Emotional Functioning Research Articles

Quality of Life in Children With Chronic Health Conditions and Its Contribution to Unmet Supportive Care Needs of Families.

While theoretical models have established the bidirectional relationship between health and wellbeing of parents and children with chronic health conditions (CHCs), previous work has predominantly emphasised the impact of parent functioning on child outcomes. This study examines how quality of life (QoL) domains in children with CHCs are associated with unmet supportive care needs (SCN) of their parents and explores whether these associations vary by health condition. Parents of children with congenital heart disease (CHD), type 1 diabetes (T1D) and cancer diagnosed before the age of 12 years and receiving treatment within the last 5 years were eligible. Parents recruited through charity organisations and social media platforms completed a secure, online survey via Qualtrics. The PedsQL examined child QoL across four dimensions: physical, emotional, social and school functioning. A 34-item survey assessed parents' unmet SCN in the previous month across six need domains (e.g., care and informational). Linear regressions examined associations between child QoL and unmet SCN domains and moderation analyses determined whether associations varied as a function of CHC. The study included 186 parents (age range 25-56 years) of children diagnosed with various CHCs (52% CHD; 27% T1D, 21% cancer). The child's emotional functioning was inversely related to all unmet SCN domains, social functioning was inversely related to three domains (physical and social; support; financial), school functioning was inversely related to two domains (physical and social; care), and child's physical functioning was not associated with any SCN domains. Only the association between child school functioning and unmet care needs was significantly moderated by CHC type (p < 0.05). Poorer emotional functioning in children with a CHC is a key factor in determining parents unmet SCN. Larger studies are required to replicate these findings and inform design of interventions addressing QoL and unmet SCN in families of children with common CHCs.

Analysis of the Status Quo and Influencing Factors of Advanced Lung Cancer Patients’ Quality of Life

Objective: To investigate the quality of life and related influencing factors of patients with advanced lung cancer. Methods: A cross-sectional survey was conducted on 51 patients with advanced lung cancer who were hospitalized in the Department of Oncology from January 2023 to December 2023, and the influencing factors of patients’ quality of life were analyzed. Results: Among the five functional scales (physical, role, cognitive, emotional, and social functioning) of the QLQ-C30 scale, the social and emotional function scores were the lowest, respectively 16.7 (IQR: 0, 33.3) points, and 16.7 (IQR: 8.3, 25), and among the three symptom scales (fatigue, pain, nausea and vomiting), the fatigue symptom score was the highest: 77.7 (IQR: 66.7, 88.9) points. The results of Spearman correlation analysis showed that the anxiety score of patients with advanced lung cancer was positively correlated with depression score (P &lt; 0.01), while the quality of life of patients with advanced lung cancer was not correlated with anxiety and depression score (P &gt; 0.1). The self-care ability, the nature of the disease, and whether the patient was treated for chemotherapy were the independent influencing factors of the patient’s quality of life, and the difference was statistically significant (P &lt; 0.001). Conclusion: Patients with advanced lung cancer have different degrees of anxiety and depression, and their quality of life is affected by many factors, which are mainly related to the patient’s self-care ability, the nature of the disease, and whether they received chemotherapy.

Adaptation and feasibility of the Swedish Promoting Resilience in Stress Management intervention targeting adolescents and young adults newly diagnosed with cancer.

