https://www.commed.vcu.edu/Chronic_Disease/2012/cochranrvwrschbias.pdf

The Cochrane Collaboration's tool for assessing risk of bias in randomised trials

Telehealth in Oncology: ASCO Standards and Practice Recommendations

mHealth can be used to deliver interventions to optimize Health-related quality of life (HRQoL) of cancer patients. In this systematic-review and meta-analysis, we explored the possible impact of health interventions delivered via mHealth tools on HRQoL of cancer patients. The systematic literature search was performed on July 20, 2019, to identify studies that evaluated the impact of mHealth intervention on HRQoL of cancer patients. We identified 25 studies (17 randomized controlled trials and 8 pre-post design studies; 957 patients) that evaluated mHealth interventions. The most commonly studied mHealth interventions included physical activity/ fitness interventions (9 studies), cognitive behavioral therapy (6 studies), mindfulness/ stress management (3 studies). In the majority of studies, mHealth interventions were associated with an improved HRQoL of cancer patients. The meta-analysis of the identified studies supported the positive effect of mHealth interventions for HRQoL of cancer patients. mHealth interventions are promising for improving HRQoL of cancer patients.

Can mHealth interventions improve quality of life of cancer patients? A systematic review and meta-analysis.

/pdf/clinical-practice-guideline-exercise-and-lifestyle-in-1dioriku.pdf

Clinical practice guideline exercise and lifestyle in chronic kidney disease

Background/objectives 

People with pancreatic cancer have high levels of anxiety and depression and reduced quality of life (QoL), but few studies have assessed these outcomes for patient-carer dyads. We therefore investigated these issues in an Australian population-based study.

 Methods 

Patients with pancreatic cancer (n=136) and many of their carers (n=84) completed the Hospital Anxiety and Depression Scale (HADS) and Functional Assessment of Cancer Therapy QoL questionnaire at a median of three months after diagnosis. Overall QoL and well-being subscales (physical, social, emotional, functional) were compared with general population norms. Intraclass correlation coefficients were used to compare anxiety, depression and QoL scores of patients and their respective carers. Results 

Fifteen percent of patients and 39% of carers had HADS scores indicative of anxiety and 15% of patients and 14% of carers of depression, respectively. Overall, 70% of patients and 58% of carers had QoL scores below the Queensland population average. Patients’ anxiety, depression, overall QoL, social, emotional and functional wellbeing scores were significantly related to those scores in their carers. Among patients and carers, accessing psychological help was associated with elevated anxiety. Not receiving chemotherapy was associated with elevated depression among patients and younger age was associated with poorer outcomes in carers. Conclusions 

More carers had symptoms of anxiety than patients with pancreatic cancer, but symptoms of depression were similarly common in patients and carers. Further research is needed to assess whether interventions to reduce patients’ distress could also improve QoL among carers, or whether carer-focussed interventions are required.

Anxiety, depression and quality of life in people with pancreatic cancer and their carers

To systematically review evidence regarding the benefits of Internet-based psycho-educational interventions among cancer patients. We performed a systematic review with meta-analysis and qualitative evidence synthesis. Systematic searches for published studies in English or Chinese identified eligible randomized and clinical controlled trials. The following databases were searched: Medline, Embase, CINAHL, PsycINFO, Web of Science, Cochrane Central Register of Controlled Trials (CENTRAL), Proquest Digital Dissertations, Foreign Medical Retrieval System, China National Knowledge Infrastructure, China Science and Technology Journal Database, China Wanfang Database, and Taiwanese Airiti Library. We also searched the gray literature and reviewed reference lists from relevant articles. Studies were scored for quality using the Cochrane Risk of Bias Tool. Seven eligible studies (1220 participants) were identified that used three intervention tools: website programs (n = 5), e-mail counseling (n = 1), and a single-session psycho-educational intervention (n = 1). The quality of all studies was moderate. The meta-analysis showed that Internet-based psycho-educational interventions had a significant effect on decreasing depression (standardized mean difference (SMD) − 0.58, 95% confidence interval (CI) (− 1.12, − 0.03), p = 0.04) and fatigue (mean difference (MD) − 9.83, 95% CI (− 14.63, − 5.03), p < 0.01). However, there was no evidence for effects on distress (SMD − 1.03, 95% CI (− 2.63, 0.57), p = 0.21) or quality of life (MD 1.10, 95% CI (− 4.42, 6.63), p = 0.70). Internet-based psycho-educational interventions reduce fatigue and depression in cancer patients. More rigorous studies with larger samples and long-term follow-up are warranted to investigate the effects of these interventions on cancer patient quality of life and other psychosocial outcomes.

