Software-based interventions for low back pain management: A systematic review and meta-analysis.

INTRODUCTION: Using software for self-management interventions can improve health outcomes for individuals with low back pain, but there is a dearth of research to confirm its effectiveness. Additionally, no known research has evaluated the effective elements of software-based interventions for low back pain self-management components. This study aimed to synthesize the effectiveness of software-based interventions to promote self-management health outcomes among individuals with low back pain. DESIGN: A systematic review and meta-analysis was conducted. METHODS: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Statement, relevant studies up to July 2022 were searched via four electronic databases: PubMed, Embase, Cumulative Index to Nursing and Allied Health Literature, and Web of Science. RESULTS: 4908 adults with low back pain who participated in 23 studies were included. Software-based interventions were effective in reducing fear avoidance (mean difference [MD] = -0.95, 95% CI: -1.45 to -0.44), pain catastrophizing (MD = -1.31, 95% CI: -1.84 to -0.78), disability (MD = -8.21, 95% CI: -13.02 to -3.39), and pain intensity (MD = -0.86, 95% CI: -1.17 to -0.55). Specifically, interventions that included an exercise component were more effective in reducing pain and disability. Additionally, cognitive behavioral therapy (CBT) intervention significantly reduced fear avoidance and pain catastrophizing but had no noticeable impact on disability and pain compared to standard treatment. The certainty of the evidence in this review varied from very low to high across outcomes. The heterogeneity of the study results was significant, suggesting that future studies in this area could optimize the design, time points, measures, and outcomes to strengthen the evidence. CONCLUSIONS: Low back pain self-management interventions delivered through software-based programs effectively reduce pain intensity, disability, fear avoidance, and pain catastrophizing. CLINICAL RELEVANCE: Low back pain is among the most common reasons for seeking healthcare visits. Combining exercise and counseling through soft-based programs may effectively address this issue and its associated suffering and disability.

Health-promoting behavior among undergraduate students in the COVID-19 era: Its association with problematic use of social media, social isolation, and online health information-seeking behavior.

OBJECTIVE: To examine the association between problematic use of social media, online health information-seeking, social isolation, and health-promoting behaviors among Korean undergraduate students. METHODS: In total, 178 undergraduate students participated in this study. A multiple linear regression analysis was performed. RESULTS: Predictors of health-promoting behaviors included overall time spent on social media, problematic social media use, social isolation, and online information-seeking, explaining 33.5 % of the variance in health-promoting behaviors. CONCLUSION: Prolonged social media use and social isolation negatively affected undergraduate students' health-promoting behaviors, while online information-seeking positively affected them. Nurses should assist young adults in improving health-promoting behaviors by preventing problematic social media uses, reducing social isolation, and strengthening their online health information-seeking ability.

Real-Life Experiences of Chemotherapy-Induced Peripheral Neuropathy in Patients with Cancer: A Qualitative Meta-Synthesis Study.

PURPOSE: Chemotherapy-induced peripheral neuropathy is an unpleasant symptom experienced by most cancer survivors who receive neurotoxic chemotherapy. It is not life threatening; however, it impairs sensorimotor skills, thereby interfering with daily activities and reducing the quality of life. Healthcare providers are becoming increasingly aware of the significance of its management. Nonetheless, a lack of understanding remains. This study aimed to understand the experience of cancer survivors with chemotherapy-induced peripheral neuropathy. DATA SOURCES: The selection and search for relevant literature conformed to the Preferred Reporting Items for Systematic Review and Meta-analysis Protocols guidelines. Four databases were searched for literature exploring the experiences of cancer survivors with chemotherapy-induced peripheral neuropathy. Moreover, articles from reference lists were retrieved. Of 969 collected articles, 13 qualitative studies were included. The seven-step meta-ethnography developed by Noblits and Hare was used to analyze and synthesize selected studies. This study complied with the enhancing transparency in reporting the synthesis of qualitative research guidelines. CONCLUSION: Three themes ("Tough and challenging life with chemotherapy-induced peripheral neuropathy," "Being patient in a chaotic life," and "Transition to a new way of life") and six subthemes were derived after reviewing, analyzing, and synthesizing selected study findings. They faced difficult daily challenges and endured psychologically chaotic moments; however, they gradually learned to live with the symptoms and adapted their way of life. IMPLICATIONS FOR NURSING PRACTICE: This review emphasizes the importance of the need for personalized nursing interventions promoting self-management and new adaptation strategies for gaining better understanding of chemotherapy-induced peripheral neuropathy.

Creating a Self-management Mobile Application for People With Chronic Low Back Pain: A Focus Group Study of Unmet Needs and Strategies.

Mobile health can fulfill the unmet needs of patients with chronic low back pain by recommending individualized management plans. Limited mobile applications have been developed based on the needs, preferences, and values relative to self-management of patients with chronic low back pain. This study aimed to explore the experience of patients with chronic low back pain and the desired content, designs, and features of a self-management application. We conducted five focus groups (N = 24). Participants provided feedback on draft contents and they also discussed the desired designs and features of an application while reviewing a low-fidelity prototype. Data were audio-recorded, transcribed verbatim, and analyzed using qualitative content analysis. Three categories and eight subcategories emerged. Participants: (1) confronted difficulties of their pain experience along with vicious cycles of pain and unmet needs; (2) acknowledged the importance of self-management as they lived with chronic low back pain and realized how to self-manage their pain; and (3) suggested ways to fulfill needs and preferences among patients with chronic low back pain. The nature of chronic low back pain causes disruptions well-being and requires constant management. Developing user-centered strategies to enhance knowledge and promote self-management among chronic low back pain patients is required.

