Identifying relevant factors influencing cancer-related fatigue in patients with diffuse large B-cell lymphoma during chemotherapy

BACKGROUND Diffuse large B-cell lymphoma(DLBCL)is a rapidly growing malignant tumor,and chemotherapy is one of the treatments used to combat it.Although advancements of science and technology have resulted in more and more patients being able to receive effective treatment,they still face side effects such as fatigue and weakness.It is important to thoroughly investigate the factors that contribute to cancer-related fatigue(CRF)during chemotherapy.AIM To explore the factors related to CRF,anxiety,depression,and mindfulness levels in patients with DLBCL during chemotherapy.METHODS General information was collected from the electronic medical records of eligible patients.Sleep quality and mindfulness level scores in patients with DLBCL during chemotherapy were evaluated by the Pittsburgh Sleep Quality Index and Five Facet Mindfulness Questionnaire-Short Form.The Piper Fatigue Scale was used to evaluate the CRF status.The Self-Rating Anxiety Scale and Self-Rating Depression Scale were used to evaluate anxiety and depression status.Univariate analysis and multivariate regression analysis were used to investigate the factors related to CRF.RESULTS The overall average CRF level in 62 patients with DLBCL during chemotherapy was 5.74±2.51.In 25 patients,the highest rate of mild fatigue was in the cognitive dimension(40.32%),and in 35 patients the highest moderate fatigue rate in the behavioral dimension(56.45%).In the emotional dimension,severe fatigue had the highest rate of occurrence,34 cases or 29.03%.The CRF score was positively correlated with cancer experience(all P<0.01)and negatively correlated with cancer treatment efficacy(all P<0.01).Tumor staging,chemotherapy cycle,self-efficacy level,and anxiety and depression level were related to CRF in patients with DLBCL during chemotherapy.CONCLUSION There was a significant correlation between CRF and perceptual control level in patients.Tumor staging,chemotherapy cycle,self-efficacy level,and anxiety and depression level influenced CRF in patients with DLBCL during chemotherapy.

Effect of Individualized Exercise Therapy on Cancer-related Fatigue and Negative Emotion in Patients with Gastrointestinal Tumor during Perioperative Period

[Objectives]To investigate the effect of exercise therapy in gastric cancer patients during perioperative period.[Methods]100 patients with gastric cancer who underwent elective operation in the Department of Gastrointestinal Surgery of Taihe Hospital Affiliated to Hubei University of Medicine were divided into observation group and control group by convenience sampling.The control group received routine nursing measures,and the experimental group received exercise therapy intervention measures on the basis of the control group.The patients were evaluated by the General Information Questionnaire,Self-Rating Anxiety Scale,Self-Rating Depression Scale and Cancer-related Fatigue Scale at the time of admission,the second week and the sixth week after operation.[Results]The time effect,intervention effect and interaction effect of anxiety score,depression score and cancer-related fatigue score were significant(all P<0.05)and the index of enhanced recovery after surgery was significant(P<0.05)in the two groups at the second and sixth week after operation.[Conclusions]Exercise therapy is beneficial to promoting the enhanced recovery after surgery in advance,reduce cancer-related fatigue,negative emotion and accelerate rehabilitation in patients with gastrointestinal tumors.

Significance of music therapy in treating depression and anxiety disorders among people with cancer

Globally,cancer cases and mortality have recently escalated and have attracted global concern.The clinical diagnosis and manifestation of cancer can result in significant mental health issues like depression and anxiety disorders.The tendency of people with cancer to suffer from psychological disorders such as anxiety and depression is usually high.A significant number of deaths related to cancer may likely not be from the killer disease but from psychological disorders associated with the illness.The utilization of music as a remedial approach to healing mental disorders cannot be overstated.Thus,identifying the impacts of music therapy in dealing with depression and anxiety disorders among people with cancer is relevant,as the majority of methods used in treating cancer have some side effects which may trigger psychological disorders in cancer patients.Ultimately,this study explored the significance of music therapy in treating depression and anxiety disorders among people with cancer.To achieve the aim of this study,the authors employed a narrative literature review to investigate the significance of music therapy in addressing depression and anxiety disorders among people with cancer.The type of literature review employed in this study is to provide an understanding of the selected research papers.The review found that music therapy significantly reduces depression and anxiety disorders among breast cancer,lung cancer,prostate cancer,and colorectal cancer patients.It is needful for healthcare providers to incorporate music therapy interventions while treating people with cancer.This will help reduce cancer deaths resulting from psychological disorders rather than the killer disease,cancer.However,the standardized procedures and evaluation criteria for applying music-based intervention strategies in oncology medicine still need to be further established and improved.

