Department of General Surgery, The Second Affiliated Hospital of Harbin Medical University, Harbin, China.
Ir J Med Sci. 2023 Aug;192(4):1637-1644. doi: 10.1007/s11845-023-03405-7. Epub 2023 May 29.
Cognitive behavioral stress management (CBSM) is a psychotherapy helping individuals develop adaptive behaviors, whose application in colorectal cancer (CRC) is rare. This randomized, controlled study intended to explore the effect of CBSM on anxiety, depression, and quality of life in CRC patients post tumor resection.
One hundred and sixty CRC patients who received tumor resection were randomized (1:1) to receive weekly CBSM or usual care (UC) for 10 weeks after discharge (120 min for each session). Hospital Anxiety and Depression Scale (HADS) and Quality of Life Questionnaire-Core 30 (QLQ-C30) of each patient were assessed after randomization (M0), one month (M1), three months (M3), and six months (M6).
CBSM realized decreased HADS-anxiety scores at M1 (P = 0.044), M3 (P = 0.020), M6 (P = 0.003) compared to UC, so did anxiety rates at M3 (28.0% vs. 43.6%, P = 0.045), M6 (25.7% vs. 42.5%, P = 0.035), HADS-depression scores at M3 (P = 0.017), M6 (P = 0.005), and depression rates at M3 (25.3% vs. 41.0%, P = 0.040), M6 (22.9% vs. 41.1%, P = 0.020). Concerning the quality of life, CBSM achieved elevated QLQ-C30 global health status scores at M6 (P = 0.008), QLQ-C30 functions scores at M3 (P = 0.047), M6 (P = 0.031), and decreased QLQ-C30 symptoms scores at M3 (P = 0.048) and M6 (P = 0.039) compared with UC. By subgroup analyses, CBSM had a better utility on relieving anxiety, depression and improving quality of life in patients with higher education level and patients receiving adjuvant chemotherapy.
CBSM program alleviates anxiety, depression, and elevates quality of life in CRC patients post tumor resection.
认知行为应激管理（CBSM）是一种帮助个体发展适应性行为的心理治疗方法，其在结直肠癌（CRC）中的应用较为少见。本随机对照研究旨在探讨 CBSM 对结直肠癌患者肿瘤切除术后焦虑、抑郁和生活质量的影响。
160 例接受肿瘤切除术的 CRC 患者按 1:1 随机分为 CBSM 组（每周接受 120 分钟 CBSM，共 10 周）和常规护理（UC）组。在随机分组后（M0）、1 个月（M1）、3 个月（M3）和 6 个月（M6）时，采用医院焦虑抑郁量表（HADS）和生活质量问卷核心 30 项（QLQ-C30）评估每位患者的情况。
与 UC 组相比，CBSM 组在 M1（P=0.044）、M3（P=0.020）和 M6（P=0.003）时 HADS 焦虑评分降低，M3（28.0%比 43.6%，P=0.045）和 M6（25.7%比 42.5%，P=0.035）时焦虑发生率降低，M3（P=0.017）和 M6（P=0.005）时 HADS 抑郁评分降低，M3（25.3%比 41.0%，P=0.040）和 M6（22.9%比 41.1%，P=0.020）时抑郁发生率降低。在生活质量方面，CBSM 组在 M6 时 QLQ-C30 总体健康状况评分升高（P=0.008），在 M3（P=0.047）和 M6（P=0.031）时 QLQ-C30 功能评分升高，在 M3（P=0.048）和 M6（P=0.039）时 QLQ-C30 症状评分降低，与 UC 组相比。亚组分析显示，CBSM 对教育程度较高和接受辅助化疗的患者缓解焦虑、抑郁和改善生活质量的效果更好。
CBSM 方案可减轻结直肠癌患者肿瘤切除术后的焦虑、抑郁，提高生活质量。
