scholarly journals Harnessing digital health to objectively assess cancer-related fatigue: The impact of fatigue on mobility performance

PLoS ONE ◽  
2021 ◽  
Vol 16 (2) ◽  
pp. e0246101
Author(s):  
Yvonne H. Sada ◽  
Olia Poursina ◽  
He Zhou ◽  
Biruh T. Workeneh ◽  
Sandhya V. Maddali ◽  
...  
Keyword(s):  
Cancer Survivors ◽  
Functional Assessment ◽  
Performance Monitoring ◽  
Digital Health ◽  
Secondary Analysis ◽  
Self Report ◽  
Long Term Effects ◽  
Mobility Performance ◽  
Cancer Related Fatigue ◽  
The Impact

Objective Cancer-related fatigue (CRF) is highly prevalent among cancer survivors, which may have long-term effects on physical activity and quality of life. CRF is assessed by self-report or clinical observation, which may limit timely diagnosis and management. In this study, we examined the effect of CRF on mobility performance measured by a wearable pendant sensor. Methods This is a secondary analysis of a clinical trial evaluating the benefit of exercise in cancer survivors with chemotherapy-induced peripheral neuropathy (CIPN). CRF status was classified based on a Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F) score ≤ 33. Among 28 patients (age = 65.7±9.8 years old, BMI = 26.9±4.1kg/m2, sex = 32.9%female) with database variables of interest, twenty-one subjects (75.9%) were classified as non-CRF. Mobility performance, including behavior (sedentary, light, and moderate to vigorous activity (MtV)), postures (sitting, standing, lying, and walking), and locomotion (e.g., steps, postural transitions) were measured using a validated pendant-sensor over 24-hours. Baseline psychosocial, Functional Assessment of Cancer Therapy–General (FACT-G), Falls Efficacy Scale–International (FES-I), and motor-capacity assessments including gait (habitual speed, fast speed, and dual-task speed) and static balance were also performed. Results Both groups had similar baseline clinical and psychosocial characteristics, except for body-mass index (BMI), FACT-G, FACIT-F, and FES-I (p<0.050). The groups did not differ on motor-capacity. However, the majority of mobility performance parameters were different between groups with large to very large effect size, Cohen’s d ranging from 0.91 to 1.59. Among assessed mobility performance, the largest effect sizes were observed for sedentary-behavior (d = 1.59, p = 0.006), light-activity (d = 1.48, p = 0.009), and duration of sitting+lying (d = 1.46, p = 0.016). The largest correlations between mobility performance and FACIT-F were observed for sitting+lying (rho = -0.67, p<0.001) and the number of steps per day (rho = 0.60, p = 0.001). Conclusion The results of this study suggest that sensor-based mobility performance monitoring could be considered as a potential digital biomarker for CRF assessment. Future studies warrant evaluating utilization of mobility performance to track changes in CRF over time, response to CRF-related interventions, and earlier detection of CRF.

Cancer-Related Fatigue: Prevalence of Proposed Diagnostic Criteria in a United States Sample of Cancer Survivors

2001 ◽  
Vol 19 (14) ◽  
pp. 3385-3391 ◽  
Author(s):  
David Cella ◽  
Kimberly Davis ◽  
William Breitbart ◽  
Gregory Curt ◽  
Keyword(s):  
United States ◽  
Cancer Survivors ◽  
Diagnostic Criteria ◽  
Daily Functioning ◽  
Clinical Validation ◽  
Common Language ◽  
Cancer Related Fatigue ◽  
Prevalence Estimates ◽  
The Impact ◽  
Sizable Number

PURPOSE: To evaluate the proposed cancer-related fatigue (CRF) diagnostic criteria in a sample of cancer survivors. More accurate prevalence estimates of CRF may result in improved diagnosis and management of one of the most common symptoms associated with cancer and its treatment. METHODS: Three hundred seventy-nine individuals who had been treated with chemotherapy, either alone or in combination with radiation therapy, were surveyed. Patients were asked background questions about their current condition, their medical history, and the frequency of fatigue during their chemotherapy. Additionally, patients who reported experiencing fatigue at least a few days each month during treatment were asked a series of questions about the impact of fatigue on their daily functioning. RESULTS: One hundred forty-one (37%) individuals reported at least 2 weeks of fatigue in the previous month. Of the respondents who had received their last treatment more than 5 years ago, 33% still reported at least a 2-week period of fatigue in the month before the interview. Evaluation of the proposed criteria revealed that 17% of respondents met at least two criteria for CRF. CONCLUSION: The prevalence of diagnosable CRF in the individuals in this sample, most of whom had completed treatment more than 1 year ago, was 17%—lower than expected based on previous reports that have used less-strict criteria. In a sizable number of people, CRF persists well beyond active treatment and should be a focus of intervention. Although they will require replication in other samples and clinical validation, these formal diagnostic criteria can be a step toward common language and a better understanding of the severity range and persistence of CRF.

