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The economic burden of chronic diseases such as cancer could negatively impact patients’ health and quality of life. The daily management of the disease results in economic needs that patients often face directly, which may lead to real toxicity, just defined as financial toxicity. This study aims to explore cancer patients’ experiences, emotions, opinions, and feelings related to the phenomenon of financial toxicity. A phenomenological qualitative descriptive study was conducted through face-to-face interviews with adult oncological patients. The sample (n = 20) was predominantly composed of females (with a meanly 58 years old) with breast cancer and in chemotherapy treatment. The most relevant topics that emerged from the patients’ experiences were the impact on work, the distance from the treatment centre, the economic efforts, the impact on the quality of life, and the healthcare workers’ support during the healthcare pathway. From the phenomenological analysis of the interviews, three main themes and seven related subthemes emerged. This study provided a phenomenological interpretation of financial toxicity in adult cancer patients and underlines that this issue involves families or caregivers, too. Financial problems appear relevant for those who experience cancer and should be included in a routine assessment by healthcare professionals.

Abstract Background The effect of supplements on mortality risk in patients with cancer remains uncertain and has scarcely been investigated in subgroups of patients with varying characteristics. This study aimed to investigate the association between two popular supplements, fish oil and glucosamine, and mortality risk in a large population-based cohort and determine whether cardiovascular health and clinical prognosis influence these associations. Methods This prospective cohort study analyzed the data of UK Biobank participants who were diagnosed with cancer. The associations of fish oil and glucosamine consumption with mortality were analyzed using Cox proportional hazards models. Subgroup analyses were performed to assess the effects of Life Essential 8 [LE8] scores (a measure of cardiovascular health) and cancer prognosis (grouped according to the survival rates of specific cancer types) on the associations between supplement use and mortality. Results This analysis included 14,920 participants (mean age = 59.9 years; 60.2% female). One third (34.1%) of the participants reported using fish oil, and one fifth (20.5%) reported using glucosamine. Over a median follow-up of 12.0 years, 2,708 all-cause deaths were registered. The use of fish oil was associated with reduced risks of all-cause mortality (adjusted hazard ratio [aHR] = 0.89, 95% Confidence Interval [CI] = 0.81–0.97) and cancer mortality (aHR = 0.89, 95% CI = 0.81–0.98). Similarly, glucosamine use was associated with reduced risks of all-cause mortality (aHR = 0.83, 95% CI = 0.74–0.92) and cancer mortality (aHR = 0.83, 95% CI = 0.74–0.93) in the fully adjusted model. Subgroup analyses revealed that the protective effects of fish oil and glucosamine against mortality risk were only observed in patients with LE8 scores lower than the mean score or a poor cancer prognosis. Additionally, the association between glucosamine use and a reduced risk of CVD-related mortality was only observed in patients with lower LE8 scores. Conclusions This large cohort study identified the potential differential impact of LE8 scores and cancer prognosis on the associations of fish oil and glucosamine supplementation with survival in patients with cancer. This suggests the importance of considering these factors in future research on supplements and in the provision of personalized integrative cancer care.

Introduction: Bloodstream infections (BSIs) in cancer patients are associated with high morbidity and mortality. While common pathogens are well-studied, the role of saprophytic bacteria in BSIs among this population is less understood. To investigate the prevalence and clinical significance of saprophytic pathogens causing BSIs in cancer patients at a tertiary care center. Materials and Methods: This retrospective study included all 200 consecutive adult cancer patients with suspected sepsis over four months. Blood cultures were processed on an automated BACTEC system. Subculture and identification were performed using standard microbiological techniques and the Vitek 2 system. Antimicrobial sensitivity was performed as per CLSI guidelines. Results: The blood culture positivity in these patients was 79% (158/200). Of the 158 positive blood cultures, 10.1% (16/158) were saprophytic pathogens. These included Enterococcus avium, Sphingomonas paucimobilis, Actinomyces meyeri, Kodamaea ohmeri, Elizabethkingia meningoseptica, Aeromonas hydrophila, Achromobacter xylosoxidans, Stenotrophomonas maltophilia, Pantoea dispersa, and Burkholderia pseudomallei. The overall 30-day mortality rate for patients with saprophytic pathogen BSIs was 20%. Conclusion: Saprophytic bacteria have gained recognition as possible human pathogens, especially in immunocompromised patients including cancer patients. Such high-risk patients should be put on empiric antibiotics to improve patient outcomes till the time clinical significance is established.

BACKGROUND: The cancer burden continues to grow globally, exerting tremendous physical, emotional, and financial strain on individuals, families, and communities. The experiences of cancer patients who are diagnosed with cancer at an early stage differ from patients who reached at terminal stage. The current study is an effort to know the lived-in experiences of cancer patients who were diagnosed with cancer and taking treatment at R. L. Jalapa Hospital and Research Center (RLJHRC). MATERIAL AND METHODS: This is a phenomenological study design. Twelve cancer patients diagnosed with cancer and taking treatment at the oncology unit of RLJHRC were selected for the study using a purposive sampling technique. All patients were interviewed using open-ended questionnaires through focus group discussions in a quiet conference room to maintain privacy. The time taken was approximately 60 min to collect data and verbatim transcription. RESULTS: Study results revealed that all cancer patients were females, the majority (33%) were aged between 51 and 60 years, 59% were not having a formal education, and 83% were residing in urban areas. From the study, six themes were extracted, and they were uncertainty, dependent on family, stigma and discrimination, family influence, and believing God with hope and gratitude. CONCLUSION: The study concluded that cancer patients had undergone various psychological problems from the time of diagnosis to treatment. Hence, efforts need to be taken by the concerned authorities to conduct counseling services for these patients and families.

Abstract Background Breast cancer is one of the most common diseases globally that may have side effects on liver and renal function. Pharmacological treatments to reduce adverse liver and renal effects are still limited. It has been proposed that silymarin may possess hepatoprotective and anti-inflammatory properties. The present trial aims to assess the hepatorenal protective efficacy of silymarin supplementation in cancer patients receiving chemotherapy in an outpatient setting. Method This is a randomized, placebo-controlled clinical trial that recruited female breast cancer patients. Participants were randomly assigned to one placebo group and two intervention groups. The control group received 140 mg of placebo daily, while the two intervention groups received 140 mg silymarin daily. Follow-up assessments were conducted at baseline, 3 weeks, and 6 weeks. At the beginning of the study, the patients were subjected to a computed tomography (CT) scan, and the liver and renal parameters such as alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), bilirubin, Blood urea nitrogen (BUN) and Creatinine (Cr) were examined through laboratory tests. Results Despite two deaths and three dropouts, 100 patients completed the study. Silymarin showed significant effects on liver enzymes in the levels of ALP and bilirubin (P 0.05). The medication was well-tolerated, with minimal reported side effects (P > 0.05). Discussion The study suggests that silymarin may have hepato-renal protective potential in breast cancer patients and improve patient tolerance to chemotherapy. The data presented on the efficacy and safety of silymarin may provide stronger foundation for further trials and for a possible use in clinical practice. Trial registration information Registration Number: IRCT20201123049474N2, First Trial Registration: 16/08/2021, Access: https://www.irct.behdasht.gov.ir/trial/57641

Abstract Background In oncology, the suffering of patients and the burnout of health professionals are key issues. Mindfulness meditation is a holistic approach that can help to improve well-being. While numerous studies have shown the benefits of meditation for both patients and health professionals, the added value of offering shared meditation to groups of patients, health professionals and third persons has not been assessed. Beyond strengthening the relationship between carers and patients, opening up meditation sessions to third parties (neither carers nor patients) enables patients to escape the stigma of their illness. We previously conducted a pilot study that validated the feasibility and the relevance of shared meditation with a specifically designed programme. Methods/Design IMPLIC-2 is a two-arm randomised study designed to assess the added value of this meditation programme (optimised following the pilot study), particularly for cancer patients (our target population). People motivated to follow the programme, without previous regular practice of meditation and able to participate in the sessions are eligible. The study will include 96 participants: 16 health professionals, 16 third persons and 64 patients. The latter will be randomized in two arms: the experimental arm (“Shared” meditation) consisting of 4 mixed groups of 8 patients, 4 health professionals and 4 third parties, and the control arm (“Patient” meditation) consisting of 2 groups of 16 patients. Validated questionnaires will be used to measure the effects of the programme, notably in terms of quality of life, perceived stress, feelings of self-efficacy, qualities of mindfulness and self-compassion, and carers’ burn-out. Participants' perception of a change in their quality of life and satisfaction will be measured at the end of the programme. A complementary qualitative focus-group approach will be used to optimise implementation of the programme beyond the study. Discussion The well-being of oncology patients would be improved. Dealing with overworked carers would have a beneficial impact on the way they interact with patients. In addition, encounters between the three types of population will allow otherness to be viewed differently and alleviate suffering by promoting collective humanity. Trial Registration NCT06041607, registered: 09/18/2023. Protocol version Version n°1.2 dated from 08/29/2023.