To describe the adaptation and feasibility of the Swedish version of the Promoting Resilience in Stress Management (PRISM) intervention among adolescents and young adults (AYAs) newly diagnosed with cancer. PRISM is a 5-session, manualized program designed to strengthen AYAs individual resources for managing stress by promoting resilience skills: stress-management, goal-setting, cognitive reframing and meaning-making. It is delivered 1:1 by an interventionist via video-visits. PRISM was developed in the US and adapted for a Swedish population. A feasibility study was conducted looking at recruitment, retention, acceptability of the intervention (evaluation survey and exit interviews) and pre- and post- exploratory psychosocial outcome measures (resilience, global health, emotional functioning and rehabilitation needs). Participants were recruited from a comprehensive cancer center in Sweden. Of the 31 eligible individuals (16-30 years), 20 (65%) agreed to participate and 11 (55%) completed PRISM. Eighty-six percent (6/7) of the participants who completed the evaluation survey thought that the order of the modules and the content were "very good or good". The AYAs that participated in the exit interviews expressed that the programme contributed new knowledge and for some confirmed previous knowledge, which was valuable both during and after participation. The role of the interventionist was stressed as important to support participants through the programme. Suggestions for the future included making PRISM more personalized. Exploratory quantitative analyses suggested improved mean scores regarding resilience, global health and emotional functioning from pre- to post-intervention. This study suggests that participating in PRISM has the potential to guide AYAs during the initial period after a cancer diagnosis. Further work to make PRISM more personalized might increase AYAs' interest in, and completion of, PRISM.

Youth mental health and exposome

Abstract Mental health is a complex Public Health challenge, especially youth. A better understanding of factors that contribute to youth mental health and reduce the burden of youth mental health conditions such as executive and emotional functioning is needed to develop primary and secondary prevention interventions. One of the main challenges for better understanding mental health of youth is the complexity and diversity of exposures that individuals experience throughout their lifetime. There is a wide range of factors in the environment, and individuals are exposed to different combinations of external factors depending on their location, occupation, and lifestyles. These factors include physical (e.g., noise and indoor and outdoor air), chemical and social factors (e.g., neglect and abuse, relationship conflicts) based on the exposome framework. The exposome is a guiding framework for the multi-country study EARLY involving Albania, Belgium, Germany, Israel, Moldova, Portugal, Romania, Serbia, Spain, and Switzerland. EARLY is one of the first projects to theoretically explore and empirically investigate youth mental health in line with the exposome framework. We aim to identify factors influencing youth mental health with validated exposure measures. An exploratory list of measures was collected in Albania, Belgium, Germany, Israel, Moldova, Portugal, Romania, Serbia, Spain, and Switzerland. The measures vary widely. Besides the variation, there is still a lack of standardized methods for measuring environmental exposures. Limitations of measures affect reliability and validity. Therefore, an overview of available assessment methods and steps toward improving measures will be discussed in this talk. Speakers/Panelists Karin Boode GGD GHOR Nederland, Utrecht, Netherlands Peter Van Den Hazel INCHES, Ellecom, Netherlands

Severity of Depression among Incarcerated Men in Meru, Main Prison

Purpose: Depression is one of the most prevalent mental disorders globally and it is known to cause impairment in cognitive, social, emotional and occupational functioning. In Kenya, a moderate to high prevalence of depression has been established among incarcerated men in several prisons, Meru main prison included. This study, therefore sought to assess the severity of depression among incarcerated men in Meru, Main Prison. Methodology: The study employed a quasi-experimental research design. The study was conducted in Meru, Main Prison. A sample size of 148 inmates was selected using a simple random sampling technique. Quantitative data was obtained from the social demographic questionnaire and the BDI-II. Results: The study found that the severity of depression among incarcerated men in Meru main prison was higher at 46.3% as opposed to moderate depression at 27.9%, and mild depression at 18%. This implied that prisoners going through severe depression are more than those other levels of depression. Conclusion: The study concluded that severity of depression was higher among the participants aged 20 to 30 years compared to other age categories and among the first time in prison. The proportion of clinical depression was higher among young adults aged 20-30 years in prison compared to the middle adults and adults 30-50 years. Therefore, it is recommended that the government of Kenya may engage young adults with job opportunities, and social engagement. This might limit the proportion of young adults languishing in prison instead of utilizing their youthful strength productively in society.

