Development and Initial Application of a Combined Exercise and Psychological Intervention Program for Patients After Esophagectomy

Esophageal Cancer Clinical Trial

— Recovery  

Official title:

Development and Initial Application of a Combined Exercise and Psychological Intervention Program for Patients After Esophagectomy

Clinical Trial Details — Status: Not yet recruiting

Administrative data

• NCT number: NCT06366685
• Other study ID #: YJS20230170
• Status: Not yet recruiting
• Phase: N/A
• Start date: May 1, 2024
• Est. completion date: February 1, 2025

Study information

• Verified date: April 2024
• Source: Anhui Medical University
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

Esophageal cancer imposes a significant burden in China, accounting for over 60% of the global disease burden. While surgery remains a common and highly effective treatment for esophageal cancer, patients often experience multiple physical and psychological symptoms postoperatively, severely affecting their recovery outcomes and quality of life. Although existing exercise or psychological intervention programs have shown some effectiveness, issues such as relatively singular intervention content, imprecise intervention timing, and vague intervention details persist.

This project, based on previous research foundations (including the development of symptom measurement tools and the identification of key recovery periods), is guided by symptom management theory and knowledge translation models. Taking a perspective of the synergistic impact of physical and psychological symptoms, the study focuses on patients undergoing esophageal cancer surgery. Initially, evidence-based literature review, focus group interviews, and expert consultations were conducted to develop a combined exercise and psychological intervention program, integrating subjective (CSCA_EC) and objective (6MWT) measurement indicators, named "Recovery For EC." Subsequently, the program was preliminarily applied in clinical settings using a mixed-methods approach, combining quantitative quasi-experimental design (108 cases) and qualitative interviews to assess its acceptability. The final clinical trial version of the Recovery For EC program was developed to provide patients with a tool for self-monitoring recovery outcomes and offer clinical healthcare professionals guidance for implementing precise and personalized rehabilitation management.

Recruitment information / eligibility

• Status: Not yet recruiting
• Enrollment: 60
• Est. completion date: February 1, 2025
• Est. primary completion date: October 31, 2024
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years to 80 Years

Eligibility

Inclusion Criteria:

1. Confirmed diagnosis of esophageal cancer by pathological biopsy.

2. Undergoing surgical treatment.

3. Age = 18 years old.

4. The patient is able to communicate effectively in language.

5. The patient is fully aware of their condition and willingly participates in the investigation.

Exclusion Criteria:

1. Patients with consciousness disorders.

2. Patients with severe physical illnesses who are unable to cooperate with the investigation.

3. Participation in other studies.

Related Conditions & MeSH terms

• Esophageal Cancer
• Esophageal Neoplasms
• Exercise Training
• Psychotherapy
• Rehabilitation

Intervention

Behavioral:
• Exercise and Psychological Intervention
To address the symptoms and severity experienced by esophageal cancer patients after surgery, providing them with exercise or psychological interventions to improve their rehabilitation outcomes.

Locations

Country	Name	City	State
China	Anhui Medical University	Hefei	Anhui

Sponsors (2)

Lead Sponsor	Collaborator
Mengmeng Yuan	Anhui Medical University

Country where clinical trial is conducted

China, 

References & Publications (16)

Anandavadivelan P, Malberg K, Vikstrom K, Nielsen S, Holdar U, Johar A, Lagergren P. Home-based physical activity after treatment for esophageal cancer-A randomized controlled trial. Cancer Med. 2023 Feb;12(3):3477-3487. doi: 10.1002/cam4.5131. Epub 2022 — View Citation

Campbell KL, Winters-Stone KM, Wiskemann J, May AM, Schwartz AL, Courneya KS, Zucker DS, Matthews CE, Ligibel JA, Gerber LH, Morris GS, Patel AV, Hue TF, Perna FM, Schmitz KH. Exercise Guidelines for Cancer Survivors: Consensus Statement from Internationa — View Citation

Chinh K, Mosher CE, Brown LF, Beck-Coon KA, Kroenke K, Johns SA. Psychological Processes and Symptom Outcomes in Mindfulness-Based Stress Reduction for Cancer Survivors: A Pilot Study. Mindfulness (N Y). 2020 Apr;11(4):905-916. doi: 10.1007/s12671-019-012 — View Citation

Gupta V, Allen-Ayodabo C, Davis L, Zhao H, Hallet J, Mahar AL, Ringash J, Kidane B, Darling G, Coburn NG. Patient-Reported Symptoms for Esophageal Cancer Patients Undergoing Curative Intent Treatment. Ann Thorac Surg. 2020 Feb;109(2):367-374. doi: 10.1016 — View Citation

Hellstadius Y, Lagergren P, Lagergren J, Johar A, Hultman CM, Wikman A. Aspects of emotional functioning following oesophageal cancer surgery in a population-based cohort study. Psychooncology. 2015 Jan;24(1):47-53. doi: 10.1002/pon.3583. Epub 2014 Jun 3. — View Citation

Hofmann SG, Gomez AF. Mindfulness-Based Interventions for Anxiety and Depression. Psychiatr Clin North Am. 2017 Dec;40(4):739-749. doi: 10.1016/j.psc.2017.08.008. Epub 2017 Sep 18. — View Citation