Pro-inflammatory diet associated with low back pain in adults aged 50 and older.

AIMS: To investigate the association between pro-inflammatory diets and low back pain in a nationally representative sample of Korean adults. BACKGROUND: Low back pain is one of the most common health issues. Evidence suggests a potential association between systemic inflammation and the development of low back pain, and the role of diet in mitigating the inflammation that, in turn, can alleviate low back pain. METHODS: This cross-sectional, correlational study used data from the 6th Korea National Health and Nutrition Examination Survey involving health interviews, examinations, and nutritional surveys. Dietary inflammatory index scores were generated based on 24-hour dietary recalls. Respondents were asked if they had experienced low back pain for at least 30 days in the past three months. Multiple logistic regression analyses were conducted to investigate the independent association between pro-inflammatory diets and low back pain. RESULTS: Of 7346 respondents, most participants were middle-aged, married, and non-/ex-smokers, lived in 2+ person households, consumed alcohol less than once a week, and had no allergies or underlying medical conditions. Respondents in the highest inflammatory diet quintile had nearly 0.25 higher odds of reporting low back pain than those in the lowest quintile (adjusted ORquintile5vs1: 1.25, 95%CI [1.01-1.54]; p = .043). CONCLUSIONS: Results from this study indicate a role of pro-inflammatory diets in the development of low back pain. Nurses can screen for those consuming pro-inflammatory foods, and thus, are vulnerable to back pain, and aid in the delivery of tailored nutritional education. Future studies should investigate how diet affects low back pain diagnosis and chronicity relative to pain phenotypes.

Perceived discrimination and physical activity mediate the associations between receiving a survivorship care plan and cancer pain.

BACKGROUND: Survivorship care plan helps improve the continuity of care and manage ongoing pain that affects up to 46% of cancer survivors by promoting health behaviors, including physical activity. However, perceived discrimination may decrease the likelihood of cancer survivors participating in physical activities and negatively influence their pain status. Thus, this study aimed to examine the mediating role of physical activity and perceived discrimination in the relationship between receiving a survivorship care plan and cancer pain. METHODS: This cross-sectional, correlational study utilized data from the 2012-2019 Behavioral Risk Factor Surveillance System. Analyses accounted for the complex survey design. Logistic regression was utilized to analyze the association among survivorship care plans, discrimination, physical activity, and pain. Generalized structural equation modeling was conducted to test a hypothesized model in which survivorship care plans and discrimination affect physical activity, and subsequently influence pain status. RESULTS: Forty-two and 81% of survivors reported receiving treatment summaries and follow-up care plans, respectively, and 8% experienced cancer pain. After controlling for covariates, the highest discrimination quintile was three times more likely to report cancer pain than the lowest quintile. While receiving follow-up care plans was positively related to cancer pain, respondents in the third- to fifth- quintiles were less likely to report cancer pain when receiving follow-up care plans than the first quintile respondents. Physical activity mediated the association between discrimination and cancer pain. CONCLUSIONS: Reverse relationships between receiving follow-up care plans and cancer pain existed; however, discrimination and physical activity mediated these relationships.

Fear of cancer recurrence in Korean women after breast cancer treatment: A mixed methods study.

PURPOSE: This study aimed to identify the fear of cancer recurrence (FCR) among Korean breast cancer survivors and further explore their experiences based on their level of FCR. METHODS: A mixed-methods study was conducted with a quantitative approach (phase I) followed by a qualitative approach (phase II) between August 2019 and February 2020.70 participants who completed the FCR inventory questionnaire were categorized into either high or low groups based on their FCR level. In phase II, in-depth interviews with 14 participants from phase I were conducted to explore their specific experiences of FCR. RESULTS: 38 participants (54.3%) experienced high levels of FCR, characterized by higher severity of FCR, more reaction to triggers, higher stress levels, more functional impairments, more insight, and frequent reassurance-seeking behaviors than those with low levels of FCR. Differences in FCR levels by age were statistically significant (F = 6.83, p = .002), and participants younger than 50 years had significantly higher FCR scores than those aged 60 years and older. Of similarities and differences found between the two groups, qualitative findings showed that the experience of the high FCR group was characterized by "living with cancer but keeping a certain distance from fear of recurrence" and that of the low FCR group was characterized by "living a healing life while controlling latent fears." CONCLUSIONS: It is necessary to help those survivors who experience high FCR reduce its negative impact on their health. These findings can serve as a basis to develop a personalized approach with better understanding of the FCR among Korean women.

A predictive model of fear of cancer recurrence for patients undergoing chemotherapy.

PURPOSE: A number of cancer patients experience fear of cancer recurrence (FCR), which affects their psychological adjustment. This study tested the hypothesized model of FCR to predict psychological adjustment in cancer patients undergoing chemotherapy. METHODS: A total of 203 patients, who had been diagnosed with either breast cancer or colorectal cancer and were undergoing chemotherapy, were recruited from two university hospitals in Seoul, Korea. Data were collected using validated questionnaires and were analyzed using SPSS 24.0 and AMOS 25.0 program for structural equation modeling procedures. RESULTS: The fit index of the hypothesized model was appropriate. Symptom distress, contextual factors, FCR, and illness representations had statistically significant direct, indirect, and total effects on psychological adjustment. These variables explained 76% of the total variance of the psychological adjustment in cancer patients undergoing chemotherapy. Fear of cancer recurrence was a mediating factor for the effects of symptom distress, contextual factors, and illness representation on psychological adjustment. CONCLUSIONS: Based on these results, interventions aimed at reducing symptom distress and FCR, and improving social support, optimism, and illness representations, may be useful for the successful psychological adjustment of cancer patients undergoing chemotherapy.