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ObjectivesAdolescent and young adult (AYA) cancer patients may be at high risk of experiencing psychological distress because their diagnosis came during a key time of consolidation of identity and social growth. This study aimed (1) to examine the prevalence of psychological distress among AYA cancer patients within a year of diagnosis to long-term survivors and (2) to describe socio-demographic and cancer-related characteristics associated with psychological distress.MethodsIn a cross-sectional web-based survey, patients who scored 5 or more on the Kessler Psychological Distress Scale were assessed for significant psychological distress. Logistic regression examined whether demographics, clinical variables, and social support were associated with psychological distress.ResultsA total of 206 young adult cancer patients participated. The median age at the survey was 34.5 years (range: 22–39 years), and 87.4% were female. The prevalence of psychological distress was 55.3%. Psychological distress among patients diagnosed within a year and long-term survivors (≥10 years since diagnosis) was significantly higher than patients 1–4 years since diagnosis. Pain, decrease in income after a cancer diagnosis, experience of negative change in work/school after a cancer diagnosis and poor social support were significantly associated with psychological distress.Significance of resultsOver half of young adult patients had significant psychological distress in Japan. Our findings potentially contribute to the intervention components for distress management among AYA cancer survivors.

IntroductionIn patients with incurable advanced cancer, preferences about treatment and how to spend their final days are not adequately discussed. This process of discussion is called “advanced care planning” (ACP), and timely intervention is recommended. As the communication attitude of healthcare providers is a critical factor in ACP facilitation, improving their communication attitudes may reduce patient distress, improve care satisfaction, and reduce unnecessarily aggressive treatment. Digital mobile devices are being developed for behavioral interventions due to their low space and time restrictions, and the ease of sharing information. The purpose of this study is to evaluate the effectiveness of a facilitation program utilizing a mobile app developed to improve communication between cancer patients and healthcare providers regarding ACP.Methods and analysisThis study utilizes a parallel-group, evaluator-blind, randomized controlled trial design. We plan to recruit 264 adult patients with incurable advanced cancer. Intervention group participants will use a mobile app ACP program and undergo a 30-minute interview with a trained intervention provider to discuss with the oncologist at the next patient visit. Control group participants will continue their usual treatment. The primary outcome is the oncologist’s communication behavior score assessed using audio recordings of the consultation. The secondary outcomes include communication between patients and oncologists and the patients’ distress, quality of life, care goals and preferences, and medical care utilization. We will use a full analysis set with the registered participant population who received at least a part of the intervention.Ethics and disseminationThe study protocol was reviewed and approved by the Scientific Advisory Board of the Japan Supportive, Palliative and Psychosocial Oncology Group (Registration No. 2104) and the Institutional Review Board of the National Cancer Center Hospital (registration No. 2020-500). The results of the RCT will be published in peer-reviewed scientific journals and presented at scientific meetings.Strengths and limitations of this studyRandomized controlled trials using mobile apps for behavior change and psychological interventions are increasing, and this study is unique in its focus on facilitating communication about advanced care planning (ACP).The intervention will include mobile apps which can be used in environments the participants find relaxing and engaging. The benefit is particularly significant for patients with advanced cancer who need to express their values and what is crucial to them.There is currently no gold standard for evaluating ACP discussions between patients and healthcare providers. The methods facilitate ACP discussions in various aspects of this study to produce a variety of practical insights.The timing of introducing ACP discussions must be individualized to each patient, and it is anticipated that some participants may find this intervention burdensome. Therefore, more careful ACP referrals are needed, and qualitative exploration of study dropouts is needed.Multiple intervention components make it difficult to determine which is most effective. Individualized assessments of app usage, intervention adherence, and patient satisfaction could clarify the challenges and help determine next steps.

