The Effect of a Communicational Program on Psychological Distress in the Elderly Suffering from Cancer

Psychological distress as a risk factor for the efficacy of chemotherapy in advanced gastric cancer patients

AIM

To assess the relationship between psychological distress and quality of life (QoL), cancer-related fatigue (CRF), and chemotherapy efficacy in advanced gastric cancer patients.

METHODS

Advanced gastric cancer patients (39 with psychological distress and 35 without psychological distress) completed the Distress Thermometer (DT), QoL, and CRF test before receiving chemotherapy and assessed the efficacy after completing 2 courses of chemotherapy.

RESULTS

Psychological distress was a significant factor in the efficacy of chemotherapy in advanced gastric cancer patients (χ2 = 6.324; p = 0.042). Compared to advanced gastric cancer patients with no psychological distress, advanced gastric cancer patients with psychological distress had a poorer QoL (50.41 ± 6.17 vs. 60.01 ± 7.94, t =  - 5.882, p < 0.01) and more pronounced CRF (5.75 ± 1.16 vs. 3.22 ± 0.75, t = 11.231, p < 0.01) while receiving chemotherapy. FACT-G (p = 0.0035, r =  - 0.4568), as well as PFS (p < 0.0001, r = 0.6599), correlated significantly with efficacy for patients in the psychological distress group. The FACT-G (p = 0.0134, r =  - 0.4139) of patients in the no psychological distress group correlated significantly with efficacy.

CONCLUSION

Psychological distress has a negative impact on QoL, CRF, and efficacy and may be a potential risk for the efficacy of palliative chemotherapy in advanced gastric cancer patients.

Non-pharmacological interventions to manage psychological distress in patients living with cancer: a systematic review

BACKGROUND

Psychological distress is common in patients with cancer; interfering with physical and psychological wellbeing, and hindering management of physical symptoms. Our aim was to systematically review published evidence on non-pharmacological interventions for cancer-related psychological distress, at all stages of the disease.

METHODS

We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The review was registered on PROSPERO (CRD42022311729). Searches were made using eight online databases to identify studies meeting our inclusion criteria. Data were collected on outcome measures, modes of delivery, resources and evidence of efficacy. A meta-analysis was planned if data allowed. Quality was assessed using the Mixed Methods Appraisal Tool (MMAT).

RESULTS

Fifty-nine studies with 17,628 participants were included. One third of studies included mindfulness, talking or group therapies. Half of all studies reported statistically significant improvements in distress. Statistically significant intervention effects on distress were most prevalent for mindfulness techniques. Four of these mindfulness studies had moderate effect sizes (d = -0.71[95% CI: -1.04, -0.37] p < 0.001) (d = -0.60 [95% CI: -3.44, -0.89] p < 0.001) (d = -0.77 [CI: -0.146, -1.954] p < 0.01) (d = -0.69 [CI: -0.18, -1.19] p = 0.008) and one had a large effect size (d = -1.03 [95% CI: -1.51, -0.54] p < 0.001). Heterogeneity of studies precluded meta-analysis. Study quality was variable and some had a high risk of bias.

CONCLUSIONS

The majority of studies using a mindfulness intervention in this review are efficacious at alleviating distress. Mindfulness-including brief, self-administered interventions-merits further investigation, using adequately powered, high-quality studies.

SYSTEMATIC REVIEW REGISTRATION

This systematic review is registered on PROSPERO, number CRD42022311729.

Requirements for promoting help-seeking behaviors in family caregivers of cancer patients: A qualitative study

BACKGROUND

Caring for a family member with cancer is a challenging issue for families. Family caregivers often need the help of supportive resources to solve problems in their care role. A deep understanding of the requirements of caregivers to seek help is an effective step toward their ability to use supportive resources. This study aimed to identify and describe the requirements for promoting help-seeking behaviors in Iranian family caregivers of cancer patients.

MATERIALS AND METHODS

This qualitative study was conducted through in-depth semi-structured interviews with 28 participants selected using purposeful sampling method from 2019 to 2021. An interview guide with general questions about seeking help was used to maintain coherence in data collection. The interviews continued until data saturation. All interviews were recorded, transcribed and analyzed through qualitative content analysis.

RESULTS

The requirements of promoting help-seeking behaviors in family caregivers were grouped into four main categories: (1) improving social paths toward seeking help, (2) spiritual-psychological-cognitive empowerment toward seeking help, (3) strengthening the motivations behind seeking help, and (4) modifying the perception of cultural barriers to seeking help.

