Health-Promoting Lifestyle in Colorectal Cancer Survivors: A Qualitative Study on the Experiences and Perspectives of Colorectal Cancer Survivors and Healthcare Providers

Effects of Lifestyle Interventions on Health and Life Quality of Colorectal Cancer Survivors: A Systematic Review and Meta-analysis

BACKGROUND

The results of previous studies on the effects of lifestyle interventions on the quality of life (QoL) in colorectal cancer (CRC) survivors remain controversial, and there have been several new publications in this area in recent years.

OBJECTIVES

To assess whether lifestyle interventions can lead to favorable health outcomes and improved QoL in CRC survivors, we performed a meta-analysis.

METHODS

PubMed, EMBASE, Web of Science, and Cochrane Library were systematically searched to obtain relevant literature published from January 1, 1990, to November 1, 2021. The required data were extracted and summarized to compare the physical activity levels, QoL, mental health assessment, and anthropometric data between lifestyle interventions and routine nursing.

RESULTS

Twelve studies were included. Compared with the control group, lifestyle interventions could significantly increase the physical activity time (weighted mean difference [WMD], 9.84; 95% confidence interval [CI], 1.20-18.48; P = .026), metabolic equivalent task levels (WMD, 10.40; 95% CI, 5.30-15.49; P < .001), and Functional Assessment of Cancer Therapy Scale-Colorectal scores (WMD, 3.12; 95% CI, 0.24-5.99; P = .034). However, lifestyle interventions were not noticeably able to improve the fatigue, depression levels, anxiety levels, waist circumference, or body mass index in CRC survivors.

CONCLUSION

Lifestyle interventions could generate an increase in physical activity time, metabolic equivalent task levels, and QoL in CRC survivors.

IMPLICATIONS FOR PRACTICE

Lifestyle interventions in the future that include physical activity, diet, or comprehensive programs are needed to increase physical activity levels and improve QoL in CRC survivors.

Bibliometric analysis and visualization of research trends in total mesorectal excision in the past twenty years

BACKGROUND

Rectal cancer leads a major disease burden worldwide. Total mesorectal excision (TME) is the standard treatment for locally advanced or node-positive rectal cancer, while attempts to improve the surgery such as laparoscopic and transanal TME are widely used but have their inherent limitations. This bibliometric study analyzed research trends, cooperation, and knowledge dissemination on TME over the past 20 years to inform future directions.

METHODS

Relevant literature from 2003 to 2023 was extracted from the Web of Science Core Collection and analyzed with VOSviewer, CiteSpace, and R for publication patterns, countries, institutions, authors, and research hotspots.

RESULTS

Five thousand three hundred forty-five related publications were included, with rising annual output and citations. The US and China contributed the most studies, while the Netherlands had greater influence. Leiden University ranked first in publications. The top authors were Heald, Kapiteijn, Sauer, Nagtegaal, and Peeters. Research shifted from cancer-focused to patient-centered care and from radiotherapy/chemotherapy to advanced surgery. Multicenter trials became more common.

CONCLUSION

Although the United States and China have the largest number of publications, it should be noted that the influence of these two countries in the field of TME research is not the highest, which does not match the number of publications. In addition, telemedicine, interdisciplinary, medical-industrial integration, etc. may be potential directions for future research in the field of TME.

The Impact of Palliative Care on Mitigating Pain and Its Associated Effects in Determining Quality of Life among Colon Cancer Outpatients

Pain continues to be a significant problem for cancer patients, and the impact of a population-based strategy on their experiences is not completely understood. Our study aimed to determine the impact of palliative care on mitigating pain and its associated effects in determining the quality of life (QoL) among colon cancer outpatients. Six collection databases were used to perform a structured systematic review of the available literature, considering all papers published between the year 2000 and February 2023. PRISMA guidelines were adopted in our study, and a total of 9792 papers were evaluated. However, only 126 articles met the inclusion criteria. A precise diagnosis of disruptive colorectal cancer (CRC) pain disorders among patients under palliative care is necessary to mitigate it and its associated effects, enhance health, promote life expectancy, increase therapeutic responsiveness, and decrease comorbidity complications. Physical activities, the use of validated pain assessment tools, remote outpatient education and monitoring, chemotherapeutic pain reduction strategies, music and massage therapies, and bridging social isolation gaps are essential in enhancing QoL. We recommend and place a strong emphasis on the adoption of online training/or coaching programs and the integration of formal and informal palliative care systems for maximum QoL benefits among CRC outpatients.

