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Jimenez-Labaig P, Aymerich C, Braña I, Rullan A, Cacicedo J, González-Torres MÁ, Harrington KJ, Catalan A. A comprehensive examination of mental health in patients with head and neck cancer: systematic review and meta-analysis. JNCI Cancer Spectr 2024; 8:pkae031. [PMID: 38702757 PMCID: PMC11149920 DOI: 10.1093/jncics/pkae031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Revised: 03/04/2024] [Accepted: 04/18/2024] [Indexed: 05/06/2024] Open
Abstract
BACKGROUND Patients with head and neck cancer present particularly considerable levels of emotional distress. However, the actual rates of clinically relevant mental health symptoms and disorders among this population remain unknown. METHODS A Preferred Reporting Items for Systematic Review and Meta-Analyses and Meta-analyses of Observational Studies in Epidemiology-compliant systematic review and quantitative random-effects meta-analysis was performed to determine suicide incidence and the prevalence of depression, anxiety, distress, posttraumatic stress, and insomnia in this population. MEDLINE, Web of Science, Cochrane Central Register, KCI Korean Journal database, SciELO, Russian Science Citation Index, and Ovid-PsycINFO databases were searched from database inception to August 1, 2023 (PROSPERO: CRD42023441432). Subgroup analyses and meta-regressions were performed to investigate the effect of clinical, therapeutical, and methodological factors. RESULTS A total of 208 studies (n = 654 413; median age = 60.7 years; 25.5% women) were identified. Among the patients, 19.5% reported depressive symptoms (95% confidence interval [CI] = 17% to 21%), 17.8% anxiety symptoms (95% CI = 14% to 21%), 34.3% distress (95% CI = 29% to 39%), 17.7% posttraumatic symptoms (95% CI = 6% to 41%), and 43.8% insomnia symptoms (95% CI = 35% to 52%). Diagnostic criteria assessments revealed lower prevalence of disorders: 10.3% depression (95% CI = 7% to 13%), 5.6% anxiety (95% CI = 2% to 10%), 9.6% insomnia (95% CI = 1% to 40%), and 1% posttraumatic stress (95% CI = 0% to 84.5%). Suicide pooled incidence was 161.16 per 100 000 individuals per year (95% CI = 82 to 239). Meta-regressions found a statistically significant higher prevalence of anxiety in patients undergoing primary chemoradiation compared with surgery and increased distress in smokers and advanced tumor staging. European samples exhibited lower prevalence of distress. CONCLUSIONS Patients with head and neck cancer presented notable prevalence of mental health concerns in all domains. Suicide remains a highly relevant concern. The prevalence of criteria-meeting disorders is significantly lower than clinically relevant symptoms. Investigating the effectiveness of targeted assessments for disorders in highly symptomatic patients is essential.
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Affiliation(s)
- Pablo Jimenez-Labaig
- Head and Neck Unit, The Royal Marsden NHS Foundation Trust, London, UK
- The Institute of Cancer Research, National Institute of Health Research Biomedical Research Centre, London, UK
| | - Claudia Aymerich
- Psychiatry Department, Basurto University Hospital. Osakidetza, Basque Health Service, Bilbao, Spain
- Biobizkaia Health Research Institute, OSI Bilbao-Basurto, Bilbao, Spain
- Centro de Investigación en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - Irene Braña
- Lung and Head & Neck Tumors Unit. Medical Oncology Department, Vall d‘Hebron University Hospital, Barcelona, Spain
- Vall d’Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Antonio Rullan
- Head and Neck Unit, The Royal Marsden NHS Foundation Trust, London, UK
- The Institute of Cancer Research, National Institute of Health Research Biomedical Research Centre, London, UK
| | - Jon Cacicedo
- Radiotherapy Department, Cruces University Hospital, Barakaldo, Spain
- Biobizkaia Health Research Institute, OSI Ezkerraldea Enkarterri Cruces, Barakaldo, Spain
- Faculty of Medicine, University of the Basque Country, Leioa, Spain
| | - Miguel Ángel González-Torres
- Psychiatry Department, Basurto University Hospital. Osakidetza, Basque Health Service, Bilbao, Spain
- Biobizkaia Health Research Institute, OSI Bilbao-Basurto, Bilbao, Spain
- Centro de Investigación en Red de Salud Mental (CIBERSAM), Madrid, Spain
- Neuroscience Department, University of the Basque Country (UPV/EHU), Leioa, Spain
