Platelet-to-lymphocyte, neutrophil-to-lymphocyte and lymphocyte-to-monocyte ratios are related to cancer-related fatigue and quality of life in patients with cancer: a cross-sectional study.

OBJECTIVES: To explore the association of the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and lymphocyte-to-monocyte ratio (LMR) with cancer-related fatigue (CRF) and quality of life (QOL) in cancer patients. DESIGN: A cross-sectional study. SETTINGS: A grade A tertiary hospital in Wuhan, China. PARTICIPANTS: A total of 236 participants were recruited. Participants who were diagnosed with cancer received chemotherapy and/or radiotherapy, and aged ≥18 years were included in this study. PRIMARY AND SECONDARY OUTCOME MEASURES: The PLR, NLR and LMR were calculated based on the absolute lymphocyte count, neutrophil count, platelet count and monocyte count. The CRF and QOL of patients after the first chemotherapy/radiotherapy were evaluated. RESULTS: The median values (IQR) of PLR, NLR and LMR were 174.51 (126.14-261.02), 2.84 (1.64-5.24) and 2.56 (1.30-3.72), respectively. Univariate analysis indicated that high PLR (≥ 174.51), high NLR (≥ 2.84) and low LMR (< 2.56) at baseline significantly correlated with CRF and poor QOL after the first chemotherapy/radiotherapy (p<0.005). Multiple linear regression analysis indicated that elevated PLR might be an independent risk factor for CRF (p<0.001) and QOL (p=0.010) in cancer patients. CONCLUSION: PLR, NLR and LMR are associated with CRF and QOL in cancer patients. High PLR may predict severe CRF and poor QOL. Further studies are needed to validate these findings based on the expanded sample size.

Meta-Analysis of Effects of Early Palliative Care on Health-Related Outcomes Among Advanced Cancer Patients.

BACKGROUND: Early palliative care (PC) has received more attention for improving health-related outcomes for advanced cancer patients in recent years, but the results of previous studies are inconsistent. OBJECTIVES: This study aimed to use meta-analysis and trial sequence analysis to evaluate the effect of early PC on health-related outcomes of advanced cancer patients. METHODS: All English publications were searched in PubMed, Web of Science, Embase, and the Cochrane Library from inception to March 2023, with a restriction that the study type was a randomized controlled trial. RESULTS: The results showed that early PC positively affected quality of life, satisfaction with care, and symptom burden reduction. However, early PC had no significant effect on anxiety or survival. Trial sequence analysis results showed that the effect of early PC on the quality of life was stable. DISCUSSION: This systematic review suggested that early PC could positively affect health-related outcomes for advanced cancer patients. Early PC can be used widely in clinical settings to improve health-related outcomes of advanced cancer. However, because of the trial sequence analysis results, further well-designed, clinical, randomized controlled trials with larger sample sizes are necessary to draw definitive conclusions.

Prediction of Survival Time in Advanced Lung Cancer: A Retrospective Study in Home-Based Palliative Care Unit.

Background: There is a large group of patients suffering from lung cancer and receiving home hospice care in China. However, little is known about the prediction of their survival time. The purpose of this study was to determine whether quality of life independently predicts survival among advanced lung cancer survivors who are receiving home-based palliative care. Methods: In this retrospective study, we analyzed data from 937 advanced lung cancer patients who had received home-based palliative care between March 2010 and March 2020. We used Kaplan-Meier survival curves to determine the factors associated with survival time and applied the Cox proportional hazards model to examine the effect of quality of life on survival. Results: The study included 928 patients with a mean age of 63 years; and 72.1% of them were men. Factors associated with shortened survival included age, sex, place of residence, weight loss, anorexia, nausea, edema, quality of life, and Karnofsky performance status. After adjusting for other variables in a multivariate Cox proportional hazards model, we found that quality of life was an independent positive predictor of survival. Conclusions: As an independent factor predicting the survival of advanced lung cancer patients, quality of life should be taken seriously. Medical staff and healthcare workers need to pay special attention to this predictive factor since it may serve as early risk identification indicator for professionals who provide home-based palliative care, helping them to create effective personalized care plans.