Summary: Around 40% of cancer patients undergoing chemotherapy are malnourished, i.e. they suffer from an imbalance between nutritional intake and requirements, particularly in terms of energy and protein. This condition is deleterious, as it can lead to a loss of quality of life for the patient, increased mortality, and higher risks of recurrence and progression. In cancer patients, the onset of undernutrition is mainly due to reduced food intake and metabolic alterations, mainly due to the side effects of chemotherapy treatments. Indeed, treatment can lead to alterations in taste and smell, as well as loss of appetite, nausea, difficulty swallowing … Consequently, it is advisable to adapt the patient's nutritional management according to the degree of severity.The aim of this work is to propose food solutions providing protein enrichment to limit muscle loss and energy enrichment to limit weight loss. More specifically, culinary creativity sessions were conducted to propose enriched versions of standard recipes and a preference tests was conducted with patients to evaluate the recipes.The culinary workshop involving multidisciplinary experts (chefs, sensory and nutrition experts) led to the development of enriched recipes for oncology services, a starter, a main course and a dessert. A survey was then carried out with 237 cancer patients and measured their appreciation of the recipes developed. Using nutritional, sensory and preference performances of experimental recipes allowed to define the optimum variants to propose to undernourished patients.This study demonstrated the value of involving chefs and patients in the creation of enriched recipes in order to offer tasty, nutritious and adapted meals.

Summary: Background & Aims: Adoption and maintenance of healthy diets among vulnerable populations, such as cancer patients, can be challenging. The preliminary study of sensory-hedonic responses through the modulation of key sensory properties in food models in healthy participants, could contribute to explore a new method to answer to nutrition in cancer's issue. Sensory and hedonic responses are affected, among other factors, by sensory responsiveness and psychological traits.With the perspective of using the approach to investigate individual differences in sensory and hedonic responses in cancer patients undergoing chemotherapy experiencing taste alterations, two food models were designed and pre-tested with healthy participants. Methods: 223 healthy participants (68% women, 18–70 y.o., 40 mean age; 118 from France and 105 from Italy) participated in the study. Sensory-hedonic responses to four apple juice samples, spiked with four increasing concentrations of mint syrup corresponding to variations in perceived coolness, and to four chickpea cream samples, spiked with glucose-fructose syrup to modulate the perception of sweetness in contrast to the sourness induced by citric acid, were measured. Food neophobia, disgust sensitivity, sensitivity to reward and PROP (6-n-propylthiouracil) responsiveness were measured. Results: Sensory-hedonic responses to the food models were found to vary across participants and allowed to identify different groups. Two clusters were established for the apple juice differing in liking for the coolest sample: Moderate and Extreme Coolness Dislikers. Instead, three clusters were identified for the chickpea cream: 1) Sweet Likers – perceiving sweet as less intense in all samples and showing liking increments with increasing sweetness and decreasing sourness; 2) Sweet Dislikers – tended to perceive higher sweetness intensity and liking raised with increasing sourness and decreasing sweetness; 3) Inverted U-Shaped – with an optimum liking corresponding to intermediate concentrations. Clusters' differences were found in age and in sensitivity to reward, with Sweet Likers being the youngest and the most sensitive to reward. The approach allowed identifying the level of sensory properties that minimized rejection and maximized liking within and across clusters. Conclusions: The two food models will be adopted to study the effect of cancer therapy on taste perception and liking responses, for the development of tailor-made products well accepted by patients experiencing taste alterations.

Abstract Background During the prolonged COVID-19 pandemic, hospitals became focal points for normalised prevention and control. In this study, we investigated the feasibility of an inpatient bed reservation system for cancer patients that was developed in the department?s public WeChat account. We also explored its role in improving operational efficiency and nursing quality management, as well as in optimising nursing workforce deployment. Methods We utilised WeChat to facilitate communication between cancer patients and health care professionals. Furthermore, we collected data on admissions, discharges, average number of hospitalisation days, bed utilisation rate, and the number of bed days occupied by hospitalised patients through the hospital information system and nurses? working hours and competency levels through the nurse scheduling system. The average nursing hours per patient per day were calculated. Through the inpatient bed reservation system, the number of accepted admissions, denied admissions, and cancelled admissions from the reservation system were collected. The impact of the bed reservation system on the department?s operational efficiency was analysed by comparing the number of hospitalisation discharges before and after reservations, as well as the average hospitalisation and bed utilisation rates. By comparing nurses? working hours per month and average nursing hours per patient per day, the system?s impact on nurses? working hours and nursing quality indicators was analysed. Results The average hospitalisation length, bed utilisation rate, and nurses? working hours were significantly lower, and the average number of nursing hours per patient per day was significantly higher after the implementation of the reservation system. The full-cycle bed information management model for cancer patients did not affect the number of discharged patients. Conclusion Patients? ability to reserve bed types from home in advance using the department?s official WeChat-based inpatient bed reservation system allowed nurses to prepare for their work ahead of time. This in turn improved the operational efficiency of the department and nursing quality, and it optimised the deployment of the nursing workforce

Abstract Background Hospitalisation resulting from complications of systemic therapy and radiotherapy places a substantial burden on the patient, society, and healthcare system. To formulate preventive strategies and enhance patient care, it is crucial to understand the connection between complications and the need for subsequent hospitalisation. This review aimed to assess the existing literature on complications related to systemic and radiotherapy treatments for cancer, and their impact on hospitalisation rates. Methods Data was obtained via electronic searches of the PubMed, Scopus, Embase and Google Scholar online databases to select relevant peer-reviewed papers for studies published between January 1, 2000, and August 30, 2023. We searched for a combination of keywords in electronic databases and used a standard form to extract data from each article. The initial specific interest was to categorise the articles based on the aspects explored, especially complications due to systemic and radiotherapy and their impact on hospitalisation. The second interest was to examine the methodological quality of studies to accommodate the inherent heterogeneity. The study protocol was registered with PROSPERO (CRD42023462532). Findings Of 3289 potential articles 25 were selected for inclusion with ~ 34 million patients. Among the selected articles 21 were cohort studies, three were randomised control trials (RCTs) and one study was cross-sectional design. Out of the 25 studies, 6 studies reported ≥ 10 complications, while 7 studies reported complications ranging from 6 to 10. Three studies reported on a single complication, 5 studies reported at least two complications but fewer than six, and 3 studies reported higher numbers of complications (≥ 15) compared with other selected studies. Among the reported complications, neutropenia, cardiac complications, vomiting, fever, and kidney/renal injury were the top-most. The severity of post-therapy complications varied depending on the type of therapy. Studies indicated that patients treated with combination therapy had a higher number of post-therapy complications across the selected studies. Twenty studies (80%) reported the overall rate of hospitalisation among patients. Seven studies revealed a hospitalisation rate of over 50% among cancer patients who had at least one complication. Furthermore, two studies reported a high hospitalisation rate (> 90%) attributed to therapy-repeated complications. Conclusion The burden of post-therapy complications is emerging across treatment modalities. Combination therapy is particularly associated with a higher number of post-therapy complications. Ongoing research and treatment strategies are imperative for mitigating the complications of cancer therapies and treatment procedures. Concurrently, healthcare reforms and enhancement are essential to address the elevated hospitalisation rates resulting from treatment-related complications in cancer patients.

Purpose of the study. To determine the thyroid status of primary cancer patients in the early stages of uterine body cancer, kidney cancer, breast cancer, skin melanoma and lung cancer without a history of endocrine pathology.Patients and methods. The content levels of thyroid-stimulating hormone (TSH), thyroid hormones (THs) T4 and T3 of total and free forms were determined in the blood serum by RIA method in 132 patients with breast cancer, uterine body cancer, lung cancer, kidney cancer and skin melanoma (average age 55 years). The comparison group consisted of practically healthy donors.Results. Only in skin melanoma, serum TSH levels were reduced by 1.5 times (p < 0.05). The T4 content was reduced by 1.4–1.7 times (p < 0.05) in uterine body cancer and kidney cancer, increased in lung cancer patients and 16 % of breast cancer patients by 1.4–1.7 times though (p < 0.05). A 1.3–1.5‑fold low (p < 0.05) T3 level was found in breast cancer, kidney cancer, and skin melanoma, while an 1.6‑fold increase (p < 0.05) was found in uterine body cancer. The revealed changes in THs by the type of clinical hyperthyroidism are an increase of 1.8 times (p < 0.05) FT3 on the background of low TSH in the blood in patients with skin melanoma, and by the type of hyperthyroxinemia in patients with lung cancer and breast cancer, consisting in increased concentrations of T4 and FT3, and with free and total T3 levels in patients uterine body cancer, as well as FT4, without changes in TSH in the blood serum of patients, may be associated with the features of malignant pathology, since it is known that THs are proliferation stimulants and can build up in tumors.Conclusion. The development of a malignant tumor even in the early stages of the disease is perceived by the body as a threat for homeostasis and the response to the occurrence of neoplasm is the reaction of the hypothalamicpituitary-thyroid regulatory axis. As an outcome, patients develop euthyroid disorder syndrome.