Do Stimulants Reduce the Risk for Alcohol and Substance Use in Youth With ADHD? A Secondary Analysis of a Prospective, 24-Month Open-Label Study of Osmotic-Release Methylphenidate

2016 ◽  
Vol 21 (1) ◽  
pp. 71-77 ◽  
Author(s):  
Paul Hammerness ◽  
Carter Petty ◽  
Stephen V. Faraone ◽  
Joseph Biederman
Keyword(s):  
Clinical Trial ◽  
Substance Use ◽  
Drug Use ◽  
Secondary Analysis ◽  
Self Report ◽  
Open Label ◽  
Stimulant Treatment ◽  
Alcohol And Drug Use ◽  
The Impact ◽  
Youth With Adhd

Objective: The purpose of this study was to examine the impact of stimulant treatment on risk for alcohol and illicit drug use in adolescents with ADHD. Method: Analysis of data derived from a prospective open-label treatment study of adolescent ADHD ( n = 115, 76% male), and a historical, naturalistic sample of ADHD ( n = 44, 68% male) and non-ADHD youth ( n = 52, 73% male) of similar age and sex. Treatment consisted of extended-release methylphenidate in the clinical trial or naturalistic stimulant treatment. Self-report of alcohol and drug use was derived from a modified version of the Drug Use Screening Inventory. Results: Rates of alcohol and drug use in the past year were significantly lower in the clinical trial compared with untreated and treated naturalistic ADHD comparators, and similar to rates in non-ADHD comparators. Conclusion: Well-monitored stimulant treatment may reduce the risk for alcohol and substance use in adolescent ADHD.

scholarly journals Harnessing Digital Health to Objectively Assess Cognitive Impairment in People undergoing Hemodialysis Process: The Impact of Cognitive Impairment on Mobility Performance Measured by Wearables

2019 ◽  
Author(s):  
He Zhou ◽  
Fadwa Al-Ali ◽  
Changhong Wang ◽  
Abdullah Hamad ◽  
Rania Ibrahim ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Performance Metrics ◽  
Digital Health ◽  
Hemodialysis Patients ◽  
Intact Group ◽  
Mobility Performance ◽  
Walking Performance ◽  
Task Conditions ◽  
Additional Value ◽  
The Impact

AbstractBackgroundCognitive impairment is prevalent but still poorly diagnosed in hemodialysis adults, mainly because of the impracticality of current tools. This study examined whether remotely monitoring mobility performance can help identifying digital measures of cognitive impairment in hemodialysis patients.MethodsSixty-nine hemodialysis patients (age=64.1±8.1years, body mass index=31.7±7.6kg/m2) were recruited. According to the Mini-Mental State Exam, 44 (64%) were determined as cognitive-intact, and 25 (36%) as cognitive-impaired. Mobility performance, including cumulated posture duration (sitting, lying, standing, and walking), daily walking performance (step and unbroken walking bout), as well as postural-transition (daily number and average duration), were measured using a validated pendant-sensor for a continuous period of 24-hour during a non-dialysis day. Motor capacity was quantified by assessing standing balance and gait performance under single-task and dual-task conditions.ResultsNo between-group difference was observed for the motor capacity. However, the mobility performance was different between groups. The cognitive-impaired group spent significantly higher percentage of time in sitting and lying (Cohens effect size d=0.78, p=0.005) but took significantly less daily steps (d=0.69, p=0.015) than the cognitive-intact group. The largest effect of reduction in number of postural-transition was observed in walk-to-sit transition (d=0.65, p=0.020). Regression models based on demographics, addition of daily walking performance, and addition of other mobility performance metrics, led to area-under-curves of 0.76, 0.78, and 0.93, respectively, for discriminating cognitive-impaired cases.ConclusionsThis study suggests that mobility performance metrics could be served as potential digital biomarkers of cognitive impairment among HD patients. It also highlights the additional value of measuring cumulated posture duration and postural-transition to improve the detection of cognitive impairment. Future studies need to examine potential benefits of mobility performance metrics for early diagnosis of cognitive impairment/dementia and timely intervention.