Measuring functioning and disability in Korea: comparing general and dedicated surveys using the ICF

Abstract Background Functioning is the third health indicator besides mortality and morbidity. Although Korea periodically collects functioning information, the functioning indicator has not been generated yet. This study aimed to evaluate how functioning information is currently collected in Korea’s health and disability surveys, especially in terms of comparability and comprehensiveness, using the International Classification of Functioning, Disability and Health (ICF) as a reference framework. Methods Data sources included three health and disability surveys in Korea (Population and Housing Census, Korean National Health and Nutrition Examination Survey, Survey on the Living condition of Persons with Disabilities) and two international ICF-based surveys (International Spinal Cord Injury Survey, Model Disability Survey). Functioning information was linked by category to the ICF Generic-30 Set utilizing the ICF linking rules. Results Three ICF categories (walking, washing oneself, dressing) were covered by all the data sources. Excluding the Census, which inherently differs from the other data sources, all the surveys addressed six ICF categories-b152 emotional functions; b280 sensation of pain; d240 handling stress and other psychological demands; d450 walking; d510 washing oneself; d540 dressing. Despite of the common ICF categories, important differences in the operationalization of questions and response options were found. Conclusions The overlap of content of health and disability surveys in Korea enables interoperability with other data sources. Available functioning data can be used for estimating the functioning indicator and metric, as recommended by WHO, which can serve as a valuable epidemiological indicator for complementing mortality and morbidity indicators and for estimating and monitoring rehabilitation or long-term care needs of the Korean population. Key messages • Korea’s health and disability surveys periodically collect functioning information at the national level, and the level of overlap across surveys enables interoperability with other data sources. • This study can contribute to generate a Korean common health metric based on functioning that can serve as a valuable epidemiological indicator by utilizing the international standard ICF.

Biopsychosocial Approaches for the Management of Female Chronic Pelvic Pain: A Systematic Review.

Current guidelines recommend biopsychosocial-informed treatment for chronic pelvic pain (CPP). The objective of this systematic review was to describe the available biopsychosocial approaches for the treatment of CPP, and the outcomes reported, to understand how guideline-recommended treatments can be applied. MEDLINE, CINAHL, PsycINFO, EMBASE, Emcare, AMED and Cochrane trial registries were searched (inception to 17 November 2023). CPP Studies in women where the principal treatment modality was a biopsychosocial approach were included. Prospero registration: CRD42022374256. Data extraction included study setting, population, study design, intervention characteristics and outcome measures and is described via a narrative synthesis. The review included 14 RCTs (871 patients) and identified four broad intervention categories (Acceptance Commitment Therapy n = 2, Cognitive Behavioural Therapy n = 6, Mindfulness-based approaches n = 2, and Physiotherapy-based interventions n = 4). Pain science education (PSE) and, exposure/engagement with valued activity were recognised as important aspects of treatment regardless of intervention type. The most utilised outcomes were pain reduction and emotional functioning, with all studies reporting improvements in these domains. Heterogeneity in outcomes prevented efficacy comparison. High risk of bias was identified in six studies (1/4 physiotherapy-based approaches, 2/6 CBT, 1/2 ACT and 2/2 mindfulness-based interventions). CBT and ACT-based biopsychosocial approaches were found effective in reducing pain and improving psychometric outcomes for CPP. Evaluation indicated PSE, and exposure/engagement in valued activity are important components of biopsychosocial management. Outcome heterogeneity needs to be addressed in future trials.

Fibre & fermented foods: differential effects on the microbiota-gut-brain axis.