| | - Kevin J Harrington
- Head and Neck Unit, The Royal Marsden NHS Foundation Trust, London, UK
- The Institute of Cancer Research, National Institute of Health Research Biomedical Research Centre, London, UK
| | - Ana Catalan
- Psychiatry Department, Basurto University Hospital. Osakidetza, Basque Health Service, Bilbao, Spain
- Biobizkaia Health Research Institute, OSI Bilbao-Basurto, Bilbao, Spain
- Centro de Investigación en Red de Salud Mental (CIBERSAM), Madrid, Spain
- Neuroscience Department, University of the Basque Country (UPV/EHU), Leioa, Spain
- Department of Psychiatry, University of Oxford, Oxford, UK
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Liang Y, Jing P, Gu Z, Shang L, Ge P, Zhang Y, Wang L, Qiu C, Zhu X, Tan Z. Application of the patient-reported outcome-based postoperative symptom management model in lung cancer: a multicenter randomized controlled trial protocol. Trials 2024; 25:130. [PMID: 38365704 PMCID: PMC10874066 DOI: 10.1186/s13063-024-07963-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Accepted: 02/01/2024] [Indexed: 02/18/2024] Open
Abstract
INTRODUCTION Lung cancer is the most common cancer in China, with the highest mortality rate. Surgery is the primary treatment for early lung cancer. However, patients with lung cancer have a heavy burden of symptoms within 3 months after surgery, which seriously affects their quality of life (QOL). The symptom management model based on the patient-reported outcome (PRO) is considered the best caregiving model. The clinical evidence about the symptom management of lung cancer within 3 months after the operation is very limited. Herein, we propose a randomized controlled trial to evaluate the PRO score-based monitoring and alert system for follow-up on psychological and physiological symptoms of lung cancer patients within 3 months after surgery and further investigate the effect of intervention measures based on this PRO score-based system. METHODS AND ANALYSIS This multicenter, open-label, randomized, parallel superiority trial will be conducted at four hospitals in China. A total of 440 lung cancer patients will be recruited in this study, who will be randomly assigned to the intervention group or the control group in a ratio of 1:1. Any of the target symptoms reaches the preset threshold (score ≥ 4), the patients will accept the symptom management advices based on the PRO. The patients in the control group will follow the current standard procedure of symptom management. The symptom management system is an electronic management system based on WeChat mini programs. All patients will be evaluated for symptoms through the lung cancer module of the MDASI lung cancer-specific scale on the day before surgery, days 1, 3, 5, and 7 after surgery, and once a week during the 12-week post-discharge period. Simultaneously, the EORTC QLQ-C30 scale will be used to evaluate patients' quality of life at baseline and the fourth and twelfth week after the surgery. The mean number of symptom threshold events of the intervention and the control groups were compared by t-test, and the changes of PRO were compared by a mixed effect model. The primary endpoint has been set as the 12-week post-discharge period. DISCUSSION This study will test the feasibility of the symptom management system based on the mobile social media applet in postoperative caregiving and the efficacy of psychiatrist-assisted treatment and provide evidence in managing the symptoms of patients in the medium and long term. TRIALS REGISTRATION Trials registration number: ChiCTR 2200058876, Registered 18 April 2022.
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Affiliation(s)
- Ying Liang
- Department of Health Statistics, Ministry of Education Key Lab of Hazard Assessment and Control in Special Operational Environment, Airforce Military Medical University (Fourth Military Medical University), Xi'an, 710032, Shaanxi Province, China
| | - Pengyu Jing
- Department of Thoracic Surgery, Tangdu Hospital, Xi'an, 710000, Shaanxi Province, China
| | - Zhongping Gu
- Department of Thoracic Surgery, Tangdu Hospital, Xi'an, 710000, Shaanxi Province, China.
| | - Lei Shang
- Department of Health Statistics, Ministry of Education Key Lab of Hazard Assessment and Control in Special Operational Environment, Airforce Military Medical University (Fourth Military Medical University), Xi'an, 710032, Shaanxi Province, China.