Early impact of the Affordable Care Act (ACA) on financial worry.

2016 ◽  
Vol 34 (7_suppl) ◽  
pp. 44-44
Author(s):  
Amy J. Davidoff ◽  
Xin Hu ◽  
Helen M. Parsons ◽  
Zhiyuan Zheng ◽  
Keyword(s):  
Cancer Survivors ◽  
Cancer Survivor ◽  
Self Report ◽  
Cancer History ◽  
Interaction Terms ◽  
Non Melanoma Skin Cancer ◽  
Interview Survey ◽  
Status Interaction ◽  
Linear Probability ◽  
The Impact

44 Background: We examined changes in financial worry for working-aged cancer survivors compared to individuals without a cancer history (controls) after ACA-mandated health insurance enrollment and caps on cost-sharing were implemented in 2014. We hypothesized that cancer survivors would be more likely to report financial worry, and that ACA implementation would reduce financial worry. Methods: We pooled data from the 2013-2014 National Health Interview Survey for adults aged 21-64 years. Cancer survivors were identified based on self-report of ever being told by a physician that they had cancer (excluding non-melanoma skin cancer). Reports of worry about eight financial matters were dichotomized as “very worried” vs. “less worried”; a summary measure captured reports of being “very worried” about any item. Linear probability regressions assessed the impact of being a cancer survivor and the post-ACA period on high financial worry, controlling for demographics and health status. Interaction terms between cancer and post-ACA tested for differential ACA effects for cancer survivors. Results: Compared to controls (n = 50,304), cancer survivors (n = 2,192) were more likely to report being very worried about finances pre-ACA (46.7% vs. 39.6%) and post-ACA (42.3% vs. 36.0%). The ACA was associated with an adjusted 3.9 (CI: 2.9-4.9) percentage point (PPT) decrease in the probability of financial worry overall. Being a cancer survivor was associated with increased likelihood of being very worried about finances overall (PPT = 3.5, CI: 0.8-6.2), medical costs associated with a serious illness (PPT = 3.4, CI: 0.9-5.9) and normal healthcare (PPT = 3.4, CI: 1.1-5.7), having enough money for retirement (PPT = 2.4, CI: 0.0-4.8), and being able to maintain an enjoyable standard of living (PPT = 2.5, CI: 0.3-4.7). The ACA did not affect financial worry for cancer survivors differently than for controls. Conclusions: The ACA was associated with small but significant reductions in financial worry for working-aged adults, with similar effects for cancer survivors and controls. Cancer survivors were more likely to report financial worry, and worried about both paying for healthcare and the ability to maintain an adequate financial position in the short and longer run.

The role of peer support in psychosocial outcomes among adolescent and young adult (AYA) cancer survivors.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e22528-e22528
Author(s):  
Motohiro Matsui ◽  
Kanako Taku ◽  
Rina Tsutsumi ◽  
Midori Ueno ◽  
Mayuri Seto ◽  
...  
Keyword(s):  
Cancer Survivors ◽  
Posttraumatic Growth ◽  
Cancer Patients ◽  
Peer Support ◽  
Self Report ◽  
Adolescent And Young Adult ◽  
Single Spectrum ◽  
Event Scale ◽  
Good Communication ◽  
The Impact

e22528 Background: Adolescents and young adults (AYA) who experienced cancer treatment sometimes show posttraumatic stress symptoms (PTSS) and yet report positive psychological changes, known as posttraumatic growth (PTG). Literature suggests PTSS and PTG are not on opposite ends of a single spectrum but rather coexist. It is expected to have distinct relationships with social support, and yet, the roles of peer support remain unknown. This study examines PTG and PTSS, and their correlates with peer support among AYA cancer survivors. Methods: A cross-sectional study was conducted using a questionnaire survey with AYA cancer survivors. A total of 212 AYA survivors were recruited from 11 cancer centers and 12 cancer patients’ communities. They completed a self-report measure of the PTG Inventory and the Impact of Event Scale revised (IES-R) to assess PTSS. Diagnosis, treatment, peer support (i.e., affiliation to AYA patients’ community and friendship with other AYA cancer patients), and social status information was also collected from questionnaires. A series of multiple regression analyses was used to identify significant correlates among peer support, PTG and PTSS. Results: PTG and PTSS were not significantly correlated with each other, being consistent with the previous studies. PTG was positively associated with male gender, years since diagnosis, good communication with others, and friendship with other AYA cancer patients. Friendship with other AYA cancer patients was positively associated with not just the overall PTG but all five domains of PTG. PTSS was associated with years since diagnosis, unemployed status, and symptom of late effects. PTSS was, however, unlike PTG, not related with friendship with other AYA cancer patients or affiliation to AYA patients’ community. Conclusions: Good communication and friendship with other AYA cancer patients is suggested to play an important role in PTG but not PTSS. Psychosocial intervention to facilitate peer support among AYA cancer patients would possibly contribute to revive their lives through PTG. Future studies should further investigate what factors would contribute to alleviation of PTSS and foster PTG. Clinical trial information: UMIN000035439.