The ability to manipulate brain function through the communication between the microorganisms in the gastrointestinal tract and the brain along the gut-brain axis has emerged as a potential option to improve cognitive and emotional health. Dietary composition and patterns have demonstrated a robust capacity to modulate the microbiota-gut-brain axis. With their potential to possess pre-, pro-, post-, and synbiotic properties, dietary fibre and fermented foods stand out as potent shapers of the gut microbiota and subsequent signalling to the brain. Despite this potential, few studies have directly examined the mechanisms that might explain the beneficial action of dietary fibre and fermented foods on the microbiota-gut-brain axis, thus limiting insight and treatments for brain dysfunction. Herein, we evaluate the differential effects of dietary fibre and fermented foods from whole food sources on cognitive and emotional functioning. Potential mediating effects of dietary fibre and fermented foods on brain health via the microbiota-gut-brain axis are described. Although more multimodal research that combines psychological assessments and biological sampling to compare each food type is needed, the evidence accumulated to date suggests that dietary fibre, fermented foods, and/or their combination within a psychobiotic diet can be a cost-effective and convenient approach to improve cognitive and emotional functioning across the lifespan.

Natural language processing reveals differences in mental time travel at higher levels of self-efficacy

The (re-)construction of past and future personal experiences, termed mental time travel (MTT), is highly adaptive and contributes to self-related beliefs and attitudes. Mounting evidence suggests that self-efficacy (SE), the belief that one can overcome obstacles on their own account, is functionally related to MTT. In the present study, we used novel methods for the analysis of MTT narratives based on natural language processing (NLP) to investigate the relation between SE and MTT. We demonstrated that self-efficacious participants remembered and imagined experiences which were semantically less similar and contained a wider variety of contents. Additionally, increased SE was related to a positive reappraisal of personal episodes and reports of a more active role within mental scenarios. In conclusion, NLP appears to be a valuable method to quantify changes to the (re-)construction of personal experience that might support cognitive and emotional functioning.

Alterations of regional brain activity and corresponding brain circuits in drug-naïve adolescents with nonsuicidal self-injury

Nonsuicidal self-injury (NSSI) is one of the major public health problems endangering adolescents. However, the neural mechanisms of NSSI is still unclear. The purpose of this study was to explore regional brain activity and corresponding brain circuits in drug-naïve adolescents with NSSI using amplitude of low-frequency fluctuations (ALFF) combined with functional connectivity (FC) analysis. Thirty-two drug-naïve adolescents with NSSI (NSSI group) and 29 healthy controls matched for sex, age, and level of education (HC group) were enrolled in this study. ALFF and seed-based FC analyses were used to examine the alterations in regional brain activity and corresponding brain circuits. The correlation between ALFF or FC values of aberrant brain regions and clinical characteristics were detected by Pearson correlation analysis. The NSSI group showed increased ALFF in the left inferior and middle occipital gyri, lingual gyrus, and fusiform gyrus; additionally, decreased ALFF in the right medial cingulate gyrus, left anterior cingulate gyrus, and left medial superior frontal gyrus compared to those in the HC group. With the left inferior occipital gyrus as seed, the NSSI group showed increased FC between the left inferior occipital gyrus and the bilateral superior parietal gyrus, right inferior parietal angular gyrus, right inferior frontal gyrus of the insular region, and left precuneus relative to that the HC group. With the left anterior cingulate gyrus as seed, the NSSI group showed increased FC between the left anterior cingulate gyrus and right dorsolateral superior frontal gyrus. With the left lingual gyrus as seed, the NSSI group showed increased FC between the left lingual gyrus and right middle frontal gyrus, and decreased FC between the left lingual gyrus and the left superior temporal gyrus, right supplementary motor area, and left rolandic operculum. With the left fusiform gyrus as seed, the NSSI group showed increased FC between the left fusiform gyrus and left middle and inferior temporal gyrus, and decreased FC between the left fusiform gyrus and the bilateral postcentral gyrus, right precentral gyrus, right lingual gyrus, and left inferior parietal angular gyrus. Moreover, the FC value between the left fusiform gyrus and left inferior temporal gyrus was positively correlated with suicidal ideations score. This study highlights alterations in regional brain activity and corresponding brain circuits in brain regions related to visual and emotional regulation functions in drug-naïve adolescents with NSSI. These findings may facilitate better understand the underlying neural mechanisms of NSSI in adolescents.

Differential temporal decline of cerebral oxytocin and μ-opioid receptor density during the aging process in mice.

