Effectiveness of telerehabilitation on short-term quality of life of patients after esophageal cancer surgery during COVID-19: a single-center, randomized, controlled study

Abstract

Background: The occurrence of postoperative complications may lead to delayed recovery and a decline in physical function in the first 3 months after esophagectomy. The outbreak of COVID-19 imposed physical and emotional obstacles for traditional face-to-face rehabilitation. Meanwhile, the effectiveness of telerehabilitation remained unknown. In this study, we aimed to investigate the effectiveness of telerehabilitation. Methods: A cohort of 86 patients who received minimally invasive esophagectomy between September 2020 and January 2021 was randomly allocated into two groups. The telerehabilitation group received additional online consulting and training, including (I) precautions for nutritional support; (II) swallowing function training; (III) respiratory function training; (IV) guidance and feedback on matters such as patient's current vital signs, wound status, medication, and sleep status. The primary outcome was the change of quality of life (QOL) of each patient at 3 months after surgery.Results: No serious adverse events were observed in either group. The telerehabilitation group showed significant improvements in pain using the OLQ-C30 scale (P<0.001), and in choking using the QLQ-OES18 scale (P<0.001). The comparison of the QLQ-C30 and QES-18 score changes at three months after discharge revealed that nearly all aspects in the telerehabilitation group displayed more score changes with significant changes in the appetite loss and pain part (P<0.001 and P<0.05, respectively). The score changes in QLQ-OES18 revealed significant improvement in swallowing saliva (P<0.05), as well slight improvements in choking, dry mouth, taste, and cough without significance.Conclusions: Our study demonstrated that telerehabilitation was at least an important supplement to traditional face-to-face consulting and training for patients after esophageal cancer surgery during the COVID-19 period.

Mental Health in Postoperative Thyroid Patients During the COVID-19 Pandemic

“…The psychological and emotional issues in numerous populations during the COVID-19 pandemic have received increasing attention (11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21). While psychological symptoms such as insomnia, anxiety, depression, and reduced quality of life after thyroid surgery have been reported by patients (34)(35)(36), the mental health of postoperative thyroid patients during the pandemic and the factors affecting it remain relatively unknown (37).…”

“…Several studies have explored anxiety, depression, and quality of life during the COVID-19 pandemic in a variety of populations, including the general population (1,2,11), health care workers (12)(13)(14), medical students (15,16), cancer patients (17)(18)(19), and postoperative surgical patients (20,21). The majority of these study populations experienced negative emotional states during the pandemic; however, to date, no studies have focused on the mental health of patients after thyroid surgery (22).…”

Effect of Mobile Phone App–Based Interventions on Quality of Life and Psychological Symptoms Among Adult Cancer Survivors: Systematic Review and Meta-analysis of Randomized Controlled Trials

“…A total of 80% (24/30) of the studies [16,19,[25][26][27][28][29][30][33][34][35][37][38][39][40][41][42][43][44][45][46][47][48][49] involving 4822 participants used various scales to report the outcome of QOL. Of these 24 studies, 8 (33%) [19,26,27,37,39,40,42,43] focused on patients with breast cancer, and the other 16 (67%) included patients with multiple types of cancer (such as breast cancer, brain cancer, and prostate cancer).…”

“…Owing to the significant heterogeneity among the studies (P<.001; I 2 =77%), the results were pooled using a random-effects model. Overall, the mHealth app interventions significantly improved cancer-related QOL scores (SMD=0.39, 95% CI 0.27-0.51; P<.001; Figure 3 [16,19,[25][26][27][28][29][30][33][34][35][37][38][39][40][41][42][43][44][45][46][47][48][49]). We conducted subgroup analyses according to intervention duration, type of cancer, intervention theory, treatment strategy, and intervention delivery format to investigate potential sources of heterogeneity.…”

“…We conducted subgroup analyses according to intervention duration, type of cancer, intervention theory, treatment strategy, and intervention delivery format to investigate potential sources of heterogeneity. Pooled results for the short-term (≤3 months) follow-up period suggested that mHealth app medical interventions were effective in improving QOL (SMD <3 months =0.41, 95% CI 0.26-0.57; P=.001; SMD 3 to 12 months =0.36, 95% CI 0.14-0.57; P=.001; Table 2 and Multimedia Appendix 3 [16,19,[25][26][27][28][29][30][33][34][35][37][38][39][40][41][42][43][44][45][46][47][48][49]). When studies were grouped by type of cancer, the results showed that mHealth app interventions may improve cancer-related QOL scores across cancer types (SMD Breast cancer =0.42, 95% CI 0.21-0.63; P<.001; SMD Various cancers =0.38, 95% CI 0.23-0.53; P=.001; Table 2 and Multimedia Appendix 4 [16,19,[25][26][27][28][29][30][33][34][35][37][38][39][40][41][42]…”