scholarly journals Open to Exploration? Association of Personality Factors With Complementary Therapy Use After Breast Cancer Treatment

2018 ◽  
Vol 17 (3) ◽  
pp. 785-792 ◽  
Author(s):  
Kirsti I. Toivonen ◽  
Rie Tamagawa ◽  
Michael Speca ◽  
Joanne Stephen ◽  
Linda E. Carlson
Keyword(s):  
Breast Cancer ◽  
Cancer Survivors ◽  
Secondary Analysis ◽  
Complementary Therapy ◽  
Openness To Experience ◽  
Self Report ◽  
Personality Factors ◽  
Novelty Seeking ◽  
Personality Variables ◽  
Different Types

Purpose: Many cancer survivors seek complementary therapies (CTs) to improve their quality of life. While it is well-known that women who are younger, more highly educated, and have higher incomes are more likely to use CTs, individual differences such as personality factors have been largely unexplored as predictors of CT use. Methods: In a secondary analysis of a larger study, 270 women with stage I to III breast cancer completed self-report measures of demographic and illness-related information, personality variables, and use of several different types of CTs. A series of logistic regression models were used to explore whether demographic, illness-related, and personality variables predicted different types of CT use. Results: Prior relationships between education and CT use were replicated. There were no significant relationships between illness-related variables and different types of CT use. Of the 5 personality factors, only openness to experience was a significant predictor of multiple types of CT use. Conclusions: Openness to experience may represent an individual difference variable that predicts CT use among cancer survivors. CTs themselves may represent a form of intellectual curiosity and novelty seeking. Further studies are needed to replicate and examine the generalizability of the relationship between openness to experience and CT use in oncology populations.

scholarly journals The impact of perceived control on psychological distress and health behavior adherence in patients with cardiovascular disease

2018 ◽  
Vol 9 (2) ◽  
pp. 76
Author(s):  
Kalon R. Eways ◽  
Kymberley K. Bennett ◽  
Kadie M. Harry ◽  
Jillian M.R. Clark ◽  
Elizabeth J. Wilson
Keyword(s):  
Cardiovascular Disease ◽  
Psychological Distress ◽  
Health Behavior ◽  
Perceived Control ◽  
Self Report ◽  
Depression And Anxiety ◽  
Long Term Effects ◽  
Symptoms Of Depression ◽  
The Impact ◽  
The Relationship

Background: Symptoms of depression and anxiety have been shown to negatively impact physical health outcomes among individuals with cardiovascular disease (CVD). Therefore, an important step in developing interventions to reduce risk for cardiac event recurrence is to identify the emotional and cognitive predictors of psychological distress. This study examined one possible cognitive predictor: perceived control (PC). Specifically, this study tested whether symptoms of depression and anxiety mediate the relationship between PC and adherence to health behavior recommendations in patients participating in a cardiac rehabilitation (CR) program.Methods: Self-report measures were administered to 146 CR patients at the beginning of CR and 12-weeks later, at the end of CR.Results: Anxiety and depressive symptoms did not mediate the relationship between PC and health behavior adherence. Rather, PC was cross-sectionally related to symptoms of psychological distress, and it predicted health behavior adherence 12-weeks later.Conclusions: Results imply that PC has long-term effects on health behavior adherence, an important outcome in CR that reduces risk for recurrence.

scholarly journals The association between cancer-related fatigue and diabetes from pre-chemotherapy to 6-months post-chemotherapy

2021 ◽  
Author(s):  
Amber Kleckner ◽  
Ian R. Kleckner ◽  
Eva Culakova ◽  
Michelle Shayne ◽  
Elizabeth K. Belcher ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Repeated Measures ◽  
Diabetes Management ◽  
Menopausal Status ◽  
Secondary Analysis ◽  
Prospective Longitudinal Study ◽  
Cancer Related Fatigue ◽  
Diabetes Status ◽  
Prospective Longitudinal ◽  
The Impact

