The Moderated Mediating Effects of Nutrition and Physical Activity Between Fatigue and Quality of Life in Childhood Cancer Survivors

Purpose@#The aim of this study was to investigate the associations between nutrition, physical activity, fatigue, and quality of life (QoL) among childhood cancer survivors. The specific purpose was to examine whether nutrition mediated and physical activity moderated the relationship between fatigue and QoL in this population. @*Methods@#A pooled sample of 120 childhood cancer survivors was recruited at pediatric oncology wards and ambulatory settings between August 2020 and May 2021. We collected data on participants’ demographic characteristics, fatigue, nutritional status, physical activity, and QoL. We then adapted Hayes Process Macro to examine the mediating and moderating effects of nutrition and physical activity on the relationship between fatigue and QoL. @*Results@#In models adjusted for age and sex, (1) the simple mediation analysis identified the mediating effect of nutrition on the relationship between fatigue and QoL; and (2) the mediation and moderation analysis identified that the direct effect of nutrition between fatigue and QoL was significant when adding (a) physical activity and (b) fatigue × physical activity. There were significantly decreasing trends in physical activity at 1 standard deviation below the mean and at the mean, but not at 1 standard deviation above the mean. @*Conclusions@#Our findings demonstrate that nutrition mediated and physical activity moderated the relationship between fatigue and QoL. This highlights an opportunity to enhance QoL among childhood cancer survivors through healthy lifestyle interventions. To ensure that future interventions address children's needs and promote the greatest impact, such interventions should include nutrition and physical activity components that involve nurses, pediatric oncology physicians, nutritionists, and physical therapists.Keyword

Communication in Oncology Outpatient Clinic Settings: Congruence of Quality of Life Assessment between Patient-Physician and Patient-Caregiver Dyads.

Objectives: The aims of this study were to investigate the congruence of HRQOL reports between patient-physician and patient-caregiver dyads and to determine the association of variables, if any, with the congruence between dyads. Methods: This correlational study with a cross-sectional design first approached physicians who provided care for patients with advanced cancer at the participating institution. Then, participating physicians' patients and their caregivers were recruited. All participants were required to independently fill out an HRQOL questionnaire during their outpatient visits. Descriptive statistics, weighted kappa, Wilcoxon signed-rank test, and linear regression were employed for data analysis. Results: A total of 52 patient-physician and 27 patient-caregiver dyads were examined. Patients suffered from considerable problems in all three HRQOL domains: symptom, functioning, and overall HRQOL. The patients' level of agreement was moderate with the caregivers and fair with the physicians. A significant relationship was found between several patient-related variables and disagreement. Conclusion: These patients with advanced cancer experienced a compromised HRQOL, warranting immediate attention. When there are barriers to obtaining a patient's self-report, clinicians may consider caregivers as a reasonable source. Patients with special characteristics need additional attention because their problems may be at a greater risk of being overlooked.

[Case-control study on spinal leveraging manipulation and medicine for the treatment of degenerative scoliosis].

OBJECTIVE: To compare clinical effects of spinal leveraging manipulation and medicine for the treatment of degenerative scoliosis in pain and function. METHODS: From July 2010 to June 2013, 38 patients with degenerative scoliosis were randomly divided into spinal leveraging manipulation group and medicine group by coin tossing. In manipulation group, there were 9 males and 11 females aged from 58 to 74 years old with an average of (66.63±7.73), the courses of diseases ranged from 3 to 8 months with an average of (5.65±2.58), spinal leveraging manipulation(following meridian to straighten tendon,relieving spasm, osteopathy and massage, clearing and activating the channels and collaterals) were performed for 30 min, once a day, 4 days for a period treatment, totally 9 courses. In medicine group, there were 8 males and 10 females aged from 57 to 70 years old with an average of (63.51±6.61) the courses of diseases ranged from 3 to 5 months with an average of (4.82±1.43), celecoxib with eperisone hydrochloride were orally taken, 4 days for a period treatment, totally 9 courses. VAS score, Cobb angle and ODI score were measured. RESULTS: After treatment, VAS score in manipulation group was (5.38±0.99), (6.36±1.31) in medicine group,and had significant meaning (t=2.618, P<0.05); there was significant differences in Cobb angle between manipulation group (16.51±4.89)° and medicine group (19.85±5.03) °(t=2.074,P<0.05); and had obviously meaning in ODI score between manipulation group (20.20±2.93) and medicine group (26.01±3.11) (t=5.592, P<0.05). CONCLUSION: Spinal leveraging manipulation for degenerative scoliosis could regulate muscle balance on both side of spine, correct coronal imbalances in spine, recover normal sequence of spine, reduce and remove opperssion and stimulation of nerve root, relieve pain in leg and waist and further improve quality of life.

Development and Preliminary Evaluation of Psychometric Properties of Symptom-Management Self-Efficacy Scale for Breast Cancer Related to Chemotherapy

PURPOSE: The purpose of this study was to develop and preliminarily evaluate the reliability and validity of the Symptom-Management Self-Efficacy ScaleeBreast Cancer (SMSES-BC) related to chemotherapy. METHODS: The study included three stages. This paper presents the results of stage 2 and stage 3. In total, 34 items in the SMSES-BC were found during stage 1 from qualitative findings, a literature review, and expert suggestions; the 34 items were used for the psychometric properties test. Test-retest reliability and Cronbach alpha were assessed in the first sample, which included 45 participants for the pilot test (stage 2). The second sample, which included 152 patients, was used to assess the construct validity and concurrent validity (stage 3). RESULTS: The pilot test results revealed a test-retest reliability of .73 (p < .001) and Cronbach alpha coefficient of .96 for the total scale. Three factors (managing chemotherapy-related symptoms, acquiring problem solving, and managing emotional and interpersonal disturbances) were identified from exploratory factor analysis. Correlation coefficient r was .40 (p < .001), which supported the association between SMSES-BC and the General Self-Efficacy Scale for concurrent validity. CONCLUSIONS: The study results demonstrate acceptable reliability and validity for the SMSES-BC that was developed for measuring symptom-management self-efficacy related to chemotherapy for patients with breast cancer. This study suggests further research to validate the construct of the SMSES-BC.