Department of Mental Health and Psychiatric Nursing, School of Nursing and Midwifery, Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran.
Department of Mental Health and Psychiatric Nursing, School of Nursing and Midwifery, Community-Based Psychiatric Care Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
JMIR Mhealth Uhealth. 2021 May 18;9(5):e19262. doi: 10.2196/19262.
Psychoeducation has turned into an effective tool in taking care of cancer patients and improving their psychophysical symptoms and quality of life. Despite the growing use of mobile phone apps in medical settings for improving health, evidence supporting their effectiveness in the psychoeducation of patients with breast cancer is rarely available.
This study was conducted to investigate the effect of psychoeducational interventions on anxiety and self-esteem in women with breast cancer using a mobile app and an online support group.
An unblinded randomized controlled trial based on mobile phones was conducted in Shiraz, Iran. A research assistant recruited 82 women with nonmetastatic breast cancer aged 20 to 60 years were from clinics during a face-to-face visit at the point of care and randomly assigned to an intervention group (n=41) and a wait-list control group (n=41) through blocked randomization. The intervention group received psychoeducational interventions through a mobile phone app and participated in nurse-assisted online mobile support sessions for a total four weeks, whereas the control group was put on a waiting list. The State-Trait Anxiety Inventory (STAI) and the Rosenberg Self-Esteem Scale (RSES) were used to measure the levels of anxiety and self-esteem as the main outcomes at baseline and one week after the intervention.
A total of 82 patients with a mean age of 46.45 (SD 9.29) years recruited in Winter 2016 were randomly assigned to a wait-list control group (n=41) and intervention group (n=41). Five patients dropped out for different reasons. Comparing the postintervention mean scores of anxiety and its subscales using the independent t test showed statistically significant differences between the mobile psychoeducation group and controls (P<.001). The paired t test used to compare the postintervention mean scores of anxiety with its preintervention scores in the intervention group showed significant reductions in the scores of anxiety (95% CI -17.44 to -8.90, P<.001, d=1.02) and its two subscales (state anxiety: 95% CI -9.20 to -4.21, P<.001, d=0.88 and trait anxiety: 95% CI -8.50 to -4.12, P<.001, d=0.94). Comparing the postintervention mean scores of self-esteem showed statistically insignificant differences between the control and intervention groups (16.87 vs 17.97, P=.24). In contrast with the controls, using the paired t test showed that the increase in the postintervention mean scores of self-esteem were statistically significant in the intervention group compared with the preintervention scores (mean difference 2.05, 95% CI 1.28 to 2.82, P<.001).
This study demonstrated the key role of mobile apps in decreasing anxiety and improving self-esteem in women with breast cancer through psychoeducational interventions. Similar studies with longer follow-ups are recommended that be conducted in this context.
Iranian Registry of Clinical Trials IRCT2015072123279N2; https://en.irct.ir/trial/19882.
心理教育已成为照顾癌症患者、改善其身心症状和生活质量的有效工具。尽管在医疗环境中越来越多地使用手机应用程序来改善健康状况，但很少有证据支持其在乳腺癌患者心理教育中的有效性。
本研究旨在通过手机应用程序和在线支持小组，调查心理教育干预对乳腺癌女性焦虑和自尊的影响。
这是一项基于手机的、无盲的随机对照试验，在伊朗设拉子进行。研究助理通过面对面就诊，在护理点招募了 82 名年龄在 20 岁至 60 岁之间、非转移性乳腺癌的女性，并通过分组随机化将其随机分配到干预组（n=41）和等待名单对照组（n=41）。干预组通过手机应用程序接受心理教育干预，并参加护士协助的在线移动支持会议，共四周；而对照组则在等待名单上。使用状态-特质焦虑量表（STAI）和罗森伯格自尊量表（RSES）作为主要结局指标，在基线和干预后一周测量焦虑和自尊水平。
2016 年冬季共招募了 82 名平均年龄为 46.45（SD 9.29）岁的患者，随机分配到等待名单对照组（n=41）和干预组（n=41）。由于各种原因，有 5 名患者退出。使用独立 t 检验比较干预后焦虑及其子量表的平均得分，发现移动心理教育组与对照组之间存在统计学显著差异（P<.001）。使用配对 t 检验比较干预后焦虑及其两个子量表的平均得分与干预前的得分，发现焦虑评分显著降低（95%CI-17.44 至-8.90，P<.001，d=1.02），且两个子量表的评分也显著降低（状态焦虑：95%CI-9.20 至-4.21，P<.001，d=0.88；特质焦虑：95%CI-8.50 至-4.12，P<.001，d=0.94）。比较对照组和干预组的自尊后测平均得分，差异无统计学意义（16.87 与 17.97，P=.24）。与对照组相比，使用配对 t 检验显示，干预组干预后自尊的后测平均得分较干预前显著增加（平均差值 2.05，95%CI 1.28 至 2.82，P<.001）。
本研究表明，手机应用程序在通过心理教育干预降低乳腺癌女性焦虑和提高自尊方面发挥着关键作用。建议在这方面进行类似的、随访时间更长的研究。
伊朗临床试验注册中心 IRCT2015072123279N2；https://en.irct.ir/trial/19882.
