Network evolution of core symptoms after lung cancer thoracoscopic surgery:A dynamic network analysis.

OBJECTIVES: To investigate relationships between various symptoms occurring 1-2 and 5-6 days following days after thoracoscopic surgery, to identify core symptoms, and to monitor changes in core symptoms over time following lung cancer thoracoscopic surgery. METHODS: We evaluated symptoms using the Anderson Symptom Scale (Chinese version) and the Lung Cancer-Specific Symptoms Template in 214 lung cancer patients hospitalized in the Department of Thoracic Surgery of a provincial hospital in Jiangsu Province from March 2023 to September 2023. Data was collected at 1-2 days and 5-6 days postoperatively. Symptom networks were constructed for each time point, and centrality indicators were analyzed to identify core symptoms while controlling for influencing factors. RESULTS: According to the network analysis, fatigue (rs = 26.00、rc = 0.05、rb = 1.02) had the highest strength, closeness, and betweenness in the symptom network 1-2 days after lung cancer surgery. At 5-6 days after surgery, shortness of breath (rs = 27.00) emerged as the symptom with the highest strength, fatigue (rc = 0.04) had the highest closeness, and cough (rb = 1.08) ranked highest in betweenness within the symptom network. CONCLUSION: Fatigue stands out as the most core symptom in the network 1-2 days after lung cancer surgery. Shortness of breath, fatigue and cough are the most core symptoms in the symptom network 5-6 days after surgery. Therefore, clinical staff can improve the postoperative symptom experience of lung cancer patients by developing symptom management programmes tailored to these core symptoms.

Association between dietary inflammatory potential and frailty is mediated by inflammation among patients with colorectal cancer: A cross-sectional study.

Patients with colorectal cancer (CRC) are at high risk of frailty, leading to reduced quality of life and survival. Diet is associated with frailty in the elderly through regulating inflammation. Thus, we hypothesized that dietary inflammatory potential (as assessed by dietary inflammatory index [DII]) might be associated with frailty in patients with CRC through regulating inflammatory biomarkers. A total of 231 patients with CRC were included in this cross-sectional study. Dietary intake was evaluated by 3-day, 24-hour dietary recalls, and frailty status was assessed in accordance with the Fried frailty criteria. Plasma inflammatory cytokines were determined in 126 blood samples. A total of 67 patients (29.0%) were frail, with significantly higher DII scores than nonfrail patients, accompanied with significantly increased interleukin-6 (IL-6) and decreased interleukin-10 (IL-10) concentrations. Each 1-point increase of DII was related to a 25.0% increased risk of frailty. IL-6 was positively correlated with frailty and DII, whereas IL-10 was negatively correlated. After adjusting for age, sex, body mass index, education level, smoking status, and energy, mediation analysis revealed that the association between DII and frailty was significantly mediated by IL-6 (average causal mediation effect [ACME], 0.052; 95% confidence interval, 0.020-0.087; P = .002) and IL-10 (ACME, 0.025; 95% confidence interval, 0.004-0.063; P = .016). The ρ values for the sensitivity measure at which estimated ACMEs were zero were 0.3 and -0.2 for IL-6 and IL-10, respectively. Therefore, a pro-inflammatory diet was associated with frailty in patients with CRC possibly in part by affecting circulating IL-6 and IL-10 concentrations.

Effectiveness of Person-Centered Health Education in the General Practice of Geriatric Chronic Disease Care.

