Supportive Care Interventions Research Articles

Associations Between Dietary Patterns and Quality of Life in a Longitudinal Cohort of Colorectal Cancer Survivors

Purpose: To characterize dietary patterns and examine associations with cross-sectional and longitudinal changes in quality of life (QOL) over approximately one year after colorectal cancer (CRC) diagnosis. Methods: The ColoCare Study is an international, multi-center, prospective cohort study of newly diagnosed CRC survivors of any stage. A subset of participants with CRC in the United States completed patient-reported outcome measures at 6- and 12-months post-enrollment, including the Food Frequency Questionnaire (FFQ) and European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30). Dietary patterns at 6 months (around the time of treatment completion) were identified using Principal Component Analysis (PCA) with varimax rotation. Adherence scores were calculated for participants within each dietary pattern, with higher scores indicating higher adherence. Mixed models were used to examine the effect of each dietary pattern on changes in QOL at 6- and 12-month follow-ups, controlling for cancer stage, biological sex, body mass index (BMI), smoking status, and age. Results: Participants (N = 174) were, on average, 56 ± 14 years old and were mostly female (51.5%), stage III or IV (51.7%), never smokers (60.2%), non-Hispanic (97.1%), and White (83.3%) with a BMI of 27.9 ± 6.1 kg/m2. PCA revealed two emerging dietary patterns: “Western diet”, characterized by processed meats, refined grains, and sugars, and “Prudent diet” characterized by lean proteins, fruits, and vegetables. Higher adherence to a Western diet was associated with worse social functioning at 6-month follow-up (FE = −12.6, p = 0.010). Loss of appetite from 6 to 12 months was associated with higher adherence to both the Western and Prudent dietary patterns (FE = 1.5, p = 0.044; FE = 1.3, p = 0.046, respectively). Neither dietary pattern was associated with global QOL score at 6- or 12-month follow-up (p’s > 0.05). Conclusions: Among CRC survivors in the United States, the Western diet was concurrently associated with worse social functioning. Loss of appetite was reported by CRC survivors following both dietary patterns, suggesting that loss of appetite may be a global experience for CRC survivors during this timeframe. Further research is needed to understand specific social challenges experienced by CRC survivors and develop supportive care interventions to address appetite and nutritional concerns.

Trends in brain MRI and CP association using deep learning.

Cerebral palsy (CP) is a neurological disorder that dissipates body posture and impairs motor functions. It may lead to an intellectual disability and affect the quality of life. Early intervention is critical and challenging due to the uncooperative body movements of children, potential infant recovery, a lack of a single vision modality, and no specific contrast or slice-range selection and association. Early and timely CP identification and vulnerable brain MRI scan associations facilitate medications, supportive care, physical therapy, rehabilitation, and surgical interventions to alleviate symptoms and improve motor functions. The literature studies are limited in selecting appropriate contrast and utilizing contrastive coupling in CP investigation. After numerous experiments, we introduce deep learning models, namely SSeq-DL and SMS-DL, correspondingly trained on single-sequence and multiple brain MRIs. The introduced models are tailored with specialized attention mechanisms to learn susceptible brain trends associated with CP along the MRI slices, specialized parallel computing, and fusions at distinct network layer positions to significantly identify CP. The study successfully experimented with the appropriateness of single and coupled MRI scans, highlighting sensitive slices along the depth, model robustness, fusion of contrastive details at distinct levels, and capturing vulnerabilities. The findings of the SSeq-DL and SMSeq-DL models report lesion-vulnerable regions and covered slices trending in age range to assist radiologists in early rehabilitation.

Living With and Beyond Cancer With Comorbid Conditions: Qualitative Insights to Understand Psychosocial Support Needs.

