Size Control and Biological Properties of PAMAM-Cored Multiarm Block Copolymers.

Size is one of the crucial factors influencing the biological properties of nanomedicines. However, the size control of nanomaterials is still very challenging, and the size effect on their biological properties is worth studying. Herein, we present the synthesis and size control of a series of multiarm block copolymers with the third-generation PAMAM (G3 PAMAM) as the core. The multiarm copolymers were synthesized by the ring-opening polymerization of N-carboxyanhydride of the l-glutamic acid-5-tert-butylester [Glu(OtBu)-NCA] monomer with the amine-terminated PAMAM as the initiator, followed by the synthesis of the poly(carboxybetaine) (PCB) block via the atom transfer radical polymerization of the 2-(dimethylamino)ethyl methacrylate monomer, the reaction with tert-butyl bromoacetate, and the deprotection of the tert-butyl ester groups. The polyglutamic acid (PGA) block provided abundant reactive groups for the functionalization of the multiarm block copolymers, and the PCB block imparted excellent water solubility and anti-protein adsorption capability. We synthesized three multiarm copolymers with diameters of 15, 24, and 41 nm, respectively, by tuning the polymerization degrees of the arms. Doxorubicin was coupled to the PGA block through the acylhydrazone linkage, which resulted in a pH-sensitive drug release and a drug loading of over 20%. We systematically investigated the size effects on their cellular uptake, cytotoxicity, endocytic pathway, biodistribution, tumor penetration, and antitumor activity. This work is helpful for the design of polymeric nano-drug carriers for tumor therapy.

Dynamic modulation of a surface-enhanced Raman scattering signal by a varying magnetic field.

Surface-enhanced Raman scattering (SERS) signals are fundamental for spectroscopy applications. However, existing substrates cannot perform a dynamically enhanced modulation of SERS signals. Herein, we developed a magnetically photonic chain-loading system (MPCLS) substrate by loading magnetically photonic nanochains of Fe3O4@SiO2 magnetic nanoparticles (MNPs) with Au nanoparticles (NPs). We achieved a dynamically enhanced modulation by applying an external stepwise magnetic field to the randomly dispersed magnetic photonic nanochains that gradually align in the analyte solution. The closely aligned nanochains create a higher number of hot spots by new neighboring Au NPs. Each chain represents a single SERS enhancement unit with both a surface plasmon resonance (SPR) effect and photonic property. The magnetic responsivity of MPCLS enables a rapid signal enhancement and tuning of the SERS enhancement factor.

Relationships between depression, self-efficacy, and professional values among Chinese oncology nurses: a multicenter cross-sectional study.

OBJECTIVES: Many factors are related to oncology nurses' professional values. However, the evidence on the relevance of professional values among oncology nurses in China remains sparse. This study aims to investigate the relationship between depression, self-efficacy, and professional values among Chinese oncology nurses and analyze the mediating effect of self-efficacy on this association. METHODS: It was a multicenter cross-sectional study designed with the STROBE guidelines. An anonymous online questionnaire recruited 2530 oncology nurses from 55 hospitals in six provinces of China between March and June 2021. Measures included self-designed sociodemographic and fully validated instruments. Pearson correlation analysis was employed to explore the associations between depression, self-efficacy, and professional values. Bootstrapping analysis by the PROCESS macro was used to examine the mediating effect of self-efficacy. RESULTS: The total scores of depression, self-efficacy, and professional values of Chinese oncology nurses were 52.75 ± 12.62, 28.39 ± 6.33, and 101.55 ± 20.43, respectively. About 55.2% of Chinese oncology nurses were depressed. Chinese oncology nurses' professional values were generally intermediate. Their professional values were negatively related to depression and positively correlated with self-efficacy, while depression was negatively related to self-efficacy. Moreover, self-efficacy partially mediated the relationship between depression and professional values, accounting for 24.8% of the total effect. CONCLUSIONS: Depression negatively predicts self-efficacy and professional values, and self-efficacy positively predicts professional values. Meanwhile, depression in Chinese oncology nurses has an indirect effect on their professional values through self-efficacy. Nursing managers and oncology nurses themselves should develop strategies aimed at relieving depression and improving self-efficacy to strengthen their positive professional values.

Knowledge, attitude, and practice of sexual healthcare and its influencing factors among oncology nurses: a multicenter study.