The concept of family resilience of cancer patients was discussed through literature review, which provided reference for nursing of cancer patients.

Abstract Background Enterocytozoon bieneusi is the most common species found in humans. Although E. bieneusi has been investigated in humans, genotype profile of E. bieneusi is not known in Türkiye. Methods In this study, we screened E. bieneusi in patients (n = 94) with different types of malignant solid tumors by Real Time PCR and then sequenced E. bieneusi positive samples. All cancer patients were undergoing chemotherapy and had diarrhea. Moreover, as control groups, we also screened E. bieneusi in patients with diarrhea (n = 50) and without diarrhea (n = 50). Results Among all patients analyzed, 33 (17%) were found to be E. bieneusi-positive. As the patients were categorized, the molecular prevalence of E. bieneusi increased to 25.5% among cancer patients with diarrhea. However, the molecular prevalence of E. bieneusi was found to be lower in patients with presenting only diarrhea (8%) and patients without diarrhea (10%). The high molecular prevalence value detected among cancer patients with diarrhea was also statistically significant compared to other patient groups (P = 0.00112 and P = 0.0269). Among the 33 Real Time PCR positive samples, 10 of them were amplified by nested PCR and among these 10 samples, 6 of them were successfully genotyped. The phylogenetic tree showed the presence of D and Type IV which were also identified in stray cats living in İzmir in our previous study. Conclusions High molecular prevalence value indicates the importance of screening stool samples of cancer patients with diarrhea for E. bieneusi and genotyping results indicate that D and Type IV are circulating between humans and cats.

Abstract Background Given the lack of valid and reliable instruments for evaluating the quality of communication between physicians and cancer patients and their family caregivers in China, this study translated and culturally adapted the Quality of Communication questionnaires for cancer patients (QOC-P) and their family caregivers (QOC-F) for use in the Chinese context and evaluated their psychometric properties. Methods The QOC-P and QOC-F were translated following an adapted version of Brislin’s translation model and culturally adapted according to a Delphi expert panel. We pretested and refined the Chinese versions of the QOC-P and QOC-F among 16 dyads of patients and their family caregivers. Subsequently, we administered the questionnaires to 228 dyads of patients and their family caregivers who were recruited from six tertiary hospitals. The content validity, construct validity, convergent validity, and reliability of the QOC-P and QOC-F were examined. Results Through exploratory factor analysis, The QOC-P and QOC-F were divided into two dimensions: general communication and end-of-life communication. The Cronbach’s coefficients ranged from 0.905 to 0.907 for the two subscales of the QOC-P and from 0.908 to 0.953 for the two subscales of the QOC-F. The two-week test-retest reliability was acceptable for both the QOC-P and QOC-F, with intraclass correlation coefficients of 0.993 and 0.991, respectively. The scale content validity index (QOC-P: 0.857, QOC-F: 1.0) and split-half reliability (QOC-P: 0.833, QOC-F: 0.935) were satisfactory. There was a negative correlation with anxiety and depression for both the QOC-P (r = -0.233 & -0.241, p

Abstract This study aimed to investigate impacts of Omicron infection on cancer patients in China. A retrospective study was conducted, including 347 cancer patients undergoing radiotherapy or chemoradiotherapy between July 2022 and March 2023. Three groups involved: 108 patients without SARS-CoV-2 infection (non-COVID-19 group), 102 patients beginning treatment 10 days after first SARS-CoV-2 infection (≥ 10 days COVID-19 group), and 137 patients beginning treatment less than 10 days after first SARS-CoV-2 infection (

Abstract Background Cancer is a disease that transcends what is purely medical, profoundly affecting the day-to-day life of both patients and family members. Previous research has shown that the consequences of cancer are greatly aggravated in patients at the end of life, at a time when they must also grapple with numerous unmet needs. The main objective of this study was to obtain more in-depth insight into these needs, primarily in patients with end-stage cancer nearing death. Methods Semi-structured interviews were conducted in Spain with cancer patients at the end of life (n = 3) and their family members (n = 12). The findings from the interviews were analyzed using qualitative thematic analysis and a grounded theory approach. Results Four major themes emerged from the interviews that explored the needs and concerns of patients with cancer at the end of life: (1) physical well-being (2) emotional well-being (3) social well-being and (4), needs relating to information and autonomous decision-making. The interviews also shed light on the specific needs of family members during this period, namely the difficulties of managing increased caregiver burden and maintaining a healthy work-life balance. Conclusions A lack of support, information and transparency during a period of immense vulnerability makes the end-of-life experience even more difficult for patients with cancer. Our findings highlight the importance of developing a more in-depth understanding of the needs of this population, so that informed efforts can be made to improve palliative healthcare and implement more comprehensive care and support at the end of life.

Abstract Background Patients undergoing radiation therapy (RT) often experience anxiety, which may jeopardize the treatment success. The efficacy of music interventions in reducing anxiety remains contentious. This randomized trial aimed to evaluate the impact of music listening on anxiety symptoms in patients undergoing initial RT. Methods First-time RT patients were randomly allocated to experimental and control groups. The Brief Symptom Rating Scale (BSRS-5), Distress Thermometer (DT), and Beck Anxiety Inventory (BAI-C) were administered pre- and post-RT. Changes in physiological anxiety symptoms were monitored over 10 consecutive days starting from the first day of RT. The experimental group received music during RT; the control group did not. The generalized linear mixed model was used to estimate the pre–post difference in the BSRS-5, DT, and BAI-C scores between the music intervention and control group. Results This study included 50 patients each in the experimental and control groups. BSRS-5 and DT scores were significantly reduced in the experimental group post-RT (p = 0.0114 and p = 0.0023, respectively). When music listening was discontinued, these scores rebounded. While the posttest BAI-C score was significantly lower in the experimental group (p

The incidence of early onset colorectal cancer (EOCRC) in Canada has increased. To address the growing incidence of EOCRC, Colorectal Cancer Canada (CCC) developed the Never Too Young (N2Y) program to identify gaps in care and evaluate patient and caregiver experiences with CRC. The survey was available online using SurveyMonkey across Canada between 12 December 2022 and 1 May 2023. The patient and caregiver survey consisted of 113 and 94 questions, respectively. A total of 108 EOCRC patients and 20 caregivers completed the survey. Many respondents were unaware of EOCRC (41.6%) and the disease symptoms (45.2%) before diagnosis. Patient age at diagnosis was between 45 and 50 years in 31.7%, and 72.8% of them were diagnosed at stage III or IV. A perception of an initial misdiagnosis was common (67.4%) for EOCRC patients, and 51.2% felt dismissed due to their age. Patients and caregivers reported impacts of EOCRC on their mental health, with 70.9% of patients expressing a need for support with depression and 93.3% of caregivers experiencing a constant fear of recurrence of their loved one’s cancer. Improving the Canadian population’s awareness of EOCRC (e.g., CRC symptoms) is important for ensuring timely diagnoses. Similarly, it is critical to ensure that healthcare providers are aware of the increase in EOCRC cases and the unique needs of these patients. Re-evaluation of the CRC screening age should be undertaken in Canada to determine whether lowering the start age to 45 years will improve outcomes in this demographic.