There is a pressing need to understand and explore the complex experiences and psychosocial support needs of people LWBC-CM and their informal caregivers, to inform survivorship and supportive care interventions. In-depth qualitative interviews were conducted with people LWBC-CM and their informal caregivers in Scotland, invited via primary care. One-to-one, face-to-face interviews were conducted with informed consent exploring experiences of symptoms, psychosocial support needs and interactions with health services. Interviews were transcribed and analysed using a thematic approach. Forty-one people LWBC-CM and twenty-three informal caregivers were interviewed. Four themes were identified: the Physical and Psychological Impact of Cancer and Comorbidity, Dominant Storie-Prioritising Conditions and Making Sense of Illness, Navigating Health Services and Treatments and Caring for People with Complex Health Conditions. Type and severity of conditions mediated people's experiences and daily living. Complex fatigue-fatigue arising from a number of health conditions-dominated symptomology. Participants navigated multiple appointments and complex medication regimes. Patients identified the need for acknowledgement of other chronic conditions and for streamlined care provision. Mutual caring and social isolation were also identified as part of the caring relationship. There is a mandate to address the psychosocial support needs of people LWBC-CM, and their informal carers, given the burden of treatment for cancer survivors with moderate to severe complex conditions as they navigate health services. A patient representative has been involved in all stages of the study from development of the application through study design, commenting on documentation, analysis of transcripts and writing the manuscript. They are included as an author on the manuscript.

Multisite Randomized Controlled Trial of CareSTEPS: A Supportive Care Intervention for the Family Caregivers of Patients With Advanced Lung Cancer

ObjectivesPatients with advanced lung cancer (LC) face significant physical, psychological, and functional challenges, increasing their reliance on caregivers. This study evaluates the efficacy of CareSTEPS (Self-Care, Stress management, Symptom management, Effective communication, Problem-solving, and Social support), a 6-week telephone-delivered intervention designed to improve psychological functioning (depression and anxiety symptoms) and reduce caregiver burden among family caregivers of patients with advanced LC. MethodsIn this multisite, open-label, parallel-group randomized controlled trial, 174 caregivers (74.1% female individuals, 40.2% from a racial or ethnic minority group) of patients with stage IIIB or IV NSCLC or extensive-stage SCLC completed baseline surveys and were randomly assigned to CareSTEPS (n = 87) or usual care (n = 87) using stratified block randomization. Caregivers in the CareSTEPS arm received a manual with information on self-care, stress management, symptom management, effective communication, problem-solving, and social support. They also participated in six weekly telephone sessions with Masters-level trained interventionists with a mental health background, who provided psychoeducation, skills training, and support. Eight weeks after baseline, caregivers completed a follow-up survey. ResultsUsing an intent-to-treat framework, analyses of covariance were conducted to assess the efficacy of CareSTEPS, with p values lower than 0.05 indicating significant differences. Caregivers who received CareSTEPS reported improved psychological functioning and lower burden compared with those who received usual care, with effect sizes ranging from small to large (depression d = −0.55, anxiety d = −0.81, burden d = −0.37). ConclusionsThe CareSTEPS intervention reports great promise in meeting the critical support needs of the family caregivers of patients with advanced LC, significantly improving caregivers' psychological functioning and reducing their burden. Overall, the findings emphasize the importance of incorporating caregiver support into the comprehensive management of advanced LC. Clinical Trial RegistrationClinicalTrials.gov NCT02414672.

In focus: Engaging Black and African American women in oncology supportive care interventions.

54 Background: For individuals navigating cancer, unaddressed psychosocial needs can adversely impact quality of life, treatment adherence, and healthcare expenditures. It is recognized that African American cancer survivors are more likely to experience distress, yet they are underrepresented in studies that evaluate interventions. Mind Over Matter (MOM) is a five-week psychoeducational program aimed at bolstering emotional coping skills. A previous study among predominantly White female-identifying breast cancer survivors revealed improvements from pre to post-MOM for anxiety, depression, and physical symptom severity and interference; no data exists for women who identify as Black and/or African American. This presentation will illustrate the strategies and processes implemented to recruit, consent, and retain Black and African American cancer survivors to test the feasibility and acceptability of MOM. Methods: In forming the research team, the diversity in institutions, experience, racial and cultural identities, and professional perspectives were prioritized. As a result of this process, team members were social workers and psychologists, one was at an HBCU institution, and another was a patient advocate from the Black community who was hired and trained enabling full participation in the research process. To improve access all aspects of the study were available online and the intervention was offered virtually in the evening to support participants' availability. Efforts were made to build relationships with non-profit organizations, then disseminating the study through emails, healthcare systems, and social media. Results: During the 3-month recruitment period, 79 individuals expressed interest in the study via email and the study website. Of these, 40 participants (50.6%) enrolled in the study, surpassing the goal of 27. Half of the enrolled survivors learned about the study through community, medical, and academic organizations, while 20% and 10% were referred via the home health system and social media, respectively. 17.5% were referred from unspecified sources. Conclusions: Through robust team development, strategic community partnerships, using a study design that addressed common barriers (e.g., program hours and delivery method, tech orientation, incentives) and a high touch approach, this study successfully enrolled half of the Black and African American female-identified cancer survivors who expressed interest in this mixed-methods study. Clinical trial information: NCT06168825 .

