Patient and Clinical Variables Account for Changes in Health-related Quality of Life and Symptom Burden as Treatment Outcomes in Colorectal Cancer: A Longitudinal Study

Hung, Hsiu-Chi,Chien, Tsui-Wei,Tsay, Shiow-Luan,Hang, Hewi-Ming,Liang, Shu-Yuan Asian Pacific Journal of Cancer Prevention 2013 Asian Pacific journal of cancer prevention Vol.14 No.3

Objective: The aim of the current study was to evaluate changes in treatment outcomes in terms of health-related quality of life (HRQoL) and symptom burden at zero, one, three, and six months after an initial diagnosis of colorectal cancer. The demographic and clinical characteristics that account for outcome changes in patients were investigated using a repeated measures framework. Methods and Materials: A cohort study was performed of 134 colorectal cancer patients followed from diagnosis to 6 months post-treatment in Central Taiwan. HRQoL and symptoms were assessed at diagnosis and one, three, and six months thereafter. The Functional Assessment of Cancer Therapy-Colon (FACT-C) questionnaire, VAS pain, and the Memorial Symptom Assessment Scale (MSAS) were used for data collection. A generalized estimating equation (GEE) was applied for statistical analysis. Results: The majority of the patients were male (55%) and married (91.5%). The mean age was 60.4 years (SD = 11.71). Most were diagnosed stage III and IV colorectal cancer (54.5%). All underwent surgery; some also received chemotherapy (CT) or concurrent chemoradiation therapy (CCRT). The results of the GEE showed that overall, the HRQoL, pain, and symptoms of the patients significantly improved over the treatment period. Patients with stage IV disease who had received surgery and CCRT showed the worst HRQoL. Females, patients with comorbidity, and stage IV patients had higher pain scores over time. Female and stage IV patients had more severe physical symptoms, whereas stage II and IV patients had worse psychological symptoms over time. Conclusion: The patients' HRQoL, pain, and symptoms significantly improved over the 6-month treatment period. Certain patient and clinical variables accounted for changes in treatment outcomes regarding HRQoL and symptom burden in colorectal cancer patients.

Effects of A Short-term Cardio Tai Chi Program on Cardiorespiratory Fitness and Hemodynamic Parameters in Sedentary Adults: A Pilot Study

Timothy Sam-Kit Tin,Chi-Hsiu Daniel Weng,Patricia dos Santos Vigário,Arthur de Sá Ferreira 사단법인약침학회 2020 Journal of Acupuncture & Meridian Studies Vol.13 No.1

This study evaluates the effects of a short-term Cardio Tai Chi program on the cardiorespiratory fitness and hemodynamic parameters in sedentary adults. Thirty-one sedentary participants (age: 58 Æ 9 years, body mass: 63 Æ 12 kg) were subjected to an exercise program during 10 sessions over a 10-day period within 2 weeks. The Cardio Tai Chi program consisted in a series of three to five intervals lasting 90 s each at w70% maximal heart rate separated by 2-min of low-intensity recovery. Primary outcome measures were cardiorespiratory fitness (peak oxygen uptake, _ VO 2peak ) assessed by the Rockport walking test and resting hemodynamic parameters (systolic, diastolic, mean, and pulse pressures). We observed a significant difference of means on post-pre _ VO 2peak [4.5 ml/kg/ min, 95% confidence interval (CI): 3.1 to 5.8, p Z 0.004], systolic blood pressure (-5.5 mmHg, 95% CI:-7.3 to -3.8, p Z 0.010) and pulse pressure (-3.7 mmHg, 95% CI: -5.2 to -2.3, p Z 0.028). No significant differences were observed for diastolic pressure (À1.8 mmHg, 95% CI: -2.6 to -1.0, p Z 0.226), mean blood pressure (2.5 mmHg, 95% CI: 1.4 to 3.6, p Z 0.302), or resting heart rate (-0.9 beat/min, 95% CI: -2.0 to 0.1, p Z 0.631). Our findings suggest that engaging in a short-term Cardio Tai Chi program can improve cardiorespiratory fitness and hemodynamic parameters in sedentary adults.

The Action Research

Tzu-Chi Lin,Hsiu-Hung Wang,Shin-Lan Lin 한국간호과학회 2009 한국간호과학회 학술대회 Vol.2009 No.10

Protective Factors of Demoralization among Cancer Patients in Taiwan: An Age-matched and Gender-matched Study

Yu-Chi Li,Chung-Han Ho,Hsiu-Hung Wang 한국간호과학회 2017 Asian Nursing Research Vol.11 No.3

