BACKGROUND: Symptom distress after heart transplantation (HTx) is a significant problem causing uncertainty, low self-efficacy, and psychological distress. Few studies have addressed self-reported symptoms. The aim was to explore self-reported symptom distress from time on the waiting list to 5 years after HTx and its association with self-reported psychological well-being, chronic pain, and fatigue in order to identify possible predictors of psychological or transplant specific well-being.
METHODS: This multicenter, longitudinal cohort study includes 48 heart recipients (HTRs), 12 women, and 36 men, with a median age of 57 years followed from pretransplant to 5 years post-transplant. Symptom distress was explored by means of four instruments measuring psychological general wellbeing, transplant specific wellbeing, pain, and fatigue.
RESULTS: Transplant specific well-being for the whole improved in a stepwise manner during the first 5 years compared to pretransplant. Heart transplant recipients with poor psychological wellbeing were significantly more burdened by symptom distress, in particular sleep problems and fatigue, for up to 5 years after HTx, and their transplant-specific well-being never improved compared to baseline. The prevalence of pain varied from 40% to 60% and explained a significant proportion of the variance in transplant-specific well-being, while psychological general well-being was mainly predicted by overall symptom distress.
CONCLUSIONS: The presence of distressing symptoms explains a significant proportion of poor psychological wellbeing both among HTRs reporting chronic pain and those without pain.

OBJECTIVE: This study aimed to determine the effectiveness of a Phone-Based Support Program (PBSP) for newly diagnosed women with breast cancer.
METHODS: A two-group repeated measures randomized controlled trial was designed. Participants included 94 patients aged 18-60 years who were newly diagnosed with breast cancer and undergoing chemotherapy in a tertiary hospital in China. They were randomly assigned to the intervention and the control groups. Participants in the intervention group were enrolled in a four-session PBSP, consisting of four interactive sections: learning, discussion, ask-the-expert, and personal stories, plus the routine care. Outcomes included patients\' self-care self-efficacy, psychological distress (including symptom distress, anxiety, and depression), and quality of life. These were assessed at three time points: pre-intervention (T1), post-intervention (T2), and follow-up (T3) by using the self-care self-efficacy scale, the M.D. Anderson Symptom Inventory, the hospital anxiety and depression scale, and the global health status scale.
RESULTS: After completion of the intervention, participants in the intervention group had significantly (p < .001) higher self-care self-efficacy (T2: Mdiff = 11.49, T3: Mdiff = 22.33), better quality of life (T2: Mdiff = 8.18, T3: Mdiff = 17.19), lower symptom distress (T2: Mdiff = -26.68, T3: Mdiff = -54.76), less anxiety (T2: Mdiff = -2.52, T3: Mdiff = -5.11), and less depression (T2: Mdiff = -3.61, T3: Mdiff = -6.71) than those in the control group.
CONCLUSIONS: These findings indicate that the PBSP is effective. Healthcare professionals, especially nurses, could utilize it to enhance self-care self-efficacy and quality of life, as well as decrease psychological distress among women newly diagnosed breast cancer.
BACKGROUND: The Thai Clinical Trial Registry #TCTR20230321010.