Development and psychometric properties of Health-Promoting Lifestyle Scale in Colorectal Cancer Survivors (HPLS-CRCS): a mixed-method study

BACKGROUND

Detecting a health-promoting lifestyle in colorectal cancer (CRC) survivors is of paramount importance to manage disease complications, prevent their recurrence, and enhance survival; however, no specialized tool has yet been provided to measure the lifestyle of these patients. Accordingly, this study aimed to develop and determine the psychometric properties of the Health-Promoting Lifestyle Scale in CRC Survivors (HPLS-CRCS).

METHODS

This study was a mixed study with an exploratory sequential design in two phases. Concept analysis was performed in the first phase according to Schwartz-Barcott and Kim's (2000) hybrid model to explain the concept, identify dimensions, and generate items. In the second phase, psychometrics including validity (face, content, and construct) and reliability (internal consistency and stability) were determined. Responsiveness, interpretability, ease of use, item weighting, and scale scoring were also determined.

RESULTS

After explaining the concept, an initial scale encompassing 211 items was developed, content and item analyses were conducted, and the items decreased to 89 items after the face validity assessment. For construct validity, confirmatory factor analysis (CFA) was conducted with a sample size of 500 survivors, and convergent validity was performed for the Persian version of the Health-Promoting Lifestyle Profile II (HPLP-II). Accordingly, 80 items were classified into six factors: activity and rest, spiritual growth, health responsibility, nutrition, interpersonal relationships, and psychological management, with RMSEA = 0.055, χ2/df = 2.484, and χ2 = 6816.516. The reliability of the scale was confirmed, Cronbach's alpha was between 0.865 and 0.928, and the intraclass correlation coefficient (ICC), the standard error of measurement (SEM), the minimal important change (MIC), and the smallest detectable change (SDC) were 0.896, 3.36, 13.86, and 19.87, respectively.

CONCLUSION

The HPLS-CRCS consists of 80 items in six dimensions and is a valid and reliable scale for evaluating the health-promoting lifestyle in CRC survivors. Using this scale to evaluate the healthy lifestyle in these survivors can lead healthcare providers to detect deficiencies and plan the lifestyle of CRC survivors during the post-treatment period.

Health-Promoting Lifestyle among the Survivors of Colorectal Cancer: An Integrative Review

Introduction

Health-promoting lifestyle (HPL) among the survivors of colorectal cancer (CRC) is essential to reduce CRC complications, prevent its recurrence, and improve survival. Nonetheless, there is no comprehensive definition for the concept of HPL in CRC survivors. This study aimed to define the concept of HPL among CRC survivors based on the existing literature.

Methods

This integrative review was conducted in 2021 using Whittemore and Knafl's method. The national and international databases of SID, Magiran, ProQuest, Medline, ScienceDirect, Web of Science, and Scopus were searched. Quality appraisal was performed using the Mixed Methods Appraisal Tool (MMAT) and the data were analyzed using the four-step approach proposed by Whittemore and Knafl.

Results

After data evaluation, 167 documents were included in final analysis. In total, 1863 codes were generated and categorized into eighteen main categories and the three main themes of antecedents, attributes, and consequences. Accordingly, HPL among CRC survivors was defined as "a set of behaviors in the areas of health responsibility, physical activity, nutrition, spiritual growth, psychological management, and interpersonal relations which are affected by socio-demographic characteristics, clinical characteristics, psychological status, physical conditions, time and place limitations, and patient education, and lead to better disease prognosis, better general health status, better bio-psycho-social status, and better quality of life".

Conclusion

The definition of HPL among CRC survivors provided in the present study can be used in counseling, educational, supportive, and care programs for CRC survivors in order to improve their quality of life and survival.

Evaluating the psychometric properties of the Persian version of the Healthy Lifestyle Instrument for Breast Cancer Survivors (HLI-BCS)

BACKGROUND

Precise examination of breast cancer survivors' lifestyles can lead to improved planning and implementation of care and counseling interventions to increase their survival rate and improve their quality of life. Therefore, a valid and reliable instrument needs to be developed. Therefore, the present study aimed to determine the psychometric properties of the Persian version of the Healthy Lifestyle Instrument for Breast Cancer Survivors (HLI-BCS).

METHODS

This methodological study was conducted on 420 Iranian breast cancer survivors between May and November 2022. Participants were selected using convenience sampling. The face, content, construct validity, convergent, and reliability of the Persian version of the HLI-BCS were assessed.