| | - Peng Ge
- Department of Thoracic Surgery, The Second Affiliated Hospital of Xi'an Medical College, Xi'an, 710038, Shaanxi Province, China
| | - Yong Zhang
- Department of Thoracic Surgery, The Affiliated Hospital of Shaanxi University of Traditional Chinese Medicine, XianYang, 712000, Shaanxi Province, China
| | - Lv Wang
- Department of Thoracic Surgery, Daxing Hospital, Xi'an, 710000, Shaanxi Province, China
| | - Chun Qiu
- Department of cerebral Surgery, Tangdu Hospital, Xi'an, Shaanxi Province, 710000, China
| | - Ximing Zhu
- Department of Thoracic Surgery, Tangdu Hospital, Xi'an, 710000, Shaanxi Province, China
| | - Zhijun Tan
- Department of Health Statistics, Ministry of Education Key Lab of Hazard Assessment and Control in Special Operational Environment, Airforce Military Medical University (Fourth Military Medical University), Xi'an, 710032, Shaanxi Province, China
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Fischl A, Gerken M, Roos P, Haedenkamp T, Hillberg A, Klinkhammer-Schalke M, Kölbl O, Linker R, Proescholdt M, Pukrop T, Riemenschneider MJ, Schmidt NO, Schön I, Vogelhuber M, Hau P, Bumes E. Does the distance to the cancer center affect psycho-oncological care and emergency visits of patients with IDH wild-type gliomas? A retrospective study. Neurooncol Pract 2023; 10:446-453. [PMID: 37720387 PMCID: PMC10502780 DOI: 10.1093/nop/npad023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/19/2023] Open
Abstract
Background Malignant isocitrate dehydrogenase wild-type (IDHwt) gliomas impose a high symptomatic and psychological burden. Wide distances from patients' homes to cancer centers may affect the delivery of psycho-oncological care. Here, we investigated, in a large brain tumor center with a rural outreach, the initiation of psycho-oncological care depending on spatial distance and impact of psycho-oncological care on emergency visits. Methods Electronic patient charts, the regional tumor registry, and interviews with the primary care physicians were used to investigate clinical data, psycho-oncological care, and emergency unit visits. Interrelations with socio-demographic, clinical, and treatment aspects were investigated using univariable and multivariable binary logistic regression analysis and the Pearson's Chi-square test. Results Of 491, 229 adult patients of this retrospective cohort fulfilled the inclusion criteria for analysis. During the last three months of their lives, 48.9% received at least one psycho-oncological consultation, and 37.1% visited the emergency unit at least once. The distance from the cancer center did neither affect the initiation of psycho-oncological care nor the rate of emergency unit visits. Receiving psycho-oncological care did not correlate with the frequency of emergency unit visits in the last three months of life. Conclusion We conclude that the distance of IDHwt glioma patients' homes from their cancer center, even in a rural area, does not significantly influence the rate of psycho-oncological care.
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Affiliation(s)
- Anna Fischl
- Department of Neurology and Wilhelm Sander-NeuroOncology Unit, Regensburg University Hospital, Regensburg, Germany
| | - Michael Gerken
- Center for Quality Assurance and Health Services Research, University of Regensburg, Regensburg, Germany
| | - Philipp Roos
- Department of Neurology and Wilhelm Sander-NeuroOncology Unit, Regensburg University Hospital, Regensburg, Germany
| | - Tareq Haedenkamp
- Department of Neurology and Wilhelm Sander-NeuroOncology Unit, Regensburg University Hospital, Regensburg, Germany
| | - Andrea Hillberg
- Department of Internal Medicine III, Regensburg University Hospital, Regensburg, Germany
| | - Monika Klinkhammer-Schalke
- Center for Quality Assurance and Health Services Research, University of Regensburg, Regensburg, Germany
| | - Oliver Kölbl
- Department of Radiotherapy, Regensburg University Hospital, Regensburg, Germany
| | - Ralf Linker
- Department of Neurology and Wilhelm Sander-NeuroOncology Unit, Regensburg University Hospital, Regensburg, Germany
| | - Martin Proescholdt
- Department of Neurosurgery, Regensburg University Hospital, Regensburg, Germany
| | - Tobias Pukrop
- Department of Internal Medicine III, Regensburg University Hospital, Regensburg, Germany
| | | | - Nils Ole Schmidt
- Department of Neurosurgery, Regensburg University Hospital, Regensburg, Germany
| | - Ingrid Schön
- Department of Internal Medicine III, Regensburg University Hospital, Regensburg, Germany
| | - Martin Vogelhuber
- Department of Internal Medicine III, Regensburg University Hospital, Regensburg, Germany
| | - Peter Hau
- Department of Neurology and Wilhelm Sander-NeuroOncology Unit, Regensburg University Hospital, Regensburg, Germany
