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  • 1
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    Online Resource
    C‐reactive protein, symptoms and activity of daily living in patients with advanced cancer receiving palliative care
    Wiley ; 2017
    In:  Journal of Cachexia, Sarcopenia and Muscle Vol. 8, No. 3 ( 2017-06), p. 457-465
    Details
    In: Journal of Cachexia, Sarcopenia and Muscle, Wiley, Vol. 8, No. 3 ( 2017-06), p. 457-465
    Abstract: The association between C‐reactive protein (CRP) level, symptoms, and activities of daily living (ADL) in advanced cancer patients is unclear. Methods Secondary data analysis of a multicenter prospective cohort study consisted of 2426 advanced cancer patients referred to palliative care settings was conducted to examine the cross‐sectional relationships between CRP level, symptoms, and ADL disabilities. Laboratory data, symptoms, ADL, and manual muscle testing (MMT) results were obtained at baseline. Participants were divided into four groups: low (CRP  〈  1 mg/dl), moderate (1 =  〈 CRP 〈 5 mg/dl), high (5 =  〈 CRP  〈  10 mg/dl), and very high CRP (10 mg/dl =  〈 CRP). The proportions of eight symptoms, five ADL disabilities, and three categories of MMT according to the CRP groups were tested by chi‐square tests. Multiple‐adjusted odd ratios (ORs) were calculated by using ordinal logistic regression after adjustment for age, gender, site of primary cancer, metastatic disease, performance status, chemotherapy, and setting of care. Results A total of 1702 patients were analysed. Positive rates of symptoms and ADL disabilities increased with increasing CRP level. In the very high‐CRP group, rates of positivity for anorexia, fatigue, and weight loss were 89.8%, 81.0%, and 79.2%, respectively, and over 70% of patients received assistance for bathing, dressing, going to the toilet, and transfer. The grade of MMT also deteriorated with increasing CRP level. Adjusted ORs for the accumulated symptoms significantly increased with increasing CRP level in the moderate‐CRP, high‐CRP, and very high‐CRP groups [1.6 (95% confidence interval 1.2–2.0), P   〈  0.001; 2.5 (1.9–3.2), P   〈  0.001; 3.5 (2.7–4.6), P   〈  0.001, respectively]. Adjusted ORs for the accumulated ADL disabilities significantly increased in the very high‐CRP groups [2.1 (1.5–2.9), P   〈  0.001]. Conclusions Associations between CRP level, symptoms, and ADL were observed in advanced cancer patients receiving palliative care.
    Type of Medium: Online Resource
    ISSN: 2190-5991 , 2190-6009
    URL: Issue
    URL: Article
    DOI: 10.1002/jcsm.v8.3
    DOI: 10.1002/jcsm.12184
    Language: English
    Publisher: Wiley
    Publication Date: 2017
    detail.hit.zdb_id: 2586864-0
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  • 2
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    Changes in depressive symptoms among family caregivers of patients with cancer after bereavement and their association with resilience: A prospective cohort study
    Wiley ; 2022
    In:  Psycho-Oncology Vol. 31, No. 1 ( 2022-01), p. 86-97
    Details
    In: Psycho-Oncology, Wiley, Vol. 31, No. 1 ( 2022-01), p. 86-97
    Abstract: To elucidate changes in depressive symptoms after bereavement and the impact of pre‐loss resilience on such changes and on the extent of complicated grief and posttraumatic growth. Methods Prospective cohort surveys were provided to family caregivers of patients with cancer in four palliative care units (PCUs) before and after bereavement. Pre‐loss Connor–Davidson Resilience Scale scores, pre‐ and post‐loss Patient Health Questionnaire‐9 scores, post‐loss Brief Grief Questionnaire scores, and the expanded Posttraumatic Growth Inventory scores were determined. Results Out of 186 bereaved family caregivers, 71 (38.2%) responses were analyzed, among which 47% pre‐loss and 15% post‐loss responses suggested to be a high risk for major depressive disorder (MDD). Approximately 90% of family caregivers at a high risk for post‐loss MDD were already at a high risk for pre‐loss MDD. Even after adjustment of the background variables as covariates, the interaction effect between family caregivers' pre‐loss depressive symptoms and resilience on post‐loss depressive symptoms was observed ( F  = 7.29; p   〈  0.01). Moreover, pre‐loss resilience was not associated with other bereavement outcome measures. Conclusions Among family caregivers of patients with cancer in PCUs, 47% and 15% had high risk for MDD before and after bereavement, respectively. Moreover, pre‐loss resilience mitigated post‐loss depressive symptoms among family caregivers who had high risk for MDD before bereavement. However, considering the study's small sample size, further research is needed.
