Background: Patients with diabetic foot ulcer (DFU) usually have a poor quality of life (QoL) and selfefficacy, which is affected by many risk factors. However, the role of psychological resilience in QoL and selfefficacy in DFU patients has remained unclear.Methods: This prospective cross-sectional study was performed in a single center from January 2018 to February 2020. A total of 98 DFU patients were enrolled in this study. Some demographic and clinical data were prospectively collected from participants. The psychological resilience of participants was assessed by Connor-Davidson resilience scale (CD-RISC). Self-efficacy was also assessed using the diabetes management self-efficacy scale (DMSES) and QoL was assessed by the 36-item short-form (SF-36) health survey. Univariable and multivariable linear regression were used to analyze the risk factors of self-efficacy and QoL. Then, logistic regression was used to analyze the predictors of psychological resilience among the participants.Results: A CD-RISC score of more than 85 points was defined as high psychological resilience in this study; there were 28 participants diagnosed with high psychological resilience and 70 patients with low psychological resilience. Those with high psychological resilience had significantly higher selfefficacy, general health, vitality, social functioning, role emotional, and mental health than those with low psychological resilience. According to multivariable linear regression, low psychological resilience and older age were identified as risk factors of self-efficacy. On the contrary, low psychological resilience, older age, lower perceived social support and higher level of glycated hemoglobin were identified as risk factors of QoL. Finally, males had lower psychological resilience than females and those receiving more social support had higher psychological resilience than participants receiving less social support.Conclusions: Some risk factors of QoL and self-efficacy were identified in this study and these results may provide some evidence for the improvement of QoL and self-efficacy in DFU patients. Being female and receiving higher social support were shown to have potential for improving psychological resilience in DFU patients.

Little is known about the relationship between diet and depression through the gut microbiota among breast cancer patients. This study aimed to examine the dietary intake differences between depressed breast cancer (DBC) and non-depressed breast cancer (NBC) patients, and whether the differences could lead to gut microbiota changes that affect depressive symptoms. Participants completed the Center for Epidemiological Studies-Depression Scale (CES-D) and 24 h dietary recall. Fecal samples of 18 DBC patients and 37 NBC patients were collected for next-generation sequencing. A total of 60 out of 205 breast cancer patients reported significant depressive symptoms suggested by a CES-D score ≥ 16, which might be related to lower intakes of energy, protein, dietary fiber, vitamin A, vitamin B2, niacin, calcium, phosphorus, potassium, iron, zinc, selenium, manganese and tryptophan, and a poor diet quality indicated by a lower total Chinese Healthy Eating Index (CHEI) score. Additionally, NBC patients demonstrated greater gut microbiota diversity and a healthier composition, in which the relative abundances of Proteobacteria and Escherichia-Shigella were both lower than in the DBC patients (p < 0.05). Alpha diversity was a significant mediator between diet quality and depression, while calcium, phosphorus and selenium significantly regulated depression independent of the gut microbiota. Breast cancer-related depressive symptoms might be associated with a poor diet quality via gut microbiota-dependent pathways and lower micronutrient intake via microbiota-independent pathways.

Background: A large number of studies have shown that the assignment of long-term care duties brings great pressure and negative emotions to caregivers of cancer patients, and also affects the quality of care.Lazarus and Folkman's stress and coping theory holds that the process of cognition and evaluation of stress is key to the stress response when a stressor acts on individuals. This study is to explore the mediating effect of benefit finding between caregiver burden and anxiety-depression of esophageal cancer caregivers, according to a model hypothesis constructed based on stress and coping theory. The design of this study involved correlation and theoretical testing using a structural equation model.Methods: A total of 228 pairs of esophageal cancer patients from 2 tertiary hospitals and their family caregivers were recruited in this study from May 2020 to January 2021. A questionnaire survey was conducted using the general information questionnaire, the caregiver burden inventory (CBI), the benefit finding scale (BFS), and the hospital anxiety and depression scale (HADS).Results: A good fitting model [chi-square (χ 2 )/degrees of freedom (df) =2.212, root mean square error of approximation (RMSEA) =0.07, comparative fit index (CFI) =0.976, Tucker-Lewis index (TLI) =0.964, goodness of fit (GFI) =0.954, normed fit index (NFI) =0.957] indicated the mediating effect of benefit finding between caregiver burden and anxiety-depression of esophageal cancer caregivers. A higher level of benefit finding had a negative effect on caregiver burden and anxiety-depression, which reduced the burden and psychological distress of caregivers. The theoretical hypothesis was validated.Conclusions: Clinical nurses should pay attention to the benefit finding level of caregivers. For caregivers with low-level of benefit finding, intervention measures should be taken to improve the psychological cognitive level of caregivers, which can ultimately improve the quality of life of patients.

This study examined the association between the energy-adjusted Dietary Inflammatory Index (E-DII)-based dietary inflammatory potential and depressive symptoms (DepS) among patients with breast cancer and explores whether systemic inflammation mediates this association. We assessed dietary intake and DepS in 220 breast cancer patients by three 24 h dietary recalls and the Center for Epidemiological Studies Depression Scale (CES-D), respectively, and determined plasma levels of C-reactive protein (CRP), tumor necrosis factor-α (TNF-α), and interleukin (IL)-1β, IL-4, and IL-6 in 123 blood samples. We found that each one-point increase of E-DII was related to a 53% elevated risk of DepS. Patients with the most pro-inflammatory diets had a 5.13 times higher risk of DepS than those with the most anti-inflammatory diets. Among the E-DII components, vitamin B2, zinc, and iron were inversely associated with DepS risk. Furthermore, E-DII scores were positively associated with CRP and TNF-α. Higher levels of TNF-α and IL-6 were associated with higher DepS risk. A significant mediating effect of TNF-α was revealed between E-DII and DepS. Our findings suggest that a pro-inflammatory diet is positively associated with breast cancer-related DepS, which may be mediated by TNF-α.