Effect of Comprehensive Nursing Based on Cognitive Behavior on Psychological Function of Glioma Patients

Cognitive-behavioural therapy effectiveness for fear of cancer recurrence: systematic review and meta-analysis

OBJECTIVE

Fear of cancer recurrence is one of the psychological distresses for patients with cancer and cancer survivors, which poses a physical and psychological threat. There is scant evidence on the effectiveness of cognitive-behavioural therapy in reducing fear of cancer recurrence. Therefore, we conducted a systematic review and meta-analysis to assess the effectiveness of cognitive-behavioural therapy for fear of cancer recurrence.

METHOD

The review was reported according to Preferred Reporting Items for Systematic Review and Meta-analyses statement. Seven databases were systematically searched from inception to 31 March 2023. Randomised controlled trials implementing cognitive-behavioural therapy interventions and studies reporting fear of cancer recurrence were included. The methodological quality of included studies was assessed using the Cochrane Risk of Bias Tool 2.

RESULTS

A total of 32 randomised controlled trials involving 1515 cancer survivors and 1845 patients with cancer undergoing treatment were included. The meta-analysis indicated a significant effect of cognitive-behavioural therapy on fear of cancer recurrence in patients with cancer and cancer survivors compared with controls (g=-0.65; 95% CI=-0.86, -0.44; p<0.001). The results of the overall risk of bias indicated some concerns in 4 studies and a high risk in 28 studies.

CONCLUSION

The study indicated the effectiveness of cognitive-behavioural therapy intervention for fear of cancer recurrence in patients with cancer and cancer survivors, which should inform future clinical practice of interventions for the treatment of fear of cancer recurrence.

PROSPERO REGISTRATION NUMBER

CRD42023404948.

[Rational treatment of depressive syndromes in brain tumor patients]

BACKGROUND

Brain tumors represent a disease that causes both physical and psychological distress for those affected. The pharmacological treatment of depressive symptoms in particular has not been sufficiently researched in these patients. Depression can severely affect the quality of life and has an impact on the course of the disease.

OBJECTIVE

The aim of this work is to describe the diagnosis and treatment of depressive symptoms in brain tumor patients.

MATERIAL AND METHODS

For this work a comprehensive literature search was conducted to identify relevant studies addressing the topic of depressive symptoms in brain tumors. The included studies were critically appraised to ensure their quality and relevance.

RESULTS

The review of the literature revealed that depressive symptoms are a common complication in brain tumor patients. It was found that there are no studies to date on the efficacy of antidepressant medications in brain tumor patients.

DISCUSSION

The results of this work highlight the need to pay increased attention to mental health in brain tumor patients. It is important that healthcare professionals identify depression in these patients at an early stage and provide appropriate interventions to improve their quality of life. Future research should focus on further exploring the mechanisms behind the association between brain tumors and depression in order to develop targeted and effective intervention options.

Is digital intervention for fear of cancer recurrence beneficial to cancer patients?: A systematic review and meta-analysis

OBJECTIVE

This study aimed to compare the effectiveness of digital and face-to-face interventions in reducing fear of cancer recurrence (FCR) among individuals with cancer.

METHODS

This study was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for evaluating the efficacy of psychological interventions for FCR published between July 2018 and December 2021. We searched for research papers using PubMed, Embase, and Cochrane and assessed their quality using the Revised Cochrane risk-of-bias tool for randomized trials.

RESULTS

Of the 2113 identified studies, we analyzed 17 samples (N = 1482) from 14 studies, of which 13 were RCTs. The overall sample showed a moderate effect size (Hedges' g = 0.607; 0.356 to 0.858; p < 0.001; I2  = 81.29%) in FCR reduction. The overall effect size was 0.621 (95% CI, 0.276 to 0.966; p < 0.001; I2  = 81.78%) for face-to-face interventions and 0.517 (95% CI, 0.093 to 0.941; p = 0.017; I2  = 83.19%) for digital interventions. The difference between the two effect sizes was not statistically significant.