CONCLUSION

According to the results of this study, it is expected that by identifying the requirements of caregivers for seeking help and by health stakeholders designing comprehensive programs to address these needs, caregivers will be empowered to use supportive resources and provide a better care role.

Effect of Health Belief Model Education on Increasing Cognition and Self-Care Behaviour among Elderly Women with Malignant Gynaecological Tumours in Fujian, China

Objective

This study evaluated the effect of a health belief model (HBM) educational intervention on the self-perception of and complications related to disease in elderly gynaecological malignancy patients.

Methods

This randomized controlled trial was conducted at the Fujian Maternal and Child Health Hospital, China. A total of 301 women aged 60 years and older who were diagnosed with gynaecological malignancies from January 2019 to August 2020 were recruited. Participants were randomly divided into the HBM education and basic nursing groups. The participants in the HBM education group received perioperative rehabilitation education based on the HBM, and the participants in the basic nursing group received routine basic nursing. Rehabilitation training compliance, psychological resilience, psychological flexibility, self-efficacy, self-care ability, and lower extremity deep venous thrombosis (LEDVT) incidence were assessed before and after the intervention.

Results

Thirty-three women were excluded based on the exclusion criteria, and 268 participants were eventually included and randomly divided into two groups: 134 participants in the HBM education group and 134 participants in the basic nursing group. Before HBM education, there were no significant differences in the mean scores of psychological resilience (50.43 ± 3.29 vs. 50.55 ± 2.29, P = 0.738), psychological flexibility (48.98 ± 3.45 vs. 49.29 ± 3.59, P = 0.465), self-efficacy (26.49 ± 5.26 vs. 26.29 ± 6.41, P = 0.781), or rehabilitation training compliance (28.4% vs. 27.8%, P = 0.922) between the two groups. After HBM education, the scores of training compliance (80.6% vs. 30.1%, P < 0.001), psychological resilience (55.47 ± 5.01 vs. 50.46 ± 2.62, P < 0.001), psychological flexibility (56.53 ± 4.51 vs. 49.13 ± 3.62, P < 0.001), self-efficacy (30.79 ± 4.56 vs. 26.41 ± 6.37, P < 0.001), self-care knowledge (43.36 ± 7.60 vs. 34.05 ± 6.99, P < 0.001), self-concept (29.57 ± 5.67 vs. 20.11 ± 3.86, P < 0.001), self-care responsibility (27.54 ± 5.09 vs. 20.86 ± 4.53, P < 0.001), and self-care skills (34.51 ± 5.62 vs. 21.62 ± 5.64, P < 0.001) were higher in the HBM education group than those in the basic nursing group. Additionally, the incidence of LEDVT was lower in the HBM group than that in the basic nursing group (2.2% vs. 8.3%, P = 0.027).

Conclusion

This study indicated that perioperative HBM education can improve the cognition and self-care ability of elderly gynaecological malignancy patients and reduce postoperative complications.

The Effect of Dignity Therapy on the Quality of Life of Patients with Cancer Receiving Palliative Care

Background:

Patients with cancer deal with physical, psychosocial, spiritual, and existential problems that impact on their quality of life. This study aimed to assess the effect of dignity therapy on the quality of life of mentioned patients.

Materials and Methods:

In this quasi-experimental study, 50 patients with cancer hospitalized in a palliative care center in Tehran, Iran, in 2017-18 who fulfilled inclusion criteria were selected through convenience sampling. The European Organization for Research and Treatment of Cancer Quality of Life-C15-Palliative (EORTC-QLQ-C15-PAl) questionnaire was filled by patients before and 2 weeks after dignity therapy. Data were analyzed using descriptive statistics such as frequency, mean, and standard deviation, as well as inferential statistics, including independent t-test and Chi-square test.

Results:

Results showed that dignity-therapy led to more improvement in the quality of life of the intervention group (t_35,18= 4.82, p = 0.001). There was also a significant difference between the two groups in terms of the physical functioning scale (t_32,96= -2.60,p = 0.01) and emotional functioning (t _45,69= 6.54, p < 0.001). We also found that dignity-therapy led to more improvement in nausea and vomiting (χ² = 5.71, p = 0.02), insomnia (χ² = 15.78, p < 0.001), appetite (χ² = 5.09, p = 0.02), and constipation (χ² = 12.50, p < 0.001).

Conclusions:

The application of new approaches like-dignity therapy could benefit patients with cancer in terms of reducing their distress, improving symptom severity, physical and emotional functioning, and total quality of life.