Background: The provision of sexual healthcare plays an integral role in the field of oncology nursing. However, limitations in the knowledge, attitude, and practice perspectives of oncology nurses require detailed study. Aim: In this study the authors sought to describe the knowledge, attitude, and practice of oncology nurses regarding sexual healthcare from a nationwide perspective and to explore the factors that influence them. Methods: This was a cross-sectional descriptive study using stratified random sampling of certified oncology nurses from 55 hospitals in 6 provinces in Central South China. In total, 2530 nurses participated and completed the Knowledge, Attitude and Practice questionnaire of Sexual Health Care (KAP of SHC), the Nurses Clinic Communication Competency Scale, the Nurses Professional Values Scale, and the General Self-efficacy Scale. Multivariate linear regression was used to explore influencing factors. Outcomes: The primary variable was the knowledge, attitude, and practice of sexual healthcare provision. Secondary variables included professional value, clinical communication competency, self-efficacy, and demographic factors. Results: The median KAP of SHC score was 139 (possible range 72 to 288). Attitude of SHC scored highest, followed by knowledge and practice scores. Professional values were positively associated with knowledge (odds ratio [OR] = 0.057; 95% CI: 0.023-0.091; P < .01) and attitude (OR = 0.319; 95% CI: 0.268-0.370, P < .01) of SHC. Clinical communication competency was only positively related to the attitude of SHC (OR = 3.960; 95% CI: 2.701-5.218, P < .01). Self-efficacy was positively related to KAP and the knowledge (OR = 0.616; 95% CI: 0.506-0.725, P < .01), attitude (OR = 0.187; 95% CI: 0.052-0.322, P < .01), and practice (OR = 0.840; 95% CI: 0.735-0.944, P < .01) of SHC. Clinical Implications: Knowledge assistance, attitude training, and practice coaching resources must be on the agenda to optimize professional practice for oncology nurses. Strengths and Limitations: This study provides data based on the Knowledge, Attitude, Belief and Practice (KABP) model in a nationwide sample of oncology nurses. In addition, the relationship between self-efficacy and KAP of SHC has been explored for the first time. The limitations are that this study may have some bias and did not take into account mediating relationships. Conclusions: Oncology nurses exhibit moderate levels of KAP of SHC. It is noteworthy that self-efficacy and position are the only 2 factors that influenced all aspects of KAP of SHC.

Coupling Au-loaded magnetic frameworks to photonic crystal for the improvement of photothermal heating effect in SERS.

The combination of plasmonic metals and photonic crystal (PC) structure is considered to have potential for further enhancement of the surface-enhanced Raman scattering (SERS) effect in comparison with conventional metal SERS substrates. Many studies have suggested that SERS signals probably suffer from an often-neglected effect of strong surface plasmon resonance (SPR)-induced photothermal heating during SERS detection. Herein, we have discovered that the photothermal heating problem arises in a traditional hybrid substrate that is prepared by doping plasmonic Au nanoparticles (NPs) into the voids of an opal PC (Au-PC). This happens mainly because excess Au agglomerates formed by non-uniformly distributed Au NPs can cause a strong SPR effect under laser illumination. To fully address this issue, we have employed an improved hybrid substrate that is fabricated by substituting Au NPs in Au-PC with an Au-loaded magnetic framework (AuMF). The AuMF can effectively prevent the aggregation of Au NPs and ensure sufficient hot spots for SERS. This novel substrate prepared by doping AuMFs into a PC (AuMF-PC) was free of strong photothermal heating and showed high SERS intensity and reproducibility of the SERS signal compared with Au-PC. For practical applications, we have demonstrated AuMF-PC as an appropriate candidate for the SERS assay of the trace thiol pesticide thiram, and it enables recycling and reuse to achieve low cost.

A ratiometric near-infrared fluorescence/photoacoustic dual-modal probe with strong donor dithienopyrrole for in vivo nitric oxide detection.

Integrating the imaging techniques of near-infrared fluorescence (NIRF) and photoacoustic (PA) can make up for each other and provide more useful medical information. Ratiometric imaging activated by disease-associated biomarkers can further augment imaging specificity. However, very few studies have employed the NIRF/PA dual-modal ratiometric imaging to improve the accuracy and specificity of disease diagnosis to date. In this paper, we present the synthesis of a nitric oxide (NO)-activated ratiometric NIRF/PA dual-modal nanoprobe RAPNP for in vivo NO imaging. The ratiometric imaging function was achieved jointly by a NO/acidity-responsive molecule DTP-BTDA and a nonresponsive fluorophore DTP-BBTD. In these fluorophores, the dithienopyrrole (DTP) moiety had strong electron-donating ability and imparted strong intramolecular charge transfer and relatively long emission wavelengths. The BTDA moiety in DTP-BTDA could be rapidly oxidized by NO under weak acidic environments, achieving the NIRF and PA signal activation. By using RAPNP as a contrast agent, we achieved the ratiometric detection of the endogenous NO in inflammatory bowel disease by NIRF/PA dual-modal imaging. This work provides the first case of the NIRF/PA dual-signal ratiometric probe for the real-time detection of NO in vivo.

