Feasibility of an exercise-nutrition-psychology integrated rehabilitation model based on mobile health and virtual reality for cancer patients: a single-center, single-arm, prospective phase II study.

OBJECTIVE: Explore the feasibility of a mobile health(mHealth) and virtual reality (VR) based nutrition-exercise-psychology integrated rehabilitation model in Chinese cancer patients. METHODS: We recruited cancer patients in the Oncology department of the Affiliated Changzhou No. 2 People's Hospital of Nanjing Medical University from October 2022 to April 2023. The rehabilitation program was provided by a team of medical oncologists, dietitians, psychotherapists, and oncology specialist nurses. Participants received standard anti-cancer therapy and integrated intervention including hospitalized group-based exercise classes, at-home physical activity prescription, behavior change education, oral nutrition supplements, and psychological counseling. An effective intervention course includes two consecutive hospitalization and two periods of home-based rehabilitation (8 weeks). Access the feasibility as well as changes in aspects of physical, nutritional, and psychological status. RESULTS: At the cutoff date of April 2023, the recruitment rate was 75% (123/165). 11.4%patients were lost to follow-up, and 3.25% withdrew halfway. Respectively, the completion rate of nutrition, exercise, and psychology were 85%,55%, and 63%. Nutrition interventions show the highest compliance. The parameters in nutrition, psychology, muscle mass, and quality of life after the rehabilitation showed significant improvements (P < .05). There was no significant statistical difference (P > .05) in handgrip strength and 6-minute walking speed. CONCLUSION: It is feasible to conduct mHealth and VR-based nutrition-exercise-psychology integrated rehabilitation model in Chinese cancer patients. A larger multi-center trial is warranted in the future. TRIAL REGISTRATION: ChiCTR2200065748 Registered 14 November 2022.

Perceived Stress and Psychological Impact Among Healthcare Workers at a Tertiaty Hospital in China During the COVID-19 Outbreak: The Moderating Role of Resilience and Social Support.

Aims: To investigate the psychological distress experienced by healthcare workers (HCWs) at a tertiary hospital in Changzhou, China, outside Wuhan, during the early stage of COVID-19 and evaluate the moderating effects of resilience and social support on the relationship between stress and psychological distress. Methods: The study was conducted between February 10 and 15, 2020, in a non-probabilistic way. The survey included questions regarding the risk of exposure, sociodemographics, perceived stress [10-item Perceived Stress Scale (PSS-10)], resilience [10-item Connor-Davidson Psychological Resilience (CD-RISC-10)], social support [Multidimensional Scale of Perceived Social Support (MSPSS)], and psychological distress [12-item General Health Questionnaire (GHQ-12)]. We applied the PROCESS macro for SPSS to test the hypotheses that resilience and social support moderated the stress response. In addition, a simple slope analysis was conducted when the interaction effect was statistically significant. Results: Some 33.6% of participants suffered from psychological distress (GHQ-12 ≥ 12). Perceived stress was positively related to psychological distress (r = 0.42, p < 0.001). In addition, resilience (ΔR2 = 0.03, p for interaction < 0.001) and social support (ΔR2 = 0.01, p for interaction <0.01) moderated the stress response. The impact of perceived stress on psychological distress was attenuated when subjects who were resilient (high ß = 0.15, p < 0.001; low ß = 0.36, p < 0.001), and perceived stress had less impact on psychological distress when social support was high (ß = 0.24, p < 0.001) rather than low (ß = 0.34, p < 0.001). Limitations: The cross-sectional design led to a lack of causal relationships between variables. Conclusions: Our data showed that resilience and social support moderated the stress response among HCWs in the pandemic, suggesting that improving resilience and social support could be appropriate targets to improve HCWs' mental health in the pandemic.

Diagnosis and Monitoring Value of Diffusion-Weighted Magnetic Resonance Imaging Using Neuroendocrine Analysis During Radiotherapy for Laryngeal Cancer.

We used 1.5T magnetic resonance imaging (MRI) to investigate the role of semiquantitative parameters related to dynamic contrast-enhanced (DCE)-MRI and the apparent diffusion coefficient (ADC) of diffusion-weighted imaging (DWI) in predicting and monitoring the efficacy of concurrent radiotherapy and chemotherapy for laryngeal cancer. The data from 58 patients with newly diagnosed laryngeal cancer who had been treated at our hospital from August 2016 to March 2018 were collected. The 58 patients included 56 men and 2 women, with a median age of 57 years. The pathologic examination of the biopsy specimens revealed squamous cell carcinoma. The time signal curve (TIC) of the tumor and related semiquantitative parameters was measured before, during (radiation dose, 50 Gy), and at the end of treatment (monitoring value after treatment). The results revealed that the TIC types and DCE-MRI-related semiquantitative parameters can predict the efficacy of concurrent chemoradiotherapy for laryngeal and hypopharyngeal cancer. Of the semiquantitative parameters, the signal enhancement ratio at 56 seconds had the greatest predictive value. Patients with TIC type I before treatment had a better prognosis than those with TIC type III. The pre-ADC value was not enough to predict the efficacy. The ADC value, DCE-MRI-related semiquantitative parameters, and their change before treatment had a certain effect in monitoring the changes in water molecule diffusion movement and hemodynamic changes after tumor treatment. However, these were not enough to predict the efficacy.