Objective: This study assesses the impact of personalized health education on elderly patients with chronic diseases in a general practice setting. The rationale behind the incorporation of personalized health education stems from the growing recognition of the need for patient-centered care approaches, particularly in geriatric populations, where such interventions could lead to improved health outcomes. Our study aims to evaluate the effects of personalized health education on elderly patients with chronic diseases in a general practice context. The initiation of this study is grounded in the increasing acknowledgment of patient-centered care's significance, especially in geriatric demographics. We hypothesize that personalized health education interventions could significantly enhance health outcomes in this patient group. Methods: We conducted a randomized controlled trial involving 126 elderly patients with chronic diseases, assigning them equally to receive either standard care or standard care supplemented with personalized health education. The effectiveness of this education was measured through outcomes related to cognition, self-care, health literacy, psychological and physical health, quality of life, and prognosis. In our study, we executed a randomized controlled trial encompassing 126 elderly patients diagnosed with a range of chronic diseases. These participants were evenly divided into two groups: one receiving standard care and the other receiving standard care enhanced with personalized health education. The study spanned over a specified period, during which the impact of the personalized health education was meticulously evaluated. To comprehensively measure the effectiveness of the personalized health education, we employed a variety of tools and scales. These instruments were specifically chosen to assess changes in cognition, self-care abilities, health literacy, and psychological and physical health. Additionally, we evaluated the quality of life and prognosis of these patients, aiming to capture the holistic impact of the intervention. This approach ensured a thorough and nuanced understanding of how personalized health education influences the health outcomes of elderly patients with chronic diseases. Results: The intervention group demonstrated significant improvements across all measured outcomes compared to the control group, highlighting the efficacy of personalized health education in enhancing comprehensive health parameters in geriatric patients with chronic conditions. In our study, the intervention group, which received personalized health education, exhibited notable improvements in several key areas compared to the control group. Specifically, there was a marked enhancement in cognition and health literacy, with patients showing improved understanding and management of their conditions. Additionally, significant gains were observed in the quality of life, indicating that the tailored health education effectively addressed the holistic needs of geriatric patients with chronic diseases. These specific findings underscore the substantial impact of personalized health education in improving critical health outcomes in this patient population. Conclusion: Personalized health education in geriatric chronic disease management significantly betters disease comprehension, health literacy, self-care, psychological well-being, and physical health while also lowering the risk of adverse events. This study underscores the value of patient-centered educational strategies in chronic disease care for the elderly.Our study conclusively demonstrates that personalized health education plays a pivotal role in managing chronic diseases among the elderly. It significantly improves disease comprehension, health literacy, self-care capabilities, psychological well-being, and physical health. Furthermore, it contributes to a reduced risk of adverse health events. These findings emphasize the critical importance of integrating patient-centered educational strategies into general practice care for the elderly. By doing so, we can enhance their overall well-being and quality of life, making personalized health education an essential component in the holistic care of elderly patients with chronic conditions. This approach not only aligns with the principles of modern geriatric care but also sets a benchmark for the future of chronic disease management in older populations.

A survey of nurses' knowledge, attitudes, and practice of sarcopenia: A cross-sectional study.

AIM: This paper aims to assess the current knowledge, attitudes, and behaviors of nursing staff regarding sarcopenia and explore associating factors that influence them. BACKGROUND: Sarcopenia has an insidious onset and is easily overlooked. However, it is has become very common in older people, seriously jeopardizing the quality of life in patients. The present situation of nurses in China is inadequate, even though they are the primary professionals tasked with screening for sarcopenia, the ability to recognize and effectively manage the disease, and the critical role they play in preventing and controlling sarcopenia in patients. DESIGN: We conducted a cross-sectional design of nurses. METHODS: Facilitated sampling was used in seven hospitals in Jiangsu Province, China. A total of 409 hospital nursing staff participated in the survey from December 2022 to March 2023. The main survey instruments were the nursing staff about the knowledge of sarcopenia, beliefs, a behavior questionnaire, and a self-designed general information questionnaire. Descriptive of general data, t-test, and ANOVA for influencing factors of three dimensions, whereas multiple linear regression analyses were performed using SPSS23.0 software. RESULTS: Questionnaires were distributed to 460 nurses, and of the 426 (92.6%) questionnaires returned, 409 (96.0%) were valid. The total mean score of nurses' knowledge, beliefs, and behavior about sarcopenia was 125.42 (SD 18.97), the mean score of knowledge latitude was 29.09 (SD 7.80), the mean score of attitude dimension was 57.53 (SD 7.63), and the mean score of behavior latitude was 38.80 (SD 10.71). Multiple linear regression analysis revealed that the nurse's position, Knowledge of sarcopenia, whether or not they were specialist nurses and years of experience in the workplace were the most significant factors correlated with the level of knowledge, belief, and practice (P < 0.05). CONCLUSIONS: In China, nurses have little knowledge about sarcopenia, but their attitude towards sarcopenia care is positive. However, there is potential for improvement in nursing behavior toward sarcopenia management. RELEVANCE TO CLINICAL PRACTICE: Managers are advised to develop targeted training programs for nurses. Further, it improves their screening and diagnosing abilities, allowing them to prevent and control sarcopenia more effectively.

