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Multiple Endocrine Neoplasia 1 gene (MEN1), which is known to be a tumor suppressor gene in lung tissues, encodes a 610 amino acid protein menin. Previous research has proven that MEN1 deficiency promotes the malignant progression of lung cancer. However, the biological role of this gene in the immune microenvironment of lung cancer remains unclear. In this study, we found that programmed cell death-ligand 1 (PD-L1) is upregulated in lung-specific KrasG12D mutation-induced lung adenocarcinoma in mice, after Men1 deficiency. Simultaneously, CD8+ and CD3+ T cells are depleted, and their cytotoxic effects are suppressed. In vitro, PD-L1 is inhibited by the overexpression of menin. Mechanistically, we found that MEN1 inactivation promotes the deubiquitinating activity of COP9 signalosome subunit 5 (CSN5) and subsequently increases the level of PD-L1.
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Antígeno B7-H1 , Neoplasias Pulmonares , Proteínas Proto-Oncogênicas , Evasão Tumoral , Animais , Antígeno B7-H1/metabolismo , Antígeno B7-H1/genética , Neoplasias Pulmonares/genética , Neoplasias Pulmonares/imunologia , Neoplasias Pulmonares/patologia , Camundongos , Humanos , Proteínas Proto-Oncogênicas/genética , Proteínas Proto-Oncogênicas/metabolismo , Evasão Tumoral/genética , Complexo do Signalossomo COP9/genética , Complexo do Signalossomo COP9/metabolismo , Microambiente Tumoral/imunologia , Adenocarcinoma de Pulmão/genética , Adenocarcinoma de Pulmão/imunologia , Adenocarcinoma de Pulmão/patologia , Adenocarcinoma de Pulmão/metabolismo , Linhagem Celular Tumoral , Linfócitos T CD8-Positivos/imunologia , Linfócitos T CD8-Positivos/metabolismo , Proteínas Proto-Oncogênicas p21(ras)/genética , Ubiquitinação , MutaçãoRESUMO
We explored the frequency of CD14-CD10-CD45+HLA-DR-SSC++ neutrophils (CD10- neutrophils) in patients with non-Hodgkin's lymphoma (NHL), and their immunologic characteristics and clinical significance. Patients with NHL who were newly diagnosed (NDP; n = 33), in remission (RMP; n = 28) and relapsed (RLP; n = 29) were included, and 47 volunteers were recruited as healthy controls (HCs). The frequency of CD10- neutrophils in the peripheral blood from HC and patients with NHL was detected. CD10- and CD10+ neutrophils were sorted, and their cytology was analyzed. CD3+ T cells were also isolated and cultured with the autologous CD10- or CD10+ neutrophils, after which the proliferation and death rates of T cells were determined. The levels of arginase-1 (Arg-1) and reactive oxygen species (ROS) in CD10+ or CD10- neutrophils were examined. Few CD10- neutrophils were detected in HCs but were significantly elevated in patients with NHL, especially in NDP and RLP. In addition, CD10- neutrophils in NDP with advanced stage and high risk were markedly higher than those in NDP with limited stage and low risk. In RMP and RLP, the relapse-free survival and overall survival in patients with high CD10- neutrophils were shorter than those with low CD10- neutrophils. CD10- neutrophils from patients with NHL, which mainly consist of immature neutrophils, inhibit T-cell proliferation and facilitate T-cell death. Furthermore, a significant increase was observed in Arg-1 expression, along with an increase to a certain extent in ROS. CD10- neutrophils in patients with NHL have characteristics of myeloid-derived suppressor cells and may be related to disease progression and poor prognosis.