Intelligent physical activity versus modified behavioral activation in adolescent and young adult cancer patients with psychological distress: A randomized, controlled pilot trial.

BACKGROUND: More than 80% of adolescent and young adult cancer patients (AYACPs) experienced psychological distress. Physical activity and behavioral activation are effective to relieve the psychological distress in AYACPs. METHODS: Participants aged 15-39 years diagnosed with malignant tumors were included. A total of 143 eligible AYACPs were randomly assigned to three groups. The treatment-as-usual group (N = 48) received routine care, the physical activity group (N = 47) received 8 weeks of physical activity program based on intelligent wearable devices, and the behavioral activation group (N = 48) received an internet-based modified behavioral activation program for 8 weeks. Objective outcome measures included salivary cortisol and testosterone. RESULTS: Linear mixed-model analyses showed significant differences between treatment-as-usual, physical activity and behavioral activation in salivary cortisol, as well as total scores on depression and anxiety, physical activity, self-efficacy, and social support. Significantly stronger effect sizes for physical activity group compared with behavioral activation group were found on physical activity (d = 0.53) (1 week after intervention), moderate activity (d = 0.61), and walking activity (d = 0.57) (3-month follow-up). CONCLUSIONS: Intelligent, wearable, device-based physical activity program is more effective in alleviating anxiety and depression, reducing saliva cortisol, and improving physical activity in AYACPs than internet-based modified behavioral activation program. Intelligent, wearable, device-based physical activity program can reduce the time cost of AYACPs to ensure that the intervention is carried out.

Fluorination Effects on the Drug Delivery Property of Cylindrical Polymer Brushes.

Fluorination has been widely applied to improving the properties of small-molecule drugs. However, relatively little is known about the effects of fluorination on the drug delivery property of nanomaterials. In this paper, we synthesized a fluoroalkane-modified cylindrical polymer brush (CPB) BCPB-F and an alkane-modified analogue BCPB-H. Doxorubicin (DOX) was used as a model drug and was loaded onto the CPBs through a pH-responsive acylhydrazone linkage. High drug loading and good water solubility were achieved. The in vitro and in vivo experiments suggested that fluorination played an important role in improving the cellular uptake, blood circulation, tissue permeability, and tumor targeting ability of CPBs. Due to these superiorities, the DOX-loaded BCPB-F exhibited excellent antitumor efficacy and eradicated the tumors of mice after five-dose treatments. The well-defined structures of the drug-free and drug-loaded CPBs guaranteed the accuracy of the results. This work demonstrates that fluorination is a promising strategy to improve the overall properties of nanomedicines.

Time management disposition and relevant factors among new nurses in Chinese tertiary hospitals: A cross-sectional study.

Introduction: New nurses struggled with time management, which was a prominent theme in safety care for patients. However, the transition training of time management for new nurses was complicated and ignored by clinical managers. The purpose of this study was to understand the level of new nurses' TMD from a nationwide perspective and detect the influencing factors of the TMD. Materials and methods: A cross-sectional study design with a stratified sampling method was sampled in China. Six hundred and seventy new nurses within the first year of employment were recruited. New nurses' time management disposition, job stressors, self-efficacy, clinical communication competence, and safety behavior were measured by corresponding scales. Results: New nurses showed the best sense of time's value, followed by the sense of time efficacy and time monitoring view for time management disposition. The related factors of time management disposition were communication skills, safety behavior, job stressors, and being without a preceptor. New nurses' time management disposition was at a moderate level and they performed worse in time allocation. The highest education, with or without a preceptor, the experience of part-time jobs, and class cadre were significantly influencing the time management disposition of new nurses. Conclusion: Nursing managers should pay attention to new nurses' time management disposition. Reducing the job stressors, improving communication ability, and safe behavior were important measures to improve the time management disposition.

Stepwise Interactive Situated Training Program for Young Nurses' Safety Behavior and Interrupted Coping Behavior.