Impact of comorbid subthreshold depressive symptoms on cancerrelated fatigue and complications in adults with leukemia

BACKGROUND Patients not only experience symptoms caused by cancer but also suffer from the accompanying psychological pain.Therefore,these patients do not have high quality of life.According to the World Health Organization,the incidence of leukemia in China in 2020 was 5.1/100000,the mortality rate was 3.3/100000,and the prevalence rate was 16.7/100000.Therefore,it is important to examine the influence of comorbid subthreshold depressive symptoms on leukemia patients.AIM To determine the impact of comorbid subthreshold depressive symptoms on cancer-related fatigue and complications in leukemia patients,thereby providing a basis for early diagnosis and treatment in clinical practice.METHODS A questionnaire survey was conducted among leukemia patients admitted to a tertiary hospital in Xi'an,Shaanxi Province,China,from August 2022 to December 2023.Patients with a score>16 on the Chinese Classification of Mental Disorders(CCMD-3)and a Hamilton Depression Rating Scale score of 8-17 were classified as the subthreshold depressive group(n=95),while 100 leukemia patients admitted during the same period were classified as the control group.Data were collected using Epidata 3.1 software,and comparisons were made between the two groups regarding general clinical data,the Piper Fatigue Scale(PFS),the Pittsburgh Sleep Quality Index(PSQI),the Numeric Rating Scale for pain assessment,laboratory indicators,and the occurrence of complications.RESULTS In this survey,120 leukemia patients with depression were preliminarily screened,95 patients with subthreshold depression were ultimately selected as the subthreshold depression group,and 100 leukemia patients admitted during the same period were enrolled as the normal group.Comparison of basic clinical data between the two groups revealed no significant differences in age,sex,body mass index,cognitive function,or comorbidity with other chronic diseases.However,there were statistically significant differences in the use of radiotherapy and regular exercise between the two groups(P<0.05).Comparisons of scales and laboratory indicators revealed no significant differences in albumin or PSQI scores between the two groups,but there were statistically significant differences in pain scores,PSQI scores,PFS scores,hemoglobin levels,and C-reactive protein levels(P<0.05).Spearman’s correlation analysis indicated that cancer-related fatigue was correlated with age,hemoglobin levels,C-reactive protein levels,pain,and regular exercise among leukemia patients with subthreshold depression.Multivariate regression analysis revealed that advanced age,combined radiotherapy,pain,and low hemoglobin levels were risk factors for cancer-related fatigue in leukemia patients with comorbid subthreshold depression,while regular exercise was a protective factor against cancer-related fatigue.Follow-up comparisons revealed a significantly lower overall incidence of complications in the control group(4%)than in the depressive group(24.21%;P<0.001).CONCLUSION Leukemia patients with comorbid subthreshold depressive symptoms experience more severe cancer-related fatigue and a higher incidence of complications.These findings may be related to advanced age,combined radiotherapy,pain,and low hemoglobin levels,while regular exercise may effectively alleviate symptoms.

Sense of Coherence, Self-Disclosure, and Depression in Lung Cancer Patients

This study aimed to investigate the relationship between sense of coherence and depression and the mediating role of self-disclosure in lung cancer patients. Α cross-sectional study was conducted in “Sotiria” Chest Diseases Hospital, Greece, with a sample of 200 lung cancer patients. The administered questionnaires included demographic-medical information, SOC-13, Distress Disclosure Index, and CES-D scale. Analysis was performed by SPSS v.23 and PROCESS. Depression was common (41%) and negatively correlated to SOC (rho = -0.843, df = 198, p < 0.001), while self-disclosure did not mediate this relationship. Hierarchical linear regression analysis showed that patients with weak SOC, disease recurrence, metastases, low income, and receiving therapy in Day clinic had higher levels of depression. In conclusion, a strong SOC represents a protective factor against depression in lung cancer patients. Consequently, there is a need for targeted interventions, which should mainly increase SOC of these patients.