Abstract Background Palliative care schemes, which include pain management, symptom control, psychosocial support and rehabilitation, aim to boost patients’ quality of life, ease the burden and anxiety of informal caregivers, and ultimately provide a comprehensive approach to enhance well-being during this challenging and sensitive period. This study aims to evaluate the impact of a comprehensive rehabilitation palliative care program on the quality of life of patients with terminal cancer and their informal caregivers. Methods This quasi-experimental study, conducted from August 2023 to January 2024 at outpatient clinics affiliated with the Oncology Center at Mansoura University, Egypt, focused on cancer patients and their caregivers in the palliative care department. Employing pre- and post-test phases, data were gathered using a questionnaire, EORTC QLQ C30, Hospital Anxiety and Depression Scale, Short Form Health Survey, Caregiver Burden Inventory, and Beck Anxiety Inventory. The investigation evaluated a 16-week rehabilitation program comprising exercise, psychoeducation, individual counselling, and spiritual support. Exercises, led by a physiotherapist, targeted fatigue and stress through tailored aerobic and resistance training. Psychoeducation sessions aimed to bolster coping abilities, covering fatigue management and nutrition. Trained counsellors addressed spiritual and existential concerns. Personal advisory sessions were available for individual support. Caregivers received education on rehabilitation and palliative care protocols, ensuring comprehensive patient care. Results The mean age for cancer patients was 65.79 ± 13.85. In contrast, the mean age for primary carers was 42.05 ± 11.15. The QOL for cancer patients during the pre-test phase was 77.8 ± 7.16 and rose to 87.34 ± 14.56 during the post-test phase. Additionally, the total anxiety level of patients before the rehabilitation palliative care program was conducted was 15.45 ± 3.05 compared to 6.12 ± 3.21 after the post test phase. Furthermore, the total depression levels of the patients during the pre-test phase were 20.89 ± 9.21. However, after implementing the rehabilitation palliative care program, it decreased to 15.5 ± 6.86. In regards to the total quality of life of informal caregivers, it was measured at 67.28 ± 32.09 before conducting the program. Nevertheless, it increased to 25.95 ± 40.29 after conducting it. Additionally, the total Caregiver Burden Inventory before implementing the program was 37.45 ± 25.7, and it decreased to 29.36 ± 16.4 after conducting it. Additionally, the total score on the Beck Anxiety Inventory decreased from 45.7 ± 4.3 during the initial testing phase to 17.35 ± 23.67. Conclusion The program for rehabilitation palliative care successfully achieved its goals by enhancing the overall quality of life for cancer patients and their caregivers. Additionally, it reduced the anxiety and depression levels among the patients, as well as the anxiety and caregiver burden among the caregivers. Continue research into the effectiveness of rehabilitation palliative care programs to identify best practices, improve existing programs, and expand access to these services.

Abstract Background Death anxiety is thought to cause a range of mental disorders among cancer patients, which may affect their mental health and even quality of life. This study sought to investigate experiential avoidance, meaning in life, and death anxiety among Chinese cancer patients and then explore the relationship between these 3 variables. Methods A total of 300 cancer patients recruited from a tertiary cancer hospital participated in this study from October to December 2021. A cross-sectional survey was conducted using a demographic and clinical characteristics questionnaire, the Acceptance and Action Questionnaire II, the Meaning in Life Questionnaire, and Templer’s Death Anxiety Scale. Correlation analysis, hierarchical regression analysis, and mediating effect analysis were used to analyze the relationship among experiential avoidance, meaning in life (including 2 dimensions: presence of meaning and search for meaning), and death anxiety. Results A total of 315 questionnaires were distributed, and 300 valid questionnaires were returned, resulting in a valid response rate of 95.2%. Experiential avoidance (r = 0.552, p

Abstract Cancer patients experience psychological symptoms such as depression during the cancer treatment period, which increases the burden of symptoms. Depression severity can be assessed using the beck depression inventory (BDI II). The purpose of the study was to use BDI-II scores to measure depression symptoms in cancer patients at a large tertiary hospital in Palestine. A convenience sample of 271 cancer patients was used for a cross-sectional survey. There are descriptions of demographic, clinical, and lifestyle aspects. In addition, the BDI-II is a tool for determining the severity of depression. Two hundred seventy-one patients participated in the survey, for a 95% response rate. Patients ranged in age from 18 to 84 years, with an average age of 47 years. The male-to-female ratio was approximately 1:1, and 59.4% of the patients were outpatients, 153 (56.5%) of whom had hematologic malignancies. Most cancer patients (n = 104, 38.4%) had minimal depression, while 22.5%, 22.1%, and 17.0% had mild, moderate, and severe depression, respectively. Education level, economic status, smoking status, and age were significantly associated with depression. The BDI-II is a useful instrument for monitoring depressive symptoms. The findings support the practice of routinely testing cancer patients for depressive symptoms as part of standard care and referring patients who are at a higher risk of developing psychological morbidity to specialists for treatment as needed.

Abstract Background Chemotherapy, whilst treating tumours, can also lead to numerous adverse reactions such as nausea and vomiting, fatigue and kidney toxicity, threatening the physical and mental health of patients. Simultaneously, misuse of chemotherapeutic drugs can seriously endanger patients' lives. Therefore, to maintain the safety of chemotherapy for cancer patients and to reduce the incidence of adverse reactions to chemotherapy, many guidelines state that a comprehensive assessment of the cancer patient should be conducted and documented before chemotherapy. This recommended procedure, however, has yet to be extensively embraced in Chinese hospitals. As such, this study aimed to standardise the content of pre-chemotherapy assessment for cancer patients in hospitals and to improve nurses' adherence to pre-chemotherapy assessment of cancer patients by conducting a national multi-site evidence implementation in China, hence protecting the safety of cancer patients undergoing chemotherapy and reducing the incidence of adverse reactions to chemotherapy in patients. Methods The national multi-site evidence implementation project was launched by a JBI Centre of Excellence in China and conducted using the JBI approach to evidence implementation. A pre- and post-audit approach was used to evaluate the effectiveness of the project. This project had seven phases: training, planning, baseline audit, evidence implementation, two rounds of follow-up audits (3 and 9 months after evidence implementation, respectively) and sustainability assessment. A live online broadcast allowed all participating hospitals to come together to provide a summary and feedback on the implementation of the project. Results Seventy-four hospitals from 32 cities in China participated in the project, four withdrew during the project's implementation, and 70 hospitals completed the project. The pre-and post-audit showed a significant improvement in the compliance rate of nurses performing pre-chemotherapy assessments for cancer patients. Patient satisfaction and chemotherapy safety were also improved through the project's implementation, and the participating nurses' enthusiasm and belief in implementing evidence into practice was increased. Conclusion The study demonstrated the feasibility of academic centres working with hospitals to promote the dissemination of evidence in clinical practice to accelerate knowledge translation. Further research is needed on the effectiveness of cross-regional and cross-organisational collaborations to facilitate evidence dissemination.

Abstract Background Understanding factors associated with opioid dispensing in cancer patients is important for developing tailored guidelines and ensuring equitable access to pain management. We examined patterns and predictors of opioid dispensing among older cancer patients from 2008 to 2015. Methods We analyzed data from the Surveillance, Epidemiology, and End Results (SEER) database linked to Medicare claims. We included the most common cancer types among patients aged 66–95 years. Opioids dispensed within 30 days before and 120 days after cancer diagnosis were assessed. We used logistic regression models to examine trends, adjusted odds ratios (aORs), and 95% confidence intervals (CIs) for opioid dispensing, considering patient demographics, geography, cancer stage, comorbidities, and treatment options. Models were stratified by sex. Results A total of 211,759 cancer patients aged 66–95 years were included in the study. For cancers combined, non‐Hispanic Black men had a significantly lower odds of receiving opioids during the 120 days post‐diagnosis (aOR = 0.89, 95% CI = 0.84–0.94) compared to non‐Hispanic White men. Factors such as pre‐diagnosis opioid dispensing, age, geography, cancer stage, comorbidities, and type of cancer treatment were associated with opioid dispensing during the 120 days post‐diagnosis. Surgery had the strongest association, with men undergoing surgery being 4.4 times more likely to receive opioids within 120 days post‐diagnosis (aOR = 4.41, 95% CI = 4.23–4.60), while women had an odds ratio of 2.72 (95% CI = 2.62–2.83). Chemotherapy and radiotherapy were also positively associated with opioid dispensing, with less pronounced estimates. Conclusions We observed significant variations in opioid dispensing among cancer patients aged 66‐95 years across cancer types and demographic and clinical factors.

BackgroundSince 2019, approximately 760 million SARS-CoV-2 cases have been reported globally, with post-COVID-19 syndrome posing significant challenges for cancer patients due to their immunosuppressed status and poor nutritional conditions. The role of nutritional status in influencing their infection risk and post-COVID-19 outcomes remains unclear, underscoring the need for targeted research and strategies.ObjectiveTo investigate the impact of baseline nutritional status on SARS-CoV-2 infection and the risk of post-COVID-19 syndrome in cancer patients.MethodsA multicenter cross-sectional study was conducted from December 2022 to June 2023 in four tertiary hospitals across China. Cancer inpatients aged 18 years and older were enrolled and classified into two groups based on their Nutritional Risk Screening (NRS) scores. The correlation between SARS-CoV-2 infection, post-COVID-19 syndrome and nutritional status were analyzed using multivariable logistic regression.ResultsAmong 834 eligible cancer patients, 10.8% were in the high nutritional risk group (NRS ≥ 3). The prevalence of SARS-CoV-2 infection was 58.8% (95% confidence interval, CI: 56.8–60.8%), and post-COVID-19 syndrome was 21.0% (95% CI: 10.4–14.4%). After adjusting for confounding factors, the high nutritional risk group had a significantly higher prevalence of post-COVID-19 syndrome compared to the low nutritional risk group (32.7% vs. 19.5%, AOR: 2.37, 95% CI: 1.23–4.54, p = 0.010). However, no significant difference in SARS-CoV-2 infection rates was found between the two groups (61.1% vs. 58.5%, AOR: 1.12, 95% CI: 0.70–1.80; p = 0.634).InterpretationPoor baseline nutritional status in cancer patients is associated with a higher prevalence of post-COVID-19 syndrome, providing preliminary information on post-COVID-19 syndrome in this population. These findings underscore the importance of adequate nutritional management in cancer patients, particularly during pandemic recurrences.

