School of Nursing, University of South China, Hengyang, China.
People's Hospital of Longhua District, Shenzhen, China.
Eur J Cancer Care (Engl). 2019 Sep;28(5):e13120. doi: 10.1111/ecc.13120. Epub 2019 Jun 11.
A randomised controlled trial (RCT) was implemented to verify the feasibility and acceptability of cognitive education in the format of mind maps for increasing perceived control and decreasing the symptom distress of lung cancer patients who were receiving chemotherapy.
A total of 136 lung cancer patients who were receiving chemotherapy were randomised using stratified blocks (1:1 ratio, from March 2016 to April 2017). The intervention group was given cognitive education in the format of mind maps. The control group was provided conventional education. The primary outcomes were perceived control, including cancer experience and cancer efficacy; the secondary outcomes included symptom distress (arising from fatigue, distress, sleep disturbance, poor appetite, drowsiness, shortness of breath, etc.). The Mann-Whitney U test, chi-squared test, two-sample t test and repeated measurement analysis of variance were used.
Ninety-four patients completed the final study. The results of the repeated measurement analysis of variance indicated that at the 8th or 12th week following cognitive education intervention in the format of mind maps, the cancer experience, cancer efficacy (except personal efficacy) and symptom distress (arising from fatigue, distress, sleep disturbance, and sadness and its total scores) of the patients in the intervention group were considerably improved compared with those of the control group (p < 0.05). The longer the intervention was, the higher the level of the patients' perceived control was and the lower the degree of patient symptom distress was (p < 0.05).
Our findings suggest that cognitive education in the format of mind maps could improve perceived control and decrease the symptom distress of lung cancer patients who were receiving chemotherapy and that it was feasible and acceptable. Cognitive education in the format of mind maps was found to be an effective teaching tool for lung cancer patients who were receiving chemotherapy.
采用随机对照试验（RCT）验证以思维导图形式进行认知教育对提高正在接受化疗的肺癌患者的感知控制和减轻症状困扰的可行性和可接受性。
采用分层区组（1:1 比例）随机化方法，于 2016 年 3 月至 2017 年 4 月，将 136 例正在接受化疗的肺癌患者分为干预组（接受思维导图形式的认知教育）和对照组（接受常规教育）。主要结局指标为感知控制，包括癌症体验和癌症效能；次要结局指标包括症状困扰（疲劳、苦恼、睡眠障碍、食欲减退、嗜睡、呼吸急促等）。采用 Mann-Whitney U 检验、卡方检验、两样本 t 检验和重复测量方差分析。
94 例患者完成了最终研究。重复测量方差分析结果表明，在接受思维导图形式的认知教育干预 8 或 12 周后，干预组患者的癌症体验、癌症效能（个人效能除外）和症状困扰（疲劳、苦恼、睡眠障碍和悲伤及其总分）显著优于对照组（p<0.05）。干预时间越长，患者的感知控制水平越高，症状困扰程度越低（p<0.05）。
本研究表明，以思维导图形式进行认知教育可以提高正在接受化疗的肺癌患者的感知控制水平，减轻其症状困扰，具有可行性和可接受性。以思维导图形式进行认知教育是一种针对正在接受化疗的肺癌患者的有效教学工具。