Relationship of serum neurotransmitters with anxiety depression, T lymphocyte subsets and NK cells in patients with lung cancer chemotherapy

Objective:To study the relationship of serum neurotransmitters with anxiety depression, T lymphocyte subsets and NK cells in patients with lung cancer chemotherapy.Methods: 56 cases of patients with advanced lung cancer who received chemotherapy in the First Affiliated Hospital of Chengdu Medical College between July 2013 and August 2016 were collected as observation group, and 50 healthy subjects who received physical examination in our hospital during the same period were selected as normal control group. Serum neurotransmitter, negative emotions and immune index levels were compared between the two groups of subjects. Pearson test was used to evaluate the relationship of serum neurotransmitter contents with negative emotions and immune index levels in patients with lung cancer chemotherapy. Results: Serum neurotransmitters DA, 5-HT and NE contents in observation group were lower than those in normal control group;SAS and SDS scores were higher than those of normal control group;peripheral blood CD4+T lymphocyte level, CD4+/CD8+ ratio and NK cell level were lower than those in normal control group while CD8+ T lymphocyte level was higher than that in normal control group. Pearson test showed that serum neurotransmitters DA, 5-HT and NE contents in patients with lung cancer chemotherapy were directly correlated with anxiety depression, T lymphocyte subset and NK cell levels.Conclusion: Serum neurotransmitter expression decrease in patients with lung cancer chemotherapy, and this is one of the important causes of anxiety depression and immune dysfunction in patients.

Effect of mindfulness therapy on the intervention of cancer-related fatigue in patients with lung cancer: a meta-analysis

Objective:To systematically evaluate the effects of mindfulness therapy on oncogenic fatigue in patients with lung cancer.Methods:Computer searching was conducted in the Cochrane Library,PubMed,Embase and other databases.Combined with manual search,randomized controlled trials about the effect of mindfulness therapy on the cancer-related fatigue in patients with lung cancer were collected.The search time was from the establishment of the database to December 2019.Two researchers independently screened the literature,extracted the data,and evaluated the risk of bias in the included study.RevMan 5.3 software was used for meta-analysis.Results:A total of 448 patients were included in 6 randomized controlled trials.Meta-analysis results show that mindfulness therapy can help reduce carcinogenic fatigue in patients with lung cancer(standardized mean difference(SMD)=−1.67,95%confidence interval(CI)(−2.09,−1.24),P<0.001),and improve anxiety(SMD=−1.33,95%CI(−2.53,−0.13),P=0.03),relieve depression(SMD=−1.43,95%CI(−2.13,−0.73),P<0.001).Conclusion:There is limited evidence that mindfulness therapy can improve cancer-related fatigue,anxiety,and depression in patients with lung cancer.Limited by the number and quality of included studies,the above conclusions need to be further validated by high-quality clinical trials.

Analysis of the Status Quo and Influencing Factors of Advanced Lung Cancer Patients’ Quality of Life

Objective:To investigate the quality of life and related influencing factors of patients with advanced lung cancer.Methods:A cross-sectional survey was conducted on 51 patients with advanced lung cancer who were hospitalized in the Department of Oncology from January 2023 to December 2023,and the influencing factors of patients’quality of life were analyzed.Results:Among the five functional scales(physical,role,cognitive,emotional,and social functioning)of the QLQ-C30 scale,the social and emotional function scores were the lowest,respectively 16.7(IQR:0,33.3)points,and 16.7(IQR:8.3,25),and among the three symptom scales(fatigue,pain,nausea and vomiting),the fatigue symptom score was the highest:77.7(IQR:66.7,88.9)points.The results of Spearman correlation analysis showed that the anxiety score of patients with advanced lung cancer was positively correlated with depression score(P<0.01),while the quality of life of patients with advanced lung cancer was not correlated with anxiety and depression score(P>0.1).The self-care ability,the nature of the disease,and whether the patient was treated for chemotherapy were the independent influencing factors of the patient’s quality of life,and the difference was statistically significant(P<0.001).Conclusion:Patients with advanced lung cancer have different degrees of anxiety and depression,and their quality of life is affected by many factors,which are mainly related to the patient’s self-care ability,the nature of the disease,and whether they received chemotherapy.