CONCLUSION

Our meta-analysis suggests that digital interventions are moderately effective in reducing FCR, similar to face-to-face interventions. However, given the high degree of heterogeneity, this conclusion should be interpreted with caution. Further studies are required to identify the most effective digital interventions and the populations that may benefit from them.

Depression and anxiety in glioma patients

AbstractGlioma patients carry the burden of having both a progressive neurological disease and cancer, and may face a variety of symptoms, including depression and anxiety. These symptoms are highly prevalent in glioma patients (median point prevalence ranging from 16-41% for depression and 24-48% for anxiety when assessed by self-report questionnaires) and have a major impact on health-related quality of life and even overall survival time. A worse overall survival time for glioma patients with depressive symptoms might be due to tumor progression and/or its supportive treatment causing depressive symptoms, an increased risk of suicide or other (unknown) factors. Much is still unclear about the etiology of depressive and anxiety symptoms in glioma. These psychiatric symptoms often find their cause in a combination of neurophysiological and psychological factors, such as the tumor and/or its treatment. Although these patients have a particular idiosyncrasy, standard treatment guidelines for depressive and anxiety disorders apply, generally recommending psychological and pharmacological treatment. Only a few nonpharmacological trials have been conducted evaluating the efficacy of psychological treatments (eg, a reminiscence therapy-based care program) in this population, which significantly reduced depressive and anxiety symptoms. No pharmacological trials have been conducted in glioma patients specifically. More well-designed trials evaluating the efficacy of nonpharmacological treatments for depressive and anxiety disorders in glioma are urgently needed to successfully treat psychiatric symptoms in brain tumor patients and to improve (health-related) quality of life.

Palliative care and end-of-life care in adults with malignant brain tumors

BACKGROUND

This systematic review provides updated insights, from the published literature in the past 5 years, based on the 2017 European Association of Neuro-Oncology (EANO) guidelines for palliative care in adults with malignant brain tumors. It provides an overview of palliative care options, including during the end-of-life phase for patients with malignant brain tumors.

METHODS

A systematic literature search was conducted from 2016 to 2021 focusing on four main topics: (1) symptom management, (2) caregiver needs, (3) early palliative care, and (4) care in the end-of-life phase. An international panel of palliative care experts in neuro-oncology synthesized the literature and reported the most relevant updates. A total of 140 articles were included.

RESULTS

New insights include that: Hippocampal avoidance and stereotactic radiosurgery results in a lower risk of neurocognitive decline in patients with brain metastases; levetiracetam is more efficacious in reducing seizures than valproic acid as first-line monotherapy antiseizure drug (ASD) in glioma patients; lacosamide and perampanel seem well-tolerated and efficacious add-on ASDs; and a comprehensive framework of palliative and supportive care for high-grade glioma patients and their caregivers was proposed. No pharmacological agents have been shown in randomized controlled trials to significantly improve fatigue or neurocognition.

CONCLUSIONS

Since the 2017 EANO palliative care guidelines, new insights have been reported regarding symptom management and end-of-life care, however, most recommendations remain unchanged. Early palliative care interventions are essential to define goals of care and minimize symptom burden in a timely fashion. Interventional studies that address pain, fatigue, and psychiatric symptoms as well as (the timing of) early palliative care are urgently needed.

Effects of comprehensive nursing on postoperative complications, mental status and quality of life in patients with glioma

BACKGROUND

The complexity and refractory of brain glioma requires treatment that should involve a multidisciplinary approach to improve quality of care and fulfill patients’ needs.

AIM

To explore the effects of comprehensive nursing on postoperative complications, psychological state and quality of life in patients with brain glioma.

