depression and nursing satisfaction of the two groups before and after nursing were statistically analyzed. We statistically analyzed patients' anxiety and depression levels, as well as their appraisal of the nursing service.

RESULTS

Compared to the scores obtained at the time of admission, the anxiety and depression scores significantly decreased for patients in both groups at the time of discharge (P < 0.05). Decrease in the anxiety and depression scores for the test group was significantly higher than that in the control group (P < 0.05). Patients in the test group reported significantly greater satisfaction with the nursing care when compared to the control group (P < 0.05).

CONCLUSION

Flexible nursing can significantly decrease the anxiety and depression level in patients with lung cancer who receive chemotherapy and ensure more satisfactory nursing.

Prediction of the 1-Year Risk of Incident Lung Cancer: Prospective Study Using Electronic Health Records from the State of Maine

BACKGROUND

Lung cancer is the leading cause of cancer death worldwide. Early detection of individuals at risk of lung cancer is critical to reduce the mortality rate.

OBJECTIVE

The aim of this study was to develop and validate a prospective risk prediction model to identify patients at risk of new incident lung cancer within the next 1 year in the general population.

METHODS

Data from individual patient electronic health records (EHRs) were extracted from the Maine Health Information Exchange network. The study population consisted of patients with at least one EHR between April 1, 2016, and March 31, 2018, who had no history of lung cancer. A retrospective cohort (N=873,598) and a prospective cohort (N=836,659) were formed for model construction and validation. An Extreme Gradient Boosting (XGBoost) algorithm was adopted to build the model. It assigned a score to each individual to quantify the probability of a new incident lung cancer diagnosis from October 1, 2016, to September 31, 2017. The model was trained with the clinical profile in the retrospective cohort from the preceding 6 months and validated with the prospective cohort to predict the risk of incident lung cancer from April 1, 2017, to March 31, 2018.

RESULTS

The model had an area under the curve (AUC) of 0.881 (95% CI 0.873-0.889) in the prospective cohort. Two thresholds of 0.0045 and 0.01 were applied to the predictive scores to stratify the population into low-, medium-, and high-risk categories. The incidence of lung cancer in the high-risk category (579/53,922, 1.07%) was 7.7 times higher than that in the overall cohort (1167/836,659, 0.14%). Age, a history of pulmonary diseases and other chronic diseases, medications for mental disorders, and social disparities were found to be associated with new incident lung cancer.

CONCLUSIONS

We retrospectively developed and prospectively validated an accurate risk prediction model of new incident lung cancer occurring in the next 1 year. Through statistical learning from the statewide EHR data in the preceding 6 months, our model was able to identify statewide high-risk patients, which will benefit the population health through establishment of preventive interventions or more intensive surveillance.

Prevalence and Determinants of Depression and Anxiety Symptoms in Surgical Patients

OBJECTIVES

Mood disorders are prevalent in hospitalized patients. However, risk factors for early diagnosis have not been studied exclusively in surgical patients. Our study aimed to investigate the prevalence and determinants of depression and anxiety symptoms in surgical patients.

METHODS

We included 392 surgical patients in this prospective cross-sectional study, which took place between June 2011 and June 2012. The Hospital Anxiety and Depression Scale (HADS) was used to screen for symptoms of depression and anxiety at weekly interviews. Regression analysis was performed to identify risk factors for early (the day after admission) and late (one week or more) in-hospital psychiatry symptoms.

RESULTS

Depression and anxiety symptoms increased from the time of admission toward longer hospital stay. Scores obtained in the second and third weeks of admission were associated with the need for surgery while HADS in the third week was associated with lack of familial support and being under the poverty line (p < 0.050). Regression model analysis showed that early depression was associated with female gender, and early anxiety was inversely affected by female gender and protected by higher education level. A history of mood disorder was a risk factor. Later anxiety was also associated with longer hospital stay.

CONCLUSIONS

Depression and anxiety symptoms are a major concern in surgical patients especially in females and those with a history of mood disorders or lower educational level. Patients with a longer hospital stay, in particular, those with underlying diseases, postoperative complications, lack of familial support, and the need for reoperation were also at increased risk.

Lung and colorectal cancer treatment and outcomes in the Veterans Affairs health care system

Lung cancer (LC) and colorectal cancer (CRC) are the second- and third-most commonly diagnosed cancers in the Veterans Affairs (VA) health care system. While many studies have evaluated the treatment quality and outcomes of various aspects of VA LC and CRC care, there are no known reviews synthesizing this information across studies. The purpose of this literature review was to describe LC and CRC treatment (ie, surgical and nonsurgical) and outcomes (eg, mortality, psychosocial, and other) in the VA health care system as reported in the existing peer-reviewed scientific literature. We identified potential articles through a search of published literature using the PubMed electronic database. Our search strategy identified articles containing Medical Subject Headings terms and keywords addressing veterans or veterans' health and LC and/or CRC. We limited articles to those published in the previous 11 years (January 1, 2003 through December 31, 2013). A total of 230 articles were retrieved through the search. After applying the selection criteria, we included 74 studies (34 LC, 47 CRC, and seven both LC and CRC). VA provides a full array of treatments, often with better outcomes than other health care systems. More work is needed to assess patient-reported outcomes.

[Consequences of hospitalisations on smoking behaviour in psychiatric and somatic inpatients]

BACKGROUND

To examine the differences and potential changes that occur in smoking habits among psychiatric and somatic patients due to and during their hospital stay in a general hospital.

METHODS

Inpatients of three departments (psychiatry,cardiology, pulmology) were given a questionnaire that asked for epidemiologic data and their smoking habits,including the Fagerstrom-Test. In order to achieve sufficient data, the questionnaire was administered twice on two different dates. Primary goal of this examination was to determine a potential change in smoking behaviour whereas the secondary goal was to check for differences between psychiatric and somatic inpatients and within the psychiatric diagnostic groups according to their smoking habits respectively. According to a lack of normal distribution of the data non parametric tests undvisual classifying were used for statistical analysis.

RESULTS

A substantial proportion (26.4 %) of psychiatric inpatients reported an increase in cigarette consumption or have restarted or newly started smoking cigarettes are due to their admission. On the other hand, none of the somatic patients did so, actually they showed higher proportion of being non-smokers. There were statistically significant differences between psychiatric and somatic patients in two age-groups due to their change in smoking habits and severity of nicotine dependence as measured by the Fagerstrom-test. Among the psychiatric patients sampled, those with schizophrenia and affective disorders showed high prevalence of being highly addicted smokers in 85.7 and 44.4 % respectively.

CONCLUSIONS

As a result of this small sample and hindered comparability of somatic and psychiatric groups of inpatients further investigations are needed to evaluate the influence of hospitalisations on smoking behaviour and to tailor suitable actions