Dyadic effects of social support, illness uncertainty on anxiety and depression among lung cancer patients and their caregivers: a cross-sectional study.

OBJECTIVES: To explore the dyadic relationships between perceived social support, illness uncertainty, anxiety, and depression among lung cancer patients and their family caregivers. To examine the potential mediating role of illness uncertainty and the moderating role of disease stage in lung cancer patient-caregiver dyads. METHODS: A total of 308 pairs of lung cancer patients and their family caregivers from a tertiary hospital in Wuxi, China, from January 2022 to June 2022 were included. Participants' perceived social support, illness uncertainty, anxiety, and depression were assessed by corresponding questionnaires. To test for dyadic relationships between the variables, we employed the actor-partner interdependence mediation model. RESULTS: There were actor and partner effects of both patient and caregiver perceived social support on anxiety and depression, and illness uncertainty mediated the effect of perceived social support on anxiety and depression. Lung cancer stage plays a moderating role in lung cancer patient-caregiver dyads. There is an indirect positive partner effect of perceived social support from family caregivers on anxiety and depression in patients with early lung cancer; there is a direct or indirect negative partner effect of social support from family caregivers on anxiety and depression in patients with advanced lung cancer. CONCLUSIONS: This study confirmed the dyadic interdependence between perceived social support, illness uncertainty, anxiety, and depression among lung cancer patients and family caregivers. Furthermore, studies on differences between different lung cancer stages may provide a theoretical basis for different dyadic supportive interventions based on lung cancer stages.

Factors influencing return to work 3 months after percutaneous coronary intervention in young and middle-aged patients with coronary heart disease: A single-center, cross-sectional study.

BACKGROUND: Today, patients with coronary heart disease (CHD) are becoming younger and younger, and after percutaneous coronary intervention (PCI), most patients want to resume their occupations. The return to work of patients with CHD post PCI in China, however, has received little research attention. So, the goal of this study was to investigate the variables impacting the return to work following PCI in young and middle-aged patients with CHD in Wuxi and to offer a reference basis for the development of targeted interventions. METHODS: This study was executed at the Affiliated Hospital of Jiangnan University. We selected 280 young and middle-aged patients who underwent PCI for CHD as the study subjects and gathered general data about them while they were hospitalized. At 3 months after PCI, we surveyed the subjects with the return to work self-efficacy questionnaire, the Chinese version of the brief fatigue inventory, and the social support rating scale, and obtained information about their return to work. The factors affecting patients' returning to work were analyzed using binary logistic regression. RESULTS: The final 255 cases were included in the study, of which 155 (60.8%) were successfully returned to work. Binary logistic regression showed that women (OR = 0.379, 95%CI:0.169,0.851), ejection fraction ≥50% (OR = 2.053, 95%CI:1.085,3.885), the brain-based job types (OR = 2.902, 95%CI:1.361,6.190), the kind of employment requiring both mental and physical capacity (OR = 2.867, 95%CI:1.224,6.715), moderate fatigue (OR = 6.023, 95%:1.596,22.7251), mild fatigue (OR = 4.035, 95%:1.104,14.751), return to work efficacy (OR = 1.839, 95%:1.140,3.144), and social support (OR = 1.060, 95%:1.003,1.121) were independent influences on patients' return to work at 3 months after PCI (All P<0.05). CONCLUSION: In order to help patient return to work as soon as possible, healthcare professionals should focus on those who are female, have worked mainly in physical activities, have low return-to-work self-efficacy, have severe fatigue, have low social support, and have poor ejection fraction.

Impact of caregiver burden on caregiver mental health in patients with esophageal cancer: chain mediating effects of benefit finding and rumination, a cross-sectional study.