Depression and quality of life before and after diagnosis of lung cancer

Objective The aim of the present study was to assess the frequency of depression and quality of life(QoL) in lung cancer patients before and after diagnosis,and to investigate the potential related factors. Methods The subjects consisted of 115 consecutive adult patients newly diagnosed for lung cancer in Shanghai Pulmonary Hospital between April 2008 and October 2008. Depression

肺移植受者术后抑郁调查及影响因素分析

目的纵向追踪肺移植受者术后抑郁情绪水平的动态变化并分析其影响因素,为临床开展精准心理护理提供参考。方法于2022年10月—2023年12月,便利抽取广州市某三级甲等医院肺移植受者,采用自编一般资料问卷、患者健康问卷、移植症状发生和症状困扰量表,于术后出院前1 d(T0)、术后3个月(T1)、术后6个月(T2)3个时间点开展调查。结果共62例肺移植受者完成3个时间点调查,其抑郁情绪得分在T0、T1、T2时点的中位数分别为9.00(4.00,14.00)、5.00(1.75,10.00)和3.00(0.00,9.00),呈下降趋势(Z=38.174,P<0.001)。线性混合模型分析结果显示,肺移植受者年龄增长(β=0.012,P=0.043)、术后住院时间延长(β=0.006,P=0.025)、症状发生频率及严重程度越高(β=0.038,P<0.001)是其抑郁情绪的危险因素,轻度经济负担(β=-0.469,P=0.005)是其抑郁情绪的保护因素。结论肺移植受者抑郁情绪术后随时间推移呈逐渐降低趋势。医护人员应重点关注高龄、经济条件差、伴随多种症状的肺移植受者,及时提供个性化精准心理护理,促进其身心全面康复。

从“金郁泄之”论治溃疡性结肠炎

“金郁泄之”理论出自《黄帝内经》,“金”是肺与肠的基本属性,“郁”指郁滞,壅塞不通的异常状态,故“金郁”可理解为属金脏腑如肺、大肠所发壅滞、阻塞之证。“泄之”是五行属金脏腑郁滞的治疗方法,其具体含义应随“金郁”的病理产物、病位的不同而不同。溃疡性结肠炎多由邪蕴肠腑,气血瘀滞,肠道传导失司,湿、热、瘀于大肠相互搏结成郁,改变肠道属金肃降之性所致,其核心病机为湿热内蕴,气血瘀滞,属于“金郁”的范畴,病位虽在大肠,可波及于肺。故治疗应顺应“泄之”的法则,以祛除肺肠之郁为主,包括清泄与宣泄两种方法,同时补益肺、脾、肾三脏之气,以恢复肺肠之功能,达到扶正祛邪,标本兼顾的目的,促进溃疡性结肠炎的愈合。

基于COM-B模型晚期肺癌患者预立医疗照护计划参与度影响因素分析

目的 基于COM-B模型分析晚期肺癌患者预立医疗照护计划参与度的影响因素,为临床干预决策提供参考。方法 便利选取317例晚期肺癌患者,采用预立医疗照护计划参与问卷、预立医疗照护计划问卷、心理韧性量表等进行调查。根据COM-B模型中能力、机会、动机3维度分析晚期肺癌患者预立医疗照护计划参与度的影响因素。结果 晚期肺癌患者预立医疗照护计划参与度得分为(67.37±6.14)分。多元线性分层回归分析显示,知晓疾病诊断时间,能力因素中预立医疗照护计划知识和心理弹性,动机因素中预立医疗照护计划信念、动机、死亡态度(自然接受)、焦虑和抑郁,机会因素中社会支持是晚期肺癌患者预立医疗照护计划参与度的主要影响因素(均P<0.05),可解释总变异的50.4%。能力因素、动机因素、机会因素的新增解释量分别为18.6%、18.4%、3.4%。结论 晚期肺癌患者预立医疗照护计划参与度偏低,能力和动机因素的影响较大,机会因素的影响相对较小。医护人员需提高晚期肺癌患者预立医疗照护计划相关知识和心理弹性水平,激发预立医疗照护计划信念和动机,树立正确的死亡态度,减轻焦虑和抑郁水平,增加社会支持,以提高预立医疗照护计划的参与。