Effects of Internet-based psycho-educational interventions on mental health and quality of life among cancer patients: a systematic review and meta-analysis

Acute leukemia (AL) not only impairs the quality of life (QOL) of patients, but also affects that of their family caregivers (FCs). Studies on QOL of AL patients and their FCs are limited. This study aimed to evaluate the QOL of AL patients and their FCs, and to explore the factors associated with QOL of patients and of FCs. A multicenter cross-sectional study was conducted. The QOL of 196 patient–FC dyads was assessed. The Functional Assessment of Cancer Therapy-Leukemia (FACT-Leu) was used for patients, and the 36-item Short-Form Health Survey (SF-36) was used for FCs. Independent-samples t-tests or one-way analysis of variance were used to compare QOL subscale scores between groups with different sociodemographic/clinical characteristics. Multiple regression analysis was conducted to identify the factors associated with QOL of AL patients and their FCs. The total FACT-Leu score for AL patients was 76.80 ± 16.44, and the physical component summary (PCS) and mental component summary (MCS) scores for FCs were 64.67 ± 15.44 and 52.50 ± 13.49, respectively. All QOL subscales for patients (t = 12.96–34.73, p < 0.001) and FCs (t = 2.55–14.36, p < 0.05), except role emotional (t = − 0.01, p = 0.993), were lower than those reported in previous studies. Sex, employment, and chemotherapy were significantly associated with total FACT-Leu score in AL patients (p < 0.05). Age, sex, marital status, education, employment, and relationship to patients were significantly associated with SF-36 PCS or MCS (p < 0.05). AL patients and their FCs both have lower QOL than the population in previous studies. These findings suggest that not only AL patients’ physical and mental health but also overall family QOL should be assessed. Interventions supporting patient–FC dyads should be developed to improve their QOL.

/pdf/factors-associated-with-quality-of-life-of-adult-patients-j2454o9vg1.pdf

Factors associated with quality of life of adult patients with acute leukemia and their family caregivers in China: a cross-sectional study.

Effects of family participatory dignity therapy on the psychological well-being and family function of patients with haematologic malignancies and their family caregivers: A randomised controlled trial.

Objectives:Combined aerobic and resistance exercise (CARE) is beneficial for improving renal function. To confirm this, we conducted a meta-analysis to evaluate the effects of CARE on renal functio...

Effects of combined aerobic and resistance exercise on renal function in adult patients with chronic kidney disease: a systematic review and meta-analysis:

Rehabilitation effects of exercise training on adults with chronic kidney disease (CKD) have been generally recognised; however, the effects of exercise training on proteinuria have been underexplored. Our aim was to explore the effects of exercise training on proteinuria in adult CKD patients without renal replacement therapy. Randomised controlled trials (RCTs) and quasi-experimental studies examining the effects of exercise training on proteinuria in adults CKD patients without renal replacement therapy were searched in 10 electronic databases (MEDLINE, Embase, CINAHL, Cochrane Central Register of Controlled Trials, Allied and Complementary Medicine Database, SPORTDiscus with full text, Web of Science, China Wan Fang Database, China National Knowledge Internet, China Science and Technology Journal Database) until June 2019. The quality of quasi-experimental studies was assessed using the Joanna Briggs Institute Checklist for non-randomised experimental studies. The Cochrane risk of bias tool was used to evaluate the RCT quality. We analysed 11 studies (623 participants). The 24-h urinary protein (24 h UP) level significantly decreased after exercise training in the within-group analysis (standard mean difference [SMD], 0.48; 95% confidence interval [CI], 0.08 to 0.88). There was a slight decrease in 24 h UP levels in the between-group analysis (SMD, 0.91; 95% CI, 0.00 to 1.82); however, the subgroup analysis showed that the change was insignificant (RCT: SMD, 0.24; 95% CI, − 0.44 to 0.92; quasi-experimental studies: SMD, 2.50; 95% CI, − 1.22 to 6.23). Exercise resulted in no significant differences in the urinary albumin-to-creatinine ratio in the between-group analysis (SMD, 0.06; 95% CI, − 0.54 to 0.67), but a significant decrease was found in the within-group analysis (SMD, 0.21; 95% CI, 0.04 to 0.38). No evidence of a decreased urinary protein-to-creatinine ratio was found after exercise (between-group analysis: SMD, 0.08 and 95% CI, − 0.33 to 0.48; within-group analysis: SMD, 0.04; 95% CI, − 0.25 to 0.32). Exercise training does not aggravate proteinuria in adult CKD patients without renal replacement therapy. Further research is warranted in the future to determine the effectiveness of exercise training on proteinuria and to explore the mechanisms by which exercise training influences proteinuria.

/pdf/effects-of-exercise-training-on-proteinuria-in-adult-2yk4i5lvlt.pdf

Chunfeng Wang

Papers

Effects of Internet-based psycho-educational interventions on mental health and quality of life among cancer patients: a systematic review and meta-analysis

Factors associated with quality of life of adult patients with acute leukemia and their family caregivers in China: a cross-sectional study.

Effects of family participatory dignity therapy on the psychological well-being and family function of patients with haematologic malignancies and their family caregivers: A randomised controlled trial.

Effects of combined aerobic and resistance exercise on renal function in adult patients with chronic kidney disease: a systematic review and meta-analysis:

Effects of exercise training on proteinuria in adult patients with chronic kidney disease: a systematic review and meta-analysis