Mind-body-medicine in oncology-from patient needs to tailored programs and interventions: a cross-sectional study.

Introduction: National and international guidelines recommend early integration of evidence-based multimodal interventions and programs, especially with a focus on relaxation techniques and other Mind-Body-based methods to maintain the quality of life of oncology patients, improve treatment tolerability, and promote healthy lifestyle behaviors. Consequently, we aim to understand what drives patients and how they navigate integrative medicine to best advise them. This study aimed to detect possible topics of particular interest to patients and identify the patient groups that could benefit most from further programs. Furthermore, we aimed to investigate if patients are open-minded toward integrative oncology concepts and learn about their motivational level to maintain or change behavior. Methods: Between August 2019 and October 2020 we surveyed patients undergoing oncological therapy in a university oncological outpatient center using a custom-developed questionnaire based on established Mind-Body Medicine concepts. Results: We included 294 patients with various cancers. More than half reported problems sleeping through (61%) and 42% felt stressed frequently, invariably rating this as detrimental to their health. Moreover, a slight majority (52%) felt physically limited due to their disease and only 30% performed defined exercise programs. Women were significantly more likely to feel stressed and reported with alarming frequency that they often feel "everything was up to them." The 40-65-year-olds reported significantly less restful sleep, more stress and were more dissatisfied with their situation. However, this group already used natural remedies most frequently and was most often motivated to use relaxation techniques in the next 6 months. The lower the perceived individual energy level (EL), the less frequently patients did sport, the more frequently they felt their disease impaired their activity, mostly feeling stressed and tense. We also found significant associations between negative emotions/thoughts and the variables "sleep," "use of relaxation techniques," "personal stress perception," and "successful lifestyle modification." Conclusion: Mind-Body programs that focus on patient's individual resources, with tools to explore impairing patterns of self-perception and cognitive biases, can be a valuable resource for oncology patients and should therefore be part of an integrative medical treatment concept.

Corrigendum: Every fifth patient suffered a high nutritional risk - Results of a prospective patient survey in an oncological outpatient center.

[This corrects the article DOI: 10.3389/fnut.2022.1033265.].

Prevention and Treatment of Chemotherapy-Induced Peripheral Neuropathy (CIPN) with Non-Pharmacological Interventions: Clinical Recommendations from a Systematic Scoping Review and an Expert Consensus Process.

Background: Most individuals affected by cancer who are treated with certain chemotherapies suffer of CIPN. Therefore, there is a high patient and provider interest in complementary non-pharmacological therapies, but its evidence base has not yet been clearly pointed out in the context of CIPN. Methods: The results of a scoping review overviewing the published clinical evidence on the application of complementary therapies for improving the complex CIPN symptomatology are synthesized with the recommendations of an expert consensus process aiming to draw attention to supportive strategies for CIPN. The scoping review, registered at PROSPERO 2020 (CRD 42020165851), followed the PRISMA-ScR and JBI guidelines. Relevant studies published in Pubmed/MEDLINE, PsycINFO, PEDro, Cochrane CENTRAL, and CINAHL between 2000 and 2021 were included. CASP was used to evaluate the methodologic quality of the studies. Results: Seventy-five studies with mixed study quality met the inclusion criteria. Manipulative therapies (including massage, reflexology, therapeutic touch), rhythmical embrocations, movement and mind-body therapies, acupuncture/acupressure, and TENS/Scrambler therapy were the most frequently analyzed in research and may be effective treatment options for CIPN. The expert panel approved 17 supportive interventions, most of them were phytotherapeutic interventions including external applications and cryotherapy, hydrotherapy, and tactile stimulation. More than two-thirds of the consented interventions were rated with moderate to high perceived clinical effectiveness in therapeutic use. Conclusions: The evidence of both the review and the expert panel supports a variety of complementary procedures regarding the supportive treatment of CIPN; however, the application on patients should be individually weighed in each case. Based on this meta-synthesis, interprofessional healthcare teams may open up a dialogue with patients interested in non-pharmacological treatment options to tailor complementary counselling and treatments to their needs.

Every fifth patient suffered a high nutritional risk-Results of a prospective patient survey in an oncological outpatient center.