音乐干预肺癌相关焦虑抑郁结局指标及评价工具的现状分析

目的分析音乐干预肺癌相关焦虑抑郁的随机对照试验(Randomized controlled trial,RCT)中结局指标及评价工具的使用情况。方法检索9个数据库,按照纳入排除标准筛选文献,随后汇总结局指标,按照结局指标的属性进行分类、使用频次频率统计分析。结果共检索到243篇文献,最终纳入18篇文献。按照结局指标的功能属性,将其分为8个指标域:焦虑状态评分量表(24.19%)、抑郁状态评分量表(16.13%)、生活质量评分量表(14.52%)、睡眠质量评分量表(9.68%)、疼痛评分量表(4.84%)、血生化指标(14.52%)、生命体征(11.29%)、肺及运动功能指标(FEV1%、6MWD、BODE指数)(4.84%)。纳入的RCTs整体偏倚风险较高;疗程长短不一导致测量时间不同;音乐干预形式呈多样性;他评量表及客观指标使用较少;忽视安全性指标;评价工具方法较单一;部分RCTs未明确分级标准。结论目前音乐干预肺癌相关焦虑抑郁的RCTs结局指标使用尚存在一定缺陷,影响了试验的可信度,建议规范化使用结局指标,建立音乐干预肺癌焦虑抑郁临床研究的核心指标集。

基于肝肺同治法针刺治疗抑郁症的理论探讨

当前临床中以针刺法治疗抑郁症多从肝论治,以疏肝理气、调畅情志为大法,取穴以督脉、肝经为主,但以此种思路进行治疗并不适用于所有患者。从一气周流理论看,人身经气循行如环无端,周流不息,肝属木,司人身生发之性,若仅从生发处求治则属有升无降,不足以推动一气周流。肺属金,在志为悲,又主肃降,从肝肺同治的角度治疗抑郁症或可弥补仅从肝论治的不足,更能推动人身气机周流。

基于“诸气膹郁,皆属于肺”理论探讨冠心病合并焦虑抑郁的辨治

基于《黄帝内经》“诸气膹郁,皆属于肺”探讨治疗冠心病合并焦虑抑郁的思路与方法。通过分别探究冠心病(胸痹)、焦虑抑郁(郁证)等病因,认为冠心病合并抑郁焦虑的病因应为“气机失调,气血失和”。故通过中医学整体辨证论治可分为“气滞血瘀证、气虚血瘀证、痰阻心脉证、气阴两虚证”四种主要证型,均以“肺—气主攻之”的治疗思路,分别提出“宣肺理气、补益肺气、温肺化饮、益肺养阴”等四种主要治法,以期为指导临床应用提供诊疗思路和方法。

基于“一气周流”理论探讨甲状腺结节的辨治

“一气周流”源于中国古代哲学的“气一元论”和《黄帝内经》的阴阳气化理论,由黄元御的《四圣心源》正式提出,该书阐述了土枢四象、左升右降的一气周流理论。本文基于此理论探讨了甲状腺结节的辨治,认为甲状腺结节的发生发展实与其中的土虚气郁、肝肺失调密切相关,并结合现代研究证据论述土虚气郁、肝肺失调为甲状腺结节的重要病机。结合临床提出参考甲状腺超声弹性成像结果分期、分型治疗甲状腺结节,概括了分期分型辨治的临床用药,旨在恢复体内的“一气周流”。以期为临床辨治甲状腺结节提供新的诊疗思路。

