Schlafstörungen bei onkologischen Patienten

Schlafstörungen zählen zu den häufigsten Beschwerden unter denen Krebspatienten leiden, dennoch haben sie lange Zeit wenig Beachtung in der onkologischen Forschung und Praxis gefunden. Schlafstörungen können bei Krebspatienten bedingt durch zahlreiche individuelle, krankheits- und behandlungsspezifische Faktoren in jeder Phase einer Krebserkrankung auftreten und weit über den Abschluss der Therapie hinaus fortbestehen. Sie stellen hierbei eine leidvolle Erfahrung für die Patienten dar, welche negativen Einfluss auf die Tagesfunktion, die Lebensqualität und das Erleben der generellen Symptombelastung der Patienten hat. Ebenso kann das Auftreten von Fatigue, Depression und Angststörungen begünstigt werden. In Form einer systematischen Literaturübersicht wird in der vorliegenden Arbeit den Forschungsfragen nachgegangen, welche Auswirkungen nicht-medikamentöse Interventionen auf Schlafstörungen bei onkologischen Patienten haben und welche Veränderungen von damit assoziierten Symptombelastungen festzustellen sind. Anhand einer systematischen Literaturrecherche werden 50 relevante experimentelle Studien identifiziert. Die Studienergebnisse werden in Interventionsansätze kategorisiert, zusammengetragen und auf ihre Evidenzstärke und Qualität geprüft. Der derzeitige Stand der Forschung wird dargestellt und Schlussfolgerungen werden abgeleitet. Die überwiegend positiven Ergebnisse können als vielversprechend bezeichnet werden, es ist jedoch weitere Forschung notwendig um die Effektivität von nicht-medikamentösen Interventionen bei Schlafstörungen von onkologischen Patienten zu belegen. Erste wertvolle Implikationen für die onkologische Pflegepraxis können für kognitiv-verhaltenstherapeutische Interventionen festgehalten werden.Despite the evidence that sleep disturbances are among the most common complaints of people with cancer, sleep disturbances in cancer patients have been a neglected problem and received little attention from researchers and clinicians. Numerous factors may underlie sleep disturbances in cancer patients. While these disturbances may be of a temporal nature, they may develop a chronic course and persist long after treatment for cancer is completed. Sleep disturbances in cancer patients can adversely affect their daytime functioning, quality of live as well as the perceived symptom burden and may contribute to the subsequent development of cancer-related fatigue, depression and anxiety disorders. In the present thesis a systematic review is conducted in order to identify the impact of non-pharmacological interventions on sleep disturbances in cancer patients, as well as the impact on additional patient outcomes. Evidence from 50 experimental studies is gathered through a systematic literature search, then categorized and appraised for quality and strength of evidence. The status of current research is demonstrated and conclusions are drawn. The results are promising, however further research is needed to verify the efficacy of non-pharmacological interventions for cancer patients suffering from sleep disturbances. First valuable implications for oncology nursing practice can be drawn for cognitive-behavioural interventions

GMAG: An open-source python package for ground-based magnetometers

Magnetometers are a key component of heliophysics research providing valuable insight into the dynamics of electromagnetic field regimes and their coupling throughout the solar system. On satellites, magnetometers provide detailed observations of the extension of the solar magnetic field into interplanetary space and of planetary environments. At Earth, magnetometers are deployed on the ground in extensive arrays spanning the polar cap, auroral and sub-auroral zone, mid- and low-latitudes and equatorial electrojet with nearly global coverage in azimuth (longitude or magnetic local time—MLT). These multipoint observations are used to diagnose both ionospheric and magnetospheric processes as well as the coupling between the solar wind and these two regimes at a fraction of the cost of in-situ instruments. Despite their utility in research, ground-based magnetometer data can be difficult to use due to a variety of file formats, multiple points of access for the data, and limited software. In this short article we review the Open-Source Python library GMAG which provides rapid access to ground-based magnetometer data from a number of arrays in a Pandas DataFrame, a common data format used throughout scientific research

Descriptive data: Clinical and socio-demographic variables of the sample.

<p>(<i>N</i> = 343).</p

Conceptual diagram.

<p>Proposed relationship between resilience (Connor-Davidson Resilience Scale), psychological distress and activity level (Rotterdam Symptom Checklist), with age and social support as moderators.</p

Moderating effect of age on the relationship between resilience and psychological distress.