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Linfoma não Hodgkin , Células Supressoras Mieloides , Humanos , Neutrófilos , Espécies Reativas de Oxigênio , Linfoma não Hodgkin/patologia , Antígenos HLA-DR/metabolismo , Progressão da DoençaRESUMO
PURPOSE: To inform the development of an eHealth application for patients with cervical cancer for monitoring supportive care needs, perceived care supply and quality of life. METHODS: A mixed-method design was used. The 19-month process involved five phases: (1) a literature review to screen the components of applications, (2) a cross-sectional needs assessment for patients with cervical cancer to define the needs and application program frame, (3) expert consultation to refine the draft, (4) software development, and (5) pilot testing and user comment collection. Patients in the intervention group received a 7-day application intervention combined with usual care. Supportive care needs, perceived care supply, quality of life and user's additional comments were collected. RESULTS: The literature review results in phase 1 revealed the importance of full preparation, especially a supportive care needs assessment, before application development. Subsequent supportive care needs investigation in phase 2 revealed that the most urgent needs were informational needs and privacy protection. In phase 3, 43 expert recommendations for application improvement were refined. The new application contained the patient and the health care professional portal in phase 4. Then, on Day 7, there existed score changes of the outcome measures in both intervention and control group. Users had a positive experience with the application. CONCLUSIONS: This study demonstrates the feasibility of applications targeting access to supportive care, which may be effective for improving the outcome measures but needed to be evaluated in future studies.
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Telemedicina , Neoplasias do Colo do Útero , Feminino , Humanos , Neoplasias do Colo do Útero/cirurgia , Estudos de Viabilidade , Qualidade de Vida , Estudos Transversais , Telemedicina/métodosRESUMO
IgG4-related disease (IgG4-RD) is a systemic autoimmune disease characterized by the infiltration of a large number of IgG4+ plasma cells, neoplastic lesions in the affected tissues, and a sharp increase in the concentration of serum IgG4. IgG4-RD is a rare and novel disease involving multiple organs with various clinical manifestations. Understanding and studying the pulmonary manifestations of IgG4-RD is critical for improving diagnosis, treatment, and prognosis. However, lung involvement alone is less common. Here we present a rare case of IgG4-related lung disease (IgG4-RLD) to show the variable manifestations of this disease in the lungs and review the relevant literature.
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Doenças Autoimunes , Doença Relacionada a Imunoglobulina G4 , Pneumopatias , Humanos , Doença Relacionada a Imunoglobulina G4/diagnóstico , Doença Relacionada a Imunoglobulina G4/patologia , Pulmão , Pneumopatias/diagnóstico , Pneumopatias/tratamento farmacológico , Prognóstico , Imunoglobulina G , Doenças Autoimunes/diagnóstico , Doenças Autoimunes/tratamento farmacológicoRESUMO
The presence of adverse childhood experiences (ACEs) in adolescents diagnosed with depression has been associated with an extensive range of mental health issues, including non-suicidal self-injury (NSSI). However, there has been a dearth of research into the prevalence of ACEs and their associations with NSSI among depressed adolescent populations in China. This study aimed to investigate the prevalence of different types of ACEs and their associations with NSSI in depressed Chinese adolescents. Utilizing Chi-squared tests, latent class analysis (LCA), and multinomial logistic regression, the prevalence of different types of ACEs and their associations with NSSI were determined in a sample of 562 adolescents with depression. Among depressed adolescents. 92.9% of depressed adolescents reported ACEs, and the prevalence of emotional neglect, physical abuse, caregiver treated violently, and bullying was relatively high. ACEs, including sexual abuse (OR = 5.645), physical abuse (OR = 3.603), emotional neglect (OR = 3.096), emotional abuse (OR = 2.701), caregiver divorce/family separation (OR = 2.5), caregiver treated violently (OR = 2.221), and caregiver substance abuser (OR = 2.117), were associated with increased odds of exposure among depressed adolescents with NSSI. The high ACEs class (19%), the moderate ACEs class (40%), and the low ACEs class (41%) were identified as latent classes. NSSI was more prevalent in the high/moderate ACEs class compared to the low ACEs class, particularly in the high ACEs class. The situation of the prevalence of ACEs among adolescents with depression was unsatisfactory, and certain types of ACEs were associated with NSSI. Eliminating potential risk factors for NSSI requires the early prevention and targeted intervention of ACEs. Moreover, additional large-scale longitudinal studies are necessary to assess the different development trajectories associated with ACEs, such as the relationships between the different development periods of ACEs and NSSI, and to ensure the adoption of evidence-based prevention and intervention strategies.