Erratum to: Glioma resource outreach with support: A program to identify and initiate supportive care interventions for unmet needs among adult lower-grade glioma patients

Erratum to: Glioma resource outreach with support: A program to identify and initiate supportive care interventions for unmet needs among adult lower-grade glioma patients

An integrated framework for the study of exercise across the postdiagnosis cancer continuum.

Exercise plays many important roles across the entire cancer continuum that have been described in previous frameworks. These frameworks, however, have generally provided a simplified description of the roles of exercise postdiagnosis. The modern cancer treatment landscape has become complex and often consists of multiple lines of multimodal treatments combined concurrently and/or sequentially and delivered over many months or years. This complexity requires a more multifaceted and targeted approach to the study of exercise after a cancer diagnosis. Here, we propose a new integrated framework-Exercise Across the Postdiagnosis Cancer Continuum (EPiCC)-that highlights the distinct roles of exercise for disease treatment and supportive care from diagnosis until death. We also propose new terminology to clarify the distinct roles of exercise that emerge in the context of the modern cancer treatment landscape. The EPiCC Framework is structured around multiple sequential cancer treatments that highlight six distinct cancer treatment-related time periods for exercise-before treatments, during treatments, between treatments, immediately after successful treatments, during longer term survivorship after successful treatments, and during end of life after unsuccessful treatments. The EPiCC Framework proposes that the specific roles of exercise as a disease treatment and supportive care intervention will vary depending on its positioning within different cancer treatment combinations. As a cancer treatment, exercise may serve as a "priming therapy", primary therapy, neoadjuvant therapy, induction therapy, "bridging therapy", adjuvant therapy, consolidation therapy, maintenance therapy, and/or salvage therapy. As a supportive care intervention, exercise may serve as prehabilitation, intrahabilitation, interhabilitation, rehabilitation, "perihabilitation", health promotion/disease prevention, and/or palliation. To date, exercise has been studied during all of the cancer treatment-related time periods but only in relation to some cancer treatments and combinations. Moreover, fewer studies have examined exercise across multiple cancer treatment-related time periods within any cancer treatment combination. Future research is needed to study exercise as a disease treatment and supportive care intervention within and across the distinct cancer treatment-related time periods contained within different cancer treatment combinations. The aim of the EPiCC Framework is to stimulate a more targeted, integrated, and clinically-informed approach to the study of exercise after a cancer diagnosis.

Effects of COVID-19 nursing home restrictions on people with dementia involved in a Supportive Care programme

BackgroundSupportive Care is a person-centred approach encompassing non-pharmacological interventions targeted towards persons with dementia to contain the effects of their behavioural disorders, improving their quality of life.AimsTo investigate the effects of lockdown restrictions during the first wave of COVID-19 pandemic on behavioural symptoms of patients involved in a Supportive Care programme in an Italian nursing home.MethodsAnalysis is based on Neuropsychiatric Inventory (NPI) scores and related symptoms data collected before (October/November 2019) and after (July 2020) the introduction of COVID-19 restrictions on a non-random sample of 75 patients living in two units of the facility: 38 involved in a Supportive Care programme and 37 receiving standard care (Control). Group performances were compared over time according to univariate statistics and Latent Class Analysis (LCA).ResultsNPI scores and number of reported symptoms in NPI evaluations increased over time among Supportive Care patients with dementia and decreased in the Control group. Differences are statistically significant. LCA resulted in 3-classes and 5-classes specifications in the two time-occasions.DiscussionSupportive Care patients showed a worsening in behavioural and psychological symptoms after the first pandemic wave, as opposed to the elderly not involved in the programme. LCA showed that patients in the two groups differed according to the combinations of NPI symptoms.ConclusionsThe discontinuation of a Supportive Care programme due to COVID-19 restrictions had strong negative effects on nursing home persons with dementia involved in the programme: Supportive Care interventions are important in controlling the psycho-behavioural symptoms associated with dementia.

A traffic light approach for treatment and supportive care stratification in lung cancer.