<p>The moderator effects by age showing that compared to younger patients, older patients with equivalent levels of resilience (measured by CD-RISC 10) have lower levels of psychological distress (measured by RSCL). <i>Note</i>. The values of age represent the 10^th, 25^th, 50^th, 75^th and 90^th percentiles in the sample distribution of age.</p

Statistical diagram of the revised model.

<p><b>Relationship between resilience (Connor-Davidson Resilience Scale) psychological distress and activity level (Rotterdam Symptom Checklist).</b> Regression paths for age and social support are also shown, controlling for work status in the analysis. <i>Note</i>. Resilience*Age, Resilience*Social support: the moderating effects of age and social support. Standardized coefficients and standard errors are shown. ^aResidual error in the prediction of the latent variable. **<i>p</i> < 0.01</p

Relationship among symptom clusters, quality of life, and treatment-specific optimism in patients with cancer

Purpose: There is increasing evidence that disease and therapy-related symptoms frequently co-occur in so-called symptom clusters (SCs), which may significantly impair quality of life in patients with cancer. Although psychosocial resources may play pivotal roles in maintaining or improving quality of life, they have been neglected in SC research. Therefore, we aim to identify SCs and their relative impact on quality of life when psychosocial resources are accounted for. Methods: Patients with cancer (n = 304) undergoing chemotherapy or chemo-radiation therapy participated in a cross-sectional survey consisting of measures assessing symptoms, quality of life, resilience, treatment-specific optimism (TSO), and social support. Exploratory factor analyses and multiple regression analyses were used to identify SCs and significant explanatory variables of overall quality of life. Results: Fatigue-pain, anxiety-depression, cancer therapy-related toxicity, and nausea-vomiting clusters were identified. In our final model, the fatigue-pain cluster (β = − 0.41, p < 0.001), nausea-vomiting cluster (β = − 0.28, p < 0.001), TSO (β = 0.21, p < 0.001), and receiving chemo-radiation treatment (β = − 0.11, p = 0.03) accounted for 44% of variance in overall quality of life. However, the identified SCs explained quality of life in patients with varying levels of TSO to a different extent. Conclusions: Our findings indicate that the TSO of patients may be a major factor to consider in managing SCs, because—depending on its level—different SCs and even clusters encompassing comparatively less distressing symptoms (i.e., cancer therapy-related toxicities) may strongly affect quality of life.© The Author(s) 201

GMAG:an open-source python package for ground-based magnetometers

Abstract Magnetometers are a key component of heliophysics research providing valuable insight into the dynamics of electromagnetic field regimes and their coupling throughout the solar system. On satellites, magnetometers provide detailed observations of the extension of the solar magnetic field into interplanetary space and of planetary environments. At Earth, magnetometers are deployed on the ground in extensive arrays spanning the polar cap, auroral and sub-auroral zone, mid- and low-latitudes and equatorial electrojet with nearly global coverage in azimuth (longitude or magnetic local time—MLT). These multipoint observations are used to diagnose both ionospheric and magnetospheric processes as well as the coupling between the solar wind and these two regimes at a fraction of the cost of in-situ instruments. Despite their utility in research, ground-based magnetometer data can be difficult to use due to a variety of file formats, multiple points of access for the data, and limited software. In this short article we review the Open-Source Python library GMAG which provides rapid access to ground-based magnetometer data from a number of arrays in a Pandas DataFrame, a common data format used throughout scientific research

Resilience in Adult Cancer Care: An Integrative Literature Review

In cancer care, empirical research and theory development on resilience has primarily been the domain of pediatric settings. This article aims to (a) describe current scientific perspectives on the concept of resilience, (b) summarize quantitative research on resilience in adult cancer care, and (c) identify implications for cancer nursing. An integrative literature review using PubMed, CINAHL®, and PsycINFO databases was performed and full-text, peer-reviewed articles published since 2003 were included. To summarize quantitative research, 252 articles were retrieved yielding 29 eligible studies, of which 11 articles were evaluated and synthesized. Appropriate articles were reviewed and data were extracted and tabulated for synthesis. Resilience is a dynamic process of facing adversity related to a cancer experience. It may be facilitated through nursing interventions after people affected by cancer have been confronted with the significant adversity posed by diagnosis, treatment, (long-term) symptoms, and distress. Resilience in adult cancer care is an under-researched area. Studies confirm the association with improved health outcomes (e.g., psychological well-being, mental and physical health). Resilience is an important issue for adult cancer care. Researchers must carefully define a conceptual framework for developing nursing interventions aimed at furthering resilience in adult cancer care