Background: Cancer caregivers are the main supporter for the tumor patients, they not only need to provide daily nursing to the patients, but also suffering the pressure from economy, emotion and even family members. The mental health of tumor patient is mostly noticed, while not caregivers. The mental health of caregiver greatly affected the nursing quality and even the treatment outcomes. In the current study, the mechanisms underlying the links between caregiver burden, benefit finding, mental health, and rumination in those caring for people with esophageal cancer were examined. Methods: The study was using a convenience sampling, 166 esophageal cancer patients in 2 general hospitals in Jiangsu Province, China, and caregivers of patients were included after excluded the non-conforming patients. Data were collected using investigator-developed questionnaires, the Benefit Finding Scale (BFS), the Event-Related Rumination Inventory (ERRI), the Zarit Burden Interview (ZBI), and the Hospital Anxiety and Depression Scale (HADS) during May 2020 to December 2020. The results were analyzed by SPSS, and the chain mediating effect was analyzed by the the SPSS PROCESS Macro Model. Results: The study comprised 166 caregivers with an average age of (59.96±11.48) years, most of them were female (85.5%). The ZBI was positive correlated with HADS (r=0.882, P<0.01), and negative correlated with BFS (r=-0.873, P<0.01). Intrusive rumination and deliberate rumination in caregivers were negatively correlated (r=-0.901, P<0.01) and positive correlated (r=0.904, P<0.01) with BFS scores, respectively. Furthermore, research have discovered a chain mediation impact of benefit finding and rumination between caregiver burden and psychological well-being among carers of esophageal cancer patients. Conclusions: The findings of this study imply that benefit finding and rumination are crucial components of the coping strategy used to buffer against negative emotion (such as anxiety and depression). Therefore, the mental health of caregivers should also be noticed, and health care professionals should provide targeted interventions to increase the caregiver's level of benefit finding and promote deliberate ruminative thinking.

Impact of Gut Microbiota on the Association between Diet and Depressive Symptoms in Breast Cancer.

Little is known about the relationship between diet and depression through the gut microbiota among breast cancer patients. This study aimed to examine the dietary intake differences between depressed breast cancer (DBC) and non-depressed breast cancer (NBC) patients, and whether the differences could lead to gut microbiota changes that affect depressive symptoms. Participants completed the Center for Epidemiological Studies-Depression Scale (CES-D) and 24 h dietary recall. Fecal samples of 18 DBC patients and 37 NBC patients were collected for next-generation sequencing. A total of 60 out of 205 breast cancer patients reported significant depressive symptoms suggested by a CES-D score ≥ 16, which might be related to lower intakes of energy, protein, dietary fiber, vitamin A, vitamin B2, niacin, calcium, phosphorus, potassium, iron, zinc, selenium, manganese and tryptophan, and a poor diet quality indicated by a lower total Chinese Healthy Eating Index (CHEI) score. Additionally, NBC patients demonstrated greater gut microbiota diversity and a healthier composition, in which the relative abundances of Proteobacteria and Escherichia-Shigella were both lower than in the DBC patients (p < 0.05). Alpha diversity was a significant mediator between diet quality and depression, while calcium, phosphorus and selenium significantly regulated depression independent of the gut microbiota. Breast cancer-related depressive symptoms might be associated with a poor diet quality via gut microbiota-dependent pathways and lower micronutrient intake via microbiota-independent pathways.

TNF-α Mediates the Association between Dietary Inflammatory Index and Depressive Symptoms in Breast Cancer.

This study examined the association between the energy-adjusted Dietary Inflammatory Index (E-DII)-based dietary inflammatory potential and depressive symptoms (DepS) among patients with breast cancer and explores whether systemic inflammation mediates this association. We assessed dietary intake and DepS in 220 breast cancer patients by three 24 h dietary recalls and the Center for Epidemiological Studies Depression Scale (CES-D), respectively, and determined plasma levels of C-reactive protein (CRP), tumor necrosis factor-α (TNF-α), and interleukin (IL)-1ß, IL-4, and IL-6 in 123 blood samples. We found that each one-point increase of E-DII was related to a 53% elevated risk of DepS. Patients with the most pro-inflammatory diets had a 5.13 times higher risk of DepS than those with the most anti-inflammatory diets. Among the E-DII components, vitamin B2, zinc, and iron were inversely associated with DepS risk. Furthermore, E-DII scores were positively associated with CRP and TNF-α. Higher levels of TNF-α and IL-6 were associated with higher DepS risk. A significant mediating effect of TNF-α was revealed between E-DII and DepS. Our findings suggest that a pro-inflammatory diet is positively associated with breast cancer-related DepS, which may be mediated by TNF-α.

The construction of the structural equation model of burden, benefit finding, and anxiety-depression of esophageal cancer caregivers based on Lazarus stress and coping theory.

