The psychological distress of gastrointestinal cancer patients and its association with quality of life among different genders.

BACKGROUND: Psychological distress is a prevalent unpleasant experience faced by many cancer patients. However, the psychological distress among gastrointestinal (GI) cancer patients is scarcely explored. Moreover, the association between psychological distress and quality of life in different genders has yet to be explored. AIMS: To explore the psychological distress among GI cancer patients and examine its association with quality of life among different genders. METHODS: This study was a cross-sectional study. A total of 237 gastrointestinal cancer patients completed the distress thermometer and the Functional Assessment of Chronic Illness Therapy-General. RESULTS: The mean score of psychological distress of the participants was 3.04 (SD = 2.90). A greater proportion of female gastrointestinal cancer patients (52.8%) had clinically relevant psychological distress compared to males (35.9%). The quality of life was negatively associated with their psychological distress (B = - 1.502, 95%CI: - 2.759 to - 0.245, p = 0.019) among gastrointestinal cancer patients. Such association was stronger among males compared to females in gastrointestinal cancer patients (Interaction term, B = - 1.713, 95%CI: - 3.123 to - 0.303, p = 0.017). CONCLUSIONS: These findings suggest that healthcare providers should attach their attention to gastrointestinal cancer patients' psychological distress, especially females. Longitudinal studies could adopted to track the changes in psychological distress and its association with quality of life over time among different genders. In future intervention studies, the focus of psychological interventions needs to be gender-specific.

Exploring the spiritual needs of patients with advanced cancer in China: a qualitative study.

This qualitative study aimed to gain a deep understanding of the spiritual needs of patients with advanced cancer. A qualitative study using semi-structured interviews was conducted. The interviews were audio-recorded, transcribed verbatim, and subjected to thematic analysis. Two researchers coded the interviews independently in NVivo 12 plus and developed major themes and subthemes by inductive and constant comparison. This study was conducted in the inpatient ward of a tertiary cancer hospital in Hunan Province, Chinese Mainland. Eligible participants with advanced cancer were recruited using the purposive sampling method. The sample size was determined by data saturation. All interviews were conducted face-to-face individually from May 2021 to July 2021. A total of 13 patients with advanced cancer patients were interviewed. Six themes were identified, namely being treated as normal and independent individuals, receiving and giving love, seeking inner peace, connecting with spiritual sources, finding meaning and purpose, and preparing for death. Different categories of spiritual needs of patients with advanced cancer were identified in this study. Healthcare professionals need to develop interventions that aim to meet patients' spiritual needs.

Association between dietary diversity, sedentary time outside of work and depressive symptoms among knowledge workers: a multi-center cross-sectional study.

BACKGROUND: Low-diversity diets and sedentary status are risk factors for depressive symptoms, while knowledge workers were ignored before. The purpose of this current study was to examine the relationship between dietary diversity, sedentary time spent outside of work, and depressive symptoms among knowledge workers. STUDY DESIGN AND METHODS: This was a multicenter and cross-sectional design that included 118,723 knowledge workers. Participants self-reported online between January 2018 and December 2020. Demographic information, the Dietary Diversity Scale, the Patient Health Questionnaire-9, dietary habits (which included eating three meals on time, midnight snacking, overeating, social engagement, coffee consumption, sugary drink consumption, smoking and alcohol use), sedentary time spent outside of work and physical activity were investigated. RESULTS: The relationships between demographic information, dietary habits and dietary diversity, and depressive symptoms were estimated. Compared with the first and second levels of dietary diversity, the third level of dietary diversity (OR: 0.91; 95% CI: 0.84-0.98) reduced the risk of depressive symptoms. Knowledge workers with different degrees of sedentary status (2-4 h (OR: 1.11; 95% CI: 1.07-1.14), 4-6 h (OR: 1.21; 95% CI: 1.17-1.26), and > 6 h (OR: 1.49; 95% CI: 1.43-1.56), presented a progressively higher risk of depressive symptoms. CONCLUSION: High amounts of sedentary time spent after work and low levels of dietary diversity are risk factors for depressive symptoms. In addition, an irregular diet and overeating are also major risk factors for knowledge workers.

Associations of serum cortisol and inflammatory marker features with depression and anxiety in young women with gynecologic cancer.