Purpose: This study aimed to explore the protective factors of demoralization in cancer patients via investigation of cancer patients' demographic and disease characteristics. Methods: This was a cross-sectional descriptive study. We used a structured questionnaire, which contained items on demographic and disease characteristics, as well as the Demoralization Scale Mandarin Version (DS-MV), with a cutoff of 30 or more indicating high demoralization. Data were analyzed with age-matched and gender-matched conditional logistic regression analysis. For the study, 428 questionnaires were delivered and 411 were recovered. After being age-matched and gender-matched, 182 participants of high demoralization (DS-MV > 30) and low demoralization (DS-MV 30) were obtained respectively, for a total of 364 participants. Results: Cancer patients' demoralization was significantly related to family support (p = .019), education (p = .049), and monthly income (p = .001). Family support [odds ratio = 0.38; p = .028; 95% confidence interval (0.16, 0.91)] and monthly income [odds ratio = 0.49; p = .009; 95% confidence interval (0.29, 0.84)] were protective factors of demoralization in cancer patients. Conclusion: Early and appropriate demoralization assessment of cancer patients' demographic and disease characteristics is very important in clinical settings. Healthcare providers might regularly monitor demoralization in cancer patients, and develop related nursing care guidelines or treatment for demoralization in cancer patients. The study results can be a reference for healthcare providers who work with cancer patients.

The Effectiveness of Dignity Therapy as Applied to End-of-Life Patients with Cancer in Taiwan: A Quasi-Experimental Study

Yu-Chi Li,Yin-Hsun Feng,Hui-Ying Chiang,Shu-Ching Ma,Hsiu-Hung Wang 한국간호과학회 2020 Asian Nursing Research Vol.14 No.4

Purpose: The aim of the study was to determine the effectiveness of dignity therapy for end-of-lifepatients with cancer. Methods: This study used a quasi-experimental study design with a nonrandomized controlled trial. Dignity therapy was used as an intervention in the experimental group, and general visit was used in thecontrol group. Thirty end-of-life patients with cancer were recruited, with 16 in the experimental groupand 14 in the control group. Outcome variables were the participants' dignity, demoralization, anddepression. Measurements were taken at the following time points: pre-test (before intervention), posttest1 (the 7th day), and post-test 2 (the 14th day). The effectiveness of the intervention in the twogroups was analyzed using the generalized estimating equation, with the p value set to be less than .05. Results: After dignity therapy, the end-of-life patients with cancer reflected increased dignity significantly[b ¼ 37.08, standard error (SE) ¼ 7.43, Wald c2 ¼ 24.94, p < .001], whereas demoralization(b¼ 39.55, SE ¼ 6.42,Wald c2 ¼ 37.95, p < .001) and depression (b¼ 12.01, SE ¼ 2.17,Wald c2 ¼ 30.71,p < .001) were both reduced significantly. Conclusion: Clinical nurses could be adopting dignity therapy to relieve psychological distress andimprove spiritual need in end-of-life patients with cancer. Future studies might be expanded tolooking at patients vis- a-vis end-of-life patients without cancer to improve their psychologicaldistress. These results provide reference data for the care of end-of-life patients with cancer fornursing professionals.

Die grundlegende Tugend des Lehrers - Von der pädagogischen Liebe zur Geduld

Chu. Chi-Hua,Lo. Hsiu-Ching 한독교육학회 2016 한독교육학회 학술대회 자료집 Vol.2016 No.3

Dignity and Related Factors in Patients with Cancer: A Cross-Sectional Study

Li Yu-Chi,Feng Yin-Hsun,Ma Shu-Ching,Wang Hsiu-Hung 한국간호과학회 2023 Asian Nursing Research Vol.17 No.1

Purpose: Dignity is a basic human right that is related to psychological distress factors in patients with cancer such as depression and demoralization. Hence, the dignity issue is of great importance to healthcare professionals. The present study aimed to advise healthcare professionals regarding the related distress factors of dignity in patients with cancer by investigating its relationship with patients’ demographics, disease characteristics, and psychological distress. Methods: This was a cross-sectional study design. A convenience sample of 267 patients with cancer from a medical center was recruited into this study. Each patient completed demographics and disease characteristics questionnaires, the Patient Dignity Inventory Mandarin Version, the Demoralization Scale Mandarin Version (DS-MV), and the Patient Health Questionnaire-9 (PHQ-9). Data were analyzed with SPSS 22.0 software. Results: Dignity was significantly correlated with age, demoralization, and depression. Cancer patients aged 65 or above were more likely to have a lower sense of dignity. In the present study, the sensitivity and specificity of the Patient Dignity Inventory Mandarin Version for demoralization (DS-MVꠑ30) were 84.8% and 79.1% and for depression (PHQ-9ꠑ10) were 73.8% and 70.9% in patients with cancer with an aggregate score of 35 or above. Conclusions: Dignity is significantly correlated with personal demographic characteristics and psychoꠓlogical distress in patients with cancer. The results provide reference data for healthcare professionals to understand and enable dignity in patients with cancer and aid in the development of methods that promote their dignity

Evaluation of Malignancy Risk of Ampullary Tumors Detected by Endoscopy Using 2-[18F]FDG PET/CT