METHODS

A total of 106 patients with confirmed brain gliomas admitted to Nanchong Central Hospital between January 2019 and May 2021 were selected by random sampling. They were categorized into an observation group and a control group using a random number table with 53 patients in each group. Patients in the observation group were given comprehensive nursing in addition to conventional nursing and patients in the control group were given conventional nursing. The overall incidence of postoperative complications including limb dysfunction, high fever and epilepsy was compared between the two groups. The mental status was evaluated in the two groups before and after intervention using self-rating anxiety scale (SAS) and self-rating depression scale (SDS). Quality of life was assessed and compared using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire between the two groups before and after the intervention.

RESULTS

After intervention, the overall incidence of postoperative complications was significantly lower in the observation group (7.55%) than that in the control group (20.75%) (P < 0.05). Before intervention, there was no significant difference in SAS and SDS scores between the two groups (P > 0.05). However, after intervention, scores of SAS and SDS decreased in the two groups compared with those before intervention, and the scores of SAS and SDS were lower in the observation group than in the control group (all P < 0.05). There was no significant difference in quality of life between the two groups before the intervention (P > 0.05). In contrast, quality of life increased in the two groups compared with those before intervention, and it was higher in the observation group than in the control group (P < 0.05).

CONCLUSION

Comprehensive nursing can reduce the incidence of postoperative complications, improve the psychological state of anxiety and depression and improve quality of life in patients with brain glioma.

Effect of High-Quality Nursing Based on Comprehensive Nursing on the Postoperative Quality of Life and Satisfaction of Patients with Malignant Glioma

Objective

To explore the effect of high-quality nursing based on comprehensive nursing on postoperative quality of life and satisfaction of patients with malignant glioma.

Methods

From September 2017 to May 2020, 86 patients with malignant glioma treated in our hospital were recruited and assigned (1 : 1) to receive either comprehensive nursing (comprehensive group) or high-quality nursing plus comprehensive nursing (high-quality group). Outcome measures included preoperative and postoperative self-rating anxiety scale (SAS) scores, self-rating depression scale (SDS) scores, quality of life, and nursing satisfaction.

Results

High-quality nursing plus comprehensive nursing was associated with significantly lower SAS and SDS scores versus comprehensive nursing alone (P < 0.05). Patients receiving high-quality nursing plus comprehensive nursing showed higher quality of life scores versus those only given comprehensive nursing (P < 0.05). High-quality nursing plus comprehensive nursing resulted in higher nursing satisfaction of the patients versus comprehensive nursing alone (P < 0.05).

Conclusion

High-quality nursing can relieve the negative emotions of patients with malignant glioma and significantly enhance their quality of life, thereby improving the nursing satisfaction of patients with nursing, so it is worthy of clinical application.

Cerebral mechanism of opposing needling for managing acute pain after unilateral total knee arthroplasty: study protocol for a randomized, sham-controlled clinical trial

Background

Opposing needling is a unique method used in acupuncture therapy to relieve pain, acting on the side contralateral to the pain. Although opposing needling has been used to treat pain in various diseases, it is not clear how opposing needling affects the activity of the central nervous system to relieve acute pain. We herein present the protocol for a randomized sham-controlled clinical trial aiming to explore the cerebral mechanism of opposing needling for managing acute pain after unilateral total knee arthroplasty (TKA).

Methods

This is a randomized sham-controlled single-blind clinical trial. Patients will be allocated randomly to two parallel groups (A: opposing electroacupuncture group; B: sham opposing electroacupuncture group). The Yinlingquan (SP9), Yanglingquan (GB34), Futu (ST32), and Zusanli (ST36) acupoints will be used as the opposing needling sites in both groups. In group A, the healthy lower limbs will receive electroacupuncture, while in group B, the healthy lower limbs will receive sham electroacupuncture. At 72 h after unilateral TKA, patients in both groups will begin treatment once per day for 3 days. Functional magnetic resonance imaging will be performed on all patients before the intervention, after unilateral TKA, and at the end of the intervention to detect changes in brain activity. Changes in pressure pain thresholds will be used as the main outcome for the improvement of knee joint pain. Secondary outcome indicators will include the visual analogue scale (including pain during rest and activity) and a 4-m walking test. Surface electromyography, additional analgesia use, the self-rating anxiety scale, and the self-rating depression scale will be used as additional outcome indices.