PURPOSE: Serum cortisol and inflammatory markers may play a role in depression and anxiety, but little is known about whether various features of serum cortisol and inflammatory markers have different associations with depression and anxiety. This study examines the associations of serum cortisol and inflammatory marker features with depression and anxiety in young women with gynecologic cancer. METHODS: Sixty-four young women with gynecologic cancer, aged 15-39 years, were recruited in a tertiary general hospital and a tertiary hospital specializing in oncology in China from May to December 2021. The Hospital Anxiety and Depression Scale was used to evaluate depression and anxiety. Blood samples were taken at 8 am, 4 pm, and 10 pm on the same day to examine the various features (average, variability, and diurnal patterns) of serum cortisol and inflammatory markers, namely C-reactive protein (CRP), interleukin-6 (IL-6), and tumor necrosis factor alpha (TNF-α). RESULTS: Young women with gynecologic cancer who reported depression/anxiety had significantly higher average levels of serum cortisol, IL-6 and TNF-α than those who did not. The dysregulations in the diurnal patterns of serum cortisol and IL-6 were associated with depression and anxiety. Serum cortisol levels were significantly higher in the depression/anxiety group at 10 pm. Depression and anxiety were associated with elevated levels of IL-6 and TNF-α at each time point. CONCLUSION: This study revealed various associations of serum cortisol and inflammatory marker features with depression and anxiety in young women with gynecologic cancer. Further research is needed to understand the role of serum cortisol and inflammatory marker features in the progression of depression and anxiety.

Influence of metabolic syndrome and lifestyle factors on thyroid nodules in Chinese adult men: a cross-sectional study.

Introduction: Given the high prevalence of thyroid nodules and the potential for malignancy, it is imperative to understand the various factors that contribute to their development. This study aimed to explore the relationship between metabolic syndrome, lifestyle, and thyroid nodules in adult men in southern China. Methods: This study enrolled a total of 183,990 subjects at a medical examination center in a general hospital in southern China between January 1, 2015, and December 31, 2020. Multivariate logistic regression analysis was utilized to evaluate the relationship between metabolic syndrome, lifestyle factors, and thyroid nodules. Furthermore, structural equation modeling elucidated the intricate relationships among these variables. Results: The prevalence of thyroid nodules among Chinese adult males was 14.9%. Several factors were identified as risk factors for thyroid nodules, including advanced age, irregular meal time, smoking or quitting smoking, quitting drinking, heavy manual labor, hypertension, diabetes, dyslipidemia and centripetal obesity, and those belonging to ethnic minorities and drinking alcohol were found to be protective factors against thyroid nodules. Structural equation modeling highlighted metabolic syndrome's mediating role amidst lifestyle influences on thyroid nodules. Conclusion: The prevalence of thyroid nodules in Chinese adult males is relatively moderate to low. The factors identified in this study can help clinicians identify high-risk patients and develop targeted screening strategies for the timely detection of thyroid nodules. However, further mechanistic research and longitudinal studies are necessary to explore the underlying causes and establish causal relationships.

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.

Effectiveness and feasibility of online fertility preservation decision aids for young female patients with cancer: a systematic review protocol.

INTRODUCTION: Cancer diagnosis and treatment can impair fertility, and younger female patients with cancer have a particularly strong need for fertility preservation. Fertility preservation decision aids are thought to help patients make proactive and informed treatment decisions. This systematic review aims to assess the effectiveness and feasibility of online fertility preservation decision aids for young female patients with cancer. METHODS AND ANALYSIS: PubMed, Web of Science Core Collection, Embase, The Cochrane Central Register of Controlled Trials, PsycINFO and CHINAL, along with three grey literature sources (Google Scholar, ClinicalTrials.gov and WHO International Clinical Trials Registry Platform), will be searched from each database's establishment to 30 November 2022. Two trained reviewers will independently screen the articles, and the data extraction and methodological quality of eligible randomised controlled trials and quasiexperimental studies will be assessed. A meta-analysis will be performed using Review Manager V.5.4 (Cochrane Collaboration) software, and heterogeneity will be assessed using I² statistics. If a meta-analysis is not possible, a narrative synthesis will be done. ETHICS AND DISSEMINATION: Since this systematic review is based on published data, no ethical approval is required. The study's findings will be disseminated through peer-reviewed publications and conference presentations. PROSPERO REGISTRATION NUMBER: CRD42022363287.

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.

Spiritual well-being and its association with hope and meaning in life among gastrointestinal cancer patients: a cross-sectional study.

