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基于微信的多模式心理教育干预对中国急性白血病患者心理健康和生活质量的影响:一项随机对照试验。

Effects of a WeChat-based multimodal psychoeducational intervention on psychological well-being and quality of life in acute leukaemia patients in China: a randomised controlled trial.

作者信息

Wang Ying, Yang Lei, Xu Wenkui, Wang Chunfeng, Chen Jingyi, Wu Yong, Hu Rong

机构信息

The School of Nursing, Fujian Province, Fujian Medical University, No.1 Xueyuan Road, Shangjie Town, Minhou County, Fuzhou City, 350108, China.

Department of Hematology, Fujian Medical University Union Hospital, Fujian Institute of Hematology, 29 Xinquan Road, Fuzhou, 350001, China.

出版信息

J Cancer Surviv. 2022 Dec;16(6):1461-1477. doi: 10.1007/s11764-021-01124-5. Epub 2021 Oct 27.

Abstract

PURPOSE

The treatment and side effects of chemotherapy for acute leukaemia (AL) may cause both physical and psychological symptoms in patients. This study evaluated the effects of a WeChat-based multimodal psychoeducational intervention (ICARE programme) on fatigue, distress, anxiety, depression, and quality of life (QoL) among adult AL patients.

METHODS

In total, 72 participants were randomly assigned either to an intervention or control group (n = 36), respectively, from two large tertiary hospitals in Fuzhou, China (from April to December 2019). Data were collected at baseline, post-intervention, and after a 4-week follow-up using the Brief Fatigue Inventory, Distress Thermometer, Hospital Anxiety and Depression Scale, and Functional Assessment of Cancer Therapy-leukaemia. Descriptive statistics was used to summarise the sociodemographic and clinical characteristics of the participants and a linear mixed model was used to analyse the score changes.

RESULTS

Between the two groups, there were statistically significant improvements in fatigue, distress, anxiety, depression, physical well-being, social/family well-being, emotional well-being, functional well-being (all p < 0.001), and leukaemia-specific subscale (p = 0.001). The difference over time was significant for leukaemia-specific subscale and fatigue, both (p < 0.001), anxiety (p = 0.001), and social/family well-being (p = 0.005). The interaction effects were significant for fatigue, distress, anxiety, physical well-being, social/family well-being, and emotional well-being, all (p < 0.001), depression (p = 0.019), leukaemia-specific subscale (p = 0.008), and total QoL score (p = 0.004).

CONCLUSION

WeChat-based multimodal psychoeducational intervention demonstrated a significant effect in reducing fatigue, distress, anxiety, depression, and QoL in AL patients. This ICARE programme contributed to continuing care to support AL patients.

IMPLICATIONS FOR CANCER SURVIVORS

The ICARE programme can improve the mental health and QoL of AL patients. The application of WeChat-based psychoeducational interventions have significant potential to benefit cancer patients due to their reach and can be an added value to routine care.

摘要

目的

急性白血病(AL)化疗的治疗及副作用可能给患者带来生理和心理症状。本研究评估了基于微信的多模式心理教育干预(ICARE项目)对成年AL患者疲劳、痛苦、焦虑、抑郁及生活质量(QoL)的影响。

方法

2019年4月至12月,从中国福州的两家大型三级医院共招募72名参与者,随机分为干预组和对照组(每组n = 36)。在基线、干预后及4周随访时,使用简明疲劳量表、痛苦温度计、医院焦虑抑郁量表及癌症治疗功能评估量表-白血病收集数据。采用描述性统计总结参与者的社会人口学和临床特征,并使用线性混合模型分析得分变化。

结果

两组在疲劳、痛苦、焦虑、抑郁、身体幸福感、社会/家庭幸福感、情绪幸福感、功能幸福感(均p < 0.001)及白血病特异性子量表(p = 0.001)方面均有统计学显著改善。白血病特异性子量表、疲劳、焦虑及社会/家庭幸福感随时间的差异均有统计学意义(均p < 0.001),焦虑(p = 0.001)及社会/家庭幸福感(p = 0.005)。疲劳、痛苦、焦虑、身体幸福感、社会/家庭幸福感、情绪幸福感(均p < 0.001)、抑郁(p = 0.019)、白血病特异性子量表(p = 0.008)及总生活质量得分(p = 0.004)的交互效应均有统计学意义。

结论

基于微信的多模式心理教育干预在减轻AL患者的疲劳、痛苦、焦虑、抑郁及改善生活质量方面显示出显著效果。该ICARE项目有助于为AL患者提供持续护理支持。

对癌症幸存者的启示

ICARE项目可改善AL患者的心理健康和生活质量。基于微信的心理教育干预因其覆盖面广,对癌症患者有益的潜力巨大,可为常规护理增添价值。

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