BACKGROUND: A large number of studies have shown that the assignment of long-term care duties brings great pressure and negative emotions to caregivers of cancer patients, and also affects the quality of care. Lazarus and Folkman's stress and coping theory holds that the process of cognition and evaluation of stress is key to the stress response when a stressor acts on individuals. This study is to explore the mediating effect of benefit finding between caregiver burden and anxiety-depression of esophageal cancer caregivers, according to a model hypothesis constructed based on stress and coping theory. The design of this study involved correlation and theoretical testing using a structural equation model. METHODS: A total of 228 pairs of esophageal cancer patients from 2 tertiary hospitals and their family caregivers were recruited in this study from May 2020 to January 2021. A questionnaire survey was conducted using the general information questionnaire, the caregiver burden inventory (CBI), the benefit finding scale (BFS), and the hospital anxiety and depression scale (HADS). RESULTS: A good fitting model [chi-square (χ2)/degrees of freedom (df) =2.212, root mean square error of approximation (RMSEA) =0.07, comparative fit index (CFI) =0.976, Tucker-Lewis index (TLI) =0.964, goodness of fit (GFI) =0.954, normed fit index (NFI) =0.957] indicated the mediating effect of benefit finding between caregiver burden and anxiety-depression of esophageal cancer caregivers. A higher level of benefit finding had a negative effect on caregiver burden and anxiety-depression, which reduced the burden and psychological distress of caregivers. The theoretical hypothesis was validated. CONCLUSIONS: Clinical nurses should pay attention to the benefit finding level of caregivers. For caregivers with low-level of benefit finding, intervention measures should be taken to improve the psychological cognitive level of caregivers, which can ultimately improve the quality of life of patients.

Status quo of exercise participation among gastric cancer patients after radical gastrectomy and analysis of the influencing factors.

BACKGROUND: To investigate the status quo of participation in exercise among gastric cancer patients after radical gastrectomy and analyze the influencing factors. METHODS: Convenient sampling was used to conduct a questionnaire survey of 163 patients after radical gastric cancer surgery from January to December 2020. The survey content included general information, exercise participation, exercise knowledge, attitude, and social support. Descriptive statistics, single factor analysis, and multiple linear regression analysis were performed using Statistical Product and Service Solutions 24.0 (SPSS24.0, IBM, USA). RESULTS: After radical gastrectomy, the form of exercise that patients participated in was relatively simple. The average amount of exercise involved was 8.10 Mets-h/week, which was at the level of almost no exercise. Univariate analysis showed that differences in age, gender, education level, work status, main caregivers and sports knowledge, attitudes, and social support levels all led to different levels of exercise participation. Multiple linear regression analysis showed that the factors affecting the patient's level of participation in exercise included age, degree of self-care in life, attitude towards exercise after surgery, and level of social support. CONCLUSIONS: The status quo of exercise participation among gastric cancer patients after radical gastrectomy is not ideal. In this study, we found that age, level of self-care in life, sports attitude, and level of social support were the main factors affecting the exercise participation of patients. Therefore, improving patients' self-care ability, exercise attitude, and increasing social support may play an important role in improving the status quo of patients' exercise participation after radical gastric cancer surgery.

Impacts of psychological resilience on self-efficacy and quality of life in patients with diabetic foot ulcers: a prospective cross-sectional study.

BACKGROUND: Patients with diabetic foot ulcer (DFU) usually have a poor quality of life (QoL) and self-efficacy, which is affected by many risk factors. However, the role of psychological resilience in QoL and self-efficacy in DFU patients has remained unclear. METHODS: This prospective cross-sectional study was performed in a single center from January 2018 to February 2020. A total of 98 DFU patients were enrolled in this study. Some demographic and clinical data were prospectively collected from participants. The psychological resilience of participants was assessed by Connor-Davidson resilience scale (CD-RISC). Self-efficacy was also assessed using the diabetes management self-efficacy scale (DMSES) and QoL was assessed by the 36-item short-form (SF-36) health survey. Univariable and multivariable linear regression were used to analyze the risk factors of self-efficacy and QoL. Then, logistic regression was used to analyze the predictors of psychological resilience among the participants. RESULTS: A CD-RISC score of more than 85 points was defined as high psychological resilience in this study; there were 28 participants diagnosed with high psychological resilience and 70 patients with low psychological resilience. Those with high psychological resilience had significantly higher self-efficacy, general health, vitality, social functioning, role emotional, and mental health than those with low psychological resilience. According to multivariable linear regression, low psychological resilience and older age were identified as risk factors of self-efficacy. On the contrary, low psychological resilience, older age, lower perceived social support and higher level of glycated hemoglobin were identified as risk factors of QoL. Finally, males had lower psychological resilience than females and those receiving more social support had higher psychological resilience than participants receiving less social support. CONCLUSIONS: Some risk factors of QoL and self-efficacy were identified in this study and these results may provide some evidence for the improvement of QoL and self-efficacy in DFU patients. Being female and receiving higher social support were shown to have potential for improving psychological resilience in DFU patients.