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BACKGROUND: Family resilience plays a crucial role in protecting the mental health and family stability of infertile patients. However, information associated with infertile families resilience is scarce. The double ABC-X model provides a roadmap for this, helps organize knowledge, and lays the foundation for knowledge development. AIMS: To describe the current situation of family resilience of infertile women, and to test the predictive theoretical model of family resilience based on infertility stigma, individual resilience, coping style, and posttraumatic growth. DESIGN: A cross-sectional study. METHODS: A convenience sample of 372 infertile women undergoing in vitro fertilization were recruited between April and August 2020. The Chinese-Family Resilience Assessment Scale, Infertility Stigma Scale, Simplified Coping Style Questionnaire, Chinese version of Connor-Davidson Resilience Scale, and Chinese version of Post Traumatic Growth Inventory were used to measure family resilience, infertility stigma, individual resilience, coping style, and posttraumatic growth. Structural equation models were used to analyze the relationship among these variables. RESULTS: The results showed that family resilience was related to infertility stigma, positive coping, and individual resilience. Moreover, the path analysis indicated that positive coping and individual resilience mediated the effects of infertility stigma on family resilience. CONCLUSIONS: A high level of stigma among infertile women should be identified. Interventions for targeting positive coping and individual resilience might ultimately increase their family resilience.
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Infertilidade Feminina , Resiliência Psicológica , Feminino , Humanos , Infertilidade Feminina/terapia , Infertilidade Feminina/psicologia , Estudos Transversais , Saúde da Família , Adaptação Psicológica , Fertilização in vitro , Inquéritos e QuestionáriosRESUMO
PURPOSE: This study aimed to investigate the attitudes of adolescents toward NSSI, and to explore their perspectives on barriers to seeking professional treatment for NSSI. METHODS: A qualitative phenomenological design was used to conduct in-depth interviews with 17 adolescents with NSSI in a psychiatric hospital in Beijing, China. Data from the 17 adolescents were analyzed using Colaizzi's 7-step analysis. RESULTS: Two themes were extracted: (1) attitudes toward NSSI (normal, effective, ignorant, disgraceful); (2) subjective/objective barriers to seeking professional treatment (negative attitudes toward NSSI, fear of being regarded as an attention getter, fear of interfering with personal relationships, fear of aggravating the family burden, fear of being criticized by parents, fear of ongoing hospitalization, fear of the side effects of medication, etc.). CONCLUSIONS: It is suggested to strengthen the knowledge of NSSI among adolescents, families and society, formulate interventions suitable for Chinese sociocultural backgrounds, and cultivate the specialty literacy of mental health nurses and their abilities to identify the barriers, which are required for eliminating barriers to seeking professional treatment and establishing a system for seeking full coverage of professional treatment.
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Comportamento Autodestrutivo , Humanos , Adolescente , Comportamento Autodestrutivo/terapia , Comportamento Autodestrutivo/psicologia , Atitude , China , Estudos LongitudinaisRESUMO
PURPOSE: This study aimed to develop and test the psychometric properties of a Professional Nursing Support Scale for patients with cancer in mainland China. METHODS: The study was conducted in two phases from January 2017 to January 2020. Phase I involved item generation and developing a preliminary version of Professional Nursing Support Scale through literature review, qualitative interviews, content validity evaluation and a pilot study. Phase II involved psychometric properties testing of the Professional Nursing Support Scale in 700 patients with cancer recruited from four public hospitals in Anhui Province, China. RESULTS: A 49-item Professional Nursing Support Scale was finally developed. Exploratory factor analysis showed a four-factor structure of the 49-item Professional Nursing Support Scale, accounting for 56.95% of variance. Cronbach's α ranged from 0.91 to 0.94 for the four subscales. Confirmatory factor analysis further confirmed the best model fit of four-factor structure of the Professional Nursing Support Scale. The Professional Nursing Support Scale also showed an acceptable concurrent validity with Supportive Care Needs Scale short form 34 (r = 0.75, p < 0.001) and Psychological Distress Thermometer (r = 0.39, p < 0.001). CONCLUSIONS: The Professional Nursing Support Scale is a reliable and valid instrument to assess perceived needs of professional nursing support and support acquisition in relation to the care in Chinese patients with cancer.
