Background: Few studies have evaluated the effects of cognitive training and social support on cancer-related fatigue and quality of life. We performed a meta-analysis of randomized controlled trials to examine the efficacy of cognitive training and social support in colorectal cancer patients and survivors. Methods: The PubMed, Ovid, EMBASE, Cochrane Central Register of Controlled Trials, and China National Knowledge Infrastructure databases were searched from database establishment until August 2021 to identify suitable studies according to relevant key words, taking cancer-related fatigue and quality of life as the outcomes. The Jadad scale was used to evaluate the methodological quality of the studies. Stata 15.1 software was used for statistical analyses, and sensitivity analyses were performed. Results: Eleven studies (6 published in English and 5 published in Chinese) involving 980 patients and survivors were included in the meta-analysis. All studies had Jadad scores ≥3. Statistically significant effects of cognitive training and social support were detected for cancer-related fatigue within 14 weeks (SMD = −1.13, P < .001) and after 14 weeks (SMD = −0.56, P < .001), overall quality of life within 14 weeks (SMD = 0.73, P < .001) and after 14 weeks (SMD = 0.54, P = .003). However, no statistically significant effects of the combination intervention were detected on long-term QOL (SMD = 0.50, P = .435). Conclusions: Distinct cognitive interventions and a combination of cognitive and social support interventions can help to alleviate long-term and short-term CRF and short-term QOL. Further studies are needed to examine the mechanisms of cognitive training and social support for cancer-related fatigue and overall quality of life in patients and survivors with colorectal cancer.
Aims: To develop a model to predict the risk of moderate to severe cancer-related fatigue (CRF) in colorectal cancer patients after chemotherapy. Methods: The study population was colorectal cancer patients who received chemotherapy from September 2021 to June 2022 in a grade 3 and rst-class hospital. Demographic, clinical, physiological, psychological, and socioeconomic factors were collected 1 to 2 days before chemotherapy. Patients were followed for 1 to 2 days after chemotherapy to assess fatigue using the Piper Fatigue Scale. A random sampling method was used to select 181 patients with moderate to severe CRF as the case group. The risk set sampling method was used to select 181 patients with mild or no CRF as the control group.Logistic regression, back-propagation arti cial neural network (BP-ANN) and decision tree models were constructed and compared.Results: A total of 362 patients consisting of 241 derivation samples and 121 validation samples were enrolled. Comparing the three models, the prediction effect of BP-ANN was the best, with a receiver operating characteristic curve (ROC) of 0.83. Internal and external veri cation indicated the accuracy of prediction was 70.4% and 80.8%, respectively. Signi cant predictors identi ed were surgery, complications, hypokalaemia, albumin, neutrophil percentage, pain (VAS score), Activities of Daily Living (ADL) score, sleep quality (PSQI score), anxiety (HAD-A score), depression (HAD-D score) and nutrition (PG-SGA score).Conclusions: BP-ANN was the best model, offering theoretical guidance for clinicians to formulate a tool to identify patients at high risk of moderate to severe CRF.
Impact• A prediction model can be developed to predict the risk of moderate to severe cancer-related fatigue in colorectal cancer patients after chemotherapy.• The BP-ANN model offers theoretical guidance for a clinically predictable tool to assist nurses in identifying and supporting patients at high risk of moderate to severe CRF.• There are 11 risk factors for moderate to severe CRF in patients with colorectal cancer after chemotherapy, and the BP-ANN is the best prediction model with strong predictive performance.
ObjectivesEnriched environment (EE) is a promising strategy to protect the intestinal mucosal barrier and regulate brain-gut peptide expression. However, the optimal enriched environment intervention duration is unknown. Here, different EE intervention durations were applied to assess the optimal intervention duration in rats with colorectal cancer.MethodsWe used a rat model of 1,2-dimethylhydrazine-induced colorectal cancer. Rats were housed in an EE for 0, 2, 4 or 8 weeks. The intestinal mucosa and serum TNF-α, IL-6, IL-10, DAO, ATP, CRF, and occludin levels and bacterial translocation (BT) were measured, and the intestinal mucosa morphology was evaluated.ResultsEight-week EE intervention was more beneficial to the intestinal mucosal mechanical barrier than 2-week or 4-week intervention (P<0.05). There was a significant different between the 4-week and 8-week groups on BT (P=0.049). However, which intervention duration had the greatest advantages in intestinal mucosa and serum inflammatory factor regulation was not determined. There were no significant differences in the effects of different EE intervention durations on BT or brain intestinal peptide levels among the other groups (P>0.05).ConclusionsThe effect of an 8-week environmental intervention duration on the intestinal mucosal barrier was better than that of 2-week and 4-week durations overall, but the effect of different environmental intervention durations on brain-gut peptide levels was not obvious. In the future, we can further explore the molecular biological mechanism of the effect of different EE intervention durations on the intestinal mucosal barrier and analyze the effect of an EE on other brain-gut peptides.
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