BACKGROUND: Colorectal cancer (CRC) is a primary cause of cancer-related mortality, and, after treatment, cancer survivors often worry that disease recurrence may worsen their health. Nevertheless, limited research on fear of cancer recurrence (FCR) and treatment-related symptoms has been conducted on survivors of CRC.
OBJECTIVE: This study was designed to explore (1) symptom distress severity and post-treatment FCR in CRC survivors and (2) the predictors of FCR.
METHODS: A cross-sectional correlational research design and convenience sampling approach were used to recruit patients at the colorectal surgery outpatient department of a medical center in central Taiwan. Basic demographic data, the Symptom Distress Scale - Chinese Modified Form, and Fear of Progression Questionnaire - Short Form were used as monitoring tools. Pearson\'s product-moment correlation analysis, independent t-tests, one-way ANOVA, and stepwise linear regression analysis were used for statistical analysis.
RESULTS: One hundred fourteen survivors of CRC with an average age of 63.44 were enrolled as participants. The top five symptoms of distress were numbness, bowel patterns, fatigue, insomnia, and dry mouth, and the average FCR score was 18.09. Gender, educational level, monthly disposable income, and symptom distress were identified as significant predictors of FCR, with an overall explanatory power of 41.4%.
CONCLUSIONS: Level of post-treatment FCR in survivors of CRC is influenced by symptom distress severity. Early intervention by healthcare providers to control or alleviate physical symptoms can help prevent the emergence of negative emotions and improve quality of life in this patient group.
BACKGROUND: 結腸直腸癌存活者癌症治療後的症狀困擾與害怕癌症復發.
UNASSIGNED: 結腸直腸癌仍然是癌症相關死亡的主要原因，治療後的癌症存活者擔心疾病復發容易使健康狀況更加惡化。儘管如此，有關結腸直腸癌存活者的害怕癌症復發與治療相關症狀的研究篇幅有限。.
UNASSIGNED: 本研究目的探討：(1)結腸直腸癌存活者癌症治療後的症狀困擾、害怕癌症復發現況；(2)其害怕癌症復發的預測因子。.
UNASSIGNED: 採橫斷式相關性研究設計，方便取樣，於台灣中部地區某醫學中心大腸直腸外科門診收案。以基本資料表、症狀困擾量表、害怕疾病進展量表為監測工具，統計分析方法採用皮爾森積差相關分析、獨立t檢定、one-way ANOVA與逐步線性迴歸分析。.
UNASSIGNED: 本研究共招募114名結腸直腸癌存活者，平均年齡63.44歲，症狀困擾以麻木感、排便改變、疲倦、失眠及口乾等症狀排名前5名。「害怕癌症復發」（fear of cancer recurrence）平均分數18.09分。性別、教育程度、每月可支配收入及症狀困擾等變項為存活者害怕癌症復發的重要預測因子，整體解釋力41.4%。.
UNASSIGNED: 結腸直腸癌存活者癌症治療結束後的害怕癌症復發的程度會受到症狀困擾的影響。健康照護提供者及早協助存活者控制或緩解身體的症狀，將有助於避免負面情緒的產生，及改善病人的生活品質。.

OBJECTIVE: This study aims to explore the multiple mediating roles of illness acceptance and symptom severity between health locus of control and symptom distress in acute leukemia patients.
METHODS: From June 2022 to March 2023, a convenience sampling method was used to recruit 208 acute leukemia patients in the inpatient center of a hospital in Hebei. The Chinese versions of Multidimensional Health Locus of Control Scale, Illness Acceptance Scale, and Anderson Symptom Assessment Scale was used in the cross-sectional study.
RESULTS: All participants reported the presence of symptom distress. Symptom distress was significantly correlated with chance health locus of control, illness acceptance, and symptom severity (P＜0.05). Illness acceptance alone played a mediating role in the relationship between chance health locus of control and symptom distress in acute leukemia patients (β=0.087, 95%CI 0.030-0.167). The indirect role of chance health locus of control on symptom distress through symptom severity alone was also statistically significant (β=0.131, 95%CI 0.008-0.252). Furthermore, the multiple mediating role of chance health locus of control and symptom distress through illness acceptance and symptom severity combined was verified (β=0.027, 95%CI 0.001-0.089). The alternative model is also valid, indicating bidirectional relationships between symptom severity, illness acceptance, and chance health locus of control, collectively influencing symptom distress.
CONCLUSIONS: There is a positive relationship between chance health locus of control and symptom distress; additionally, increasing social psychological interventions for illness acceptance and strengthening the management of core symptoms will help alleviate the impact of health chance locus of control on symptom distress in acute leukemia patients. Longitudinal studies are needed to confirm the causal relationships among the variables explored within the model.
UNASSIGNED: It is recommended that healthcare professionals pay attention to the assessment of health locus of control in patients, identify patients with health chance locus of control in a timely manner, take measures to enhance their disease acceptance, and strengthen the management of core symptoms, thereby reducing their level of symptom distress.