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Neoplasias , Humanos , Reprodutibilidade dos Testes , Inquéritos e Questionários , Projetos Piloto , Psicometria , Neoplasias/psicologia , ChinaRESUMO
With the growing population and rapid change in the social environment, nurses in China are suffering from high rates of stress; however, the neural mechanism underlying this occupation related stress is largely unknown. In this study, mental status was determined for 81 nurses and 61 controls using the Symptom Checklist 90 (SCL-90) scale. A subgroup (n = 57) was further scanned by resting-state functional MRI with two sessions. Based on the SCL-90 scale, "somatic complaints" and "diet/sleeping" exhibited the most prominent difference between nurses and controls. This mental health change in nurses was further supported by the spatial independent component analysis on functional MRI data. First, dynamic functional connectome analysis identified two discrete connectivity configurations (States I and II). Controls had more time in the State I than II, while the nurses had more time in the State II than I. Second, nurses showed a similar static network topology as controls, but altered dynamic properties. Third, the symptom-imaging correlation analysis suggested the functional alterations in nurses as potential imaging biomarkers indicating a high risk for "diet/sleeping" problems. In summary, this study emphasized the high risk of mental deficits in nurses and explored the underlying neural mechanism using dynamic brain connectome, which provided valuable information for future psychological intervention.
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Sintomas Comportamentais/fisiopatologia , Encéfalo/fisiopatologia , Conectoma , Rede de Modo Padrão/fisiopatologia , Rede Nervosa/fisiopatologia , Doenças Profissionais/fisiopatologia , Adulto , Sintomas Comportamentais/diagnóstico por imagem , Encéfalo/diagnóstico por imagem , Rede de Modo Padrão/diagnóstico por imagem , Feminino , Humanos , Imageamento por Ressonância Magnética , Masculino , Rede Nervosa/diagnóstico por imagem , Doenças Profissionais/diagnóstico por imagem , Adulto JovemRESUMO
PURPOSE: To examine a predictive theoretical model of psychological distress based on the following variables reflected on family caregivers of patients with cancer: the unmet supportive care needs, subjective caregiving burden, social support, and the positive aspects of caregiving. METHODS: A cross-sectional descriptive study was conducted on a sample of 484 dyads of patients and their family caregivers. The caregivers completed structured questionnaires designed to measure psychological distress, unmet supportive care needs, subjective caregiving burden, positive aspects of caregiving, and social support. Patients' demographic variables and medical data were collected from a medical record review. We used a structural equation modeling to test the predictive theoretical model. RESULTS: Path analysis results partially supported the proposed model with satisfactory fit indices. Specifically, family caregivers with an increasing number of unmet needs or a heavier caregiving burden were more likely to have more severe psychological distress. Bootstrapping results supported that the caregiving burden and social support were significant mediators. Greater unmet supportive care needs predicted higher psychological distress through increasing caregiving burden. Stronger social support predicted lower psychological distress through decreasing caregiving burden. Positive aspects of caregiving predicted lower caregiving burden through the increasing perceived social support, which in turn eliminated psychological distress. CONCLUSIONS: Unmet supportive care needs could cause psychological distress through increasing caregiving burden. The positive aspects of caregiving reduced caregiving burden through increasing social support, which subsequently alleviated psychological distress. Interventions that aim to satisfy supportive care needs, to reduce caregiving burden, and to strengthen social support ties may boost the mental health of family caregivers.
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Cuidadores , Neoplasias , Angústia Psicológica , Efeitos Psicossociais da Doença , Estudos Transversais , Família , Humanos , Neoplasias/terapia , Apoio Social , Estresse Psicológico/epidemiologia , Inquéritos e QuestionáriosRESUMO
OBJECTIVE: To systematically review male partners' caring experience and supportive care needs when caring for women with gynaecologic cancer. METHODS: The PRISMA guidelines were used to conduct this systematic review. We performed a comprehensive literature search in nine databases and qualitative studies published in English or Chinese from inception to January 2020. The included papers were appraised, using the Critical Appraisal Skills Program tool for qualitative research. An inductive thematic analysis method was adopted to synthesise major findings to construct core concepts and themes. RESULTS: Eight studies were included in this review, and four overarching themes emerged the following: the negative experience of disease, the need for supportive care to cope, adapting to a new life and post-traumatic growth. CONCLUSIONS: This study shows that male partners had both negative and positive experiences in the caring process, and they could adjust themselves to some extent. Their perceived supportive care needs were often neglected. RELEVANCE TO CLINICAL PRACTICE: Male partners of women with gynaecologic cancer are an under-recognised group. The couple-oriented or family-oriented supportive care programmes should be implemented to meet the supportive care needs of male partners to enhance their health and well-being.