| | - Elisabeth Bumes
- Department of Neurology and Wilhelm Sander-NeuroOncology Unit, Regensburg University Hospital, Regensburg, Germany
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Zhang Q, Tang L, Chen H, Chen S, Luo M, He Y, Liu M. Psychological outcomes of the systematic interventions based on the stress-induced situation, affective, bodily, and cognitive reactions framework for patients with lung cancer: A randomized clinical trial. Int J Nurs Stud 2023; 146:104566. [PMID: 37544148 DOI: 10.1016/j.ijnurstu.2023.104566] [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: 06/09/2022] [Revised: 07/09/2023] [Accepted: 07/17/2023] [Indexed: 08/08/2023]
Abstract
BACKGROUND Psychological distress is a multi-factorial unpleasant experience of a psychological, social, spiritual, and/or physical nature that may interfere with one's ability to cope effectively with cancer, physical symptoms and treatment. Psychological distress is common and affects the prognosis of cancer patients. Lung cancer accounted for 11.4 % of all new cancer cases and 18 % of all cancer mortality for 36 cancers in 185 countries. The prevalence of distress among Chinese lung cancer patients ranged from 10.1 % to 61.29 %. However, the existing intervention studies on the psychological distress in lung cancer patients are limited and intervention results may be different. OBJECTIVES To explore the psychological outcomes of a nurse-led systematic intervention program based on the stress-induced situation, affective, bodily, and cognitive reactions framework for patients with lung cancer undergoing operation at anxiety and depression. DESIGN A randomized clinical trial. SETTING Thoracic surgery ward in a tertiary hospital in China. PARTICIPANTS Lung cancer patients undergoing surgery. METHODS This is a 12-month longitudinal randomized controlled study in a tertiary hospital in China. A total of 240 lung cancer patients were randomly divided into either the control group or the intervention group. The nurse-led systematic intervention contents include psychological education, intervention measures based on the stress-induced situation, affective, bodily, and cognitive reactions framework, issuance of daily lifestyle cards, and regular follow-ups. The Hospital Anxiety and Depression Scale, Functional Assessment of Chronic Illness Therapy-Fatigue Scale, and Satisfaction with Life Scale were used for the baseline assessment within 48 h upon admission. The same assessment was performed respectively at 1, 3, 6 and 12 months after the intervention started. The effects of the systematic interventions on depression, anxiety, fatigue, and life satisfaction were tested by a linear mixed effects model. RESULTS Overall time-by-group interaction effects were significantly different with regard to anxiety, depression, and fatigue after controlling for the covariates, while a significant time-by-group interaction effect was not found for life satisfaction. Changes for anxiety and depression scores at 6 and 12 months after initiation of the intervention were significantly greater in the intervention group compared with those in the control group (t = 3.046, p = 0.002, t = 3.190, p = 0.001; t = 3.735, p = 0.000, t = 2.979, p = 0.002), whereas scores for fatigue were significantly higher in the intervention group at 6 and 12 months (t = -3.096, p = 0.002, t = -2.784, p = 0.005). CONCLUSION The systematic intervention program based on the stress-induced situation, affective, bodily, and cognitive reactions framework may effectively relieve anxiety, depression, and fatigue in lung cancer patients undergoing surgery. REGISTRATION This study was registered on December 22, 2019 with the registration number ChiCTR1900028487, and the date of first recruitment was Jan 5, 2020.
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Affiliation(s)
- Qingling Zhang
- Department of Medical Psychology, The Second Affiliated Hospital of Army Medical University, Chongqing 400037, China
| | - Lili Tang
- Department of Thoracic Surgery, The Second Affiliated Hospital of Army Medical University, Chongqing 400037, China
| | - Hui Chen
- Digestive Department, The Second Affiliated Hospital of Army Medical University, Chongqing 400037, China
| | - Shuanghong Chen
- Department of Medical Psychology, The Second Affiliated Hospital of Army Medical University, Chongqing 400037, China
| | - Maoyu Luo
- Department of Thoracic Surgery, The Second Affiliated Hospital of Army Medical University, Chongqing 400037, China
| | - Yuexia He
- Department of Thoracic Surgery, The Second Affiliated Hospital of Army Medical University, Chongqing 400037, China
| | - Minghua Liu
- Emergency Department, The First Affiliated Hospital of Army Medical University, Chongqing 400038, China.