Effectiveness of Acceptance and Commitment Therapy for people with advanced cancer: A systematic review and meta-analysis of randomized controlled trials.

AIMS: To systematically review existing evidence and assess the effectiveness of Acceptance and Commitment Therapy for people with advanced cancer. DESIGN: Systematic review and meta-analysis of randomized controlled trials. DATA SOURCES: Nine databases, including PubMed, Web of Science, Cochrane Library, Embase, CINAHL, PsycINFO, Chinese National Knowledge Infrastructure, VIP Database and Wanfang, were searched. The search covered the period between the inception of the selected databases and August 2022. REVIEW METHODS: Two authors independently examined eligible studies and appraised the methodological quality of the included studies by applying the criteria suggested by the Cochrane Effective Practice and Organization of Care followed by data abstraction. The Template for Intervention Description and Replication (TIDieR) checklist was used to identify intervention characteristics. Meta-analysis was performed using RevMan 5.4 software, and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach was used to evaluate the certainty of evidence. RESULTS: Eight studies, involving 488 people with advanced cancer, were included. The results showed significant effects of Acceptance and Commitment Therapy on the improvement of quality of life and the alleviation of anxiety, depression, psychological distress and fatigue in people with advanced cancer. However, its effects in relieving psychological flexibility and pain were not statistically significant. The certainty of the evidence was low to moderate. CONCLUSION: People with advanced cancer can benefit from Acceptance and Commitment Therapy, which is conducive to improving their health outcomes. IMPACT: This review provides evidence about the effectiveness of Acceptance and Commitment Therapy in people with advanced cancer. Further well-designed studies with larger sample sizes are required. This review may help nurses and researchers to design and implement Acceptance and Commitment Therapy in clinical practice, thereby improving health outcomes in this population. PROSPERO REGISTRATION NUMBER: CRD42021244568.

Living experiences of people with advance cancer with low socioeconomic status: A systematic review of qualitative evidence.

BACKGROUND: The number of patients with advanced cancer is rapidly increasing, and the subgroup of this population with low socioeconomic status has suffered more disease burden than others. However, there is no recent qualitative synthesis of primary research studies into advanced cancer patients with low socioeconomic status. OBJECTIVE: To synthesise qualitative research findings into advanced cancer patients' experiences with low socioeconomic status, and then to help provide targeted and effective strategies to improve their quality of life. DESIGN: A systematic review and meta-synthesis of qualitative evidence (PROSPERO: CRD42021250423). DATA SOURCES: PubMed, Web of Science Core Collection (ISI Web of Science), Cochrane Library, Embase, OVID LWW, CINAHL Complete (EBSCO), PsycINFO (EBSCO) and MEDLINE (ISI Web of Science), China National Knowledge Infrastructure (CNKI), WangFang, and Vip databases were systematically searched from their original dates to July 2022. Qualitative data were appraised using the Joanna Briggs Institute (JBI) qualitative assessment. FINDINGS: The findings were synthesised into the following three analytical themes: (1) multi-dimensional disease distresses; (2) barriers in coping with disease distresses; and (3) strategies for dealing with disease distresses. CONCLUSIONS: Patients with advanced cancer with low socioeconomic status experienced complicated and interactional distresses, unique life barriers, and a wide range of adaptation strategies. These findings will provide a comprehensive perspective to promote individual-centred health care systems and services to help these vulnerable people deal with the challenges of disease and improve their quality of life.

Factors associated with sleep quality among nurse managers during regular prevention and control of the COVID-19 in China: a cross-sectional study.