Johns SA, Von Ah D, Brown LF, Beck-Coon K, Talib TL, Alyea JM, Monahan PO, Tong Y, Wilhelm L, Giesler RB. Randomized controlled pilot trial of mindfulness-based stress reduction for breast and colorectal cancer survivors: effects on cancer-related cogniti — View Citation

Lee JY, Park HY, Jung D, Moon M, Keam B, Hahm BJ. Effect of brief psychoeducation using a tablet PC on distress and quality of life in cancer patients undergoing chemotherapy: a pilot study. Psychooncology. 2014 Aug;23(8):928-35. doi: 10.1002/pon.3503. Ep — View Citation

Liu CQ, Ma YL, Qin Q, Wang PH, Luo Y, Xu PF, Cui Y. Epidemiology of esophageal cancer in 2020 and projections to 2030 and 2040. Thorac Cancer. 2023 Jan;14(1):3-11. doi: 10.1111/1759-7714.14745. Epub 2022 Dec 8. — View Citation

Liu L, Liu QW, Wu XD, Liu SY, Cao HJ, Hong YT, Qin HY. Follow-up study on symptom distress in esophageal cancer patients undergoing repeated dilation. World J Clin Cases. 2020 Aug 26;8(16):3503-3514. doi: 10.12998/wjcc.v8.i16.3503. — View Citation

Liu Y, Pettersson E, Schandl A, Markar S, Johar A, Lagergren P. Psychological distress after esophageal cancer surgery and the predictive effect of dispositional optimism: a nationwide population-based longitudinal study. Support Care Cancer. 2022 Feb;30( — View Citation

Ma X, Ge H, Zhang X, Li S. Survival experience of patients undergoing oesophagectomy during the recovery period: A meta-synthesis of qualitative studies. J Clin Nurs. 2023 Sep;32(17-18):5579-5595. doi: 10.1111/jocn.16648. Epub 2023 Feb 17. — View Citation

Ohkura Y, Ichikura K, Shindoh J, Ueno M, Udagawa H, Matsushima E. Association between psychological distress of each points of the treatment of esophageal cancer and stress coping strategy. BMC Psychol. 2022 Sep 6;10(1):214. doi: 10.1186/s40359-022-00914- — View Citation

Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, Bray F. Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA Cancer J Clin. 2021 May;71(3):209-249. doi: 10.3322/caa — View Citation

van Vulpen JK, Hiensch AE, van Hillegersberg R, Ruurda JP, Backx FJG, Nieuwenhuijzen GAP, Kouwenhoven EA, Groenendijk RPR, van der Peet DL, Hazebroek EJ, Rosman C, Wijnhoven BPL, van Berge Henegouwen MI, van Laarhoven HWM, Siersema PD, May AM. Supervised — View Citation

Victorson D, Murphy K, Benedict C, Horowitz B, Maletich C, Cordero E, Salsman JM, Smith K, Sanford S. A randomized pilot study of mindfulness-based stress reduction in a young adult cancer sample: Feasibility, acceptability, and changes in patient reporte — View Citation

* Note: There are 16 references in all — Click here to view all references

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	the Convalescence Symptom Assessment Scale for EsophageCtomy patients (CSAS_EC)	The Convalescence Symptom Assessment Scale for EsophageCtomy patients (CSAS_EC) is an instrument developed by our research team based on patient self-reported outcomes, designed to assess the symptomatology and functional level during the recovery period of esophagectomy patients. This CSAS_EC has been developed and refined into an 11-point scale with 28 items, encompassing four dimensions (early recovery symptoms, late recovery symptoms, persistent symptoms, and psychosocial symptoms). The CSAS_EC scores range from 0 to 280, with higher scores indicating more severe postoperative symptoms in esophageal cancer patients.	Preoperative and Postoperative day 7 and through study completion, on average, 40 days post-surgery.
Secondary	6-Minute Walk Test	Participants are instructed to walk as fast as possible in a sparsely crowded, straight corridor to determine their six-minute walking distance. The cardiorespiratory functional assessment criteria are as follows: walking distance <150 meters is considered severely abnormal, 150-300 meters is moderately abnormal, 301-450 meters is mildly abnormal, and >450 meters is considered normal.	Preoperative and Postoperative day 7 and through study completion, on average, 40 days post-surgery.
Secondary	Hospital Anxiety and Depression Scale (HADS)	The Hospital Anxiety and Depression Scale (HADS) is a widely used self-assessment questionnaire for evaluating anxiety and depression symptoms in hospital patients. HADS consists of 14 items, divided into two dimensions: Anxiety and Depression. It uses a Likert 4-point scale, with scores ranging from 0 to 21. Higher scores indicate more severe anxiety and depression symptoms.	Preoperative and Postoperative day 7 and through study completion, on average, 40 days post-surgery.
Secondary	Postoperative Complications	According to the Clavien-Dindo classification system, Grade I refers to complications that do not require any treatment such as medication or surgery, Grade II involves the need for medication, blood transfusion, or nutritional support, Grade III necessitates surgical or interventional treatment, Grade IV poses a potential threat to the patient's life requiring intensive care, and Grade V results in patient death. The number and severity of postoperative complications are assessed and documented accordingly. Data on complications can be obtained from participants' electronic medical records.	Postoperative day 7