PURPOSE: Spiritual well-being is a critical element of individuals' quality of life and is overestimated by healthcare providers. A body of evidence is conducted on the spiritual well-being of cancer patients, but few on gastrointestinal (GI) cancer patients, which constitute a great proportion of the cancer burden. This study aimed to investigate the spiritual well-being of GI cancer patients and its association with hope and meaning in life. METHODS: A cross-sectional study was conducted. A total of 237 GI cancer patients were recruited in this study by convenience sampling in 2022. All the participants completed the sociodemographic and clinical characteristics, Functional Assessment of Chronic Illness Therapy-Spiritual Wellbeing, Herth Hope Index, and Meaning in Life Questionnaire. Multiple linear regression analysis was conducted to explore the associated factors with spiritual well-being. RESULTS: The GI cancer patients experience a relatively low level of spiritual well-being (mean = 31.54, SD = 9.84). The presence of meaning (B = 0.847, 95% CI [0.640, 1.054], p < 0.001), inner positive readiness and expectancy (B = 1.033, 95% CI [0.548, 1.518], p < 0.001), residence (B = 2.828, 95% CI [1.045, 4.612], p = 0.002), and search for meaning (B = 0.247, 95% CI [0.072, 0.422], p = 0.006) were associated with the spiritual well-being of GI cancer patients. These four associated variables accounted for 57.8% of the variance in spiritual well-being (F = 81.969, p < 0.001). CONCLUSION: The spiritual well-being of GI cancer patients was relatively low and associated with the presence of meaning, inner positive readiness and expectancy, residence, and search for meaning. Healthcare professionals may consider improving GI patients' spiritual well-being by enhancing their sense of meaning in life and inner positive readiness and expectancy.

Dietary diversity, physical activity and depressive symptoms among middle-aged women: A cross-sectional study of 48,637 women in China.

OBJECTIVE: Depression is the leading cause of mental health-related disease burden. This study aimed to investigate the relationship among dietary diversity, physical activity and depressive symptoms in middle-aged women. METHOD: Based on the WHO guidelines on physical activity, subjects who meet moderate-intensity aerobic physical exercise of 150-300 min per week were qualified or otherwise unqualified. The dietary diversity scores (DDS) were developed according to the balanced diet pagoda and assessed the consumption of nine food groups. The total scores ranged from 0 to 9 and could divide into three levels: insufficient [DDS-1] (score of 1-5), moderate [DDS-2] (score of 6-7), and sufficient [DDS-3] (score of 8-9). RESULTS: An age at menarche ≥12 years old (OR = 0.94; 95 % CI: 0.89-1.00; p < 0.05), a higher dietary diversity score [DDS-3] (OR = 0.59; 95 % CI: 0.55-0.63; p < 0.001), drinking coffee (OR = 0.88; 95 % CI: 0.84-0.92; p < 0.001), and qualified physical activity (OR = 0.69; 95 % CI: 0.66-0.72; p < 0.001) were protective factors for depressive symptoms, while an age at first birth ≤20 years old (OR = 1.23; 95 % CI: 1.12-1.36; p < 0.001) or ≥30 years old (OR = 1.18; 95 % CI: 1.11-1.26; p < 0.001), eating late-night snacks (OR = 1.44; 95 % CI: 1.36-1.52; p < 0.001), drinking sugar-sweetened beverages (OR = 1.15; 95 % CI: 1.06-1.24; p < 0.001), and overeating (OR = 2.30; 95 % CI: 2.069-2.56; p < 0.001) were risk factors. CONCLUSION: This study suggested that dietary diversity and physical activity are associated with depressive symptoms in middle-aged women. To improve dietary diversity, attention should be given to dietary patterns and dietary habits, instead of simply increasing the amount of food.

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.

Dietary diversity and determinants of young adults in central China: A cross-sectional study from 2015 to 2020.

Background: Early adulthood is a vulnerable period for improved nutrition at all phases of the life cycle. However, there is limited research on diversity information in young adults from middle-income countries undergoing an apparent nutritional transition. The purpose of this study was to explore dietary diversity and determinants among young adults aged 18-35 years in central China. Methods: From January 2015 to December 2020, a cross-sectional survey of 49,021 young adults in a health management center of central China was conducted through report and phone-assisted self-report for information. The outcome variable was the Dietary Diversity Score. Independent variables included age, sex, race, material status, education, BMI, taste preference, regular meals, midnight snacks, sugared beverage/coffee consumption, and smoking/drinking status. Multivariate logistic regression was performed. Results: Of 49,021 young adults, 38,374 (78.3%) reported insufficient dietary diversity, and 422 (0.9%) reported sufficient dietary diversity. Light taste preference [adjusted odds ratio (aOR) = 2.325; 95% CI: 1.779, 3.039] and those who had meals regularly (aOR = 1.241; 95% CI: 1.018, 1.513) and consumed coffee (aOR = 2.765; 95% CI: 2.257, 3.387) were more likely to be associated with sufficient dietary diversity. Midnight snacks (aOR = 0.728; 95% CI: 0.588, 0.901) and sugary beverages (aOR = 0.666; 95% CI: 0.535, 0.829) were less likely to be associated with sufficient dietary diversity. Higher BMI (aOR = 1.092; 95% CI: 1.061, 1.125) was associated with higher odds of sufficient dietary diversity. Additionally, participants who were 18-30 years old, with master or above degree and away from cigarette/alcohol were more likely to report better dietary diversity. Conclusion: Our results painted a less than ideal nutritional condition affecting young adults. High-fat/sugar/salt dietary practices can lead to low dietary diversity, while high dietary diversity might have adverse BMI outcomes in youth. This study highlighted the importance of increasing the diversity of healthy and selective food items before wide recommendation for dietary diversity.