Introduction: Malnutrition in cancer patients often remains undetected and underestimated in clinical practice despite studies revealing prevalences from 20 to 70%. Therefore, this study aimed to identify patient groups exposed to an increased nutritional risk in a university oncological outpatient center. Methods: Between May 2017 and January 2018 we screened oncological patients there using the malnutrition universal screening tool (MUST). Qualitative data were collected by a questionnaire to learn about patients' individual information needs and changes in patients' diets and stressful personal nutrition restrictions. Results: We included 311 patients with various cancers. 20.3% (n = 63) were found to be at high risk of malnutrition, 16.4% (n = 51) at moderate risk despite a mean body mass index (BMI) of 26.5 ± 4.7 kg/m2. The average age was 62.7 (± 11.8) with equal gender distribution (52% women, n = 162). In 94.8% (n = 295) unintended weight loss led to MUST scoring. Patients with gastrointestinal tumors (25%, n = 78) and patients >65 years (22%, n = 68) were at higher risk. Furthermore, there was a significant association between surgery or chemotherapy within six months before survey and a MUST score ≥2 (OR = 3.6). Taste changes, dysphagia, and appetite loss were also particular risk factors (OR = 2.3-3.2). Young, female and normal-weight patients showed most interest in nutrition in cancer. However, only 38% (n = 118) had a nutritional counseling. Conclusion: This study confirms that using the MUST score is a valid screening procedure to identify outpatients at risk of developing malnutrition. Here one in five was at high risk, but only 1% would have been detected by BMI alone. Therefore, an ongoing screening procedure with meaningful parameters should be urgently implemented into the clinical routine of cancer outpatients as recommended in international guidelines.

[Creating evidence for naturopathic nursing interventions in oncology - a systematic approach]. / Generierung von Evidenz zu naturheilkundlichen Pflegeinterventionen in der Onkologie ­ ein systematisches Verfahren.

BACKGROUND: Nurses working in oncology use a wide range of naturopathic interventions in their daily practice to alleviate symptoms and improve the quality of life of oncological patients. However, there is no external evidence for many of these interventions. Due to a lack of scientific studies in the field, the aim of the project described here is to develop a standardized procedure to generate evidence on naturopathic interventions, on the basis of which recommendations may be derived for nursing practice. METHOD: The systematic procedure presented here was developed by the working group (WG) Integrative Nursing in Oncology over a period of four years in an iterative process. This process is based on the expert panel members' experience with the development of guidelines and/or quality instruments such as practice standards. RESULT: The systematic methodological approach presented here consists of three successive steps where internal and external evidence have been combined: a scoping review, a structured consensus process with oncology nurses to collect and evaluate naturopathic interventions, and finally a further supplementary literature review based on additional findings of the consensus conference. The procedure was successfully carried out for mucositis, insomnia, fatigue, hand-foot syndrome and chemotherapy-induced polyneuropathy. CONCLUSION: Through the step-by-step synthesis of internal evidence and the best available external evidence, the evidence base for naturopathic nursing interventions in oncology can be generated and practice recommendations derived. The procedure represents a successful theory-practice transfer through structured cooperation between (nursing) scientists and nursing practitioners. In terms of the AWMF classification, the practice recommendations developed in the process described fall somewhere in between an S1 guideline (informal consensus of an expert group) and an S2e guideline (evidence-based).

Nursing Procedures for the Prevention and Treatment of Mucositis Induced by Cancer Therapies: Clinical Practice Guideline Based on an Interdisciplinary Consensus Process and a Systematic Literature Search.

BACKGROUND: Patients with cancer receiving tumor therapy often suffer from oral mucositis. OBJECTIVES: The aim of this project was to summarize experiences with nursing procedures by experts in integrative oncology and to establish recommendations for nursing interventions that can prevent or cure mucositis. METHODS: The study design was an interdisciplinary consensus process based on a systematic literature search. RESULTS: The panel discussed and agreed on 19 nursing procedures, which included mouthwashes, such as teas, supplements, oil applications, and different kinds of ice cubes to suck, as well as flaxseed solution, propolis, and mare milk. Twelve interventions were classified as effective, with effectiveness for OraLife, propolis, sea buckthorn pulp oil, marshmallow root tea also for xerostomia, Helago chamomile oil, mare milk, and Saliva Natura rated as highly effective in clinical experience. In the systematic literature search, a total of 12 out of 329 randomized controlled trials and meta-analyses on chamomile (n = 3), Calendula (n = 1) and sage (n = 1), propolis (n = 2), and sucking ice cubes (cryotherapy; n = 5) met all inclusion criteria. Trial evidence for effectiveness in oral mucositis was revealed for propolis and cryotherapy. CONCLUSIONS: The current evidence supports the use of some nursing procedures (f.e. propolis for 2 and 3 grade mucositis) for improving oral mucositis during cancer therapies. There is still a need to define general clinical practice guidelines for the supportive treatment of mucositis, as well as for more interdisciplinary research in this area.

[Differences in body image of young normal weight and overweight/obese people]. / Diferencias en imagen corporal de jóvenes con normopeso y con sobrepeso/obesidad.

INTRODUCTION: Obesity is a chronic and growing problem. Its study requires the understanding of multiple associated variables. Body image has an important role in the health condition. The purpose of this study was to compare the perception of body image of young normal weight and overweight/obese people. MATERIAL AND METHODS: A sample of 376 young men and women aged 18 to 25 was compared. Body mass index classified them in two groups: normal weight and overweight/obese. To evaluate body image participants answered the Multidimensional Body Self Relations Questionnaire (MBSRQ). To evaluate eating behavior they answered the Eating Disorders Inventory (EDI-3). RESULTS: Overweight/obese young people are less satisfied with their appearance and their body when it is evaluated separately. They evaluate their physical condition and their physical abilities badly. They show fewer behaviors intended to maintain or improve their physical appearance, perceive a worse diagnosis of their health and show less body satisfaction. They are more concerned about their weight and they are obsessed about thinness. In addition, women, compared to men, have a worse negative assessment of their body image. CONCLUSION: Despite the low assessment that overweight/obese students made in relation to their body, they are not willing to perform activities that allow them to change their condition. Further research is needed in order to develop preventive programs and more treatments that are effective.