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Caminiti C, Annunziata MA, Di Giulio P, Isa L, Mosconi P, Nanni MG, Piredda M, Verusio C, Diodati F, Maglietta G, Passalacqua R. Psychosocial Impact of Virtual Cancer Care through Technology: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Cancers (Basel) 2023; 15:cancers15072090. [PMID: 37046750 PMCID: PMC10093026 DOI: 10.3390/cancers15072090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 03/10/2023] [Accepted: 03/28/2023] [Indexed: 04/03/2023] Open
Abstract
This meta-analysis of RCTs aimed to determine whether replacing face-to-face hospital care with telemedicine deteriorates psychosocial outcomes of adult cancer patients, in terms of quality of life (QoL), anxiety, distress, and depression. RCTs on interventions aimed at improving patient psychosocial outcomes were excluded. MEDLINE, EmBASE, and PsycInfo were searched on 13 May 2022 without language or date restrictions. In total, 1400 records were identified and 8 RCTs included (4434 subjects). Study methodological quality was moderate. Statistically significant improvements were observed in favor of the intervention for QoL (SMD = 0.22, 95% CI 0.01 to 0.43, p = 0.04), anxiety (SMD = −0.17, 95% CI −0.30 to −0.04, p < 0.01), and global distress (SMD = −0.38, 95% CI −0.51 to −0.25, p < 0.01). A meta-analysis on depression could not be performed. In subgroup analyses, the intervention appeared to be more beneficial for patients receiving active treatment vs. follow-up, for “other cancer types” vs. breast cancer, and for “other modes of administration” vs. telephone. Given the many potential advantages of being assisted at home, telemedicine appears to be a viable option in oncology. However, more research is necessary to determine the types of patients who may benefit the most from these alternative care modalities.
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Affiliation(s)
- Caterina Caminiti
- Clinical and Epidemiological Research Unit, University Hospital of Parma, 43126 Parma, Italy
| | | | - Paola Di Giulio
- Department of Public Health and Pediatrics, University of Turin, 10124 Torino, Italy
| | - Luciano Isa
- Division of Oncology, Hospital of Melegnano, 20064 Gorgonzola, Italy
| | - Paola Mosconi
- Laboratory for Medical Research and Consumer Involvement, Department of Public Health, Istituto Di Ricerche Farmacologiche Mario Negri IRCCS, 20156 Milan, Italy
| | - Maria Giulia Nanni
- Department of Neuroscience and Rehabilitation, Institute of Psychiatry, University of Ferrara, 44121 Ferrara, Italy
| | - Michela Piredda
- Research Unit of Nursing Sciences, Campus Bio-Medico University of Rome, 00128 Rome, Italy
| | - Claudio Verusio
- Department of Medical Oncology, Presidio Ospedaliero di Saronno, ASST Valle Olona, 21047 Saronno, Italy
| | - Francesca Diodati
- Clinical and Epidemiological Research Unit, University Hospital of Parma, 43126 Parma, Italy
| | - Giuseppe Maglietta
- Clinical and Epidemiological Research Unit, University Hospital of Parma, 43126 Parma, Italy
| | - Rodolfo Passalacqua
- Medical Oncology Division, Department of Oncology, ASST of Cremona, 26100 Cremona, Italy
- Correspondence: ; Tel.: +39-0372-405237
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Hao H, Yang X, Zhu H, Wang Z, Zhang H, Huang C. Effect of the whole seamless connection of nursing from WeChat interactive platform on stigma and quality of life in patients with urinary system cancer. Digit Health 2022; 8:20552076221102772. [PMID: 35651732 PMCID: PMC9149617 DOI: 10.1177/20552076221102772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Accepted: 05/08/2022] [Indexed: 11/16/2022] Open
Abstract
Objective To evaluate the effects of intervention by “whole seamless connection of
nursing from WeChat interactive platform” on stigma and quality of life of
the patients with urinary system cancer. Methods Overall, 80 patients with urinary cancer were randomly divided (40 cases per
group) into control and observation groups. Routine nursing was provided to
the control group, whereas positive psychological intervention was provided
to the intervention group through a “whole seamless connection of nursing
from the WeChat interactive platform” in addition to routine nursing. The
Chinese version of social impact and cancer patients’ quality of life scales
were used to evaluate the effects before and after the intervention. Results After the intervention, the total score for stigma was significantly lower
(p < 0.01), while that of quality of life was higher
(p < 0.05) in the observation group relative to the
control group. Conclusions The whole seamless connection of nursing from the WeChat interactive platform
could reduce stigma and improve the quality of life of patients with urinary
cancer.
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Affiliation(s)
- Haiyan Hao
- Medical School of Nantong University, Jiangsu, P.R. China.,Department of Nursing, Affiliated Hospital of Nantong University, Nantong, P.R. China
| | - Xinyu Yang
- Medical School of Nantong University, Jiangsu, P.R. China
| | - Huixia Zhu
- Department of Nursing, Affiliated Hospital of Nantong University, Nantong, P.R. China
| | - Ziheng Wang
- Department of Clinical Biobank, Nantong University Affiliated Hospital, Nantong, P.R. China
| | - Haiyan Zhang
- Department of the Enhancement of Office, Affiliated Hospital of Nantong University, Nantong, P.R. China
| | - Chunxia Huang
- Department of Nursing, Affiliated Hospital of Nantong University, Nantong, P.R. China
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