We are writing to bring the readers’ attention to the evolving perspectives in the treatment of sleep disturbance among cancer patients through behavioral change induction, rather than merely relying on medication. Sleep disturbance negatively affects these patients’ quality of life [1] and therapists increasingly need to understand the role of behavioral interventions in managing sleep problems, which are among distressing symptoms affecting this population.

ObjectiveReminiscence therapy is increasingly being utilized for cancer patients to address psychological pressure and enhance their quality of life. This meta-analysis aimed to comprehensively evaluate the effect of a reminiscence therapy-involved program (RTIP) on anxiety, depression, and quality of life in cancer patients.MethodsA systematic literature search was conducted in the Web of Science, PubMed, Embase, and Cochrane Library databases until December 2023 to screen randomized control trials (RCTs) comparing the effect of RTIP and control care.ResultsA total of 16 RCTs published from 2013 to 2023 were included, with 1,963 cancer patients undergoing RTIP with or without control care (RTIP group, N = 984) or control care (control group, N = 979). The results showed the the anxiety score [standardized mean differences (SMD) = −0.539; 95% confidence interval (CI) = −0.700, −0.378; P < 0.001], anxiety rate [relative risk (RR) = 0.736; 95% CI: 0.627, 0.865; P < 0.001], depression score (SMD = −0.664; 95% CI: −0.967, −0.361; P < 0.001), and depression rate (RR = 0.632; 95% CI = 0.532, 0.750; P < 0.001) were significantly reduced in the RTIP group compared to the control group. Furthermore, overall quality of life was increased in the RTIP group than in the control group (SMD = 0.501; 95% CI: 0.314, 0.689; P < 0.001). In digestive system cancer patients, anxiety/depression scores and rates were reduced, and the overall quality of life was elevated in the RTIP group in comparison with the control group (all P < 0.050). The quality of evidence was generally high, with a low risk of bias in most studies and no publication bias in any outcomes (all P > 0.050).ConclusionRTIP attenuates anxiety and depression and improves the quality of life in cancer patients, benefitting their overall health condition.Systematic Review RegistrationThis meta-analysis was registered at PROSPERO with registration number CRD42024563266.

Disease-related malnutrition is a prevalent issue among cancer patients, affecting approximately 40–80% of those undergoing treatment. This condition is associated with numerous adverse outcomes, including extended hospitalization, increased morbidity and mortality, delayed wound healing, compromised muscle function and reduced overall quality of life. Moreover, malnutrition significantly impedes patients’ tolerance of various cancer therapies, such as surgery, chemotherapy, and radiotherapy, resulting in increased adverse effects, treatment delays, postoperative complications, and higher referral rates. At present, numerous countries and regions have developed objective assessment models to predict the risk of malnutrition in cancer patients. As advanced technologies like artificial intelligence emerge, new modeling techniques offer potential advantages in accuracy over traditional methods. This article aims to provide an exhaustive overview of recently developed models for predicting malnutrition risk in cancer patients, offering valuable guidance for healthcare professionals during clinical decision-making and serving as a reference for the development of more efficient risk prediction models in the future.

Abstract Introduction The COVID‐19 pandemic impacted healthcare organizations, necessitating a rapid transition from in‐person to virtual care. Our study explored the feasibility of a mixed in‐person/telerehabilitation intervention for cancer patients and its effects on cancer‐related fatigue (CRF), quality of life (QoL), physical function, patient satisfaction, and perceived usefulness. Methods TRACE 2020 is an observational prospective study that enrolled adult cancer patients, between January 2021 and March 2023, who were eligible for a rehabilitation program to be provided also in telerehabilitation. Patients were assessed at baseline and after the rehabilitation program. Adherence to sessions, reasons for non‐adherence and adverse events were collected. Results Of the 23 patients enrolled, 87% received a mixed intervention, with an average of 60% in‐person sessions and 40% telerehabilitation sessions. Adherence was very high (91%). Evaluation scales showed an improvement in CRF, QoL, and lower limb strength and a relevant increase in patients' level of physical activity (PA). Most patients reported good satisfaction; the few criticisms mainly concerned difficulties in connectivity, lack of physical contact and difficulties in understanding how to perform exercises during telerehabilitation sessions. The physiotherapist underlined the usefulness of the innovative approach and suggested ways to facilitate future implementation. Conclusion A mixed intervention including telerehabilitation is feasible and accepted by cancer patients. It may have a positive effect on their CRF, QoL, and level of PA and render patient care more flexible. The findings suggest what characteristics the target population for telerehabilitation should have, in order to integrate telerehabilitation in standard care for cancer patients.

IntroductionFocusing-Oriented Psychotherapy has had a long history and influence on the field of psychotherapy. By “clearing a space” and “focusing,” individuals can enhance their emotional awareness and improve their ability to self-regulate. These tasks are particularly relevant in the context of Psycho-Oncology, although the research on their potential benefits for cancer patients is limited. Furthermore, the application of these tasks in a group or online setting has not been thoroughly explored.MethodsThis study aimed to examine the effectiveness of a two-session online intervention based on Focusing for cancer-diagnosed participants and its impact on their mental health and wellbeing. The study involved three participants with a diagnosis of colorectal cancer who were undergoing palliative treatment. We used both qualitative and quantitative methods. PFC-2 was used to assess participants' accomplishment of the task; FMS was used to assess the change in the focusing attitude, while CORE-OM, and PWBS-RV were used as mental health distress and psychological wellbeing measures; participant feedback was collected through questionnaires and a semi-structured interview.ResultsThe results suggest that the tasks led to greater self-awareness, heightened self-reflection, and a sense of relief for the participants.DiscussionThese findings suggest that the group intervention protocol based on online Focusing sessions is potentially useful for broader applications.

Abstract Background In response to the rapid aging population and increasing number of cancer patients, discussions on dignified end-of-life (EoL) decisions are active around the world. Therefore, this study aimed to identify the differences in EoL care patterns between types of hospice used for cancer patients. Methods In this population-based cohort study, the Korean National Health Insurance Service cohort data containing all registered cancer patients who died between 2017 and 2021 were used. A total of 408,964 individuals were eligible for analysis. The variable of interest, the type of hospice used in the 6 months before death, was classified as follows: (1) Non-hospice users; (2) Hospital-based hospice single users; (3) Home-based hospice single users; (4) Combined hospice users. The outcomes were set as patterns of care, including intense care and supportive care. To identify differences in care patterns between hospice types, a generalized linear model with zero-inflated negative binomial distribution was applied. Results Hospice enrollment was associated with less intense care and more supportive care near death. Notably, those who used combined hospice care had the lowest probability and frequency of receiving intense care (aOR: 0.18, 95% CI: 0.17–0.19, aRR: 0.47, 95% CI: 0.44–0.49), while home-based hospice single users had the highest probability and frequency of receiving supportive care (Prescription for narcotic analgesics, aOR: 2.95, 95% CI: 2.69–3.23, aRR: 1.45, 95% CI: 1.41–1.49; Mental health care, aOR: 3.40, 95% CI: 3.13–3.69, aRR: 1.35, 95% CI: 1.31–1.39). Conclusion Our findings suggest that although intense care for life-sustaining decreases with hospice enrollment, QoL at the EoL actually improves with appropriate supportive care. This study is meaningful in that it not only offers valuable insight into hospice care for terminally ill patients, but also provides policy implications for the introduction of patient-centered community-based hospice services.

Abstract Background Due to limited numbers of palliative care specialists and/or resources, accessing palliative care remains limited in many low and middle-income countries. Data science methods, such as rule-based algorithms and text mining, have potential to improve palliative care by facilitating analysis of electronic healthcare records. This study aimed to develop and evaluate a rule-based algorithm for identifying cancer patients who may benefit from palliative care based on the Thai version of the Supportive and Palliative Care Indicators for a Low-Income Setting (SPICT-LIS) criteria. Methods The medical records of 14,363 cancer patients aged 18 years and older, diagnosed between 2016 and 2020 at Songklanagarind Hospital, were analyzed. Two rule-based algorithms, strict and relaxed, were designed to identify key SPICT-LIS indicators in the electronic medical records using tokenization and sentiment analysis. The inter-rater reliability between these two algorithms and palliative care physicians was assessed using percentage agreement and Cohen’s kappa coefficient. Additionally, factors associated with patients might be given palliative care as they will benefit from it were examined. Results The strict rule-based algorithm demonstrated a high degree of accuracy, with 95% agreement and Cohen’s kappa coefficient of 0.83. In contrast, the relaxed rule-based algorithm demonstrated a lower agreement (71% agreement and Cohen’s kappa of 0.16). Advanced-stage cancer with symptoms such as pain, dyspnea, edema, delirium, xerostomia, and anorexia were identified as significant predictors of potentially benefiting from palliative care. Conclusion The integration of rule-based algorithms with electronic medical records offers a promising method for enhancing the timely and accurate identification of patients with cancer might benefit from palliative care.