INTRODUCCIÓN: la obesidad es un problema crónico y en aumento. Su estudio requiere comprender múltiples variables asociadas. La imagen corporal tiene un papel importante en esta condición de salud. El propósito de este estudio fue comparar la percepción de imagen corporal de jóvenes normopeso y con sobrepeso/obesidad. MATERIAL Y MÉTODOS: se comparó a 376 jóvenes de ambos sexos, de una muestra general y sin tratamiento, de entre 18 y 25 años de edad, clasificados por su índice de masa corporal en dos grupos: grupo normopeso y grupo sobrepeso u obesidad. Para evaluar imagen corporal, los participantes respondieron el Multidimensional Body Self Relations Questionnaire (MBSRQ) y el Eating Disorders Inventory (EDI-3). RESULTADOS: los participantes con sobrepeso/obesidad están menos satisfechos con su apariencia y con su cuerpo cuando este es evaluado por partes, evalúan peor su estado físico y/o sus capacidades físicas, presentan menos conductas orientadas a mantener o mejorar su forma física, perciben un peor diagnóstico de su salud y tienen menor satisfacción corporal. Asimismo, están más preocupados por su peso, se autoclasifican más por su peso y presentan una mayor obsesión por la delgadez. Además, las mujeres, en comparación con los hombres, presentan una evaluación más negativa de su imagen corporal. CONCLUSIÓN: a pesar de la mala evaluación que los estudiantes con sobrepeso/obesidad realizan en relación a su cuerpo, no están dispuestos a realizar actividades concretas que les permitan cambiar su estado. Es necesario seguir investigando con el fin de desarrollar programas preventivos y de tratamiento más efectivos.

Diferencias en imagen corporal de jóvenes con normopeso y con sobrepeso/obesidad / Differences in body image of young normal weight and overweight/obese people

Introducción: la obesidad es un problema crónico y en aumento. Su estudio requiere comprender múltiples variables asociadas. La imagen corporal tiene un papel importante en esta condición de salud. El propósito de este estudio fue comparar la percepción de imagen corporal de jóvenes normopeso y con sobrepeso/obesidad. Material y métodos: se comparó a 376 jóvenes de ambos sexos, de una muestra general y sin tratamiento, de entre 18 y 25 años de edad, clasificados por su índice de masa corporal en dos grupos: grupo normopeso y grupo sobrepeso u obesidad. Para evaluar imagen corporal, los participantes respondieron el Multidimensional Body Self Relations Questionnaire (MBSRQ) y el Eating Disorders Inventory (EDI-3). Resultados: los participantes con sobrepeso/obesidad están menos satisfechos con su apariencia y con su cuerpo cuando este es evaluado por partes, evalúan peor su estado físico y/o sus capacidades físicas, presentan menos conductas orientadas a mantener o mejorar su forma física, perciben un peor diagnóstico de su salud y tienen menor satisfacción corporal. Asimismo, están más preocupados por su peso, se autoclasifican más por su peso y presentan una mayor obsesión por la delgadez. Además, las mujeres, en comparación con los hombres, presentan una evaluación más negativa de su imagen corporal. Conclusión: a pesar de la mala evaluación que los estudiantes con sobrepeso/obesidad realizan en relación a su cuerpo, no están dispuestos a realizar actividades concretas que les permitan cambiar su estado. Es necesario seguir investigando con el fin de desarrollar programas preventivos y de tratamiento más efectivos (AU)

Introduction: Obesity is a chronic and growing problem. Its study requires the understanding of multiple associated variables. Body image has an important role in the health condition. The purpose of this study was to compare the perception of body image of young normal weight and overweight/obese people. Material and methods: A sample of 376 young men and women aged 18 to 25 was compared. Body mass index classified them in two groups: normal weight and overweight/obese. To evaluate body image participants answered the Multidimensional Body Self Relations Questionnaire (MBSRQ). To evaluate eating behavior they answered the Eating Disorders Inventory (EDI-3). Results: Overweight/obese young people are less satisfied with their appearance and their body when it is evaluated separately. They evaluate their physical condition and their physical abilities badly. They show fewer behaviors intended to maintain or improve their physical appearance, perceive a worse diagnosis of their health and show less body satisfaction. They are more concerned about their weight and they are obsessed about thinness. In addition, women, compared to men, have a worse negative assessment of their body image. Conclusion: Despite the low assessment that overweight/obese students made in relation to their body, they are not willing to perform activities that allow them to change their condition. Further research is needed in order to develop preventive programs and more treatments that are effective (AU)