Effect of Psychological Intervention on Quality of Life and Psychological Outcomes of Colorectal Cancer Patients

Objective: This study was undertaken to evaluate the effect of psychological interventions on quality of life (QOL) and psychological outcomes in colorectal cancer patients. Methods: Three components-the Hospital Anxiety and Depression Scale (HADS), cancer-related distress, and QOL-were assessed at admission (T0/baseline), three-month follow-up (T1), and six-month follow-up (T2). Results: The general characteristics of participants were well balanced between the psychological intervention group and control group. Psychological intervention significantly improved the anxiety measured by HADS in the psychological intervention group at T1 and T2 compared with the control group (T1 = -2.83 versus 0.33, p = .002; T2 = -2.64 versus 0.13, p = .045). Both total and avoidance scores of cancer-related distress decreased significantly in the psychological intervention group at T1, and the amelioration maintained until T2. However, the psychological intervention group and the control group did not show any significant differences between global QOL and cognitive function. While the psychological intervention greatly improved physical function at T1 (4.30 versus -4.28, p = .012), the difference was not significant at T2 (3.36 versus -3.41, p = .116). However, the fatigue score in the psychological intervention group was reduced significantly compared with that in control group at T2 (-4.94 versus 3.61, p = .027). Conclusion: Our results suggest that psychological intervention benefits QOL and psychological outcomes of patients with colorectal cancer.

The Impact of Spiritual Care Education on Anxiety in Family Caregivers of Patients with Heart Failure

Heart failure (HF) has been emerging as a general health problem over recent decades. Spiritual care is a type of support service provided to patients suffering from HF. Spiritual care intervention in nursing is a unique aspect of care, which cannot be replaced by psychosocial care. Considering the importance of anxiety for caregivers of patients with HF, the present study aimed to examine the effect of spiritual intervention on anxiety in caregivers of patients with HF in Ilam, Iran. This research is a semi-experimental study, 71 caregivers of patients with HF were randomly assigned to experimental group (n = 34) and control (n = 37) group. Beck Anxiety Inventory, which consisted of 21 items and scored based on a 4-point Likert scale ranging from zero to three, was employed to collect data. The scores range from zero to 63 with the higher scores indicating the higher level of anxiety. The experimental group received spiritual intervention over six 45-minute sessions in a period of 2 weeks (14 days; three times a week; every other day). Data were analyzed using descriptive and inferential statistics run in the SPSS software version 16. The result showed a difference between the level of anxiety in two groups after the intervention (P = 0.001). Anxiety level in the experimental group three weeks after intervention (27.88 ± 7.10) was significant in comparison with before intervention (45.06 ± 5.79) (P = 0.001). According to the results, the spiritual intervention reduced the anxiety level in the caregivers of patients with HF. Nurses are recommended to provide such necessary training to caregivers in order to provide the grounds for reducing their anxiety.

The effect of informational-emotional support program on illness perceptions and emotional coping of cancer patients undergoing chemotherapy

PURPOSE

The present study aims to assess the effect of a nurse-led informational-emotional support program on illness perceptions and emotional coping of cancer patients undergoing chemotherapy.

METHODS

We used a quasi-experimental design, pre- and post-test. A total of 80 cancer patients undergoing chemotherapy were selected by convenience sampling method and assigned to experimental (n = 40) and control groups (n = 40). The nurse-led informational-emotional support program included five face-to-face sessions, educational booklet, and five phone follow-ups, and was conducted for the experimental group over 10 weeks. The control group received routine cares. The outcomes were assessed at baseline and end of intervention and included illness perceptions, which were assessed using the Illness Perception Questionnaire-Revised (IPQ-R), and emotional coping as the secondary outcome using the Coping Through Emotional Approach Scale. Data were analyzed in SPSS using multivariate analysis of covariance (MANCOVA) models, t test, paired t test, and chi-square.

RESULTS

Between group analysis showed that the mean scores of global illness perceptions and subscales including timeline, consequences, controllability, and coherence significantly increased in the experimental group compared to the control (P < 0.001), but no significant change was observed in two groups in the subscale of emotional representation (P < 0.571) and in the secondary outcome including emotional coping (P < 0.08).

CONCLUSIONS

A 10-week nurse-led informational-emotional support program can lead to changed illness perceptions without changing emotional coping. The effect of this support program should be studied on the coping and illness perceptions over the trajectory of cancer, especially in end stages in the future.