Chuang Pei-Ju,Wang Hsiu-Po,Tien Yu-Wen,Chin Wei-Shan,Hsieh Min-Shu,Chen Chieh-Chang,Hong Tzu-Chan,Ko Chi-Lun,Wu Yen-Wen,Cheng Mei-Fang 대한영상의학회 2024 Korean Journal of Radiology Vol.25 No.3

Objective: We aimed to investigate whether 2-[18F]fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography (2-[18F]FDG PET/CT) can aid in evaluating the risk of malignancy in ampullary tumors detected by endoscopy. Materials and Methods: This single-center retrospective cohort study analyzed 155 patients (79 male, 76 female; mean age, 65.7 ± 12.7 years) receiving 2-[18F]FDG PET/CT for endoscopy-detected ampullary tumors 5–87 days (median, 7 days) after the diagnostic endoscopy between June 2007 and December 2020. The final diagnosis was made based on histopathological findings. The PET imaging parameters were compared with clinical data and endoscopic features. A model to predict the risk of malignancy, based on PET, endoscopy, and clinical findings, was generated and validated using multivariable logistic regression analysis and an additional bootstrapping method. The final model was compared with standard endoscopy for the diagnosis of ampullary cancer using the DeLong test. Results: The mean tumor size was 17.1 ± 7.7 mm. Sixty-four (41.3%) tumors were benign, and 91 (58.7%) were malignant. Univariable analysis found that ampullary neoplasms with a blood-pool corrected peak standardized uptake value in earlyphase scan (SUVe) ≥ 1.7 were more likely to be malignant (odds ratio [OR], 16.06; 95% confidence interval [CI], 7.13–36.18; P < 0.001). Multivariable analysis identified the presence of jaundice (adjusted OR [aOR], 4.89; 95% CI, 1.80–13.33; P = 0.002), malignant traits in endoscopy (aOR, 6.80; 95% CI, 2.41–19.20; P < 0.001), SUVe ≥ 1.7 in PET (aOR, 5.43; 95% CI, 2.00–14.72; P < 0.001), and PET-detected nodal disease (aOR, 5.03; 95% CI, 1.16–21.86; P = 0.041) as independent predictors of malignancy. The model combining these four factors predicted ampullary cancers better than endoscopic diagnosis alone (area under the curve [AUC] and 95% CI: 0.925 [0.874–0.956] vs. 0.815 [0.732–0.873], P < 0.001). The model demonstrated an AUC of 0.921 (95% CI, 0.816–0.967) in candidates for endoscopic papillectomy. Conclusion: Adding 2-[18F]FDG PET/CT to endoscopy can improve the diagnosis of ampullary cancer and may help refine therapeutic decision-making, particularly when contemplating endoscopic papillectomy.

Mesenchymal Stem Cell Secreted-Extracellular Vesicles are Involved in Chondrocyte Production and Reduce Adipogenesis during Stem Cell Differentiation

Tsai Yu-Chen,Cheng Tai-Shan,Liao Hsiu-Jung,Chuang Ming-Hsi,Chen Hui-Ting,Chen Chun-Hung,Zhang Kai-Ling,Chang Chih-Hung,Lin Po-Cheng,Huang Chi-Ying F. 한국조직공학과 재생의학회 2022 조직공학과 재생의학 Vol.19 No.6

BACKGROUND: Extracellular vesicles (EVs) are derived from internal cellular compartments, and have potential as a diagnostic and therapeutic tool in degenerative disease associated with aging. Mesenchymal stem cells (MSCs) have become a promising tool for functional EVs production. This study investigated the efficacy of EVs and its effect on differentiation capacity. METHODS: The characteristics of MSCs were evaluated by flow cytometry and stem cell differentiation analysis, and a production mode of functional EVs was scaled from MSCs. The concentration and size of EVs were quantitated by Nanoparticle Tracking Analysis (NTA). Western blot analysis was used to assess the protein expression of exosomespecific markers. The effects of MSC-derived EVs were assessed by chondrogenic and adipogenic differentiation analyses and histological observation. RESULTS: The range of the particle size of adipose-derived stem cells (ADSCs)- and Wharton’s jelly -MSCs-derived EVs were from 130 to 150 nm as measured by NTA, which showed positive expression of exosomal markers. The chondrogenic induction ability was weakened in the absence of EVs in vitro. Interestingly, after EV administration, type II collagen, a major component in the cartilage extracellular matrix, was upregulated compared to the EV-free condition. Moreover, EVs decreased the lipid accumulation rate during adipogenic induction. CONCLUSION: The results indicated that the production model could facilitate production of effective EVs and further demonstrated the role of MSC-derived EVs in cell differentiation. MSC-derived EVs could be successfully used in cell-free therapy to guide chondrogenic differentiation of ADSC for future clinical applications in cartilage regeneration.