Comprehensive supportive care interventions for patients with lung cancer are being investigated in a range of ways, including: early palliative care, prehabilitation and rehabilitation. We review recent literature on supportive care and propose a traffic light system to individualise comprehensive supportive care. Green for those very likely to receive anti-cancer treatment, red for those very unlikely to receive anti-cancer treatment and orange where the chance of accessing treatment is uncertain. Comprehensive supportive care can be individualised based on the group a particular patient is in. Lung cancer outcomes are improving with the availability of increasingly efficacious treatments; however, treatment rates for advanced disease remain low. In this review, we discuss how person-centred outcomes could be improved, how outcomes can be prognosticated and how the 'host' can be staged as well as the cancer. Recent data suggests that early comprehensive supportive care improves quality of life, reduces time spent in hospital and may affect survival. Comprehensive supportive care is likely to improve quality of life in patients with advanced lung cancer. Further work is needed to see if it can improve treatment rates and survival.

Geriatric assessment for the practicing clinician: The why, what, and how.

Older adults with cancer heterogeneously experience health care, treatment, and symptoms. Geriatric assessment (GA) offers a comprehensive evaluation of an older individual's health status and can predict cancer-related outcomes in individuals with solid tumors and those with hematologic malignancies. In the last decade, randomized controlled trials have demonstrated the benefits of GA and GA management (GAM), which uses GA information to provide tailored intervention strategies to address GA impairments (e.g., implementing physical therapy for impaired physical function). Multiple phase 3 clinical trials in older adults with solid tumors and hematologic malignancies have demonstrated that GAM improves treatment completion, quality of life, communication, and advance care planning while reducing treatment-related toxicity, falls, and polypharmacy. Nonetheless, implementation and uptake of GAM remain challenging. Various strategies have been proposed, including the use of GA screening tools, to identify patients most likely to benefit from GAM, the systematic engagement of the oncology workforce in the delivery of GAM, and the integration of technologies like telemedicine and mobile health to enhance the availability of GA and GAM interventions. Health inequities in minoritized groups persist, and systematic GA implementation has the potential to capture social determinants of health that are relevant to equitable care. Caregivers play an important role in cancer care and experience burden themselves. GA can guide dyadic supportive care interventions, ultimately helping both patients and caregivers achieve optimal health.

Resiliency among older adults receiving lung cancer treatment (ROAR-LCT): A novel supportive care intervention for older adults with advanced lung cancer

IntroductionNovel supportive care interventions designed for an aging population with lung cancer are urgently needed. We aimed to determine the feasibility of a novel supportive care physical therapy (PT) plus progressive muscle relaxation (PMR) intervention delivered to older adults with advanced lung cancer in the United States (US). Materials and MethodsThis clinical trial, Resiliency Among Older Adults Receiving Lung Cancer Treatment (ROAR-LCT: NCT04229381), recruited adults aged ≥60 years with unresectable stage III/IV non-small cell (NSCLC) or small cell lung cancer (SCLC) receiving cancer treatment at The James Thoracic Oncology Center (planned enrollment, N = 20). There were no exclusion criteria pertaining to performance status, laboratory values, prior cancer diagnoses, comorbidities, or brain metastases. Participants were evaluated by PT and psychology and given an exercise pedaler, resistance bands, a relaxation voice recording, and instructions at study initiation. Participants were evaluated in-person by PTs and psychologists at the start and end of the 12-session intervention, with the intervening sessions conducted via virtual health. Participants completed self-reported measures of functional status, symptoms, and mood longitudinally with the following instruments: EQ-5D-5L, Patient Health Questionnaire-9, and General Anxiety Disorder-7. PT assessments included the Short Physical Performance Battery (SPPB) and the two-minute walk test. Feasibility was defined as at least 60% of participants completing at least 70% of all intervention sessions. Optional gut microbiome samples and activity monitoring data (ActiGraph®) were also collected. ResultsThe ROAR-LCT study concluded after consenting 22 patients. Among the 22 consented, 18 (81.8%) started the intervention; 11 participants (61.1%) completed at least 70% of all study sessions. All participants with SCLC completed the intervention. Reasons for withdrawal included progression of disease or hospitalization. The majority (88.9%) of patients who started were able to complete at least one virtual health session. Participants' functional status, SPPB, depression, and anxiety scores were stable from pre- to post-intervention. Participants who withdrew had worse baseline scores across domains. Seven microbiome and six ActiGraph® samples were collected. Discussion: This is one of the first PT + PMR supportive care interventions using virtual health among older adults with advanced lung cancer to achieve feasibility in the US.