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Neoplasias dos Genitais Femininos , Adaptação Psicológica , Feminino , Humanos , Masculino , Pesquisa QualitativaRESUMO
The objective of this study was to test the psychometric properties of the Chinese version of the Supportive Care Needs Survey for Partners and Caregivers (SCNS-P&C-C) among the caregivers of Chinese patients with cancer. The original English version of SCNS-P&C was translated into Chinese using a forward and backward translation approach. The psychometric properties of the SCNS-P&C-C including factor structure, convergent, and discriminative validities and internal consistency were then tested. A convenience sample of 498 caregivers of hospitalized patients with cancer was recruited from oncology units in three tertiary public hospitals in Hefei city, mainland China. Exploratory factor analysis revealed four domains of the SCNS-P&C-C, which resemble the original English version scale. The convergent validity of the SCNS-P&C-C has established with statistically significant correlations between the SCNS-P&C-C and the Chinese version of Kessler Psychological Distress Scale (r = 0.327, P < 0.01). The SCNS-P&C-C has also good internal consistency with Cronbach's alpha coefficients ranging from 0.79 to 0.89 for the four subscales and 0.94 for the total scale. The Chinese version of the SCNS-P&C was found to be reliable and valid to assess the supportive care needs for partners and caregivers of Chinese patients with cancer. The SCNS-P&C-C can be used to assess and understand the supportive care needs of Chinese caregivers of patients with cancer. Such information will help the healthcare professionals to formulate tailored supportive care services for the caregivers of Chinese patients with cancer.
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Cuidadores/psicologia , Avaliação das Necessidades , Neoplasias/terapia , Psicometria , Cônjuges/psicologia , Inquéritos e Questionários/normas , Adulto , Povo Asiático , China , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias/psicologia , Reprodutibilidade dos Testes , Projetos de Pesquisa , TraduçõesRESUMO
AIMS: To evaluate a web-based educational smoking cessation programme on changes in the frequency of hospital-based nurses' self-reported interventions to help smokers quit using the 5 As (i.e. Ask, Advise, Assess, Assist, Arrange), to reduce exposure to second-hand smoke and to change attitudes about nurses' involvement in tobacco control. BACKGROUND: Few nurses in China support smokers' quit attempts using evidence-based smoking cessation interventions based on the 5 As. Limited knowledge is a barrier to intervention. Web-based tobacco cessation programs have the potential to reach a large population of nurses. DESIGN: A prospective single-group design with pre-, 3- and 6-month follow-up after the educational programme evaluated the feasibility of conducting web-based educational programs in two cities in China in 2012-2013. METHODS: Frequency of interventions was assessed using a valid and reliable web-based survey with a convenience sample of nurses from eight hospitals in Beijing and Hefei, China. Generalized linear models, adjusting for age, clinical setting, education and site were used to determine changes in the consistent (usually/always) use of the 5 As from baseline to 3 and to 6 months. RESULTS: Nurses (N = 1386) had baseline and/or 3- and 6-month data. At 6 months, nurses were significantly more likely to Assess, Assist and Arrange for smoking cessation and recommend smoke-free home environments. There was significant improvement in attitudes about tobacco control. CONCLUSIONS: Nurses receiving web-based smoking cessation education significantly increased self-reports of frequency of providing interventions to patients who smoke, including recommending smoke-free home environments to support quit attempts.