Aim We examined accuracy of nurses’ clinical judgement of graft‐versus‐host‐disease (GVHD) symptoms and related factors using Common Terminology Criteria for Adverse Events (CTCAE) for patients who developed chronic cutaneous GVHD after haematopoietic stem cell transplants. Design Cross‐sectional design using nationwide survey. Methods A questionnaire survey based on Tanner's clinical judgement model to assess patients with chronic cutaneous GVHD using CTCAE was used. Free‐text descriptions and statistical analyses of relationship between correct responses and demographic data were performed. Results The rate of correct responses for main symptoms of skin GVHD was

IntroductionTimely implementation of the discussion process of advance care planning (ACP) is recommended. The communication attitude of healthcare providers is critical in ACP facilitation; thus, improving their communication attitudes may reduce patient distress and unnecessary aggressive treatment while enhancing care satisfaction. Digital mobile devices are being developed for behavioural interventions owing to their low space and time restrictions and ease of information sharing. This study aims to evaluate the effectiveness of an intervention programme using an application intended to facilitate patient questioning behaviour on improving communication related to ACP between patients with advanced cancer and healthcare providers.Methods and analysisThis study uses a parallel-group, evaluator-blind, randomised controlled trial design. We plan to recruit 264 adult patients with incurable advanced cancer at the National Cancer Centre in Tokyo, Japan. Intervention group participants use a mobile application ACP programme and undergo a 30 min interview with a trained intervention provider for discussions with the oncologist at the next patient visit, while control group participants continue their usual treatment. The primary outcome is the oncologist’s communication behaviour score assessed using audiorecordings of the consultation. Secondary outcomes include communication between patients and oncologists and the patients’ distress, quality of life, care goals and preferences, and medical care utilisation. We will use a full analysis set including the registered participant population who receive at least a part of the intervention.Ethics and disseminationThe study protocol was reviewed and approved by the Scientific Advisory Board of the Japan Supportive, Palliative and Psychosocial Oncology Group (Registration No. 2104) and the Institutional Review Board of the National Cancer Centre Hospital (registration No. 2020-500). Written informed consent is obtained from the patients. The results of the trial will be published in peer-reviewed scientific journals and presented at scientific meetings.Trial registration numbersUMIN000045305,NCT05045040.

The purpose of this study was to clarify outcomes on the lower limbs in cases of lying and taking Manual Lymph Drainage (MLD) for nurses after an 8-hour shift. The participants were eight females who were not pregnant, over 35 years old and had not had any operations on their bodies. We measured circumference of seven points on their lower limbs by two times on different days. It meant that we measured before and after at the time of lying in bed or taking MLD for 30 minutes. By the lying in bed, four points of the left side and one point of the right side decreased significantly the lower limb’s circumference. However, the circumference of the inguinal region and popliteal fossa did not change. By taking MLD, six points of on the left side and three points of right side decreased significantly the lower limb’s circumference. We found that the circumference of the lower limbs, including the inguinal region and popliteal fossa, were decreased. This result suggested MLD was a useful skill for to hasten blood circulation. To decrease the circumference of the lower limbs, we suggest that it is not only lying, but also add to MLD on their lower limbs.

To examine the relationship between cancer-related fatigue (CRF) and physical activity in daily living in premenopausal disease-free cervical and endometrial cancer survivors.A physical activity monitor was used to collect objective data on daily physical activity. CRF and related variables were measured using self-report scales in a cross-sectional manner.The average age was 44.9 years among 64 women. The higher CRF group comprised 22 women (34%), 10% of whom had severe fatigue. The participants had higher physical activity levels compared with the findings in previous studies, and reported an average of 40 min/day of moderate to vigorous activity. Moderate to vigorous levels of physical activity were derived from essential social activities rather than leisure time exercise. There were no significant differences in physical activity levels between the lower and higher CRF groups.Our study results suggested that the higher level of physical activity in daily living itself had no relationship with decreasing CRF among premenopausal cervical and endometrial cancer survivors. It would be better to focus on cognitive and psychological factors before introducing physical activity programs and be careful of the characteristics of the participants' physical activity among this population in daily basis.