    Type of Medium: Online Resource
    ISSN: 1057-9249 , 1099-1611
    URL: Issue
    URL: Article
    DOI: 10.1002/pon.v31.1
    DOI: 10.1002/pon.5783
    Language: English
    Publisher: Wiley
    Publication Date: 2022
    detail.hit.zdb_id: 1495115-0
    SSG: 5,2
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  • 3
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    The impact of cachexia on dietary intakes, symptoms, and quality of life in advanced cancer
    Wiley ; 2022
    In:  JCSM Rapid Communications Vol. 5, No. 2 ( 2022-07), p. 162-170
    Details
    In: JCSM Rapid Communications, Wiley, Vol. 5, No. 2 ( 2022-07), p. 162-170
    Abstract: The relationships between cachexia stages and the Functional Assessment of Anorexia/Cachexia Therapy Anorexia Cachexia Subscale (FAACT ACS) 12‐item, 5‐item anorexia symptoms, and 4‐item anorexia concerns have not been investigated in Asian patients with advanced cancer. Methods This is a multicentre questionnaire survey conducted in palliative and supportive care settings across Japan. Consecutive patients were enrolled. Patient characteristics and anthropometric measurements were obtained. Dietary intakes and nutrition impact symptoms were also assessed. Patients evaluated their quality of life (QOL) using FAACT ACS. Subjects were divided into two groups, that is, pre‐cachexia (non‐cachexia) and cachexia and refractory cachexia (cachexia), based on cancer cachexia criteria from the international consensus. Comparisons were performed using the Mann–Whitney U test or chi‐squared test. To evaluate the relationship between cachexia stages and FAACT ACS 12‐item, 5‐item anorexia symptoms, and 4‐item anorexia concerns, adjusted odd ratios (ORs) and 95% confidence intervals (CIs) were calculated in the logistic models. Results Among 495 patients, 378 (76.4%) responded. Due to missing data, 344 patients were classified into the non‐cachexia group ( n  = 174) and cachexia group ( n  = 170), and 318 remained in the analysis of FAACT ACS. The cachexia group had a more impaired performance status, a lower body mass index, and a higher frequency of weight loss in 1 month ( P  = 0.021, 〈 0.001, and 〈 0.001, respectively). Advancing stages were associated with lack of appetite and reduced dietary intakes ( P   〈  0.001 and P   〈  0.001, respectively). QOL scores were significantly worse in the cachexia group in FAACT ACS 12‐item, 5‐item anorexia symptoms, and 4‐item anorexia concerns ( P   〈  0.001, P  = 0.001, and P   〈  0.001, respectively). In the models of FAACT ACS 12‐item, 5‐item anorexia symptoms, and 4‐item anorexia concerns, significantly higher adjusted ORs than in the non‐cachexia group were observed in the cachexia group [2.24 (95% CI 1.34–3.77), P  = 0.002; 1.77 (95% CI 1.08–2.92), P  = 0.024; and 2.18 (95% CI 1.29–3.70), P  = 0.004, respectively]. Conclusions FAACT ACS 12‐item, 5‐item anorexia symptoms, and 4‐item anorexia concerns are useful for identifying patients at risk of QOL that deteriorates with advancing stages in this population.
    Type of Medium: Online Resource
    ISSN: 2617-1619 , 2617-1619
    URL: Issue
    URL: Article
    DOI: 10.1002/rco2.v5.2
    DOI: 10.1002/rco2.61
    Language: English
    Publisher: Wiley
    Publication Date: 2022
    detail.hit.zdb_id: 3018093-4
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  • 4
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    End‐of‐life experiences of family caregivers of deceased patients with cancer: A nation‐wide survey
    Wiley ; 2018
    In:  Psycho-Oncology Vol. 27, No. 1 ( 2018-01), p. 272-278
    Details
    In: Psycho-Oncology, Wiley, Vol. 27, No. 1 ( 2018-01), p. 272-278
    Abstract: The purpose of this study was (a) to describe the end‐of‐life experience of family caregivers of cancer patients, (b) to describe talking about death and dying of the patient to minor children, and (c) to examine the association of family caregivers' experiences by their characteristics and talking about death and dying of the patient. Methods A cross‐sectional nationwide survey of bereaved family caregivers was conducted. In total, 968 questionnaires were sent to bereaved family caregivers, and 711 were completed and returned. Fifty‐three responses indicating patients had minor children were analyzed. Univariate analysis and principal component analysis were performed. Results Family caregivers' experiences were divided into 3 domains by principal component analysis: protect children from the patient's imminent death, little regard for the children, and worry and concern about the children's emotional reaction. Family caregivers' common experiences were as follows: “I wanted to know how the children felt,” “I wanted to avoid making the children confused,” and “I did not have much time to talk with and/or play with the children.” About 30% of family caregivers reported that they “did not talk” about death and dying of patients to minor children. Spouses of patients and family caregivers who did not talk about death tended to experience distress and worry. Conclusions Most family caregivers experienced worry and fear regarding minor children's emotional reaction; therefore, clinicians need to explain children's emotional and psychological reactions to family caregivers when a patient is at the end‐of‐life.