The literature review evaluates the rehabilitation measures in the country's oncological institutions, assesses regulations in other countries, and scientific publications related to the rehabilitation of cancer patients. Studies were analysed using electronic databases PubMed, Medline, Science Direct, Scopus, Web of Science, e-Library, RSL. Over 47,900 sources were found, of which 50 papers over the past ten years were selected and included in the article. The criteria for inclusion were the rehabilitation of cancer patients, stages of rehabilitation, pre-rehabilitation, nutritional support, psychological assistance, and quality of patients’ life. Considering the urgency of the problem, WHO 2017 took the initiative and adopted the Rehabilitation 2030 program, which provides expanding global access to high-quality rehabilitation as an essential health service for people with non-communicable diseases. According to summarized data, rehabilitation is based on the following principles: stage-by-stage process, consistency, complexity, and individual approach. The stages of medical rehabilitation of cancer patients include pre-rehabilitation; stage I – a period of specialized treatment; stage II – rehabilitation in a hospital setting after discharge; and stage III – early and late rehabilitation periods. An analysis of the situation in Tajikistan showed that in oncology-related institutions, rehabilitation of cancer patients is carried out within the framework of existing protocols for individual nosology, where a set of measures for the stages of rehabilitation is not sufficiently developed. A practical assessment of the effectiveness of rehabilitation is not set up. The stereotype about limiting the use of physiotherapy and sanatorium-resort treatment for cancer patients persists. There are no regulations for comprehensive rehabilitation of cancer patients. The need to optimize treatment results, prolong the survival of patients with various functional disorders, and improve the quality of life dictates the necessity for the development and systematic implementation of comprehensive rehabilitation of cancer patients.

Abstract Background Since the biological material that remains after diagnostic and therapeutic procedures plays crucial role in biobank research, this study aims to explore cancer patients’ views on the donation of biospecimens for research purposes. Methods 548 oncology patients from two hospitals with oncology treatment units in Poznan, Poland, completed an anonymous, self-administered pen-and-paper questionnaire. Results Although only 43.4% of patients had heard of biobanks, 93.1% declared themselves willing to donate. 71.1% of patients believed that doctors should ask patients to donate, and 60.9% that this should be done before the medical procedure. While 65% of patients were willing to donate any type of tissue that remained after a medical procedure, blood, saliva and hair were indicated most frequently. 40.5% of patients would donate their entire body after death and 21% would refuse. Patients’ support for biobanks was mainly driven by the desire to support science, help advance cancer research and altruism. Some respondents expected health information or medical treatment. The most common barriers for donation were physical distance, repeated examinations, concerns over the privacy and confidentiality of data and the commercial or unethical use of samples. Patients’ attitudes toward biobank donation seemed to be associated with age, education level, declared religiousness, a family history of genetically determined diseases and whether they were a blood donor. Conclusions Although cancer patients’ lack of biobank awareness had no effect on their affirmative attitudes towards biobank research, there is a need to further increase patients’ support and overcome possible barriers that might hinder their willingness to donate.

Abstract Background Many work-related stresses are experienced by oncologists. Ukraine is currently undergoing numerous crises, including the SARS-CoV-2 pandemic and military conflicts, which represent stressful situations. The aim of this study was to explore the personal resources that Ukrainian oncologists use to cope with work demands in a situation featuring manifold crises. This study identified the ways in which people deal with stressful situations and the roles that they play in shaping the challenging situations that they encounter (work-related behavior) as well as how they cope with stress (stress management). Methods Forty oncologists (18 men and 22 women) working in a clinic in Kharkiv (Ukraine) with an average age of 46.3 ± 13.37 years (ranging from 26 to 74 years) participated in this study. The occupational psychological survey consisted of the Work-Related Behavior and Experience Patterns (German: Arbeitsbezogenes Verhaltens- und Erlebensmuster, AVEM) questionnaire, which was developed by Schaarschmidt and Fischer, and the Differential Stress Inventory (DSI), which was developed by Léfevre and Kubinger. Results 65% of oncologists exhibited AVEM risk pattern A or B. No gender differences were observed with regard to the distribution of AVEM patterns. Women obtained significantly higher scores than did men on only one dimension: experience of social support (4.86 vs. 3.44; p = 0.045). When the DSI categories were differentiated by gender, no significant differences were observed. Spearman’s correlation analysis revealed a medium-sized correlation between perfection striving and palliative coping (ρ = 0.404). Conclusions Few gender-based differences in work-related behaviors, experiences, and stress management strategies are evident among oncologists. AVEM risk patterns are more prevalent among Ukrainian oncologists than among comparable occupational groups, and interventions in the context of health management are recommended.

Background: COVID-19 pandemic has significantly disrupted healthcare systems worldwide, raising concerns about its impact on cancer patients' access to healthcare services. This study aims to explore the experiences of cancer patients and assess effect of restrictions, delays, and changes in healthcare delivery on their health. Methods: A qualitative study was performed through individual interviews and focus group discussions (FGDs) with cancer patients and key informants (KI). Participants with different cancer types, treatment stages, and residency regions in Saudi Arabia were recruited. Thematic analysis identified four major themes: access to healthcare services; impact on appointments, diagnosis, and treatment; healthcare delivery; and cancer condition deterioration due to the pandemic. Results: Cancer patients reported variable responses to the pandemic and its effects on their healthcare seeking behavior. Several patients faced challenges in accessing healthcare services and experienced difficulties in continuing their treatment, others encountered obstacles in seeking timely diagnosis and care. Lockdown measures and travel restrictions posed barriers, affecting patients' ability to reach treatment centers. Delays in appointments, diagnosis, and treatment were also reported. In contrast, some participants did not report any negative impact but received improved care and condition prioritization. Healthcare delivery underwent a shift towards virtual appointments, online access to lab results and medication’s home delivery service. Despite these adaptations, a small group of participants experienced health deterioration due to delays in treatment and difficulties in reaching their treating physicians. Conclusion: COVID-19 pandemic has had a multifaceted impact on cancer patients. Some participants faced challenges such as care delays and disruptions in accessing healthcare services. Yet others reported positive experiences such as improved communication and utilization of new healthcare delivery modalities. These findings underscore the need for resilient and adaptable healthcare systems to safeguard the well-being of cancer patients in times of crises and public health emergencies.

Background Insomnia is a common health problem among cancer patients, which is not only a physical problem but also a psychological problem. Sleep plays an important role in the mental and somatic rehabilitation of cancer patients, and the sleep beliefs and attitudes of cancer patients are key factors in improving their sleep situation and quality of life. The aim of this study was to translate the Cancer-Related Dysfunctional Beliefs and Attitudes about Sleep (C-DBAS-14) scale into Chinese and to validate its reliability and validity in cancer patients. Method The C-DBAS-14 scale was translated into Chinese using the backward and forward translation procedure. The reliability of the scale was measured by internal consistency, split-half reliability and retest reliability. The validity of the scale was assessed through the content validity indicators, exploratory factor analysis and validation factor analysis. Result The Cronbach's ɑ coefficient of the Chinese version of the C-DBAS-14 was 0.932 while the McDonald’s omega coefficient (ω t) was 0.934. The split-half reliability coefficient was 0.908, and the test-retest reliability was 0.857. The four-factor model was obtained using exploratory factor analysis, explaining 72.7% of the variance, with each item loading greater than 0.4 on the common factor. The results of the confirmatory factor analysis revealed that all indicators of model fit were within an acceptable range, indicating a well-fitting model. Conclusion The Chinese version of the C-DBAS-14 has good reliability and validity among cancer patients. It can be used to measure the sleep beliefs and attitudes of Chinese cancer patients.

Abstract Background Fertility preservation for adolescent pubescent girls is a concern of the healthcare system and parents. Oocyte cryopreservation is regarded as a standard medical intervention for patients with a minimum age of 18 years. Evidence suggests that mature oocyte cryopreservation is possible for adolescent pubescent girls, although, ovarian stimulation for these patients remains a challenge. Cases presentation This case series is the first report regarding ovarian stimulation with oocyte cryopreservation in younger than 18 years cancerous girls, who refer to ROYAN institute, Tehran, Iran, prior to the start of the treatment of cancer (November 2015 to February 2021). The oocyte cryopreservation was carried out in the 7 patients (five patients with Hodgkin lymphoma, one patient with Ewing sarcoma, and one patient with osteogenic tumor), the embryo cryopreservation in one patient with dysgerminoma, and the oocyte and embryo cryopreservation in one patient with germ cell tumor. No oocytes were retrieved after ovarian stimulation in the patient with medulloblastoma. For one of the patients with Hodgkin lymphoma, half of the tissues of one ovary were cryopreserved prior to ovarian stimulation. Conclusions Oocyte cryopreservation is a feasible option of fertility preservation in the adolescent’s patients with cancer. However, only if reported acceptable fertilization rates, as well as the successful cases of live birth from oocyte cryopreservation at the ages under 18, this option of preserving fertility can be applied to this age range.