Young nurses' safety behavior and interrupted coping behavior affect patient safety. A stepped, interactive and situated training program should be evaluated to assist young nurses in improving themselves. This study aimed to evaluate the effect of the stepwise interactive situated training program on safety behavior and practice ability with respect to nursing interruptions for young nurses and its influencing factors. This was a quasi-experimental, one-group, self-control and pretest-post-test design study. Six hundred young nurses in two provinces were included. The participants underwent a stepwise interactive situated training program from March to August 2019. The program was delivered by designated head nurses and consisted of five themes: mobilization, theoretical training, operational training, specialized training and self-improvement. Five hundred and sixty-two young nurses completed this study. The safety behavior and the practice of nursing interruption were significantly higher after intervention than before. Professional titles, age and occupational time were the influence factors. The stepwise interactive situated training program was effective at improving young nurses' safety behavior and interrupted coping behavior. Nurses with higher professional titles performed better with regard to the safety behavior and the practice of nursing interruption.

Effects of iRGD conjugation density on the in vitro and in vivo properties of cylindrical polymer brushes.

iRGD can significantly improve the tumor accumulation and tumor penetration of nanomaterials. However, it still remains unclear how far iRGD can enhance the properties of nanomaterials when its conjugation density is maximized. Herein, we synthesized three types of cylindrical polymer brushes (CPBs) with 0%, 50% and 100% of side chains terminated by iRGD, which were named CPBs-1, CPBs-2 and CPBs-3, respectively, and studied the effects of iRGD density on their cellular uptake, and tumor targeting ability and tumor permeability. It was demonstrated that compared with the iRGD-free CPBs-1, the cellular uptake of CPBs-3 was enhanced 5 times and their tumor accumulation was enhanced twice. The penetration depth of CPBs-3 in three-dimensional multicellular spheroids was larger than 100 µm. Our results provide useful information for the design of active tumor targeting nanomaterials as therapeutics or contrast agents.

Reproductive concerns among adolescent and young adult cancer survivors: A scoping review of current research situations.

Fertility is a significant concern among adolescent and young adult (AYA) cancer survivors and their caregivers, especially after their completion of cancer treatment programs. Concerns about fertility affect not only cancer patients' psychological well-being, but also all aspects of their medical treatments, including treatment protocol, decision-making, and treatment adherence. In this scoping review, the PubMed, CINAHL, Web of Science, Embase, CNKI, and Wanfang electronic databases were searched according to the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Extension for Scoping Reviews. The searches identified 669 articles, 54 of which met the inclusion criteria. Reviewers extracted the data on the study characteristics, measurements, positive factors, negative factors, and additional themes. This scoping review included studies from 10 countries. Most studies were quantitative using a cross-sectional design. The prevalence of reproductive concerns among AYA cancer survivors ranged from 44% to 86%, and 28% to 44% of the survivors experienced moderate to severe concerns. The specific implementation of fertility consultation, including timing, consult frequency, and content, deserves ongoing exploration.

The efficacy of live music for adolescent and young adult patients during hematopoietic stem cell transplantation.

BACKGROUND: Music therapy can improve mood in patients undergoing hematopoietic stem cell transplantation (HSCT). However, live music (LM) delivered by professional music therapists is not common in developing countries owing to the shortage of professional music therapists. Thus, in this study, we explored the effects of a multidisciplinary collaborative intervention based on LM on physical and psychological well-being of adolescent and young adult (AYA) patients undergoing HSCT with a quasi-experimental design. METHODS: A total of 62 AYA patients agreed to participate and were randomly assigned to the intervention group receiving 4-week LM therapy (n = 31) or control group receiving usual care (n = 31). Depression, salivary cortisol, fatigue, and quality of life were the main outcome indicators measured at baseline, immediately after the intervention, 1 month, and 3 months follow-up. The intervention effects were analyzed by generalized estimating equations. RESULTS: Significant decrease in HADS-D scores occurred in the intervention group compared with wait-list controls at immediately after intervention (p < 0.05). Participants in the LM group had greater improvement in quality of life and lower salivary cortisol level than those in the wait-list control group at immediately, 1 month, and 3 months after intervention (p < 0.05). However, the interaction effects of the BFI scores were not significant. CONCLUSIONS: LM therapy significantly alleviated depression and salivary cortisol levels as well as improved quality of life of AYA patients undergoing HSCT.

Fluorination and Betaine Modification Augment the Blood-Brain Barrier-Crossing Ability of Cylindrical Polymer Brushes.

