and the Associated Brain Networks in Patients with Gynecological Cancer Yingchun ZENG A thesis su... more and the Associated Brain Networks in Patients with Gynecological Cancer Yingchun ZENG A thesis submitted in partial fulfilment of the requirements for the degree of Doctor of Philosophy June 2018 iii CERTIFICATE OF ORIGNIALITY I hereby declare that this thesis is my own work and that, to the best of my knowledge and belief, it reproduces no material previously published or written, nor material that has been accepted for the award of any other degree or diploma, except where due acknowledge has been made in the text.
Background: Previous neurocognitive assessments in non-central nervous system cancers highlight t... more Background: Previous neurocognitive assessments in non-central nervous system cancers highlight the high incidence of neurocognitive dysfunction in this study population. However, there have been few studies exploring neurocognitive dysfunction induced by chemotherapy in gynecological cancer patients. This prospective longitudinal study was conducted to assess neurocognitive functioning and functional brain networks in Chinese gynecological cancer patients pre-and post-chemotherapy, while additionally including age-matched healthy subjects as the control group. Methods: All research participants were evaluated using a resting-state functional magnetic resonance imaging and neurocognition assessment. Behavioral data were conducted using SPSS for descriptive statistics, correlation and comparison analyses. Preprocessing of MRI (Magnetic Resonance Imaging) data and network analyses were performed using GRETNA (Graph Theoretical Network Analysis). Results: A total of 40 subjects joined this study, with 20 subjects in each group. With the exception of the mean of psychomotor speed, there was no significant difference pre-chemotherapy between patients and healthy controls in neurocognitive test mean scores (Ps > 0.05). During the post-chemotherapy assessment, there were significant differences in the mean scores of neurocognitive tests (including Digit Span tests, verbal memory, immediate recall, delayed recall, and information processing speed tests) (all Ps < 0 .05). Longitudinal graph analysis revealed statistically significant differences in the patient group, with significant decreases in both local efficiency (P < 0.01) and global efficiency (P = 0.04). Lower raw TMT-A scores were significantly associated with lower local efficiency (r = 0.37, P = 0.03). Lower verbal memory scores were statistically significant and associated with lower global efficiency (r = 0.54, P = 0.02) in the patient group, but not in the healthy control group. Conclusions: This study found that the risk of brain function and neurocognitive changes following chemotherapy could potentially guide patients in making appropriate treatment decisions, and this study may identify a cohort that could be suited for study of an intervention.
Sexuality has been recognized as an integral aspect of quality of life. Issues surrounding sexual... more Sexuality has been recognized as an integral aspect of quality of life. Issues surrounding sexuality have also been acknowledged to have a great impact on the quality of life of gynecologic cancer patients. The objectives of this study were to describe sexual function and sexual activity among Chinese women after gynecologic cancer and to identify significant predicting factors of women&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s sexuality outcome changes. This is a descriptive correlational study that was performed in mainland China. A sexuality scale was used to assess women&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s sexuality outcomes. A total of 156 Chinese women who had gynecologic cancer were included in this study. Study results revealed that sexual dysfunction was an important concern among these women (62.2%). The rate of sexual inactivity (70.5%) was relatively high. Reasons for sexual inactivity were related to worry about possibly weakening the potency of treatment (46.5%), fear of cancer recurrence (41.1%), and lack of sexual interest (31%). When looking at predictors of negative changes of women&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s sexuality after cancer, this study found that older age (&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;50 years old) was associated with the decrease of sexual desire/interest (odds ratio, 3.64; confidence interval, 1.19-11.16). Women who received radiation therapy had more severe vaginal dryness (odds ratio, 2.27; confidence interval, 1.10-4.72) and were less sexually active than those who did not have radiation therapy. Chinese women after gynecologic cancer suffered from various sexuality concerns. Considering the high rates of sexual dysfunction and sexual inactivity, there is a need to integrate sexuality into routine nursing care.
Background: Women with cervical cancer now have relatively good 5-year survival rates. Better sur... more Background: Women with cervical cancer now have relatively good 5-year survival rates. Better survival rates have driven the paradigm in cancer care from a medical illness model to a wellness model, which is concerned with the quality of womenLs lives as well ...
The aim of this review was to identify the specific work-related stressors of mainland Chinese nu... more The aim of this review was to identify the specific work-related stressors of mainland Chinese nurses and to present the current state of stress research in order to discuss directions for further research. A literature search from January 2000 to June 2007 was conducted among three electronic databases. The specific stressors among Chinese nurses were effort-reward imbalance, the poor image of nursing in the community, and managerial issues. The studies were limited to either descriptive or correlation designs, a variety of stress scales were used to investigate the nurses&#39; work-related stressors, and there were no published studies reporting stress management interventions for Chinese nurses. This review highlights that further stress research targeted to Chinese nurses needs more prospective and longitudinal studies and has to develop a consistent instrument to measure stressors. The priority issue is the initiation of stress management interventions to improve nurses&#39; coping skills, while the long-term goal is to reduce the level of stress or eliminate the stressors through individual, organizational, and societal interventions.
and the Associated Brain Networks in Patients with Gynecological Cancer Yingchun ZENG A thesis su... more and the Associated Brain Networks in Patients with Gynecological Cancer Yingchun ZENG A thesis submitted in partial fulfilment of the requirements for the degree of Doctor of Philosophy June 2018 iii CERTIFICATE OF ORIGNIALITY I hereby declare that this thesis is my own work and that, to the best of my knowledge and belief, it reproduces no material previously published or written, nor material that has been accepted for the award of any other degree or diploma, except where due acknowledge has been made in the text.