BACKGROUND: Nurse managers play a pivotal role in quality patient care and staff satisfaction and retention. An overwhelming amount of work tasks and responsibilities might result in their sleep problems which are expected to aggravate in the context of the COVID-19, thereby affecting their overall health and work quality. However, little attention has been paid to sleep quality among nurse managers. This study aimed to investigate the prevalence of sleep disorders among nurse managers and identify related factors of sleep quality during regular prevention and control of the COVID-19 pandemic in China. METHODS: This cross-sectional online survey was conducted in 14 hospitals on a sample of 327 nurse managers in China. Participants were invited to complete the general demographic questionnaire, Pittsburgh Sleep Quality Index (PSQI) and Simplified Coping Style Questionnaire (SCSQ). Multiple linear regression analysis was used to explore the influencing factors of sleep quality among nurse managers. RESULTS: In this study, 43.7% of nurse managers suffered from sleep disorders. Active coping style and frequent exercise were positive factors that could influence nurse managers' sleep quality, while passive coping style and age over 41 years old were negative predictors, collectively accounting for 52.0% of the variance of sleep quality. CONCLUSIONS: The issue of sleep disorders among nurse managers during regular epidemic prevention and control period is underscored. Coping style and demographic factors including age and frequency of exercise can significantly affect nurse managers' sleep quality. Healthcare administrators should pay more attention to nurse managers' sleep disorders and implement targeted strategies based on influencing factors to ensure their sleep quality.

Effects of progressive muscle relaxation on health-related outcomes in cancer patients: A systematic review and meta-analysis of randomized controlled trials.

BACKGROUND AND PURPOSE: Progressive muscle relaxation training (PMRT) has been widely applied to improve the physical and mental health of patients. The aim of this study was to evaluate the effects of PMRT on the symptoms and quality of life (QOL) of cancer patients. METHODS: Nine databases (Web of Science, CENTRAL, PubMed, Embase, CINAHL, OpenGrey, CNKI, Wanfang, and VIP database) were searched to identify randomized controlled trials (RCTs) that assessed the effects of PMRT on health-related outcomes for cancer patients. The risk of bias of the included studies and the evidence quality were appraised using the Cochrane Risk of Bias 2.0 tool and the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach, respectively. Meta-analysis was performed using RevMan 5.4. RESULTS: Twelve RCTs sampling 1147 patients were included. PMRT showed significant effects of alleviating anxiety [standardized mean difference (SMD) = -1.32, 95% CI (-1.88, -0.75), P < 0.001] and pain [SMD = -1.02, 95% CI (-1.93, -0.11), P = 0.030], and improving QOL [SMD = 1.65, 95% CI (0.53, 2.76), P = 0.004] in cancer patients. Regarding depression, self-esteem, nausea, and vomiting, PMRT showed better effects compared to the control group. However, no significant effect of reducing fatigue was detected [SMD = -1.00, 95% CI (-2.27, 0.27), P = 0.120]. The overall quality of evidence was moderate to very low. CONCLUSION: PMRT is a promising complementary therapy that may improve the health-related outcomes of cancer patients. Future studies with rigorous research design are needed to obtain valid conclusions.

Effects of the Heart to Heart Card Game for Patients with Advanced Cancer Receiving Home-Based Palliative Care: A Clinical Randomized Controlled Trial.

The Heart to Heart Card Game improves psychological health outcomes in hospitalized patients with advanced cancer, but effectiveness studies for patients at home are rare. This randomized controlled study was conducted to determine the effectiveness of the Heart to Heart Card Game on patients with advanced cancer receiving home-based palliative care. Sixty-six participants were randomly assigned to the intervention group (n = 34) and control group (n = 32). The quality of life, dignity, and psychological distress were considered as outcomes, which were assessed pre-intervention and six weeks after the intervention. There was a statistical difference in the quality of life (global health statues) between the intervention group and the control group after intervention (z = 2.017, p < 0.05). A significant difference was found in the quality of life (emotional, social function), dignity (symptom distress dimension), and psychological distress in the intervention group through intragroup comparison before and after the intervention. This randomized trial showed that the Heart to Heart Card Game likely alleviates barriers to end-of-life conversations and helps patients with advanced cancer maintain a more stable mental state. This trial has been registered at the Chinese Clinical Trial Registry (registration number: ChiCTR2100049933).