认知行为疗法对肺癌患者焦虑、抑郁及生活质量干预效果的meta分析

目的探讨认知行为疗法(cognitive behavioral therapy,CBT)对肺癌患者焦虑、抑郁及生活质量的干预效果。方法检索Web of Science、PubMed、Embase、CINAHL、MEDLINE、中国知网、万方、维普数据库,检索时限为建库至2023年4月1日。按照纳入、排除标准筛选CBT干预肺癌患者的相关文献,并进行文献质量评价,使用RevMan 5.4软件进行meta分析。结果纳入9篇文献,共800例肺癌患者。CBT可以改善肺癌患者的焦虑[标准化均数差(SMD)=-0.80;95%CI-0.97~-0.63;P<0.00001]及抑郁(SMD=-1.25;95%CI-1.99~-0.52;P=0.0008),提高生活质量(SMD=0.89;95%CI 0.62~1.16;P<0.00001)。结论现有证据表明,CBT可以改善肺癌患者的焦虑、抑郁,提高生活质量,但现有研究存在发表偏倚、异质性高、质量较低等问题,还需要开展多中心、大样本、同质化的高质量研究,进一步探讨CBT对肺癌患者焦虑、抑郁及生活质量的干预效果。

基于肺-脑轴学说论治特发性肺纤维化合并抑郁症

特发性肺纤维化(IPF)是呼吸系统疾病中常见的慢性复杂性肺系疾病。而抑郁症不仅是慢性肺病的常见并发症,也是导致疾病加重和恶化的重要原因。2022年2月Alexander Flügel等人发现肺部微生物可介导大脑免疫细胞,发挥免疫调控作用,正式揭示了“肺-脑轴”的存在。文章以“肺-脑轴”的中西医研究为理论基础,分析IPF合并抑郁症的发病机制,结合肺脑以“络”为轴的特色,确立“通络”的基本治疗原则,标本兼治,以期延缓疾病进展并为临床带来新的启示。

哮病-喘证-肺胀病因病机辑要

目的现代医学哮喘-慢性阻塞性肺疾病(COPD)重叠(ACO)临床表现与中医文献哮病、喘证、肺胀等描述较为接近,特征为人群多发、发作更频繁、肺功能下降更快、病理机制不明等,全球哮喘防治创议(GINA)等相关国际医学学术组织长期关注ACO研究,目前诊断标准不统一,治疗手段仍较为局限。中医对于哮喘和慢阻肺的认识源远流长,古代文献中有详细的对哮喘病名、病因病机的记载,据慢阻肺特有的临床症状,发现自秦汉以来对于此病有诸多记载,探求古代文献发现慢阻肺与哮喘虽属不同疾病,但其病因相累,病机相联,均属本虚标实之证,故可相合并病。文章通过古代中医文献梳理哮喘和慢阻肺病因病机,结合现代医家研究成果,整理出ACO病因包括外邪侵袭、七情过用、饮食失宜、体质因素4个方面,病机从肝肾亏虚、痰瘀互结、痰热郁肺方面阐述ACO以期提供诊疗新思路。

正念减压干预对晚期肺癌心理状态及睡眠效度的影响研究

目的:探讨正念减压干预对晚期肺癌患者的心理状态、睡眠效度的影响,为临床应用提供依据。方法:选取2021年5月至2023年5月福建医科大学附属泉州第一医院收治的晚期肺癌患者75例作为研究对象,按照随机数字表法分为对照组(n=35)和观察组(n=40)。所有患者均给予针对治疗,对照组实施常规护理干预,观察组同时实施正念减压干预,均干预4周;应用焦虑自评量表(SAS)、抑郁自评量表(SDS)评估患者心理状态,并观察干预前后2组患者的睡眠时长、入睡潜伏期、觉醒时间及睡眠效率,并应用匹兹堡睡眠质量指数(PSQI)评估睡眠质量。结果:干预后,2组患者SAS、SDS评分均有降低,且观察组显著低于对照组,差异均有统计学意义(均P<0.05)。观察组干预后的睡眠时长、睡眠效率均高于对照组,差异均有统计学意义(均P<0.05),入睡潜伏期短于对照组,差异有统计学意义(P<0.05),但觉醒时间组间比较,差异无统计学意义(P>0.05)。干预前,2组PSQI评分差异无统计学意义(P>0.05),干预后,2组PSQI评分均有降低,差异均有统计学意义(均P<0.05),且观察组明显低于对照组,差异有统计学意义(P<0.05)。结论:对晚期肺癌患者开展正念减压干预,有助于改善患者心理,提高患者的睡眠质量,值得实践和应用。