Effectiveness of aerobic exercise on upper limb function following breast cancer treatment: a systematic review and meta-analysis.

BACKGROUND: Aerobic exercise is currently considered to be an effective method of rehabilitation in breast cancer patients. Studies have shown that aerobic exercise after breast cancer surgery can improve upper limb function, cardiopulmonary function, and quality of life. Breast cancer rehabilitation guidelines encourage patients to actively participate in aerobic exercise to promote rehabilitation, the current study is to evaluate the effectiveness of aerobic exercise on upper limb muscle strength and range of motion (ROM) following breast cancer treatment. METHODS: Electronic databases (Cochrane Library, PubMed, Web of Science, EBSCO and Embase) were searched for randomized controlled trials (RCTs) published before September 1, 2019, using the search terms "aerobic exercise", "exercise", "breast cancer", "muscle strength", "strength", "flexibility" and "function". Grip strength and shoulder joint ROM were used to evaluate upper limb strength and upper limb flexibility respectively. All statistical tests were performed using RevMan5.3 software. RESULTS: Nine RCTs (421 patients) were included for analysis, with JBI scores ranging from 19 to 23, and bias grade B for all studies among which, there were six studies reported change in grip strength, and five studies reported change in shoulder joint ROM. Meta-analysis showed a statistically significant difference in shoulder flexion ROM (MD =4.97, 95% CI: 0.47-9.46, P=0.03), shoulder abduction ROM (MD =8.95, 95% CI: 0.99-16.91, P=0.03), shoulder internal rotation ROM (MD =3.45, 95% CI: 1.80-5.09, P<0.0001), shoulder external rotation ROM (MD =7.69, 95% CI: 0.06-15.32, P=0.05) between the intervention and control groups following completion of the aerobic exercise intervention, while there were no significant improvement with respect to grip strength and shoulder extension ROM (P>0.05). CONCLUSIONS: Aerobic exercise could improve shoulder joint ROM in breast cancer survivors, but shows no obvious effect on the improvement of upper limb strength.

[Clinical efficacy of heated humidified high-flow nasal cannula in preventing extubation failure in neonates: a Meta analysis].

OBJECTIVE: To evaluate the efficacy and safety of heated humidified high-flow nasal cannula (HHHFNC) in preventing extubation failure in neonates. METHODS: A literature search was performed using PubMed, Cochrane Library, FMRS, and CNKI to collect the randomized controlled trials (RCTs) and quasi-RCTs which compared the clinical efficacy of HHHFNC and nasal continuous positive airway pressure (NCPAP) in preventing extubation failure in neonates. The identified studies were finally selected after full-text search and quality assessment and then subjected to a Meta analysis using RevMan 5.3. RESULTS: Five eligible trials involving 1040 neonates were included in the Meta analysis. The Meta analysis showed that there was no significant difference in treatment failure rate between the HHHFNC and the NCPAP groups. The HHHFNC group had significantly lower incidence rates of nasal trauma (OR=0.49, 95% CI: 0.34-0.71, P=0.0001) and pneumothorax (OR=0.27, 95% CI: 0.07-0.97, P=0.04) than the NCPAP group, but there were no significant differences in the duration to reach full oral feedings and the incidence rates of serious adverse events or other complications between the two groups, such as in-hospital mortality, bronchopulmonary dysplasia, intraventricular hemorrhage, necrotizing enterocolitis, and retinopathy of prematurity. CONCLUSIONS: HHHFNC is safe and effective in preventing extubation failure in neonates.