Subgroups of sleep quality and associated risk factors in patients with cancer undergoing radiotherapy: A cross-sectional study based on latent profile analysis.

PURPOSE: To identify latent classes of sleep quality among patients with cancer undergoing radiotherapy, and to examine the predictors of different latent classes. METHODS: This cross-sectional study included 238 cancer patients. The assessment instrument included the Pittsburgh Sleep Quality Index, the sleep hygiene awareness and practice scale, the MD Anderson Symptom Inventory, the Distress Thermometer and the Fear of Cancer Recurrence Questionnaire. Latent profile analysis was used to identify different sleep quality subgroups. RESULTS: Three latent classes with distinct sleep characteristics were identified: good sleep quality (class 1, 66.8%), moderate sleep disturbance with high hypnotics use (class 2, 9.2%), and high sleep disturbance with low hypnotics use (class 3, 24.0%) classes. Patients who were young (P = 0.022) and diagnosed with cancer stage Ⅲ (P = 0.021) were significantly more likely to be in Class 3 than in Class 1. Patients with a senior middle school were less likely to fall into Class 2, but more likely to fall into Class 1 (P = 0.026). Those with higher sleep hygiene practice scores (P = 0.022; P < 0.001), symptom severity (P < 0.001; P < 0.001), and psychological distress (P = 0.040; P < 0.001) had a significantly higher probability of being classified in Class 2 or Class 3 than in Class 1. CONCLUSIONS: Our study revealed the heterogeneity of sleep quality in patients with cancer undergoing radiotherapy; moreover, through our findings, targeted interventions may be developed to promote the sleep quality of these patients.

Efficacy of traditional Chinese medicine external therapy on sleep quality in patients with cancer: A systematic review and network meta-analysis.

Objective: This network meta-analysis aims to assess and compare the effectiveness of various external therapies from traditional Chinese medicine (TCM) in enhancing sleep quality among patients with cancer. Methods: We systematically searched nine electronic databases, encompassing five English and four Chinese databases, for randomized controlled trials (RCTs) from their inception up to August 10, 2023. The random effects model was utilized for effect size analysis, and the standardized mean difference (SMD) along with its corresponding 95% confidence interval (CI) were computed. Network meta-analysis and comparative effects ranking were executed utilizing STATA 14.0. Results: We included thirty-four RCTs involving seven distinct external TCM therapies. Among these, Chinese medicine pillow (SMD = -3.27; 95% CI: -6.03 to -0.51), auricular acupressure (SMD = -2.33; 95% CI: -3.36 to -1.29), moxibustion (SMD = -2.28; 95% CI: -3.63 to -0.94), acupressure (SMD = -1.67; 95% CI: -2.64 to -0.70), and acupuncture (SMD = -1.43; 95% CI: -2.65 to -0.21) demonstrated significant effects in improving sleep quality when compared to usual care or waitlist. The cumulative ranking curve values revealed that the Chinese medicine pillow exhibited the highest potential for effectively enhancing sleep quality in patients with cancer, followed by auricular acupressure, moxibustion, acupressure, acupuncture, Tuina, and electroacupuncture. Conclusions: Our study highlights the Chinese medicine pillow as an optimal external TCM therapy for ameliorating sleep quality in cancer patients, but more RCTs are needed to validate this conclusion. These findings serve as valuable support for future clinical trials and research endeavors. Systematic review registration: CRD42022381370.

Adolescent's anhedonia and association with childhood trauma among Chinese adolescents: a cross-sectional study.

OBJECTIVES: To estimate the level of anhedonia among adolescents and explore the association between anhedonia and childhood trauma (CT). DESIGN: A stratified random cluster sample of adolescents participated in a survey, which included three questionnaires: Snaith-Pamilton Pleasure Scale, Childhood Trauma Questionnaire and Patient Health Questionnaire-9. SETTING: The study was conducted in 60 classes in 10 primary, middle and high schools in five economically developed cities along the Southeast Coast of China from April to October 2022. PARTICIPANTS: One thousand seven hundred and forty-five adolescents with ages ranging from 9 to 18 years participated in the study. PRIMARY AND SECONDARY OUTCOMES: The primary outcome was the level of anhedonia, CT and depression among adolescents. The association between anhedonia and CT was determined. RESULTS: The mean scores of anhedonia, CT and depression were 24.88 (6.18), 36.75 (8.87) and 4.46 (5.36), respectively. Anhedonia scores of boys (24.24±6.12) and girls (25.62±6.16) were different (t=-4.69, p<0.01). After controlling for sex, age, the presence of siblings and depression, CT was associated with adolescent anhedonia. Emotional abuse (ß=0.14), emotional neglect (ß=0.15) and physical neglect (ß=0.10) positively predicted adolescent anhedonia (p<0.01), whereas physical abuse negatively predicted adolescent anhedonia (ß=-0.07, p<0.01). Sex had a moderating effect on the relationship between adolescent anhedonia and emotional neglect during childhood, and the negative effect of emotional neglect on adolescent anhedonia in girls was greater than in boys. CONCLUSIONS: CT, including emotional abuse, physical abuse, emotional neglect, and physical neglect, was an independent predictor of adolescents' ability to experience pleasure in daily life. Therefore, awareness of CT should be promoted. Emotional neglect had a more severe effect on anhedonia among girls than among boys, suggesting that emotional neglect should be paid much attention among girls.