Abstract Objective Metagenomic next-generation sequencing (mNGS), as an emerging technique for pathogen detection, has been widely used in clinic. However, reports on the application of mNGS in cancer patients with severe pneumonia remain limited. This study aims to evaluate the diagnostic performance of bronchoalveolar lavage fluid (BALF) mNGS in cancer patients complicated with severe pneumonia. Methods A total of 62 cancer patients with severe pneumonia simultaneously received culture and mNGS of BALF were enrolled in this study. We systematically analyzed the diagnostic significance of BALF mNGS. Subsequently, optimization of anti-infective therapy based on the distribution of pathogens obtained from BALF mNGS was also assessed. Results For bacteria and fungi, the positive detection rate of mNGS was significantly higher than culture method (91.94% versus 51.61%, P

Background Postoperative recovery in patients with cancer is a complex process that influences quality of life, functional recovery, and mental well-being. Smartphone app-based interventions have emerged as potential tools for improving various aspects of health and well-being in cancer patients. However, the existing literature lacks a consensus on the efficacy of these interventions, leading to conflicting outcomes.Methods We searched multiple databases, including PubMed, Web of Science, Cochrane Library, Scopus, EMBASE, and MEDLINE Complete (EBSCO). We exclusively selected randomized controlled trials meeting the inclusion criteria for our systematic review and meta-analysis. Utilizing a random-effects model, we derived the pooled effect size estimates for the meta-analysis. Where applicable, we calculated the pooled standardized mean difference (SMD) with 95% confidence interval (CI). The Cochrane Collaboration tool (Cochrane ROB) was used to evaluate bias in randomized trials. The primary outcome was the quality of life. The secondary outcomes were psychological symptoms, health conditions, satisfaction, and self-efficacy.Results Of 731 screened articles, 15 were included, comprising 1,831 participants. Our meta-analysis revealed that app-based interventions potentially improved quality of life (SMD = −0.58, 95% CI −1.00 to −0.16), alleviated psychological symptoms (SMD = −0.43, 95% CI −0.72,−0.15; p = .003), and enhanced self-efficacy (SMD = 0.90, 95% CI 0.26 to 1.53; p = 0.001). However, there was no statistically significant effect on satisfaction (SMD = 1.25, 95% CI-1.06 to 3.57; p = 0.23).Conclusions Our findings suggest that mobile health apps hold promise in improving the well-being of cancer patients after surgery by enhancing their quality of life, health status, and self-efficacy, while also reducing anxiety and depression.

ABSTRACTPurpose This study examined hope, meaning in life (MIL), and religious/spiritual struggle (RSS) as predictors of the quality of life (QOL) in cancer patients. We hypothesized a positive association of QOL with hope and MIL, whereas a negative association with RSS. The stage of cancer was hypothesized as a moderator variable between QOL and hope. Hope and MIL were assumed as positive predictors and RSS as negative predictor of QOL.Methods Data stem from the cross-sectional survey study of 300 cancer patients (Mean age = 50.97 ± 13.50 SD). Herth Hope Index, Meaning in Life Scale, Religious Spiritual Struggle Scale and WHO-QOL-BRIEF were used. The correlation coefficient and partial least square structural equation modeling approach (PLS-SEM) were used for assessing the measurement model and the structural model.Results As hypothesized, QOL was found positively associated with Hope and MIL, but negatively associated with RSS. The stage of cancer was hypothesized as a negative moderator. The three predictors significantly predicted QOL in cancer patients and explained 75.3% of the variance in QOL, and the overall model fit was adequate (SRMR = 0.075). Hope and MIL had a positive impact on QOL (β = .356, p 0.01).Conclusion In cancer patients, hope and MIL are facilitators of QOL. Addressing religious and spiritual concerns and struggles is critical to overall QOL improvement.

ABSTRACTThis study aimed to investigate the knowledge about, attitudes toward, and acceptance and predictors of receiving the mpox vaccine among Chinese cancer patients. Patients were selected using a convenience sampling method. A web-based self-report questionnaire was developed to assess cancer patients’ knowledge, attitudes, and acceptance regarding the mpox vaccine. Multivariate logistic regression analysis was used to determine predictors of acceptance of the mpox vaccine. A total of 805 cancer patients were included in this study, with a vaccine hesitancy rate of 27.08%. Approximately 66% of the patients’ information about mpox and the vaccine came from the mass media, and there was a significant bias in the hesitant group’s knowledge about mpox and the vaccine. Multivariable logistic regression analysis suggested that retirement; chemotherapy; the belief that the mpox vaccine could prevent disease, that vaccination should be compulsory when appropriate and that the mpox vaccine prevents mpox and reduces complications; the willingness to pay for the mpox vaccine; the willingness to recommend that friends and family receive the mpox vaccine; and the belief that the mpox vaccine should be distributed fairly and equitably were factors that promoted vaccination. The belief that mpox worsens tumor prognosis was a driving factor for vaccine hesitancy. This study investigated the knowledge of cancer patients about mpox and the vaccine, evaluated the acceptance and hesitancy rates of the mpox vaccine and examined the predictors of vaccination intention. We suggest that the government scientifically promote the vaccine and develop policies such as free vaccination and personalized vaccination to increase the awareness and acceptance rate of the mpox vaccine.

This cross-sectional study conducted in Romania examines the increasing role of online pharmacies in providing Food for Special Medical Purposes (FSMP) to cancer patients. Key findings indicate patient satisfaction with ease of access, significant challenges related to costs, and the critical role of healthcare professionals in guiding FSMP selection. Introduction. As cancer treatments advance, the demand for supportive nutritional care becomes increasingly critical, with FSMPs playing a vital role in patient recovery and quality of life. Methods. Employing a cross-sectional study design, we surveyed cancer patients from Romania to assess their experiences purchasing FSMPs through traditional and online pharmacies. We analyzed the factors influencing their choices, the perceived benefits and challenges of online access, and the role of healthcare professional guidance in their decision-making process. Results. The study reveals that while patients appreciate the ease of access and the broad spectrum of available FSMPs online, they grapple with the financial burden and the need for reliable information to make informed decisions. Through a cross-sectional analysis, we found that the expertise and recommendations of healthcare professionals remain integral to the FSMP selection process, suggesting that digital solutions should enhance, not replace, traditional healthcare interactions. Moreover, our findings highlight a crucial gap in the taste and variety of FSMPs, suggesting that patient adherence could be improved through product innovation. The study found a significant association between the type of medical unit where patients followed their treatment (state-owned clinic) and whether they received recommendations from a specialist oncologist for using FSMPs. Nutritionists’ recommendations were also significantly associated with a higher likelihood of purchasing FSMPs online. Discussions. The study reveals that despite the benefits of digital access, a crucial need exists for regulatory measures and professional oversight to ensure the safe and informed use of FSMPs. The trust placed in healthcare professionals’ recommendations continues to be instrumental in navigating the digital marketplace. Conclusion. This work paves the way for future strategies to integrate online solutions with established healthcare practices to optimize cancer care in the digital age.

Abstract Objective Distress during SARS‐CoV‐2 outbreak affected also cancer patients' well‐being. Aim of this study was to investigate patient' reactions and behavior (flexible‐adaptive vs. inflexible‐maladaptive) during the SARS‐CoV‐2 outbreak. Methods A cross‐sectional survey was designed with a self‐report questionnaire, “the ImpACT questionnaire,” developed for the study. Regression analysis was performed on data. Results Four hundred and forty five cancer patients from 17 Italian regions participated in the study. 79.8% of participants were female (mean age of 58 years). 92.6% of participants reported feeling vulnerable to COVID‐19 contagion; 75.6% reported helpless, 62.7% sad, 60.4% anxious, and 52.0% anger. Avoidance of thinking about coronavirus is the principal maladaptive behavior that emerged. Participants who reported feeling anxious were more likely to have fear of staff being infected with COVID‐19 (OR = 3.01; 95% CI = 1.49–6.30) and to have disrupted sleep due to worry (OR = 2.42; 95% CI = 1.23–4.83). Younger participants reported more anxiety (OR = 0.97; 95% CI = 0.94–1.00); men reported feeling calm more than women (OR = 2.60; 95% CI = 1.27–5.43). Conclusions Majority of cancer patients reported serious concerns regarding SARS‐CoV‐2 infection; reliable information and psychological support must be offers to respond to these needs.