Blood-brain barrier (BBB)-crossing ability of drugs is of paramount importance for the treatments of central nervous system diseases. However, the known methods for drug transport across the BBB are generally complicated and inefficient, and exhibit serious side effects in some cases. Herein, we report an exciting finding that fluorination and betaine modification can significantly augment the BBB-crossing ability of cylindrical polymer brushes (CPBs), which was demonstrated by the comparison with the CPBs modified with alkyl and poly(ethylene glycol) chains, respectively. We surmise that fluorination enhances the BBB penetration of the CPBs by increasing the hydrophobicity and reducing the surface energy, and betaine medication achieves this function via a betaine transporter BGT1 expressed on brain capillaries. By means of an in vitro BBB model, we demonstrated that the CPBs penetrated the BBB through transendothelial transport. This work provides a novel strategy for enhancing the BBB-crossing ability of nanomaterials.

Effect of Two Interventions on Sleep Quality for Adolescent and Young Adult Cancer Survivors: A Pilot Randomized Controlled Trial.

BACKGROUND: Sleep disturbance is common among adolescent and young adult (AYA) cancer survivors. Physical activity (PA) and behavioral activation (BA) therapy have been reported as enhancing sleep quality, but few studies exist on the effects of such interventions combined with technology to promote sleep quality in AYA cancer patients. OBJECTIVE: The aim of this study was to investigate the feasibility and effects of intelligent wearable device-based PA therapy and internet-based modified BA therapy to improve sleep quality among AYA cancer patients. METHODS: A randomized controlled trial with 143 AYA cancer patients was conducted. Participants were randomly assigned to a control group (n = 48), which performed routine care, a PA group (n = 47), which received 8-week PA therapy based on intelligent wearable devices, and a BA group (n = 48), which participated in internet-based modified BA therapy for 8 weeks. RESULTS: At 1 week and 3 months after the intervention for sleep quality, there were statistically significant differences between the PA group and the control group (P = .020), but no statistically significant difference between the BA group and the control group. CONCLUSIONS: The intelligent wearable device-based PA therapy has more advantages than internet-based modified BA therapy in improving the overall state of AYA cancer patients, and the intervention effect was sustained for at least 3 months. IMPLICATIONS FOR PRACTICE: Developing and implementing PA plans for AYA cancer survivors can improve their sleep quality. Social media, intelligent wearable devices, and mobile health applications have unique advantages in promoting sleep quality for AYA cancer survivors.

Effect of Light Therapy on Cancer-Related Fatigue: A Systematic Review and Meta-Analysis.

CONTEXT: Light therapy is a non-pharmacological therapy that is currently being studied in cancer-related symptoms and is certificated as a low-risk intervention by FDA. Cancer-related fatigue (CRF) is the most common symptom reported by cancer patients. OBJECTIVE: To examine the effectiveness of light therapy for CRF in cancer patients through a systematic review and meta-analysis. METHODS: We conducted a systematic review of four electronic databases targeted randomized clinical trials evaluating light therapy for CRF (CRD42020215446), from inception to May 2021. The primary outcome was changes of CRF scores; secondary outcomes included depression, sleep, and quality of life (QoL). We quantitatively pooled outcomes using meta-analysis with random-effects models and assessed methodological bias. RESULTS: We identified thirteen RCTs representing 551 cancer patients, encompassing breast (n = 5), ovarian or endometrial (n = 1), multiple myeloma (n = 1), lung (n = 1), or combined (n = 5) cancers. The comparison groups included dim light (n = 12) and waiting list (n = 1). Duration of intervention ranged from 1 to 12 weeks. Light intensities ranged from 417.9 to 12,000 lux. Light therapy was associated with a significant improvement in CRF (SMD = 0.45, P = 0.007), depression (SMD = -0.26, P = 0.03) and sleep difficulty (SMD = -2.46, P = 0.0006); a statistically non-significant trend was observed for QoL (SMD = 0.33, P = 0.09). Funnel plots for CRF suggest not significant publication bias. CONCLUSION: Light therapy could be a feasible and effective option for improving CRF in cancer patients. Larger sample, rigor trials design and a standard protocol of intervention are needed to draw more conclusive conclusions.