Aging is often associated with changes in social, sexual, emotional and pain functioning, as well as with the increased prevalence of certain psychopathologies. However, the neurodevelopmental basis underpinning these age-related changes remains to be determined. Considering the key roles of oxytocin (OTR) and μ-opioid (MOPr) receptor systems in regulating social, sexual, pain, reward and emotional processing, it seems plausible that they are also implicated in age-related behavioural alterations. Although the ontogeny of both receptors has been well characterized in rodent brains from early development till adulthood, little is known concerning the neuroadaptations occurring from middle age to old age. Therefore, we mapped the neuroadaptations in OTR and MOPr in the brains of mice at those developmental endpoints. Quantitative OTR and MOPr autoradiographic binding was carried out in the brains of male mice at 2, 6, 9, 12 and 18 months of age. A significant whole brain decline in OTR density was detected between 2 and 6months of age, with no additional decline thereafter. Interestingly, for MOPrs, the decline in density was not detected until 9months of age. Region-specific age-related decline in OTR density was concentrated in the lateral anterior olfactory nuclei (AOL) and, for MOPr, in the AOL and the nucleus accumbens for MOPr. Identifying the tipping point of these age-related variations in both receptors may assist with our understanding of the neurobiology underlining age-related changes in social, pain and emotional functioning/processing. It may also help us target interventions to specific developmental windows to abrogate certain age-related psychopathologies.

Episode model: The functional approach to emotional experiences of music

We present a novel framework for music and emotion research that addresses emotional experiences with music as functional episodes. This framework, called the Episode Model, places the situation and the function of the music for the individual at the centre of the experience and integrates acts of affective self-regulation to our understanding of music as emotional experiences. The model consists of a set of five common and functionally unique episodes of emotional experiences related to music, which are: (1) Enjoyment–Distraction–Relaxation (EDR), (2) Connection–Belonging (CB), (3) Focus–Motivation (FM), (4) Personal Emotional Processing (PEP), and (5) Aesthetic–Interest–Awe (AIA). Each episode type can be characterised by a distinct configuration of six descriptive schemes: (1) core affect and emotion qualia, (2) induction mechanisms, (3) listening modes and agency, (4) reward and exposure, (5) musical meanings, and (6) functional contexts. This framework of episodes and schemes places the functionality of emotions at the forefront of music and emotion research and explains how emotional experiences are situated and functionally constructed. In addition, we provide a set of assumptions and specific predictions to facilitate focussed empirical studies of emotional engagement with music.

The impact of immersive virtual reality meditation for depression and anxiety among inpatients with major depressive and generalized anxiety disorders

BackgroundMindfulness-Based Cognitive Therapy (MBCT) is a non-pharmacological approach to alleviating depression and anxiety. While technology based MBCT is a standardized cost-effective approach, there have been concerns about its feasibility and effectiveness in clinical settings.AimsThe purpose of this study was to investigate the longitudinal relationship between improved emotional regulation resulting from participation in Immersive Virtual Reality Meditation (IVRM) and Major Depressive Disorder (MDD) and Generalized Anxiety Disorder (GAD) as monitored by electrocardiogram.MethodsThis study was a longitudinal single-arm clinical trial in which the intervention was conducted three times a week for 10 weeks at a behavioral health unit in a community hospital (n = 26). We measured Coherence Achievement Score (CAS), depression, and anxiety. The relationships between CAS, anxiety, depression, and covariates were analyzed using a Generalized Estimated Equation (GEE).ResultsThe findings of our study provide evidence that the CAS scores indicative of emotional regulation function after IVRM participation were associated with a reduction in depression and anxiety.ConclusionAmong the many technology-based complementary health care interventions that are available to reduce depression and anxiety, IVRM program use increases emotional regulatory function and decrease depression and anxiety.

