Changes in chemotherapy-induced peripheral neuropathy, disturbance in activities of daily living, and depression following chemotherapy in patients with colorectal cancer: A prospective study.

PURPOSE: This study was conducted to identify the changes in oxaliplatin-induced peripheral neuropathy (OIPN), disturbance in activities of daily living (ADL), and depression and their interrelationships during the cancer care trajectory in colorectal cancer patients. METHODS: Eighty-six subjects participated in the study and completed the questionnaire at three time points: pre-chemotherapy, undergoing chemotherapy, and 3 months after the completion of chemotherapy. The assessment tools were Chemotherapy-Induced Peripheral Neuropathy 20 for OIPN, Chemotherapy-Induced Peripheral Neuropathy Assessment Tool to measure disturbances in ADL, and Hospital Anxiety and Depression Scale for depression. Data were analyzed using descriptive statistics and repeated-measures analysis of variance. RESULTS: While undergoing chemotherapy, 37.2% of the patients complained of OIPN and 32.6% exhibited OIPN at 3-month follow-up. Repeated-measures analysis of variance showed a significant increase in OIPN after chemotherapy, which remained high at the 3-month follow-up. The most frequent symptom of OIPN was "tingling feeling in the hand and foot," and the second was "impotence." Disturbance in ADL by OIPN and depression showed similar patterns as OIPN. The mean score for disturbance in ADL of OIPN was 48.58. The mean score was 7.36 for depression, with a prevalence of 23.5%. There were significant correlations among the three variables, suggesting that OIPN may be casual in the OIPN- disturbance in ADL-depression symptom interrelationships. CONCLUSION: These results suggest that chemotherapy is highly associated with OIPN, disturbance in ADL by OIPN, and depression in colorectal cancer patients. Nursing intervention is needed to relieve depression as well as OIPN in patients undergoing chemotherapy.

[A Structural Model for Chemotherapy Related Cognitive Impairment and Quality of Life in Breast Cancer Patients].

PURPOSE: This study aimed to develop and test a structural model for chemotherapy-related cognitive impairment of breast cancer patients based on a literature review and Hess and Insel's chemotherapy-related cognitive change model. METHODS: The Participants consisted of 250 patients who were ≥19 years of age. The assessment tools included the Menopause Rating Scale, Symptom Experience Scale, Hospital Anxiety and Depression Scale, Everyday Cognition, and Functional Assessment of Cancer Therapy-Breast Cancer. Data were analyzed using the SPSS 21.0 and AMOS 21.0 programs. RESULTS: The modified model was a good fit for the data. The model fit indices were χ²=423.18 (p<.001), χ²/df=3.38, CFI=.91, NFI=.91, TLI=.89, SRMR=.05, RMSEA=.09, and AIC=515.18. Chemotherapy-related cognitive impairment was directly influenced by menopausal symptoms (ß=.38, p=.002), depression and anxiety (ß=.25, p=.002), and symptom experiences (ß=.19, p=.012). These predictors explained 47.7% of the variance in chemotherapy-related cognitive impairment. Depression and anxiety mediated the relations among menopausal symptoms, symptom experiences, and with chemotherapy related cognitive impairment. Depression and anxiety (ß=-.51, p=.001), symptom experiences (ß=-.27, p=.001), menopausal symptoms (ß=-.22, p=.008), and chemotherapy-related cognitive impairment (ß=-.15, p=.024) had direct effects on the quality of life and these variables explained 91.3%. CONCLUSION: These results suggest that chemotherapy-related toxicity is highly associated with cognitive decline and quality of life in women with breast cancer. Depression and anxiety increased vulnerability to cognitive impairment after chemotherapy. Nursing intervention is needed to relieve chemotherapy-related toxicity and psychological factor as well as cognitive decline for quality of life in patients undergoing chemotherapy.

[Effect of Cancer Symptoms and Fatigue on Chemotherapy-related Cognitive Impairment and Depression in People with Gastrointestinal Cancer].

PURPOSE: The purpose of this study was to test a hypothetical model of chemotherapy-related cognitive impairment (CRCI) and depression in people with gastrointestinal cancer. METHODS: A purposive sample of 198 patients undergoing chemotherapy was recruited from November 2014 to July 2015. The instruments were Everyday Cognition (ECog), Hospital Anxiety Depression Scale (HADS), Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F), and M. D. Anderson Symptom Inventory-Gastrointestinal Cancer Module. Data were analyzed using descriptive statistics, correlation, and path analysis. RESULTS: CRCI was directly affected by cancer symptoms (ß=.19, p=.004) and fatigue (ß=.56, p<.001)(R²=47.2%). Depression was directly affected by fatigue (ß=.48, p<.001) and CRCI (ß=.27, p<.001). However, The impact of cancer symptoms on depression was confirmed through the mediating effect of CRCI. CONCLUSION: Results indicate that in patients with gastrointestinal cancer undergoing chemotherapy along with the direct physiologic effects (fatigue, symptoms) of cancer treatment may have altered cognitive function leading to depression.

Hydrophilicity/porous structure-tuned, SiO2/polyetherimide-coated polyimide nonwoven porous substrates for reinforced composite proton exchange membranes.

Porous substrate-reinforced composite proton exchange membranes have drawn considerable attention due to their promising application to polymer electrolyte membrane fuel cells (PEMFCs). In the present study, we develop silica (SiO(2)) nanoparticles/polyetherimide (PEI) binders-coated polyimide (PI) nonwoven porous substrates (referred to as "S-PI substrates") for reinforced composite membranes. The properties of S-PI substrates, which crucially affect the performance of resulting reinforced composite membranes, are significantly improved by controlling the hygroscopic SiO(2) particle size. The 40 nm S-PI substrate (herein, 40 nm SiO(2) particles are employed) shows the stronger hydrophilicity and highly porous structure than the 530 nm S-PI substrate due to the larger specific surface area of 40 nm SiO(2) particles. Based on the comprehensive understanding of the S-PI substrates, the structures and performances of the S-PI substrates-reinforced composite membranes are elucidated. In comparison with the 530 nm S-PI substrate, the hydrophilicity/porous structure-tuned 40 nm S-PI substrate enables the impregnation of a large amount of a perfluorosulfonic acid ionomer (Nafion), which thus contributes to the improved proton conductivity of the reinforced Nafion composite membrane. Meanwhile, the reinforced Nafion composite membranes effectively mitigate the steep decline of proton conductivity with time at low humidity conditions, as compared to the pristine Nafion membrane. This intriguing finding is further discussed by considering the unusual features of the S-PI substrates and the state of water in the reinforced Nafion composite membranes.