Background: Previous neurocognitive assessments in non-central nervous system cancers highlight t... more Background: Previous neurocognitive assessments in non-central nervous system cancers highlight the high incidence of neurocognitive dysfunction in this study population. However, there have been few studies exploring neurocognitive dysfunction induced by chemotherapy in gynecological cancer patients. This prospective longitudinal study was conducted to assess neurocognitive functioning and functional brain networks in Chinese gynecological cancer patients pre-and post-chemotherapy, while additionally including age-matched healthy subjects as the control group. Methods: All research participants were evaluated using a resting-state functional magnetic resonance imaging and neurocognition assessment. Behavioral data were conducted using SPSS for descriptive statistics, correlation and comparison analyses. Preprocessing of MRI (Magnetic Resonance Imaging) data and network analyses were performed using GRETNA (Graph Theoretical Network Analysis). Results: A total of 40 subjects joined this study, with 20 subjects in each group. With the exception of the mean of psychomotor speed, there was no significant difference pre-chemotherapy between patients and healthy controls in neurocognitive test mean scores (Ps > 0.05). During the post-chemotherapy assessment, there were significant differences in the mean scores of neurocognitive tests (including Digit Span tests, verbal memory, immediate recall, delayed recall, and information processing speed tests) (all Ps < 0 .05). Longitudinal graph analysis revealed statistically significant differences in the patient group, with significant decreases in both local efficiency (P < 0.01) and global efficiency (P = 0.04). Lower raw TMT-A scores were significantly associated with lower local efficiency (r = 0.37, P = 0.03). Lower verbal memory scores were statistically significant and associated with lower global efficiency (r = 0.54, P = 0.02) in the patient group, but not in the healthy control group. Conclusions: This study found that the risk of brain function and neurocognitive changes following chemotherapy could potentially guide patients in making appropriate treatment decisions, and this study may identify a cohort that could be suited for study of an intervention.
Sexuality has been recognized as an integral aspect of quality of life. Issues surrounding sexual... more Sexuality has been recognized as an integral aspect of quality of life. Issues surrounding sexuality have also been acknowledged to have a great impact on the quality of life of gynecologic cancer patients. The objectives of this study were to describe sexual function and sexual activity among Chinese women after gynecologic cancer and to identify significant predicting factors of women&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s sexuality outcome changes. This is a descriptive correlational study that was performed in mainland China. A sexuality scale was used to assess women&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s sexuality outcomes. A total of 156 Chinese women who had gynecologic cancer were included in this study. Study results revealed that sexual dysfunction was an important concern among these women (62.2%). The rate of sexual inactivity (70.5%) was relatively high. Reasons for sexual inactivity were related to worry about possibly weakening the potency of treatment (46.5%), fear of cancer recurrence (41.1%), and lack of sexual interest (31%). When looking at predictors of negative changes of women&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s sexuality after cancer, this study found that older age (&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;50 years old) was associated with the decrease of sexual desire/interest (odds ratio, 3.64; confidence interval, 1.19-11.16). Women who received radiation therapy had more severe vaginal dryness (odds ratio, 2.27; confidence interval, 1.10-4.72) and were less sexually active than those who did not have radiation therapy. Chinese women after gynecologic cancer suffered from various sexuality concerns. Considering the high rates of sexual dysfunction and sexual inactivity, there is a need to integrate sexuality into routine nursing care.
Background: Women with cervical cancer now have relatively good 5-year survival rates. Better sur... more Background: Women with cervical cancer now have relatively good 5-year survival rates. Better survival rates have driven the paradigm in cancer care from a medical illness model to a wellness model, which is concerned with the quality of womenLs lives as well ...
The aim of this review was to identify the specific work-related stressors of mainland Chinese nu... more The aim of this review was to identify the specific work-related stressors of mainland Chinese nurses and to present the current state of stress research in order to discuss directions for further research. A literature search from January 2000 to June 2007 was conducted among three electronic databases. The specific stressors among Chinese nurses were effort-reward imbalance, the poor image of nursing in the community, and managerial issues. The studies were limited to either descriptive or correlation designs, a variety of stress scales were used to investigate the nurses&#39; work-related stressors, and there were no published studies reporting stress management interventions for Chinese nurses. This review highlights that further stress research targeted to Chinese nurses needs more prospective and longitudinal studies and has to develop a consistent instrument to measure stressors. The priority issue is the initiation of stress management interventions to improve nurses&#39; coping skills, while the long-term goal is to reduce the level of stress or eliminate the stressors through individual, organizational, and societal interventions.
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