Infant BMI trajectories as early risk markers of poor psychosocial health in preadolescence

BackgroundCommon mental disorders often emerge during childhood and adolescence, and their prevalence is disproportionately elevated among those affected by obesity. Early life growth patterns may provide a useful target for primordial prevention; however, research is lacking. Therefore, this study aimed to identify distinct body mass index (BMI) trajectories during the first year of life and to assess their associations with psychosocial outcomes in preadolescence (9–13 years).MethodsData were obtained from n = 1778 Greek children (9–13 years). Infant anthropometric data were obtained from paediatric health records and BMI trajectories during the first year of life were estimated using group-based trajectory modelling. Preadolescent emotional functioning, self-esteem, body image dissatisfaction and dieting behaviours were self-reported via validated questionnaires. Associations were estimated using binary and ordinal logistic regression, adjusted for key confounders.ResultsFour BMI trajectories were identified: low (26.7%), average (41.8%), high (25.2%), and very high (6.4%). Children belonging to the very high trajectory had greater odds of body image dissatisfaction (OR: 1.62, 95%CI: 1.11, 2.38), dieting behaviour (OR: 1.49, 95%CI: 1.01, 2.20) and restrained eating (OR: 1.69 95%CI: 1.14, 2.52) than children belonging to the average trajectory. Body image dissatisfaction was also greater in children belonging to the high trajectory (OR: 1.40, 95%CI: 1.11, 1.76). However, infant BMI trajectories did not significantly predict childhood emotional functioning or self-esteem status.ConclusionInfants with BMI growth in the high reference ranges had poorer psychosocial outcomes in preadolescence. Whilst further research is needed to replicate these findings, monitoring early infant growth trajectories may allow for early stratification of infants at risk of poor psychosocial outcomes.

Evaluating a digital tool for supporting people affected by breast cancer: a prospective randomized controlled trial—the ADAPT study

PurposeThis study reports the findings from the ADAPT randomized controlled trial (RCT), concerning the impact of a digital tool for supported self-management in people affected by breast cancer on patient activation as the primary outcome, with health-related quality of life (HRQoL), and health status as secondary outcomes.MethodsWomen with early-stage breast cancer were randomly assigned to standard care (control) or standard care in addition to the breast cancer digital tool (intervention). Data were collected using a demographic questionnaire, the Patient Activation Measure (PAM-13), the European Organization for Research and Treatment of Cancer Core Quality of Life Questionnaire (EORTC QLQ-C30), and the EuroQol 5-Dimension 5-Level questionnaire (EQ-5D-5L) at baseline, 6 weeks, 3 months, 6 months, and 1 year from diagnosis. Linear mixed effect model regression was used to assess the effect of the digital tool over the first year from diagnosis while correcting for intra-participant correlation.ResultsA total of 166 participants were included, with 85 being randomized into the intervention. No significant differences (p > 0.05) in the PAM-13 scores, EORTC QLQ-C30 scales (global QoL, physical functioning, emotional functioning, pain, fatigue), and EQ-5D-5L Index between the control and intervention groups were observed. It is important to note that there was significant non-adherence within the intervention group.ConclusionThe breast cancer digital tool had no statistically significant impact on patient activation, HRQoL, and health status over time compared to standard care alone in women with early-stage breast cancer. Future research should focus on identifying and addressing barriers to digital tool engagement to improve efficacy.Clinical trial informationThe study was registered at https://clinicaltrials.gov (NCT03866655) on 7 March 2019 (https://clinicaltrials.gov/study/NCT03866655).

Exploring Patient Empowerment in Major Depressive Disorder: Correlations of Trust, Active Role in Shared Decision-Making, and Symptomatology in a Sample of Italian Patients.