    Type of Medium: Online Resource
    ISSN: 1057-9249 , 1099-1611
    URL: Issue
    URL: Article
    DOI: 10.1002/pon.v27.1
    DOI: 10.1002/pon.4504
    Language: English
    Publisher: Wiley
    Publication Date: 2018
    detail.hit.zdb_id: 1495115-0
    SSG: 5,2
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  • 5
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    C‐reactive protein, delirium, and other psychological symptoms among patients with advanced cancer
    Wiley ; 2020
    In:  JCSM Clinical Reports Vol. 5, No. 2 ( 2020-04), p. 42-51
    Details
    In: JCSM Clinical Reports, Wiley, Vol. 5, No. 2 ( 2020-04), p. 42-51
    Abstract: It remains unclear whether a relationship exists between elevated C‐reactive protein (CRP) levels and delirium. The primary aim was to investigate the relationship between CRP and delirium in advanced cancer. Methods This study was a multicenter prospective cohort study conducted in palliative care units. At baseline, the physicians diagnosed delirium. On the seventh day, they evaluated whether new delirium had occurred. Subjects were divided into four groups according to CRP levels. We assessed the associations between CRP levels and proportions of delirium. To evaluate the relationship between CRP and delirium, adjusted odd ratios (ORs) and 95% confidence intervals (CIs) were calculated in the logistic models. Results Among 1896 patients, 1354 patients were eligible for analyses. We classified them into four groups: low (CRP  〈  1 mg/dl) ( n  = 170), moderate (1 ≤ CRP  〈  5 mg/dl) ( n  = 453), high (5 ≤ CRP  〈  10 mg/dl) ( n  = 334), and very high (10 mg/dl ≤ CRP) ( n  = 397). The incidence of delirium significantly increased with increasing CRP levels ( P  = 0.02). In model 1, significantly higher adjusted ORs than in the low CRP group were observed in the high CRP and very high CRP groups (1.63 [95% CI 1.06–2.50], P  = 0.03; 1.72 [95% CI 1.13–2.62], P  = 0.01, respectively). In model 2, a significantly higher adjusted OR than in the low CRP group was observed in the very high CRP group (1.61 [95% CI 1.05–2.45], P  = 0.03). Conclusions Relationships existed between elevated CRP levels and delirium.