Side effects of prostate cancer therapies and potential management.

Prostate cancer (PCa) remains a significant health challenge, necessitating diverse therapeutic interventions to manage the disease effectively. While these treatments offer promising outcomes, they are often accompanied by a range of side effects that can impact patient quality of life and treatment compliance. This review provides an overview of the common side effects associated with various PCa therapies, including prostatectomy, radiation therapy, thermal therapy, hormone therapy, chemotherapy, and targeted drug therapy, among others. We summarized and discussed the reported side effects encompassing ureteral problems, sexual issues, gastrointestinal symptoms, fatigue, anemia, thrombocytopenia, hematologic abnormalities, nausea, vomiting, and liver enzyme elevation. Specific managements, such as personalized treatment plans, proactive symptom monitoring, supportive care interventions, and hematological assessments, are crucial in mitigating these side effects and optimizing treatment outcomes. By prioritizing patient-centered care and tailored interventions, health-care providers can enhance treatment efficacy and improve the overall well-being of individuals undergoing PCa therapies.

Virtual reality-based supportive care interventions for patients with cancer: an umbrella review of systematic reviews and meta-analyses.

This umbrella review aimed to identify, critically appraise, and synthesize current evidence from systematic reviews and meta-analyses on the applications of virtual reality-based supportive care interventions in cancer. Three bibliographic databases were searched from inception to February 1, 2024. Two independent reviewers screened the titles and abstracts of 421 records and retrieved 26 full-text systematic reviews. Assessing the Methodological Quality of Systematic Reviews 2 (AMSTAR-2) was used for quality assessment. Qualitative syntheses were performed to investigate the effects of virtual reality-based supportive care interventions on quality of life and physical, psychological, cognitive, and functional outcomes. Meta-analysis was performed based on data from the distinct primary studies that were extracted from the included reviews. This umbrella review included 20 systematic reviews that were published between 2018 and 2023; nine of them conducted meta-analyses. A total of 86 distinct primary studies were identified. According to the AMSTAR-2 assessment, two reviews were evaluated as moderate quality, nine as low, and nine as critically low. Meta-analyses of primary studies revealed significant effects of virtual reality on anxiety (p < 0.001), depression (p < 0.001), and pain (p < 0.001), but not fatigue (p = 0.263). Qualitative syntheses revealed positive effects of virtual reality on physical function, cognitive function, and quality of life. Limited evidence was reported regarding outcomes of balance, gait, mobility, and activities of daily living. Virtual reality has proven to be a safe and feasible approach to deliver supportive care in cancer. Virtual reality can be implemented in various stages and settings of the cancer care continuum to support patients undergoing painful procedures, during or after chemotherapy, and after surgical interventions. Virtual reality can serve as an effective supportive care intervention to manage anxiety, pain, and depression for patients with cancer.

The impact of a primary brain tumor diagnosis on caregivers: Insights from the patients’ perspective

PurposeThe diagnosis of a primary brain tumor (PBT) causes significant distress for the caregiver-patient dyad, warranting increased supportive care intervention. Although researchers have previously assessed caregivers’ perceptions of their own supportive care needs, no study to date has identified how patients perceive the caregiving experience and/or patients’ recommendations for integrating supportive care of caregivers in neuro-oncology. This qualitative study examined caregiver distress as well as caregiver supportive care needs from the patients’ perspective to inform future intervention development.MethodsAdults with PBT (N = 15; Mage = 45; 53% female; 93% White) were divided into four, 90-min focus groups moderated by a clinical neuropsychologist. Patients responded to semi-structured interview questions regarding various supportive care needs throughout the course of disease. Each discussion was transcribed and coded using thematic content analysis and NVivo software. Inter-rater reliability was excellent (MKappa = 0.92, range = 0.85–0.93).ResultsSeven distinct codes related to PBT caregivers emerged and were classified into two broader themes: Caregiver Impact (47% of coded content) and Caregiver Support (53% of coded content). Caregiver Impact refers to patients’ perspective of the practical and emotional demands of caregiving. Under Caregiver Support, patients cited a strong need for increased support of caregivers, including bereavement care, individual psychotherapy, and joint caregiver-patient dyad sessions.ConclusionPatients with PBT expressed profound concerns regarding the demands of caregiving and its impact on the well-being of their loved ones. Findings emphasize the need for comprehensive dyadic support in neuro-oncology throughout the disease trajectory to enhance the overall quality-of-life for both patients and their caregivers.