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Instrução por Computador , Internet , Recursos Humanos de Enfermagem/educação , Recursos Humanos de Enfermagem/psicologia , Abandono do Hábito de Fumar/psicologia , Fumar/psicologia , Tabagismo/psicologia , Adulto , Povo Asiático/psicologia , Atitude do Pessoal de Saúde , China , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Papel do Profissional de Enfermagem , Relações Enfermeiro-Paciente , Estudos Prospectivos , Fatores Sexuais , Inquéritos e QuestionáriosRESUMO
AIMS: To describe the self-reported frequency of Chinese nurses' interventions to help smokers quit, using the 5 As (i.e. Ask, Advise, Assess, Assist, Arrange), attitudes towards tobacco control and differences in consistency interventions by demographic and professional characteristics prior to an educational intervention to increase nurses' support for quit efforts. BACKGROUND: Tobacco use is the leading cause of preventable death in China; quitting smoking reduces health risks and premature death. The China Tobacco Cessation Treatment Guideline supports the 5 As model for intervention, but nurses' frequency of delivering smoking cessation interventions is unknown. DESIGN: Descriptive survey using a convenience sample. METHODS: Nurses from eight hospitals in Beijing and Hefei, China completed a web-based survey in 2012. Differences in consistency of the 5 As by nurse characteristics were determined using multivariate logistic regression. Overall importance of nurses in tobacco control was evaluated on a 1-5 scale (5 = most important). RESULTS: Nurses (N = 2440; 1404 Beijing, 1036 Hefei) participated. 64% consistently asked about smoking status, 85% advised patients to quit, 52% assessed readiness to quit and assisted with smoking cessation and 17% arranged for follow-up. Interventions varied by nurses' education and clinical setting. Nurses positively viewed involvement in tobacco control (4·3/5) and thought nurses should be smoke-free role models (4·8/5·0). CONCLUSIONS: This study demonstrates that the majority of nurses asked about smoking status, but few assisted patients with quitting. Further efforts are needed to help nurses actively promote smoking cessation interventions.
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Atitude do Pessoal de Saúde , Papel do Profissional de Enfermagem , Recursos Humanos de Enfermagem/educação , Recursos Humanos de Enfermagem/psicologia , Abandono do Hábito de Fumar/psicologia , Fumar/psicologia , Tabagismo/psicologia , Idoso , Povo Asiático/psicologia , China , Feminino , Promoção da Saúde/métodos , Humanos , Masculino , Relações Enfermeiro-Paciente , Inquéritos e Questionários , Adulto JovemRESUMO
This study was conducted to understand patients' experiences of nursing support, to identify gaps between patients' expected needs and the nursing support they received, and to explore reasons for such disparity. A qualitative study with a phenomenological approach was used. A purposive sample of 22 patients with different types of cancer was recruited and interviewed using semistructured guidelines. The data were analyzed using phenomenological analytic methods. Several needs regarding nursing support were expressed, including informational, psychological, clinical, care coordination and communication needs, and there were some unmet or partially-met needs. Reasons for the disparities covered both patient- and nurse-related factors, including patients' lack of awareness regarding how to acquire professional assistance and reluctance to express their needs, and nurses' lack of active communication with patients, inability to provide specific support, and limited resources for coordination. The expectations of nursing support did not always correspond with the actual delivery of nursing care. A tailored intervention is warranted to meet patients' expectations, which might contribute to quality-of-care improvements.
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Neoplasias/psicologia , Cuidados de Enfermagem/normas , Percepção , Relações Médico-Enfermeiro , Apoio Social , Adulto , Idoso , China , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pesquisa QualitativaRESUMO
To investigate the surgical strategy of repeated microscopic transsphenoidal surgery (TSS) for treatment of pituitary adenoma, surgical techniques and treatment outcomes for 29 patients with pituitary adenoma were reviewed and analyzed. There were 17 patients who underwent TSS 18 times and 12 patients who underwent TSS 13 times. The interval between each TSS ranged from 3 months to 18 years, with a median time of 4 years. The tumor height was 15 to 45 mm on the last surgery. Among the 29 patients, 16 patients underwent total tumor resection, 11 patients underwent subtotal resection, and 2 patients underwent partial resection. Cerebrospinal fluid leak occurred in 10 patients. Among 24 patients who were followed up effectively, 1 patient developed abducens paralysis after surgery, 1 patient had chronic diabetes insipidus, and 1 patient received steroid-dependent alternative treatment. The repeated TSS may present satisfied outcomes in experienced hands. The upper edge of the posterior choanae should be identified to ensure the right orientation. The openings of the anterior wall of the sphenoid sinus and the sellar floor should be appropriately expanded to improve tumor exposure. The artificial materials should be identified and removed carefully. Intraoperative cerebrospinal fluid leakage should be managed well.