RESULTS

After assessing face, content, and construct validity, the Persian version of the HLI-BCS with five factors and 20 items was provided. The total Cronbach's alpha and intra-class correlation coefficient (ICC) were calculated as 0.86 and 0.79, respectively, which were at acceptable levels. A healthy lifestyle in breast cancer survivors was observed to have strong and significant relationships with quality of life in general (p < 0.001, r = 0.832), physical health (r = 0.786), and mental health (r = 0.809).

CONCLUSION

The Persian version of the HLI-BCS has favorable properties, is consistent with the conditions of breast cancer survivors, and is valid and reliable. This version of the scale can provide adequate and precise information on the lifestyles of these patients.

Application Value of Nutrition Support Team in Chemotherapy Period of Colon Cancer Based on Internet Multidisciplinary Treatment Mode

Objective

To explore the application value of the nutrition support team in chemotherapy period of colon cancer based on the internet multidisciplinary treatment mode.

Methods

For the method of retrospective study, 90 patients with colon cancer admitted to our hospital from August 2018 to August 2020 were selected as the study subjects. They were equally divided into the experimental group (n = 45) and the control group (n = 45) according to the order of initials and the method of parity group. The control group was given conventional nutrition support, and the experimental group was given the nutrition support under the internet multidisciplinary treatment mode. The serum tumor marker levels (CEA and CA19-9), immune function indexes, nutrition indicators, and the incidence of adverse reactions were compared between the two groups before and after intervention.

Results

The serum tumor marker levels in the experimental group after intervention were significantly lower than those in the control group (P < 0.001). The immune function indexes in the experimental group after intervention were significantly better than those in the control group (P < 0.001). The nutrition indicators in the experimental group after intervention were significantly better than those in the control group (P < 0.001). The incidence of gastrointestinal adverse reactions above grade 2 in the experimental group was significantly lower than that in the control group (P < 0.05). There were 20 patients with myelosuppression, 2 patients with neurotoxicity, and 1 patient with hand and foot syndrome in the experimental group, while 22 patients with myelosuppression, 4 patients with neurotoxicity, and 2 patients with hand and foot syndrome in the control group, with no significant difference in the incidence of adverse reactions between the two groups (P > 0.05).

Conclusion

The nutrition support team under the internet multidisciplinary treatment mode can improve the immune function of chemotherapy patients with colon cancer and enhance their nutritional level, thereby reducing the incidence of adverse reactions and improving the chemotherapy effects.

Psychometric Properties of the Persian Version of the Short-Form Survivor Unmet Needs Survey (SF-SUNS) among Cancer Patients

Objective

Accurate identification of the unmet needs of patients with cancer and with a valid and reliable scale leads to the improvement of planning and implementation of nursing care. Thus, this study aims to translate the Short-Form Survivor Unmet Needs Survey (SF-SUNS) into Persian and to assess the psychometric properties of the Persian version among patients with cancer in Iran.

Methods

This study was conducted by methodological design. The translation of SF-SUNS was performed by translation protocol of the Quality of Life Assessment. Qualitative assessment of the face validity was conducted through cognitive interview and content validity was assessed through expert panel. This study used a convenience sampling method for 757 patients with cancer referring to Omid and Imam Reza hospitals in Mashhad, Iran. To determine the construct validity, confirmatory factor analysis and convergent validity were employed. Cronbach's alpha and intraclass correlation coefficient were calculated for reliability.

Results

Total score of unmet needs was 2.20 ​± ​0.73, which indicates the average level of unmet needs in patients with cancer. Content validity ratio and content validity index scores were 0.88 and 0.91, respectively, Cronbach's alpha coefficient was 0.89, and intraclass correlation coefficient was 0.91. Based on confirmatory factor analysis, goodness-of-fit indices confirmed the model fit (χ²/df ​= ​4.43, GFI ​= ​0.90, TLI/NNFI ​= ​0.91, CFI ​= ​0.90, RMSEA ​= ​0.067). In the subscale of unmet work and financial needs, 4 items had a factor loading lower than 0.4, which were omitted from the Persian version. The results revealed a significant difference in the unmet needs and quality of life of patients with cancer (P ​< ​0.001).

Conclusions

The Persian version of SF-SUNS has desirable psychometric properties. It can be used to design and assess interventions to improve the quality of caring, cancer management, and as well as interaction between patients and healthcare providers.