Effects of family-centered positive psychological intervention on psychological health and quality of life in patients with breast cancer and their caregivers.

PURPOSE: Positive psychological intervention could improve individual's psychological health and quality of life. This study aimed to examine the effectiveness of family-centered positive psychological intervention on resilience, hope, perceived benefits, and quality of life in breast cancer patients and their caregivers. METHODS: A two-group, randomized controlled study, including 98 dyads of breast cancer patients and caregivers, was conducted. Dyads were randomly assigned to intervention (n = 49) and control (n = 49) groups. Both the control and intervention groups received 4 weeks of health education, while the intervention group additionally received a 4-week family-centered positive psychological intervention. Outcome measures compared at baseline (T1), immediately after the intervention (T2), and at 1-month follow-up (T3), included validated measures of resilience (Connor-Davidson Resilience Scale), hope (Herth Hope Index), perceived benefits (Perceived Benefits of Diagnosis and Treatment of Breast Cancer, Positive Aspects of Caregiving), and quality of life (Functional Assessment of Cancer Therapy-Breast, Caregiver Quality of Life Scale). RESULTS: Resilience, hope, perceived benefits, and quality of life of dyads were significantly higher in the intervention group than those in the control group at T2 and T3 (all p < 0.05). Linear mixed model analysis demonstrated a significant interaction effect of group × time × role (p = 0.007) on hope and a significant difference in the improvement of hope (p < 0.05) between patients and their caregivers. CONCLUSIONS: Our family-centered positive psychological intervention was effective in improving psychological health and quality of life for breast cancer patients and caregivers. This study provides evidence for the effectiveness of positive clinical psychological interventions. TRIAL REGISTRATION: ChiCTR2300072809.

Efficacy of mind-body therapies for sleep disturbance in patients with early-stage cancer: A systematic review and network meta-analysis.

OBJECTIVE: To evaluate and compare the efficacy of different mind-body therapies (MBTs) for sleep disturbance in patients with early-stage cancer. METHODS: Randomised controlled trials that included patients (aged ≥18 years) with early stage cancer who underwent MBTs (mindfulness, hypnosis, relaxation, yoga, and qigong) were searched in the CINAHL via the EBSCO Host, Cochrane Library, Embase, MEDLINE, PsycINFO, PubMed, and Scopus databases, from the date of database inception to October 2022. The outcomes were subjective sleep disturbance and objective sleep efficiency. Network meta-analysis (NMA) and comparative effects ranking were performed using STATA (v14.0; STATACorp, College Station, TX, USA). RESULTS: Forty-seven studies investigating five MBTs were included in the NMA. For cancer patients receiving active treatment, mindfulness demonstrated the largest effect size in reducing subjective sleep disturbance (standardised mean difference [SMD]: 0.85; 95% confidence intervals [CI]: 0.20-1.50; Grading of Recommendations Assessment, Development, and Evaluation assessment: moderate), and had the highest cumulative probability compared to usual care or waitlist. For cancer patients who had completed active treatment, qigong demonstrated the largest effect size in reducing subjective sleep disturbance (SMD: 0.99; 95% CI: 0.35-1.63; GRADE: low), followed by hypnosis (SMD: 0.87; 95% CI: 0.32-1.42; GRADE: moderate), and mindfulness (SMD: 0.42; 95% CI: 0.24-0.59; GRADE: moderate). Qigong also demonstrated the largest effect size in improving objective sleep efficiency (weighted mean differences: 10.76; 95% CI: 2.01-19.50; GRADE: low); however, the effect of qigong was tested in only one study in this NMA. Among the eight different treatment conditions, cognitive behavioral therapy (CBT) showed the highest cumulative probability (surface under the cumulative ranking curve: 96.3%) in reducing subjective sleep disturbance and the second highest cumulative probability (SUCRA: 83.3%) in improving objective sleep efficiency. CONCLUSION: There is no evidence supporting the use of MBTs to replace or be comparable to CBT. Mindfulness can be recommended as an optional treatment for reducing sleep disturbance in patients with early-stage cancer. Some support was observed for qigong and hypnosis in reducing sleep disturbances in patients with early-stage cancer who had completed active treatment. More rigorous trials are warranted to confirm whether different forms of MBTs have different effects on sleep in patients with cancer.

Mind-body therapies for sleep disturbance among patients with cancer: A systematic review and meta-analysis.