Glioma resource outreach with support: A program to identify and initiate supportive care interventions for unmet needs among adult lower-grade glioma patients

Abstract Background Lower-grade (WHO grades 2–3) gliomas typically affect young and middle-aged adults and exhibit isocitrate dehydrogenase (IDH) mutations. For such patients, symptoms related to the tumor and associated treatment contribute to morbidity and erode quality of life. With improved treatment, a better understanding of these effects over time is critically needed. Existing data characterizing unmet needs of lower-grade glioma patients is limited and little consensus exists on addressing these needs in clinical practice. Methods In order to better identify and address the unmet needs of lower-grade glioma patients, focus groups among patients and caregivers were initially conducted among patients treated at a single academic center. A semi-structured interview guide to comprehensively understand unmet needs was then developed. Each patient-defined unmet need was categorized into domains through qualitative content analysis. In parallel, a database of established local and regional community-based resources was established, and a dedicated resource specialist provided patient-specific referrals and follow-up. Results Eighty-five patients were interviewed. Median age was 41 years and the median time from tumor diagnosis was 63 months. Approximately 68% had a WHO grade 2 tumor and 60% were off therapy. Qualitative analysis of interview content identified 5 overarching domains of unmet need: Psychosocial; Neurologic/Cognitive; Lifestyle; Financial; and Other Medical. At least one unmet need was identified by 71% of participants and the most common domains were Psychosocial (40.7%) and Lifestyle (34.9%). Conclusions Our program begins to address frequently unmet survivorship needs of lower-grade glioma patients that spanned 5 major domains. Further research aimed to better define and address unmet needs among these patients is warranted.

Continuum: A Postdischarge Supportive Care Intervention for Hospitalized Patients With Advanced Cancer

ContextPatients with advanced cancer are at increased risk for multiple hospitalizations and often have considerable needs postdischarge. Interventions to address patients’ needs after transitioning home are lacking. ObjectivesWe sought to demonstrate the feasibility and acceptability of a postdischarge intervention for this population. MethodsWe conducted a single-arm pilot trial (n = 54) of a postdischarge intervention, consisting of a video visit with an oncology nurse practitioner (NP) within three days of discharge to address symptoms, medications, hospitalization-related issues, and care coordination. We enrolled English-speaking adults with advanced breast, gastrointestinal, genitourinary, or thoracic cancers experiencing an unplanned hospitalization and preparing for discharge home. The intervention was deemed feasible if ≥70% of approached patients enrolled and ≥70% of enrolled patients completed the intervention within three days of discharge. Two weeks after discharge, patients rated the ease and usefulness of the video technology on a 0–10 scale (higher scores indicate greater ease of use). NPs completed postintervention surveys to assess protocol adherence. ResultsWe enrolled 54 of 75 approached patients (77.3%). Of enrolled patients (median age = 65.0 years), 83.3% participated in the intervention within three days of discharge. The median ease of participating in the intervention was 9.0 (IQR: 6.0–10.0) and the median usefulness of the intervention was 7.0 (IQR: 4.5–8.0). The majority of visits focused on symptom management (85.7%), followed by posthospital medical issues (69.0%). ConclusionAn oncology NP-delivered intervention immediately after hospital discharge is a feasible and acceptable approach to providing postdischarge care for hospitalized patients with advanced cancer.

Social support resources in adolescents and young adults with advanced cancer: a qualitative analysis