The prevalence of thyroid nodules and its factors among Chinese adult women: A cross-sectional study.

Objective: To determine the prevalence of thyroid nodules in Chinese adult women. To analyze the relationships between lifestyle, metabolic syndrome and thyroid nodules. Methods: We conducted a retrospective cross-sectional study in the tertiary hospital from 2017 to 2019. Included participants underwent thyroid color Doppler ultrasonography, lipids examination, and dietary evaluation. Results: Totally 2,784 participants were included, and 933 participants were found to have thyroid nodule(s) by B-ultrasound. The prevalence of thyroid nodules was 33.3%. Women in 50-59 years (OR: 1.746, 95% CI [1.356-2.249]), older than 60 (2.147 [1.540-2.993]) and occupations with mainly manual work (1.780 [1.367-2.317]) were risk factors for thyroid nodules, while moderate dietary diversity (0.624 [0.476-0.817]) and normal triglycerides level (0.739 [0.604-0.905]) were protective factors. Conclusion: Women over 50 and those whose jobs are mainly manual should enhance screening, follow-up and health management of thyroid nodules. Higher dietary diversity is protective measures against thyroid nodules for adult women and should consider dietary balance and the food varieties, not just increased quantities.

Relationship between lifestyle and metabolic factors and carotid atherosclerosis: A survey of 47,063 fatty and non-fatty liver patients in China.

Background and aims: Carotid atherosclerosis and stenosis are common lesions of the artery wall that form the basis of cardiovascular events. Compared with coronary atherosclerosis, few studies have explored the influencing factors of carotid atherosclerosis. The aim of this study was to explore the influencing factors of carotid atherosclerosis and carotid stenosis without and with fatty liver disease (FLD). Methods: A total of 47,063 adults were recruited for this cross-sectional study. The color Doppler ultrasound, including metabolic factors and lifestyle surveys, was used to determine whether the participants had FLD and carotid artery disease. Multiple logistic regression was used to investigate the influencing factors of lifestyle and metabolism of carotid atherosclerosis and stenosis in the participants with and without FLD. Results: In participants without FLD, current alcohol consumption (OR: 0.749, 95% CI: 0.588) and hip circumference (OR: 0.970, 95% CI: 0.961, 0.979) were the main protective factors for carotid atherosclerosis. Systolic blood pressure (OR: 1.022, 95% CI: 1.019, 1.025) and diastolic blood pressure (OR: 1.005, 95% CI: 1.001, 1.010), elevated fasting blood glucose (OR: 1.012, 95% CI: 1.005, 1.019), and non-sedentary behavior (OR: 1.084, 95% CI: 1.014, 1.160) were the main risk factors for carotid atherosclerosis. Hip circumference (OR: 0.932, 95% CI: 0.910, 0.954) and low-density lipoprotein (OR: 0.979, 95% CI: 0.964, 0.994) were protective factors for carotid stenosis. Smoking (OR: 3.525, 95% CI: 1.113, 11.169) and unqualified exercise (OR: 1.402, 95% CI: 1.083, 1.815) were risk factors for carotid stenosis. In participants with FLD, smoking (OR: 0.827, 95% CI: 0.703, 0.973) and hip circumference (OR: 0.967, 95% CI: 0.958, 0.977) were the main protective factors for carotid atherosclerosis. BMI 18.5-23.9 (OR: 1.163, 95% CI: 1.002, 1.351), non-sedentary behavior (OR: 1.086, 95% CI: 1.009, 1.168), and waist circumference (OR: 1.030, 95% CI: 1.022, 1.038) were the main risk factors for carotid atherosclerosis. Conclusion: Based on a large-sample check-up population in China, this study investigated the influencing factors of carotid atherosclerosis and carotid stenosis in fatty liver and non-fatty liver patients and explored the influencing factors of metabolism and lifestyle, which were mainly focused on exercise, sedentary behavior, smoking, alcohol consumption, hip circumference, and blood pressure.

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.

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.

