Smoking and quality of life in lung cancer patients: systematic review.

OBJECTIVES: Lung cancer (LC) accounts for the largest number of cancer deaths worldwide, with smoking being the leading cause for its development. While quality of life (QoL) is a crucial factor in the treatment of patients with LC, the impact of smoking status on QoL remains unclear. This systematic review aims to provide a comprehensive overview of available evidence on the relationship between smoking status and QoL among patients with LC. METHODS: A systematic search of Embase, Medline and Web of Science was conducted. Studies reporting the impact of smoking status on QoL among patients with LC were eligible for inclusion. Two reviewers independently assessed the eligibility of studies, extracted data and evaluated the risk of bias using the Critical Appraisal Skills Programme appraisal tool for cohort studies. A descriptive synthesis was performed due to the heterogeneity of the studies. RESULTS: A total of 23 studies met the inclusion criteria (17 studies providing cross-sectional and 6 longitudinal data). The studies included a total of 10 251 participants. The results suggested a tendency towards lower QoL among smokers compared with non-smokers. The effect of smoking cessation on QoL was insufficiently investigated in the included studies and therefore remains inconclusive. CONCLUSIONS: The findings of this review suggest that current smokers may experience worse QoL than former and never smokers. The results of this systematic review should, however, be viewed in the context of the difficulty of data collection in this patient group given the low survival rates and low performance status, among other factors and in light of the large variety of different QoL measures used. Future research requires uniform QoL measures, a holistic representation of all patients with LC as well as a comprehensive consideration of all potential determinants of QoL. The potential benefits of smoking cessation on QoL among patients with LC require investigation.

What do healthcare workers need? A qualitative study on support strategies to protect mental health of healthcare workers during the SARS-CoV-2 pandemic.

BACKGROUND: To support healthcare workers (HCWs) during the increased burden caused by the SARS-CoV-2 pandemic, numerous recommendations for action and possible interventions have been developed. However, the actual protective factors, needs and desires of those affected, as well as potential barriers to implementing psychological interventions, have been insufficiently examined. This study addresses this research gap and captures HCWs' experiences and views. METHODS: Medical personnel including nursing staff and physicians were recruited for a qualitative study regarding protective factors as well as barriers to the implementation of support services. We conducted 21 individual, semi-structured interviews with members of the medical staff at tertiary care center in Germany. The collected data were analyzed using a qualitative content analysis. RESULTS: The analyses showed that social interaction in the professional and private context was rated as helpful in coping with the challenges of everyday work amplified by the SARS-CoV-2 pandemic. The results also suggest that the available support services, despite being highly valued, were rarely accessed. Possible barriers included the fear of negative consequences when asking for support. It could be deduced that the fear and shame of admitting one's own mistakes as well as the work-related tradition of showing no weakness could be the underlying factors for this fear. RESULTS: The results of this study suggest that medical staff need a more extensive range of low-threshold support services, which should be adapted to the respective needs of the professional groups. The study also provides indications that the norms and expectations represented in the hospital system require critical reflection.

Lethal Lust: Suicidal Behavior and Chemsex-A Narrative Review of the Literature.

Chemsex is described as the use of certain drugs-commonly methamphetamine, gamma-butyrolactone (GBL)/gammahydroxybutyrate (GHB), and mephedrone-before or during planned sexual activity primarily among men who have sex with men (MSM). Evidence shows that MSM who engage in chemsex are at increased risk of physical harm, such as sexually transmittable infections (STIs), and are more likely to experience mental health symptoms. To further assess this, we reviewed the recent literature to evaluate whether the psychological impact of chemsex behavior includes suicidal ideation and suicidal attempts. Pubmed/MEDLINE was searched for articles reporting suicidal ideation and behavior among chemsex users with the terms "chemsex", "sexualized drug use", "suicide", and "mental health". Twelve articles (three case reports and nine cross-sectional studies) were included in the final narrative review. Overall, we retrieved mixed results regarding the relationship between chemsex practice and suicidality outcomes. Considering the inhomogeneous nature of the studies, the findings indicate that suicidality could be an issue of concern among MSM in general but among chemsex users in particular. Possible risk factors for suicidality among chemsex participants may include adversities experienced due to one's sexual orientation and an increased risk for HIV and other STI infections and the resulting negative impact on mental well-being. These aspects warrant further investigations.

Impact of the coronavirus disease 2019 pandemic on healthcare workers: systematic comparison between nurses and medical doctors.

PURPOSE OF REVIEW: The COVID-19 outbreak has had major impact on individual's psychological health and overall well being worldwide. Evidence shows that these psychological challenges are especially prominent in healthcare workers (HCW); especially in nurses. Indeed, several studies report that nurses suffer more psychologically because of the consequences of the pandemic compared with medical doctors. To further look into this, we systematically review the recent literature to see whether the psychological impact of the COVID-19 pandemic differs between medical doctors and nurses across studies and which aspects of mental health are especially affected in nurses. RECENT FINDINGS: Across studies, there is solid evidence that nurses show poorer mental health outcomes compared with medical doctors during the COVID-19 pandemic. This is especially true for symptoms of depression, anxiety and posttraumatic stress disorder (PTSD). Here, prevalence rates in nurses are often higher than 50%. In contrast, general stress levels and burnout seem to be comparable between nurses and medical doctors. SUMMARY: Given that nurses suffer more from depression, anxiety and PTSD symptoms during the COVID-19 pandemic, special programs addressing their needs are required.

How to Reduce Mental Health Burden in Health Care Workers During COVID-19?-A Scoping Review of Guideline Recommendations.

The COVID-19 pandemic has posed an unprecedented demand and a huge burden for healthcare workers (HCWs) worldwide, with alarming reports of heightened mental health problems. To counteract these mental health challenges, guidelines and recommendations for the support of HCWs during the COVID-19 pandemic have been published. With this scoping review and guideline evaluation, we aim to provide a critical overview of these guidelines and recommendations and to guide policy makers in establishing respective surveillance and care programs. In summary, 41 articles were included in this review which were published between April 2020 and May 2021. Across all articles, the guidelines and recommendations could be clustered into four main categories: "Social/structural support," "Work environment," "Communication/Information," "Mental health support." Although there was substantial agreement across articles about the recommendations given, empirical evidence on the effectiveness of these recommendations is still lacking. Moreover, most recommendations were developed without involving different members of the target group (HCWs) or other involved stakeholders. Strategies to detect potential barriers and to implement these guidelines in clinical practice are lacking.