Abstract Background The surge in omicron variants has caused nationwide breakthrough infections in mainland China since the December 2022. In this study, we report the neutralization profiles of serum samples from the patients with breast cancer and the patients with liver cancer who had contracted subvariant breakthrough infections. Methods In this real‐world study, we enrolled 143 COVID‐19‐vaccinated (81 and 62 patients with breast and liver cancers) and 105 unvaccinated patients with cancer (58 and 47 patients with breast and liver cancers) after omicron infection. Anti‐spike receptor binding domain (RBD) IgGs and 50% pseudovirus neutralization titer (pVNT50) for the preceding (wild type), circulating omicron (BA.4‐BA.5, and BF.7), and new subvariants (XBB.1.5) were comprehensively analyzed. Results Patients with liver cancer receiving booster doses had higher levels of anti‐spike RBD IgG against circulating omicron (BA.4‐BA.5, and BF.7) and a novel subvariant (XBB.1.5) compared to patients with breast cancer after breakthrough infection. Additionally, all vaccinated patients produced higher neutralizing antibody titers against circulating omicron (BA.4‐BA.5, and BF.7) compared to unvaccinated patients. However, the unvaccinated patients produced higher neutralizing antibody against XBB.1.5 than vaccinated patients after Omicron infection, with this trend being more pronounced in breast cancer than in liver cancer patients. Moreover, we found that there was no correlation between anti‐spike RBD IgG against wildtype virus and the neutralizing antibody titer, but a positive correlation between anti‐spike RBD IgG and the neutralizing antibody against XBB.1.5 was found in unvaccinated patients. Conclusion Our study found that there may be differences in vaccine response and protective effect against COVID‐19 infection in patients with liver and breast cancer. Therefore, we recommend that COVID‐19 vaccine strategies should be optimized based on vaccine components and immunology profiles of different patients with cancer.

Background: Diagnosing cancer and undergoing therapeutic measures are accompanied by an intense state of death anxiety. Objectives: This study aimed to investigate death anxiety and its relationship to demographic data for cancer patients at Tishreen University Hospital in Latakia. Methods: Quantitative study was used in the current study. A descriptive, correlational design was used in the current study. The study used a convenience sampling method. The total number of the participants was 100 cancer patients. The patients were selected from Tishreen University Hospital in Lattakia /Syria. Death anxiety scale was used as a tool for data collection. Results: The results showed a moderate level of death anxiety among participants, and there was a statistically significant relationship between death anxiety and gender. Conclusions: Having cancer affects the level of death anxiety among patients and it appears to be higher among females than males. Implications for Nursing: Studying the relationships between sociodemographic characteristics and the level of death anxiety in cancer patients will help individualize education about psychological problems associated with cancer. Healthcare professionals must evaluate patients' needs and personal characteristics before starting to perform psychological interventions.

Narrative Medicine and Nursing are clinical-supporting intervention methodologies that aim to enhance professionals’ communication skills and place patients at the heart of their therapeutic path. A narrative interview (NI) is a communication tool between practitioner and patient. The role of NI is debated extensively in the literature, but no studies focus on its use by nurses responsible for first-diagnosed cancer patients.This study aimed to evaluate the feasibility and utility of NI, carried out by Nurses, in managing people recently diagnosed with cancer.A pilot mixed-methods study with before-and-after-intervention evaluation, qualitative longitudinal data analysis, and concurrent data triangulation was conducted. The Mini-Mental Adjustment to Cancer assessed disease adaptation, while the Psychological Distress Inventory investigated psychological distress. The qualitative analysis of the narrative interviews assessed the usefulness of this intervention.13 out of 14 eligible patients took voluntary part in the study. Of those, 9 (69 %) completed T1 and T2 questionnaires and NI. The following five themes emerged from thematic analysis: reaction to the disease, feelings related to the new condition of life, changes, importance of relationships and perception of care. Patients reported being highly stressed and recognized the importance of a supporting social network for better coping with the condition.The adoption of an NI approach at the time of cancer diagnosis is feasible. Due to the limited sample size, it is unclear if NI may positively impact psychological distress in this patient population. Further studies would benefit from the integration of an additional investigation tool aiming to clarify whether NI promotes disease awareness in cancer patients. Furthermore, the recruitment of a larger sample is equally recommended.

This study aimed to evaluate psychometric properties of the Italian version of the Short-Form Supportive Care Needs Survey Questionnaire (SCNS-SF34) in a cancer population. A multicenter prospective observational study was carried out in outpatient and inpatient settings. The evaluated psychometric properties were as follows: the five-domain structure, the internal consistency, the convergent validity with the Edmond Symptom Assessment System (ESAS) questionnaire, the discriminant validity and test–retest reliability. A total of 714 patients with different types, stages and treatment settings of cancer were recruited. A total of 56% of participants were women, the median age 59 years (range 18–88). The prevalence of patients reporting at least one unmet need was 78.7%. The factor analysis explained 71.3% of the total variance, confirming the five-domain structure of the original model. Internal consistency was good, with Cronbach’s alpha values ranging from 0.87 (“psychosocial need”, “patient support and health system”, “information”) to 0.90 (“sexuality”). The convergent validity of the SCNS-SF34-It with the ESAS scale was low, suggesting that these questionnaires cover different concepts. The SCNS-SF34-It was able to discriminate differences between groups, and the test–retest reliability was good (ICC 0.72–0.84). The SCNS-SF34-It proved to be a reliable instrument for use in clinical practice for evaluating unmet needs in the Italian population of cancer patients. This study was not registered.

Abstract Background A high percentage of cancer patients may experience emotional distress. Oncology nurses are expected to play an important role in recognizing emotional distress and planning and delivering care that meets the individual needs of each patient. However, few studies have focused on the experiences of clinical nurses in such cases. This study adopted a qualitative research method to gain an in-depth understanding of the experience of nursing staff in caring for cancer patients with emotional distress. Methods A qualitative descriptive design and semi-structured interviews were used in this study. Twenty-one oncology nurses were interviewed, and the qualitative content analysis suggested by Graneheim & Lundman (2004) was used to interpret the data. Results Six themes were identified, as follows: (1) dictating the abnormality of emotion, (2) soothing and comforting patients, (3) a lack of psychology knowledge and communication skills, (4) negative impacts of a lack of time, (5) managing emotional labor, and (6) reflecting on the experiences. Conclusion Hospital administrators should arrange pre-employment education and training as well as on-the-job education to help nurses in caring for cancer patients with emotional distress. They should also focus attention on the personal emotional states of nursing staff in a timely manner and provide psychological support and emotional counseling as necessary.

Abstract Objective The Illness Cognition Questionnaire (ICQ) was translated from its original English version to the Malay version for this research, adapted the Malay language version of the ICQ (ICQ-M) for use in cancer patients, and assessed the internal consistency, content, face, construct, convergent, discriminant and concurrent validity of the ICQ-M among a cohort of cancer patients with mixed cancer types in Malaysia. Method Initially, the ICQ was translated into Malay and back-translated, and its content and face validity were evaluated. Then, 346 cancer patients with various cancer types received the ICQ-M, and its internal consistency, convergent, discriminant, construct, and concurrent validity were evaluated. Results The ICQ-M and its domains had acceptable internal consistency with Cronbach’s α ranging from 0.742 to 0.927. Construct validity assessment demonstrated that the ICQ-M consists of 17 items designated in two domains with good convergent and discriminant validity. The ICQ-M and its domains also had moderate correlations with the Acceptance and Action Questionnaire II, which denotes that the ICQ-M had acceptable concurrent validity. Conclusion The ICQ-M had good psychometric properties and is now available to measure the illness cognition of cancer patients in Malaysia.

An increasing number of studies have demonstrated that potentially inappropriate medication (PIM) occurs commonly in elderly patients with cancer, with higher prevalence of PIM than general elderly, which may lead to adverse effects on prognosis of the patients. Therefore, it is necessary to conduct a systematic and comprehensive review of previous studies to provide support and reference for future studies. PubMed, CNKI and Wanfang Data were systematically searched to summarize and analyze the screen tools of PIM, prevalence of PIM, main drugs involved, influencing factors and the relationship between PIM and adverse outcomes. The results showed that the prevalence of PIM varied when different PIM screen tools were used in older patients with cancer, and the list of medications commonly used for supportive care that are of concern in older patients provided by the NCCN Guidelines for Older Adult Oncology (2020.v2) demonstrated advantages in providing individualized medication management for elderly patients with cancer. Polypharmacy, age, and comorbidities were significantly associated with the development of PIM. Benzodiazepines and analgesics are commonly used as high-risk drugs in elderly patients with cancer. PIM may be associated with higher mortality rates, drug interaction rates, adverse event rates, emergency and hospital readmission rates in elderly patients with cancer. It is hoped that this article will provide a reference for conducting studies related to PIM in elderly patients with cancer in China and provide support for promoting the safe and rational use of medication in elderly patients with cancer.