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Adenoma/cirurgia , Neoplasias Hipofisárias/cirurgia , Seio Esfenoidal/cirurgia , Adulto , Idoso , Materiais Biocompatíveis/uso terapêutico , Vazamento de Líquido Cefalorraquidiano/prevenção & controle , Diabetes Insípido/etiologia , Feminino , Seguimentos , Esponja de Gelatina Absorvível/uso terapêutico , Humanos , Complicações Intraoperatórias/prevenção & controle , Masculino , Microcirurgia/métodos , Pessoa de Meia-Idade , Cavidade Nasal/cirurgia , Septo Nasal/cirurgia , Recidiva Local de Neoplasia/cirurgia , Neoplasia Residual/cirurgia , Complicações Pós-Operatórias , Reoperação , Estudos Retrospectivos , Seio Esfenoidal/patologia , Cirurgia Assistida por Computador/métodos , Adesivos Teciduais/uso terapêutico , Resultado do Tratamento , Adulto JovemRESUMO
AIMS AND OBJECTIVES: The purpose of this study was to investigate the prevalence of preoperative psychological distress and its relationship with coping style and quality of life in Chinese patients with newly diagnosed gastric cancer. BACKGROUND: Being newly diagnosed with cancer can be a source of psychological distress. Understanding the preoperative psychological distress may contribute to the development of appropriate interventions. DESIGN: This is a descriptive correlational survey study. METHODS: The study was conducted in two teaching hospitals in Anhui province, China. A total of 165 patients with gastric cancer completed a battery of self-report questionnaires including the Distress Thermometer, the revised Chinese version of the Quality of Life Questionnaire-Stomach 22 and the Cancer Coping Modes Questionnaire. RESULTS: The prevalence of clinically significant preoperative psychological distress was 76·97% in this group. Statistically significant correlations were identified between the distress score and stomach pain, eating restrictions and anxiety subscale. Positive associations were found between the distress scores and four subdimensions of coping (avoidance and suppression, resignation, fantasy and catharsis), whereas a negative association was found between the distress scores and one subdimension of coping (Confrontation). There were also significant differences in the quality of life and coping style of patients who had different psychological distress statuses. CONCLUSION: These findings indicate a relatively high prevalence of preoperative psychological distress among Chinese patients with gastric cancer. Patients with clinically psychological distress were more likely to have poor quality of life and to demonstrate negative coping styles. RELEVANCE TO CLINICAL PRACTICE: Nursing professionals need to carefully assess the psychological status of patients with gastric cancer. Tailored interventions can be administered to help these patients appropriately cope with the disease and to enhance their quality of life.
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Adaptação Psicológica , Qualidade de Vida , Neoplasias Gástricas/psicologia , Estresse Psicológico/epidemiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , China/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Período Pré-Operatório , Prevalência , Psicometria , Neoplasias Gástricas/enfermagem , Neoplasias Gástricas/cirurgia , Estresse Psicológico/enfermagem , Estresse Psicológico/psicologia , Inquéritos e QuestionáriosRESUMO
PURPOSE: This study aimed to (1) explore the needs of cancer patients regarding common nursing professional social support from the perspective of physicians and nurses, (2) identify what type of needs clinical nurses actually fulfill and what remains to be improved, and (3) analyze the potential reasons for the gap between the identified needs and those that are fulfilled. METHODS: A qualitative approach using focus group interviews was adopted to explore the perception and provision of cancer patients' needs regarding nursing professional social support. A purposive sample of 32 health care professionals was recruited from two teaching hospitals in Anhui province, China. Five focus group interviews were conducted and all interviews were tape-recorded and transcribed verbatim. A content analysis was performed with the data. RESULTS: The healthcare professionals perceived various nursing professional support needs of cancer patients; these include informational, emotional/psychological, and technical support needs; the mobilization of social resources; and palliative care during certain stages. The findings also indicated that there are still many unmet needs, especially needs related to the mobilization of social resources and palliative care. The reasons for the deficiencies in the fulfillment of these needs varied and included both subjective and objective aspects, such as the patients' lack of awareness of how to search for professional support, a shortage of professional staff, and the lack of a culturally appropriate assessment tool. CONCLUSIONS: Cancer patients' supportive care needs were not always fully provided by nurses, even when these needs were identified by healthcare professionals. Nursing professional social support needs should be assessed quickly and effectively so that the appropriate interventions can be offered to cancer patients.