OBJECTIVES: To assess whether mind-body therapies (MBTs) are effective for relieving sleep disturbance among patients with cancer. DESIGN: Systematic review and meta-analysis of randomized controlled trials (RCTs). METHODS: Seven English electronic databases were searched from the date of inception to September 2022. All RCTs that included adults (≥18 years) who were treated with mindfulness, yoga, qigong, relaxation, and hypnosis were screened. The outcome was subjective and/or objective sleep disturbance.The revised Cochrane tool (RoB 2.0) was applied to evaluate the risk of bias. The RevMan software was applied to assessed each outcome according different control groups and assessment time points. Subgroup analyses were performed according to different categories of MBTs. RESULTS: Sixty-eight RCTs (6339 participants) were identified. After requesting for missing data from corresponding authors of included RCTs, 56 studies (5051 participants) were included in the meta-analysis. The meta-analysis showed a significant immediate effect of mindfulness, yoga, relaxation, and hypnosis on subjective sleep disturbance, compared with usual care or wait list control, and the effect of mindfulness lasted at least 6 months. For objective sleep outcomes, we observed significant immediate effects of yoga on wake after sleep onset and of mindfulness on sleep onset latency and total sleep time. Compared with active control interventions, MBTs had no significant effect on sleep disturbance. CONCLUSIONS: Mindfulness, yoga, relaxation, and hypnosis were effective in sleep disturbance severity reduction among patients with cancer at post-intervention, and the effect of mindfulness lasted at least 6 months. Future MBTs studies should apply both objective and subjective sleep measurement tools.

Construction of a cutoff and fusion model of breast cancer patients in family: a grounded theory study.

PURPOSE: To construct a coping model for interactions between breast cancer patients and their families across the disease trajectory using the patients' voice, and to establish a mechanism for restoring family balance when faced with stresses related to breast cancer. METHODS: This study employed a longitudinal qualitative study design using constructivist grounded theory. We divided breast cancer trajectory into four periods: suspicion, diagnosis, treatment, and rehabilitation. We then interviewed patients during each of these periods. RESULTS: Twenty patients with breast cancer were interviewed. A cutoff and fusion model of the breast cancer patient's interactions with her family contained three coping themes: independence, coexistence, and interconversion. The coping trajectory of breast cancer patients in their families has specific themes in each period, such as anxiety, information, emotion, and experience. CONCLUSION: We constructed a cutoff and fusion model of breast cancer patients' coping trajectory in their families. This model not only explains the opposite, coexistent, and interconvertible relationship between cutoff and fusion but also the specific challenges requiring cutoff and fusion during the four periods. Our findings highlight the dynamic balance of cutoff and fusion for patients' coping in their families. IMPLICATIONS FOR PRACTICE: This model helps clinical staff understand the coping of breast cancer patients in their families. When providing family education, clinical staff should suggest that they not only provide support to the patient but give each other space as well.

Effect of a group-based acceptance and commitment therapy programme on the mental health of clinical nurses during the COVID-19 sporadic outbreak period.

AIM: To develop and implement of a group-based acceptance and commitment therapy programme in helping clinical nurses with mental health problems during the sporadic COVID-19 outbreak period. BACKGROUND: In the face of the continuing COVID-19 pandemic, clinical nurses have a high risk of mental health issues. METHODS: A quasi-experimental design was used. Two hundred twenty-six nurses were recruited from four general hospitals to receive 10 sessions of acceptance and commitment therapy programme. The Symptom Checklist-90, Perceived Stress Scale and Connor-Davidson Resilience Scale were used to assess nurses' mental health symptom, perceived stress and psychological resilience at pre-intervention and 4-week post-intervention. RESULTS: The mean attendance sessions was 5.78. The Symptom Checklist-90 score was significantly lower at post-intervention than pre-intervention (P < 0.01), and there were no significant changes of perceived stress and psychological resilience. There were significant correlations among the changed rates of mental health, perceived stress and psychological resilience (P < 0.01). CONCLUSION: The acceptance and commitment therapy programme was effective in relieving mental health symptoms for clinical nurses and could protect clinical nurses' perceived stress and psychological resilience. However, a randomized controlled trial is needed to confirm the findings. IMPLICATION FOR NURSING MANAGEMENT: To facilitate clinical nurses' psychological health in crisis situation, nursing management team should provide and allocated appropriate resources to support the healthcare providers.

[Illness cognition and related factors in patients with prostate cancer].

OBJECTIVE: To study the illness cognition and related factors in patients with prostate cancer (PCa). METHODS: Using the convenience-sampling method, we selected 231 PCa patients treated in a general hospital in Xuzhou from October 2019 to October 2020. We conducted a cross-sectional study of the cases based on the general data of the patients and their scores on the Illness Cognition Questionnaire (ICQ). RESULTS: The PCa patients showed a high negative and a low positive illness cognition. The ICQ scores of the patients were high on "helplessness" (13.70 ± 3.54) and low on "acceptance" (16.64 ± 3.37) and "perceived benefits" (13.93 ± 3.76). Age, disease duration, disease stage and number of children were the four factors included in the regression equation of the participants' illness cognition. CONCLUSION: Negative illness cognition is high in PCa patients, higher in those at a younger age, with a longer disease duration, or with more than one child than in those at an older age, with a shorter disease duration, or with only one or no child.