BackgroundChemotherapy-induced peripheral neuropathy (CIPN) is common among cancer patients treated with neurotoxic chemotherapy agents. Better knowledge on symptom clusters of CIPN may help improve symptom management in clinical practice. This study aimed to identify symptom clusters of CIPN and to map their trajectories before initiation of chemotherapy to 12-month follow-up.MethodsA secondary analysis of a longitudinal dataset was conducted using principal component approach. The European Organization for the Research and Treatment of Cancer Quality of Life Questionnaires Core 30 and CIPN 20 were used to measure symptom clusters of CIPN in patients with mixed cancer diagnosis across 10 time points over 12 months.ResultsSample size in each assessment point ranged from 118 to 343 participants. Four CIPN symptom clusters were identified, including a clear sensory neuropathy symptom cluster, a mixed motor-sensory neuropathy symptom cluster, a mixed sensorimotor neuropathy symptom cluster, and a less clear autonomic neuropathy symptom cluster. The core symptoms in each symptom cluster were mostly stable while the secondary symptoms changed over time.ConclusionsThe analysis suggests that CIPN is predominantly a sensory neuropathy with no evidence of a pure motor dysfunction but with mixed motor-related and autonomic changes accompanying sensory dysfunctions over time. Future symptom management strategies can be designed based on the morphology of CIPN.

Opinion statement Informal caregivers invest a significant amount of time and effort to provide cancer patients with physical, psychological, information, and social support. These challenging tasks can harm their own health and well-being, while a series of social-ecological factors may also influence the outcomes of cancer caregiving. Several instruments have been developed to help clinicians and researchers understand the multi-dimensional needs and concerns of caregivers. A growing body of evidence indicates that supportive interventions including psychoeducation, skills training, and therapeutic counseling can help improve the burden, information needs, coping strategies, physical functioning, psychological well-being, and quality of life of caregivers. However, there is difficulty in translating research evidence into practice. For instance, some supportive interventions tested in clinical trial settings are regarded as inconsistent with the actual needs of caregivers. Other significant considerations are the lack of well-trained interdisciplinary teams for supportive care provision and insufficient funding. Future research should include indicators that can attract decision-makers and funders, such as improving the efficient utilization of health care services and satisfaction of caregivers. It is also important for researchers to work closely with key stakeholders, to facilitate evidence dissemination and implementation, to benefit caregivers and the patient.

Purpose The aim of the study was to evaluate the effectiveness of a modified short-term mindfulness-based intervention on improving the mindfulness, comfort, and ambulation ability of stroke survivors undergoing inpatient rehabilitation in Wuhan, China. Design A two-group, nonrandomized, nonconcurrent design was used. Method Participants undergoing inpatient rehabilitation were nonrandomly divided into control group (n = 25) and intervention group (n = 25) to avoid possible ethical discrimination as well as interaction among participants. The control group received routine care; the intervention group received a 2-week mindfulness-based intervention, which included weekly 1.5-hour group practice, individual daily practice, and routine care. Data were collected using questionnaires and assessments of ambulation before and after 2 weeks of observation. Findings Improvement on the Mindful Attention Awareness Scale score, the overall score of the Shortened General Comfort Questionnaire, and the scores of the physical, psychospiritual, and sociocultural subscales in the intervention group was greater than those in the control group (p < .05). No significant difference (p > .05) was observed between the two groups when comparing scores of the environmental subscale of Shortened General Comfort Questionnaire, Berg Balance Scale, 10-Meter Walk Test, and Functional Ambulation Classification scale. Conclusions and Clinical Relevance A 2-week mindfulness-based intervention can significantly improve stroke survivors’ mindfulness and comfort but does not significantly affect ambulation ability.

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