Abstract Purpose To quantify the impact of diabetes on the trajectory of cancer-related fatigue (CRF) from pre-chemotherapy to 6 months post-chemotherapy for patients with breast cancer compared to non-cancer controls.Methods This was a secondary analysis from a nationwide prospective longitudinal study of female patients with breast cancer undergoing chemotherapy and age-matched women without cancer (controls). CRF was measured using the Multidimensional Fatigue Symptom Inventory (MFSI) pre-, post-, and 6-months post-chemotherapy in patients; controls were assessed at equivalent time points. Diabetes status was obtained at baseline. Repeated measures mixed models estimated the association between CRF and diabetes controlling for cancer (y/n), body mass index, exercise and smoking habits, baseline anxiety and depressive symptoms, menopausal status, marital status, race, and education.Results A total of 439 patients and 235 controls (age: 52.8±10.5 years) had available data on diabetes status. Diabetes was twice as prevalent among patients as controls (11.6% vs. 6.8%). Patients had worse fatigue than controls throughout treatment (p<0.001). Diabetes was associated with worse CRF with a clinically meaningful difference of 4.7±1.7 points on the fatigue measure in all participants (p=0.009) and patients alone (p=0.030). For MFSI subdomains, diabetes was associated with worse general (p=0.002), physical (p=0.005), and mental fatigue (p=0.025) but not worse emotional fatigue or vigor (p>0.14) among patients. Conclusions Diabetes was twice as prevalent in women with breast cancer compared to controls, and diabetes was associated with more severe CRF in patients before and after chemotherapy and at 6 months post-chemotherapy. Interventions that address diabetes management may also help address CRF during chemotherapy treatment

Predictors of falls after starting an exercise program: A secondary analysis in inactive, female cancer survivors participating in the GET FIT trial.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 12075-12075
Author(s):  
Deanne Tibbitts ◽  
Sydnee Stoyles ◽  
Nathan Dieckmann ◽  
Fay B. Horak ◽  
Shiuh-Wen Luoh ◽  
...  
Keyword(s):  
Lower Extremity ◽  
Postural Control ◽  
Cancer Survivors ◽  
Cognitive Functioning ◽  
Fall Prevention ◽  
Fear Of Falling ◽  
Secondary Analysis ◽  
Exercise Program ◽  
Baseline Data ◽  
Self Report

12075 Background: Women treated for cancer are more likely to fall than women without a cancer history. Exercise is a fall prevention strategy for older adults that we are testing in the GET FIT trial as a fall prevention approach in women cancer survivors. Increasing physical activity, though, could acutely increase the risk of falls in inactive survivors with known fall risk related to treatment. Knowing who might be at risk prior to beginning an exercise program would inform additional safety precautions during exercise. Methods: We conducted a secondary analysis of baseline data from the GET FIT trial that enrolled inactive, older women who had completed chemotherapy for cancer. Women completed objective (muscle strength, static postural control, range of motion, physical functioning) and self-report (fall history, comorbidities, presence of neuropathy symptoms, pain severity, depressive symptoms, cognitive functioning, perceptions of lower extremity functioning, disability, fear of falling, demographic, and clinical characteristics) measures at baseline. Falls were prospectively collected during the 6 month intervention using monthly self report. Potential predictors of falls were included if univariate tests revealed significant differences between fallers and non-fallers. To identify the strongest predictors of falls, we used an automated model selection and multimodel inference approach to perform an exhaustive model search. Results: Baseline data were available for 415 participants with known faller status at the end of the intervention, of whom 31.3% (n = 130) reported at least one fall. The average age of the sample was 62.1±6.4 years and consisted mostly of non-Hispanic white, married, highly educated, overweight or obese women treated for breast cancer. Fallers (1+ falls) and non-fallers significantly differed on measures of fall history, comorbidities, pain, neuropathy, fear of falling, disability, perceived lower extremity functioning, cognitive functioning, depression, and postural control. The best model of faller status (per BIC) included postural control (p = 0.004), perceived lower extremity functioning (p = 0.072), and fear of falling (p = 0.030). Odds of ≥1 fall during the intervention increased by 1.72 (95% CI: 1.05-2.83) times for a 0.1-point decrease in postural control, 1.11 (1.04-1.19) times for a 0.1-point increase in fear of falling, and 1.02 (1.00-1.03) times for a 1-point decrease in perceived lower extremity functioning. Conclusions: Women cancer survivors with poor balance, poor self-rated functioning, and a fear of falling may need to take additional fall precautions when starting an exercise program. Clinical trial information: NCT01635413.

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