BACKGROUND: Hepatocellular carcinoma (HCC) is a prevalent malignancy, and transcatheter arterial embolization (TAE) has emerged as a pivotal therapeutic modality. However, TAE may induce symptom distress and fatigue, adversely affecting the quality of life of patients.
OBJECTIVE: To investigate symptom distress, fatigue, and associated factors in HCC patients undergoing TAE.
METHODS: We used a cross-sectional design and purposive sampling to enroll HCC patients who underwent TAE at our institution from January to December 2022. Questionnaires were utilized to collect data on symptom distress and fatigue scores from the first to the third day after TAE.
RESULTS: Our study revealed a significant reduction in fatigue and symptom distress among patients after TAE. Pain, fatigue, insomnia, fever and abdominal distension were the most common symptoms troubling patients during the first 3 d post-TAE. Marital status, presence of family support, physical functional status, age, and symptom distress were identified as predictors of fatigue in patients.
CONCLUSIONS: Healthcare professionals should educate HCC patients on symptom distress and fatigue, offering personalized relief strategies to lessen their psychological burden.

UNASSIGNED: Symptom distress and impaired psychological well-being after liver transplantation may lead to limitations in everyday activities and lowered health-related quality of life. The aim of this nationwide, descriptive, and cross-sectional study was to explore self-reported symptom occurrence and distress, among Danish liver transplant recipients, and their association with self-reported psychological well-being as well as demographic, and clinical characteristics.
UNASSIGNED: Liver transplant recipients transplanted from 1990 to 2022 were included. All recipients were asked to complete the Organ Transplant Symptom and Wellbeing instruments consisting of two instruments measuring self-reported symptom occurrence and distress, respectively, as well as self-reported psychological well-being by the Psychological General well-being instrument.
UNASSIGNED: Of 511 invited recipients 238 responded: 116 women and 122 men with a median post-transplant follow-up of 7.5 years (IQR 3.6-14.2 years). The most common single symptoms reported were decreased libido (18%), diarrhea (10%), and headache (8%). Sleep problems were the most common transplant-specific domain. 41% of the recipients reported poor psychological well-being, especially those who had undergone transplantation within the last 5 years, women, and younger recipients.
UNASSIGNED: In the interest of equity, the fact that women reported a higher level of symptom distress than men requires attention. Research on symptom management support is warranted with interventions focusing on how to alleviate symptom distress, which might increase long-term survival, which has not improved in recent decades.

UNASSIGNED: The increasing number of women with breast cancer undergoing chemotherapy may result in long-lasting, adverse physical side effects and reduced quality of life.
UNASSIGNED: This study aimed to develop and assess the feasibility and preliminary effects of the Phone-Based Support Program for women with breast cancer undergoing chemotherapy. The primary outcome was self-care self-efficacy; secondary outcomes were symptom distress and quality of life.
UNASSIGNED: This pilot study was conducted at a tertiary hospital in Jiangsu province, China, from February to March 2023. The Phone-Based Support Program was delivered to 20 participants through the smartphone application WeChat, consisting of learning, discussion, ask-the-expert, and personal stories components. Outcome measures were assessed at three time points: preintervention, postintervention, and follow-up.
UNASSIGNED: The Phone-Based Support Program was feasible and could improve self-care self-efficacy, decrease symptom distress, and promote quality of life. The program was well-accepted, and participants engaged actively in the online discussion and sought expert advice.
UNASSIGNED: The Phone-Based Support Program showed feasibility and effectiveness in improving self-care self-efficacy, reducing symptom distress, and enhancing quality of life.