Effectiveness of psychoeducational interventions among caregivers of patients with cancer: A systematic review and meta-analysis.

BACKGROUND: Many of the needs of caregivers of patients with cancer are unmet, particularly their informational and psychological needs. Psychoeducational interventions that focus on providing caregivers with information, and on meeting their emotional and psychosocial needs, may therefore be effective. OBJECTIVE: To evaluate the effectiveness of psychoeducational interventions on the outcomes of caregivers of patients with cancer and identify characteristics of effective psychoeducational interventions. DESIGN: A systematic review and meta-analysis of randomised controlled trials. DATA SOURCES: The databases of PubMed, Embase, the Cochrane Central Register of Controlled Trials, Cumulative Index to Nursing and Allied Health Literature Complete, the British Nursing Index, PsycINFO, Ovid Emcare, Scopus, Chinese Journal Net, and Wan Fang Data were searched in December 2020. Clinical trial registers, related websites and reference lists of included studies were also examined. REVIEW METHODS: The Cochrane Risk of Bias Tool was used to appraise the quality of included studies. Meta-analysis was conducted, and narrative syntheses were performed where meta-analysis was inappropriate. RESULTS: Fourteen articles describing 12 studies were included. The results of the meta-analysis showed that psychoeducational interventions have short-term (immediately post-intervention) positive effects on relieving anxiety [SMD: -0.50, 95%CI: (-0.97, -0.02), p = 0.04], depression [SMD: -0.54, 95%CI: (-0.76, -0.32), p < 0.00001] and caregiver burden [SMD: -0.57, 95%CI: (-0.87, -0.27), p = 0.0002] and improving their quality of life [SMD: 0.42, 95%CI: (0.23, 0.62), p < 0.0001) and self-efficacy [SMD: 0.31, 95%CI: (0.09, 0.53), p = 0.006] in the caregivers of patients with cancer. They also showed long-term (at least 3 months post-intervention) positive effects on improving physical health [SMD: 0.26, 95%CI: (0.05, 0.47), p = 0.02]. The types of psychoeducational interventions varied in the 12 studies. However, the main contents of effective psychoeducational interventions included tasks related to health care provisions for patients, caregiver self-care and stress management, and relationship and coping skills. In general, most studies had short follow-up periods and involved caregivers of older patients with cancer (>40 years old). CONCLUSIONS: Psychoeducational interventions may have short-term desirable effects on caregivers' anxiety, depression, quality of life, burden and self-efficacy and long-term desirable effects on physical health. Individual psychoeducational intervention varied in contents, delivery mode, dosage and format. Research is needed to further specify the optimal combination of contents. Further high-quality RCTs are warranted, with longer follow-up periods, for caregivers of patients with cancer, especially caregivers of younger patients with cancer.

The Impact of Dietary Diversity, Lifestyle, and Blood Lipids on Carotid Atherosclerosis: A Cross-Sectional Study.

Carotid atherosclerosis is a common arterial wall lesion that causes narrowing and occlusion of the arteries and is the basis of cardiovascular events. Dietary habits, lifestyle, and lipid metabolism should be considered integrally in the context of carotid atherosclerosis (CAS). However, this area has been investigated less often in China. To understand the prevalence of CAS in China and the impact of dietary diversity and habits, lifestyle, and lipid metabolism on CAS as well as its predictive factors, a cross-sectional study was performed in two northern and southern Chinese tertiary hospitals from 2017 to 2019. Included participants underwent carotid artery color Doppler ultrasonography, blood lipid examination and dietary evaluation. In total, 11,601 CAS patients and 27,041 individuals without carotid artery lesions were included. The prevalence of CAS was 30.0% in this group. High BMI (OR: 1.685, 95% CI [1.315-2.160]), current (1.148 [1.077-1.224]) or ex-smoking (1.349 [1.190-1.529]), abstinence from alcohol ((1.223 [1.026-1.459]), social engagement (1.122 [1.050-1.198]), hypertension (1.828 [1.718-1.945]), and total cholesterol (1.438 [1.298-1.594]) were risk factors for CAS, while higher dietary diversity according to DDS-2 (0.891 [0.805-0.989]), HDL-C (0.558 [0.487-0.639]), sugar-sweetened beverages (0.734 [0.696-0.774]), and no midnight snack consumption (0.846 [0.792-0.903]) were protective factors. This current study demonstrated that higher dietary diversity was a protective factor against CAS in a healthy population. In addition, current recommendations of healthy lifestyle and dietary habits for preventing CAS should be strengthened. In addition, dietary diversity should concentrate on food attributes and dietary balance, rather than increased quantities.

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.

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.