PurposeAdolescents and Young Adults (AYAs) with cancer are an at-risk group with unique palliative and supportive care needs. Social support in AYAs with cancer is associated with better coping, quality of life, and psychosocial well-being. Here, we extend existing research to examine the sources and types of support received by AYAs with advanced cancer.MethodsAYAs participated in a semi-structured, 1:1 interview on communication and psychosocial support needs. The present analysis focused on social support experiences for AYAs with advanced cancer. Directed content analysis was used to develop the codebook. Established social support constructs provided a coding framework. We presented our qualitative findings as a code frequency report with quantified frequency counts of all “source of support” and “type of support” codes. We assigned a global “sufficiency of support code” to each AYA.ResultsWe interviewed 32 AYAs with advanced cancer (Mage = 18, SDage = 3.2, 41% female). Most AYAs identified family (namely, caregivers) as their primary source of support and stated that family universally provided all types of support: emotional, informational, instrumental, and social companionship. They received informational and emotional support from clinicians, and received emotional support and social companionship from healthy peers, cancer peers, and their existing community. One-third of participants were coded as having “mixed support” and described a lack of support in some domains.ConclusionAYAs with advanced cancer described caregivers as their universal source of support, and that other support sources provided support for specific needs. Future research should continue to evaluate social support needs and family-based palliative and supportive care interventions to bolster social support resources in this high-risk group.

Clinical presentation and symptomatology of Guillain-Barré syndrome: A literature review.

Guillain-Barré Syndrome (GBS) is a rare but potentially life-threatening neurological disorder characterized by acute onset ascending paralysis and sensory abnormalities. This article provides a comprehensive overview of GBS, covering its epidemiology, etiology, clinical presentation, diagnostic evaluation, management and treatment, prognosis, psychosocial impact, recent advances in research, public health implications, and ethical considerations. Epidemiological data reveal variations in GBS prevalence, incidence rates, and geographical distribution influenced by climate, infectious disease prevalence, and genetic susceptibility. Etiological factors include preceding infections, vaccinations, and autoimmune mechanisms, although the precise pathophysiology remains incomplete. Clinical presentation encompasses prodromal symptoms, motor deficits, sensory abnormalities, autonomic dysfunction, and variants such as Miller-Fisher Syndrome and Bickerstaff brainstem encephalitis. Neurological examination findings include weakness, paralysis, sensory deficits, and reflex changes, while autonomic dysfunction manifests as cardiovascular, respiratory, and gastrointestinal symptoms. Diagnostic evaluation relies on clinical criteria, laboratory tests (e.g., cerebrospinal fluid analysis, nerve conduction studies), and consideration of differential diagnoses. Management strategies encompass supportive care, immunomodulatory therapies (e.g., intravenous immunoglobulin, plasma exchange), and rehabilitation interventions to optimize functional outcomes and promote recovery. Prognosis varies depending on clinical features, treatment response, and complications such as respiratory failure and autonomic instability. Psychosocial impact encompasses psychological effects on patients and caregivers, highlighting the importance of coping strategies and support systems. Recent advances in research focus on emerging treatments, genetic predisposition, and biomarker discovery, offering promise for improving GBS outcomes. Public health implications include vaccination safety concerns and healthcare system considerations for GBS management. Ethical considerations encompass patient autonomy, resource allocation, and end-of-life decision-making.

Effect of Supportive Care on Quality of Life for People Living with Human Immunodeficiency Virus: A Systematic Review

The survival of people living with HIV (PLWH) affects physical, psychological, sexual, social, and financial circumstances during the care and treatment phase. Supportive care is an effective intervention associated with a better quality of life. The aim of this systematic study was to identify effect supportive care intervention on quality-of-life infected people. This study was a systematic review to examine the effect of supportive care in PLWH. Four databases including Science Direct, ProQuest, PubMed, and Wiley library were included to identify the relevant articles. A total of eight articles out of the 247 publications potentially met the inclusion criteria. Supportive care was grouped into four categories, including Community Based Intervention, M-Health Intervention, Social Media-Based Interventions as well as Psychosocial Interventions. The combination of all interventions showed that supportive care needs to be prescribed in line with the conditions and needs of PLWH. Conclusion, several supportive care approaches including Group Support Psychotherapy (GSP), Peer Support (PS), Run4Love WeChat, ALWH treatment strategy, effective communication, and psychosocial assessment, Mental health care pathway PASEO and combination logotherapy, ACT, as well as family psychoeducation (FPE) affected the quality of life for PLWH. This helped in characterizing the intervention and its effect on the conditions of HIV patients.Keywords: Databases; Supportive care; Psychosocial interventions; Quality of life

Supportive care interventions in metastatic bone disease: scoping review

BackgroundPatients with secondary metastatic involvement of the musculoskeletal system due to primary cancers are a rapidly growing population with significant risks for health-related end-of-life morbidities. In particular, bone metastases or...