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Necessidades e Demandas de Serviços de Saúde , Neoplasias/enfermagem , Papel do Profissional de Enfermagem , Apoio Social , Adulto , China , Emoções , Feminino , Humanos , Masculino , Neoplasias/psicologia , Cuidados Paliativos , Satisfação Pessoal , Inquéritos e Questionários , Adulto JovemRESUMO
PURPOSE: This study aims to elucidate the longitudinal alterations in frailty and health-related quality of life experienced by elderly patients undergoing surgical treatment for esophageal cancer. Additionally, it seeks to ascertain the impact of preoperative frailty on postoperative health-related quality of life over time. METHODS: 131 patients were included in the prospective study. Patients' frailty and health-related quality-of-life were assessed utilizing the Tilburg and European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 at preoperative, 1 week, 1 month, and 3 months, postoperatively. Statistical analyses were performed using generalized estimating equations, repeated-measures analysis of variance, and linear mixed models (LMMs). RESULTS: Out of 131 patients, 28.2% had frailty before surgery, and the prevalence of frailty consistently higher after surgery compared with baseline (67.9%, 51.9%, and 39.7%). There was no significant change in frailty scores in preoperative frail patients within 3 months following surgery (p = .496, p < .999, p < .999); whereas in preoperative non-frail patients, the frailty scores increased at 1 week (p < .001) and then decreased at 1 month (p = .014), followed by no change at 3 months. In addition, preoperative frail patients had significantly worse global quality-of-life (ß = -4.24 (-8.31; -.18), p = .041), physical functioning (ß = -9.87 (-14.59; -5.16), p < .001), role functioning (ß = -10.04 (-15.76; -4.33), p = .001), and social functioning (ß = -8.58 (-15.49; -1.68), p = .015), compared with non-frail patients. CONCLUSIONS: A significant proportion of participants exhibited a high prevalence of preoperative frailty. These patients, who were preoperatively frail, exhibited a marked reduction in health-related quality-of-life, a more gradual recovery across various functional domains, and an increased symptom burden during the follow-up period. Therefore, it is crucial to meticulously identify and closely monitor patients with preoperative frailty for any changes in their postoperative physiology, role, and social functioning.
Assuntos
Neoplasias Esofágicas , Fragilidade , Qualidade de Vida , Humanos , Qualidade de Vida/psicologia , Idoso , Masculino , Feminino , Neoplasias Esofágicas/cirurgia , Neoplasias Esofágicas/psicologia , Estudos Longitudinais , Estudos Prospectivos , Fragilidade/psicologia , Idoso Fragilizado/psicologia , Idoso de 80 Anos ou mais , Pessoa de Meia-Idade , Inquéritos e QuestionáriosRESUMO
Lung cancer is the most common cancer and the leading cause of death in China. The current gold standard for clinical lung cancer diagnosis is based on histopathological examination of tumors, but it has the limitation for easy operation and convenient applications. Therefore, researchers are still striving to develop other tools and methods for non-invasive and rapid assessment of the health conditions of lung cancer patients. Hair, as a reflection of the metabolism of the body, is closely related to human health conditions. In principle, Fourier-transform infrared (FTIR) spectroscopy can probe the major chemical compositions in the hair. However, as indicated by previous studies, there is still the challenge to make good use of FTIR spectroscopy for achieving reliable analysis of hair from cancer patients. In this study, hair samples from 82 lung cancer patients were collected and subjected to FTIR measurements and analysis, which showed the protein content in the hair is closely related to the protein content in the blood serum of patients, and the contents of protein and lipid are statistically lower in the lung cancer patients. Furthermore, we demonstrated that FTIR spectroscopy could be employed to monitor the hair of lung cancer patients undergoing chemotherapy, and confirmed that the FTIR spectra of the hair may reflect the resultant effect of the chemotherapy. As such, this work validates the way of using FTIR spectroscopy in hair analysis for the assistance of medical diagnosis of lung cancer as well as monitoring the conditions of the patients under the medical treatment.