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The psychological distress of cancer patients seriously affects their therapeutic effects. Effective psychological rehabilitation of cancer patients significantly improves their survival chance and quality of life. Circadian rhythm results from adaptation to the environment during the organism's evolution. When the endogenous clock system is disrupted or the external environment is changed, the body and the environment are out of synchronization, and the circadian rhythm will be disrupted. Circadian rhythm disorder is a common phenomenon in cancer patients, and the changes of circadian rhythm are closely related to their psychological distress. Many studies believe that the circadian rhythm disorder of cancer patients may directly or indirectly affect their psychology through various mechanisms, and targeted intervention by regulating the circadian rhythm of patients may be an essential means to promote the psychological rehabilitation.

Phenylboronic Acid Modification Augments the Lysosome Escape and Antitumor Efficacy of a Cylindrical Polymer Brush-Based Prodrug.

Timely lysosome escape is of paramount importance for endocytosed nanomedicines to avoid premature degradation under the acidic and hydrolytic conditions in lysosomes. Herein, we report an exciting finding that phenylboronic acid (PBA) modification can greatly facilitate the lysosome escape of cylindrical polymer brushes (CPBs). On the basis of our experimental results, we speculate that the mechanism is associated with the specific interactions of the PBA groups with lysosomal membrane proteins and hot shock proteins. The featured advantage of the PBA modification over the known lysosome escape strategies is that it does not cause significant adverse effects on the properties of the CPBs; on the contrary, it enhances remarkably their tumor accumulation and penetration. Furthermore, doxorubicin was conjugated to the PBA-modified CPBs with a drug loading content larger than 20%. This CPBs-based prodrug could eradicate the tumors established in mice by multiple intravenous administrations. This work provides a novel strategy for facilitating the lysosome escape of nanomaterials and demonstrates that PBA modification is an effective way to improve the overall properties of nanomedicines including the tumor therapeutic efficacy.

NIR-II Fluorophore with Dithienylethene as an Electron Donor for Fluorescence/Photoacoustic Dual-Model Imaging and Photothermal Therapy.

Well-designed second near-infrared (NIR-II) fluorophores are promising in optical diagnosis and therapy of tumors. In this work, we synthesized a donor-acceptor-donor (D-A-D) NIR-II fluorophore named BBTD-BET with dithienylethene as an electron donor and benzobisthiadiazole as an electron acceptor. To the best of our knowledge, this is the first report of using dithienylethene, a typical photochromic molecule, as a building block for NIR-II fluorophores. We studied the geometrical configuration, electronic state, and optical properties of BBTD-BET by both theoretical and experimental means. BBTD-BET had absorption and emission in the NIR-I and NIR-II spectral ranges, respectively. Using PEGylated BBTD-BET as a theranostic agent, we achieved NIR-II fluorescence/photoacoustic (PA) dual-modal imaging and attained high imaging resolution, desired signal-to-noise ratio, and excellent photothermal therapy (PTT) efficacy. After one PTT treatment, the tumors established in mice were eradicated. This work provides a novel organic conjugated molecule integrating NIR-II/PA dual-modal imaging and PTT functionalities that is very promising in the theranostic of tumors.

Relationship of Circadian Rhythm and Psychological Health in Adolescents and Young Adults With Cancer.

BACKGROUND: Evidence shows that adolescent and young adult (AYA) cancer patients have an increasing survival rate but experience psychological distress and circadian rhythm dysregulation. Little is known about the effect of circadian rhythm on psychological distress. OBJECTIVE: To investigate the type of circadian rhythm in Chinese AYA cancer survivors and examine the associations among chronotype, demographic characteristics, psychological distress, anxiety and depression, character strengths, and medical coping in this group. METHODS: This cross-sectional study enrolled 800 AYA cancer participants, 728 of whom completed the Chinese version of the Morningness-Eveningness Questionnaire, the Distress Thermometer, the Hospital Anxiety and Depression Scale, the Three-Dimensional Inventory of Character Strengths, and the Medical Coping Modes Questionnaire. RESULTS: Evening- and morning-type participants accounted for 35.0% and 19.1%, respectively, among participants, which was significantly higher than those found in the general population. The prevalence of psychological distress was 84.9% among AYA cancer participants. Exercise, Distress Thermometer, and depression were important predictive factors for the circadian rhythm. CONCLUSIONS: Circadian rhythm disorder and psychological distress were common among AYA cancer survivors. Evening-type participants performed worse on character strength, confrontation, and avoidance of medical coping. IMPLICATIONS FOR PRACTICE: Healthcare professionals need to understand the circadian rhythm and psychological health of AYA cancer survivors. Psychological rehabilitation guidance, especially within the 6 months after diagnosis, may benefit AYA survivors according to their chronotype. Character strengths can also be used during rehabilitation to properly guide AYA survivors.