Background/Objectives: Empowerment in medicine and psychiatry involves patients gaining control over health-related decisions, improving treatment adherence, outcomes, and satisfaction. This concept is especially significant in psychiatric care due to the complex challenges of mental health conditions, including stigma and impairment of emotional and cognitive functioning. We aim to investigate the correlations between patient trust, decision-making involvement, symptom severity, and perceived empowerment among individuals with Major Depression. Methods: Patients with Major Depressive Disorder were recruited in the "Policlinico G. Rodolico" psychiatry outpatient clinic from November 2022 to June 2023. Inclusion criteria: ages 18-65, ability to consent, stable condition, psychiatric medication history, and recent consultation. Exclusion criteria: psychotic features, bipolar disorder, substance abuse, high suicide risk, and severe comorbidities. Measures included the User Scale for Measuring Empowerment in Mental Health Services (SESM), Trust in Oncologist Scale (TiOS), Clinical Decision-Making Style for Patients (CDMS-P), and Hamilton Depression Rating Scale (HAM-D). Analysis used Kendall's Tau correlation and Two-One-Sided Tests procedure. Results: Seventy-three patients completed the study. No relationship was found between decision-making involvement and perceived empowerment (τ = -0.0625; p = 0.448), or between trust in psychiatrists and empowerment (τ = 0.0747; p = 0.364). An inverse correlation existed between patient involvement in therapy management and trust (τ = -0.2505; p = 0.002). Depression severity inversely correlated with empowerment (τ = -0.2762; p = <.001), but not with trust or decision-making involvement. Conclusions: The lack of significant correlations suggests that decision-making involvement and trust alone may not suffice to enhance empowerment. Trust may encourage patient passivity, while skepticism might drive active involvement. Higher empowerment is associated with less depressive symptoms, highlighting its potential connection with patient outcomes.

Identifying Clusters of Curatively-Treated Esophageal Cancer Patients Using Patient-Reported Outcome Measures at Three Months from Discharge: A Secondary Analysis from a Longitudinal Single Center Study.

This study aims to identify meaningful clusters based on Patient-Reported Outcome Measures (PROMs) in curatively-treated esophageal cancer patients at three months post-discharge. This secondary analysis of a longitudinal single-center study included 46 esophageal cancer patients who underwent curative surgery. Patients were selected based on their completion of PROMs surveys at three months post-discharge, were aged 18 years or older, and had undergone surgical resection (esophagectomy) with or without neoadjuvant chemotherapy and/or radiotherapy. The analysis utilized t-distributed Stochastic Neighbor Embedding (t-SNE) for dimensionality reduction and hierarchical clustering to analyze PROMs data collected three months post-discharge. Clustering was performed on physical, emotional, cognitive, and social functioning variables, symptom burden, and health literacy. Three distinct clusters were identified: Cluster 1 (n = 24) with higher functioning and moderate symptoms, Cluster 2 (n = 14) with moderate functioning, higher symptoms, and lower health literacy, and Cluster 3 (n = 8) with the highest functioning, lowest symptoms, and highest health literacy. Significant differences between squamous cell carcinoma and adenocarcinoma subtypes were observed across several PROMs domains, including critical health literacy, general health status/quality of life, nausea and vomiting, and insomnia. These clusters provide an exploratory framework for tailoring post-operative interventions to enhance patient recovery, which necessitates further confirmatory investigations, including outcomes such as complications and mortality, in the analysis. This study fills a research gap by demonstrating the utility of PROMs in identifying distinct recovery patterns in esophageal cancer patients post-surgery. The findings support the use of PROMs to guide personalized post-operative care, potentially improving patient outcomes and quality of life. Further research is needed to validate these findings in larger, diverse populations.

The altered resting-state functional connectivity of thalamic subregions in patients with globus pharyngeus.