    Type of Medium: Online Resource
    ISSN: 2521-3555 , 2521-3555
    URL: Issue
    URL: Article
    DOI: 10.1002/crt2.v5.2
    DOI: 10.1002/crt2.12
    Language: English
    Publisher: Wiley
    Publication Date: 2020
    detail.hit.zdb_id: 3009848-8
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  • 6
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    Development and validation of questionnaires for eating‐related distress among advanced cancer patients and families
    Wiley ; 2023
    In:  Journal of Cachexia, Sarcopenia and Muscle Vol. 14, No. 1 ( 2023-02), p. 310-325
    Details
    In: Journal of Cachexia, Sarcopenia and Muscle, Wiley, Vol. 14, No. 1 ( 2023-02), p. 310-325
    Abstract: Eating‐related distress (ERD) is one type of psychosocial distress among advanced cancer patients and family caregivers. Its alleviation is a key issue in palliative care; however, there is no validated tool for measuring ERD. Methods The purpose of this study was to validate tools for evaluating ERD among patients and family caregivers. The study consisted of a development and validation/retest phase. In the development phase, we made preliminary questionnaires for patients and family caregivers. After face validity and content validity, we performed an exploratory factor analysis and discussed the final adoption of items. In the validation/retest phase, we examined factor validity with an exploratory factor analysis. We calculated Pearson's correlation coefficients between the questionnaire for patients, the Functional Assessment of Anorexia/Cachexia Therapy Anorexia Cachexia Subscale (FAACT ACS) and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire‐Cachexia 24 (EORTC QLQ‐CAX24) and Pearson's correlation coefficients between the questionnaire for family caregivers and the Caregiver Quality of Life Index‐Cancer (CQOLC) for concurrent validity. We calculated Cronbach's alpha coefficients (Cronbach's alpha) and intraclass correlation coefficients (ICCs) for internal consistency and test–retest reliability. We performed the Mann–Whitney U test between the questionnaires and cancer cachexia based on criteria from the international consensus for known‐group validity. Results In the development phase, 162 pairs of patients and family caregivers were asked to participate, and 144 patients and 106 family caregivers responded. In the validation/retest phase, 333 pairs of patients and family caregivers were asked to participate, and 234 patients and 152 family caregivers responded. Overall, 183 patients and 112 family caregivers did the retest. Seven conceptual groups were extracted for the ERD among patients and family caregivers, respectively. Patient factors 1–7 correlated with FAACT ACS ( r  = −0.63, −0.43, −0.55, −0.40, −0.38, −0.54, −0.38, respectively) and EORTC QLQ‐CAX24 ( r  = 0.58, 0.40, 0.60, 0.49, 0.38, 0.59, 0.42, respectively). Family factors 1–7 correlated with CQOLC ( r  = −0.34, −0.30, −0.37, −0.37, −0.46, −0.42, −0.40, respectively). The values of Cronbach's alpha and ICC of each factor and all factors of patients ranged from 0.84 to 0.96 and 0.67 to 0.83, respectively. Those of each factor and all factors of family caregivers ranged from 0.84 to 0.96 and 0.63 to 0.84, respectively. The cachexia group of patients had significantly higher scores than the non‐cachexia group for each factor and all factors. Conclusions Newly developed tools for measuring ERD experienced by advanced cancer patients and family caregivers have been validated.
    Type of Medium: Online Resource
    ISSN: 2190-5991 , 2190-6009
    URL: Issue
    URL: Article
    DOI: 10.1002/jcsm.v14.1
    DOI: 10.1002/jcsm.13133
    Language: English
    Publisher: Wiley
    Publication Date: 2023
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  • 7
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    Significance of fluid retention, body mass index, and weight loss in patients with advanced cancer
    Wiley ; 2020
    In:  JCSM Clinical Reports Vol. 5, No. 3 ( 2020-07), p. 69-78
    Details
    In: JCSM Clinical Reports, Wiley, Vol. 5, No. 3 ( 2020-07), p. 69-78
    Abstract: Few studies have investigated the relationship between body mass index (BMI) and mortality or evaluated the prognostic validity of a grading system incorporating BMI and weight loss in Asian cancer patients. We conducted a study to investigate characteristics according to BMI and to confirm the prognostic validity of BMI and the grading system. Methods This study involved a secondary analysis of a prospective cohort study. Subjects were divided into six BMI groups and five grades according to the grading system. Characteristics were compared between the six groups. We conducted time‐to‐event analyses using the Kaplan–Meier method, log‐rank test, and univariate and multivariate Cox regression analyses. Results A total of 1094 patients were classified into six BMI groups: 〈 17 ( n  = 244), 17–18.4 ( n  = 211), 18.5–19.9 ( n  = 192), 20–21.9 ( n  = 196), 22–24.9 ( n  = 161), and 25 ≤ ( n  = 90). Regarding oedema, the prevalence increased with BMI, being 70% the 25 ≤ group. The prevalence of pleural effusion and ascites were the highest in the 25 ≤ group. Median survival ranged between 18 and 22 days in the six groups. No significant differences were observed in survival rates among the six BMI groups (log rank P  = 0.83). No significant differences were observed in survival rates among the five grades (log rank P  = 0.25). Conclusions The prevalence of fluid retention is high in patients with advanced cancer. BMI and weight loss appear to lose their prognostic significance among them.
    Type of Medium: Online Resource
    ISSN: 2521-3555 , 2521-3555
    URL: Issue
    URL: Article
    DOI: 10.1002/crt2.v5.3
    DOI: 10.1002/crt2.23
    Language: English
    Publisher: Wiley
    Publication Date: 2020
    detail.hit.zdb_id: 3009848-8
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