Discussion

The results will reveal the influence of opposing needling on cerebral activity in patients with acute pain after unilateral TKA and the possible relationship between cerebral activity changes and improvement of clinical variables, which may indicate the central mechanism of opposing needling in managing acute pain after unilateral TKA.

Trial registration

Study on the brain central mechanism of opposing needling analgesia after total kneearthroplasty based on multimodal MRI ChiCTR2100042429. Registered on January 21, 2021

Supplementary Information

The online version contains supplementary material available at 10.1186/s13063-022-06066-6.

The Clinical Value of High-Quality Nursing in Concurrent Radiotherapy and Chemotherapy after Glioma Surgery and Its Influence on the Stress Indicators Cor, ACTH, and CRP

Objective

The purpose of this study is to explore the clinical value of high-quality nursing in concurrent radiotherapy and chemotherapy after glioma surgery and its influence on the stress indicators such as cortisol (Cor), adrenocorticotrophic hormone (ACTH), and C-reactive protein (CRP).

Methods

A total of 94 glioma patients diagnosed and treated in our hospital were randomly divided into a research group and a control group, with 47 cases in each group. Both groups of patients were given concurrent radiotherapy and chemotherapy. On this basis, patients in the control group were given basic care, while patients in the research group were given a combination of basic care and high-quality care. The nursing satisfaction and adverse reactions of the two groups were compared. The pain degree and the levels of stress indicators Cor, ACTH, and CRP at different time points were compared between the two groups. The sleep quality, bad mood, and quality of life before and after nursing were compared between the two groups.

Results

After nursing, the nursing satisfaction of the research group (95.74%) was higher than that of the control group (80.85%), and the difference between the two groups was statistically significant (X² = 11.678, P < 0.05). There was no significant difference between patients in the Visual Analogue Scale (VAS) score and the levels of stress indicators Cor, ACTH, and CRP at the T1 time point between the two groups (P > 0.05). With the passage of time, the levels of Cor and ACTH of the two groups showed an upward trend. At T4, the increased levels of Cor and ACTH in the research group were less than those in the control group, and the difference was statistically significant (P < 0.05). The VAS scores and CRP levels of the two groups showed an upward trend at T1 and T2 and a downward trend at T3 and T4. And, at T4, the decrease in CRP level of the research group was greater than that in the control group, and the difference was statistically significant (P < 0.05). Before nursing, there was no statistically significant difference between two groups of patients in the time to fall asleep, sleep time, number of awakenings, SAS score, self-rating depression scale (SDS) score, quality of life index scores, and total scores (P > 0.05). After nursing, the time to fall asleep and the number of awakenings in the two groups of patients showed an upward trend, and the increase in the control group was higher (P < 0.05). The sleep time of the two groups showed a downward trend, and the degree of decline in the control group was higher (P < 0.05). After nursing, the SAS score and SDS score of the two groups of patients decreased (^∗P < 0.05), and the decrease in the research group was more obvious (^#P < 0.05). After nursing, the scores of all indicators of the quality of life and the total score of the two groups increased and the score of the research group increased more significantly (P < 0.05). After nursing, the control group had 5 cases of gastrointestinal reactions, 7 cases of bone marrow suppression, 6 cases of leukopenia, 6 cases of thrombocytopenia, and 10 cases of dizziness and nausea. In the research group, there were 1 case of gastrointestinal reaction, 2 cases of bone marrow suppression, 1 case of leukopenia, 1 case of thrombocytopenia, and 2 cases of dizziness and nausea. The difference between the two groups was statistically significant (P < 0.05).

Conclusion

Glioma patients are given high-quality care during the course of concurrent radiotherapy and chemotherapy, which can reduce the pain and bad mood of the patient, reduce the stress response of the patient, and improve the quality of sleep and the quality of life of the patient, thereby improving nursing satisfaction and patients compliance, reducing adverse reactions, and having a good prognosis.