Poor sleep quality is associated with multiple factors in cardiac surgery patients.
To examine the trajectory of sleep quality and its associated factors over 3 months in Taiwanese patients undergoing cardiac surgery.
A longitudinal study. This study enrolled 95 patients undergoing cardiac surgery in northern Taiwan. Sleep quality was measured using the Pittsburgh Sleep Quality Index and Epworth Sleepiness Scale before surgery, at discharge, and at 1 month and 3 months postsurgery.
The majority of participants reported poor sleep quality before cardiac surgery (76.8%) and at discharge (81.6%), and they showed significant improvements in sleep quality at 1 month (B = -0.93, p = .023) and 3 months postsurgery (B = -1.50, p < .001). Significant daytime sleepiness was reported by 25.3% of patients before cardiac surgery, and this proportion significantly decreased at 3 months postsurgery (B = -2.59, p < .001). The significant predictors of sleep quality in cardiac surgery patients were symptom distress, sleep medications, occupation, left ventricular ejection fraction, ACE-I drugs and potassium ions, which explained 53.7% of the total variance in sleep quality. Having a nap habit was an independent predictor of daytime sleepiness in cardiac surgery patients, which could explain 3.7% of the total variation.
Poor sleep quality was common in patients undergoing cardiac surgery and was associated with multiple factors, including symptom distress, cardiac function, medications, and psychosocial and environmental factors.
Poor sleep quality was observed in cardiac surgical patients before surgery and at discharge postsurgery. Patient education on symptom management, medication adherence and sleep hygiene are suggested to improve sleep quality in patients undergoing cardiac surgery.

This study aimed to assess the health-related quality of life and identify its associated factors in women with endometriosis. A cross-sectional correlation study design and convenience sampling were conducted in the gynecological outpatient clinic of a teaching hospital in northern Taiwan. A total of 216 women with endometriosis were recruited. The data were collected using structured questionnaires and analyzed using descriptive and inferential statistics. Participants reported a moderate level of health-related quality of life. The most significant impact of endometriosis on health-related quality of life was emotional well-being, followed by feeling of control or powerless, pain, social support, and self-image. Educational attainment, menstrual cycle, period length, perceived menstrual flow, symptom distress, and self-management strategies explained 66% of the variance in health-related quality of life. Factors influencing health-related quality of life in women with endometriosis play a key role in promoting women\'s well-being. Interventions based on these related factors should be developed and taken into practice to effectively manage the disease-related symptoms for women with endometriosis and thereby improve their overall health-related quality of life.

OBJECTIVE: There are an increasing number of techniques and tools to improve the capacity for children to relay their perceptions of their symptom experience while undergoing blood and marrow transplant (BMT). Network analysis (NA) is a tool that can illustrate associations between symptoms and the distress they cause. We aimed to develop a biopsychosocial assessment clinical analytic tool to examine symptom relationships for children undergoing BMT to find actionable relationships for intervention to improve clinical outcomes including mood.
METHODS: This pilot study used an analytical mobile application tool to support a wide scope of 15 biopsychosocial symptom distress levels and five mood assessments. Children recorded their symptom distress and mood using the app. NA was used to explore relationships between symptom distress and mood.
RESULTS: Four children, 11-14 years old, undergoing BMT used the app daily during hospitalization. We found a strong presence of emotional distress and its associations symptom distress and mood. Multiple symptom associations were identified including associations between the set of symptoms difficulty breathing and fever (0.557), sad and worried (0.429). Of note, pain distress had a strong capacity to bridge other symptoms and was connected directly to many symptoms.
CONCLUSIONS: We found the significance of patient struggles with emotional and symptom distress and the importance of this relationship to other clinical outcomes. This provides valuable insights and an improved understanding of the child\'s symptoms. Our findings support early assessment, intervention, and improved symptom communication to enhance sense of well-being and the child\'s care experience.