Globus Pharyngeus (GP) is a somatic symptom that accompanies mood distress. Although the etiology of GP remains unclear, its specific symptom of a false lump sensation in the throat without physical obstruction raises the possibility of alterations in brain networks responsible for somatosensory and emotion processing in patients with GP. To address this possibility, we investigated resting-state functional connectivity (rsFC) in 31 patients with GP and 24 healthy individuals using resting-state functional magnetic resonance imaging. Considering its significance in somatosensory and emotional functions, we focused on rsFC in the subregions of the thalamus. We found significantly decreased rsFC between the right caudal temporal thalamus (rcTtha) and the midcingulate cortex (MCC) as well as significantly decreased rsFC between the right rostral temporal thalamus (rrTtha) and the left cerebellum in the patients with GP. Additionally, within the patient group, the abnormalities in rsFC between the rcTtha and the MCC were correlated with the severity of somatization symptoms but not with depression and anxiety. These findings suggest alterations in the rsFC of thalamic subregions in patients with GP, shedding light on the pathogenesis of GP and potentially leading to improved diagnosis and treatment approaches for the condition.

Effects of Virtual Reality Therapy for Patients With Breast Cancer During Chemotherapy: Randomized Controlled Trial.

Patients with breast cancer endure high levels of psychological and physical pain. Virtual reality (VR) may be an acceptable, safe intervention to alleviate the negative emotions and pain of patients with cancer. We aimed to test the long-term effects of VR on psychological distress and quality of life (QOL) with traditional care in Chinese patients with breast cancer. We also explored the intervention mechanism and the acceptability of VR. A total of 327 eligible participants were randomly assigned to a VR intervention group or a control group. The Distress Thermometer, QLQ-C30 (Quality of Life Questionnaire version 3.0), and Virtual Reality Symptom Questionnaire were assessed at baseline, postintervention (3 mo), and follow-up (6 mo). Analysis followed the intention-to-treat (ITT) principle. The generalized estimating equations model was used to analyze the longitudinal data, and the PROCESS macro was used to analyze the mediating effect. Compared with the control group, patients with breast cancer in the VR group had lower distress scores (P=.007), and higher health-related QOL scores (physical, role, emotional, cognitive, and social functioning) after 6 months (P<.05). Psychological distress had mediating effects on the longitudinal association between VR and the health-related QOL (indirect effect=4.572-6.672, all P<.05). VR intervention technology may help reduce distress and improve QOL for patients with breast cancer over time. By incorporating a mediating analysis, we showed that the QOL benefits of VR intervention was manifested through positive effects on psychological distress risk factors.

Evaluation of Lifestyle for Women with Breast Cancer

Introduction: Breast cancer is a significant global health concern, affecting millions of women worldwide. While advancements in diagnosis and treatment have improved survival rates, the impact of this disease extends beyond physical health. It also significantly influences a woman's lifestyle and overall well-being. Objectives: The current study intends to analyze the lifestyle of breast cancer patients who are receiving therapy or are being followed up at the Oncology Teaching Hospital in Medical City, Baghdad, Iraq. Method: The present study uses a descriptive design with an application of an evaluation approach. A convenience sample of 100 women with breast cancer was selected from the Teaching Oncology Hospital at the Medical City in Baghdad City, Iraq. The study's objectives are served by a questionnaire. Physical, role, emotional, cognitive, and social functioning are its five functional domains. These domains are evaluated as low, moderate and high. Each study participant received a questionnaire explaining how to complete it, along with a form requesting their approval to remain anonymous. They also had the opportunity to leave the study at any time without being provided an explanation. A panel of (10) experts determines the questionnaire's content validity, and its internal consistency reliability is calculated via the split-half method with a Cronbach’s alpha correlation coefficient of (r=0.92). Data are collected using the study questionnaire, and they are then analyzed via a descriptive statistical data analysis approach on the basis of frequency and percentage. Results: The study revealed that the majority of these women experienced sleep issues, but most of them experienced problems with body weight gain (70%), social and community activity (70%), sexuality (60%), stress (60%), diet (56%), physical activity (50%) and smoking (45%), and some of them took birth control pills and used hormone replacement therapy (43%). Conclusion: This study revealed that women with breast cancer have experienced a variety of lifestyle domain-associated problems. These problems are clearly manifested in the results of this study.