Department of Medical Psychology, The Second Affiliated Hospital of Army Medical University, Chongqing 400037, China.
Department of Thoracic Surgery, The Second Affiliated Hospital of Army Medical University, Chongqing 400037, China.
Int J Nurs Stud. 2023 Oct;146:104566. doi: 10.1016/j.ijnurstu.2023.104566. Epub 2023 Jul 22.
Psychological distress is a multi-factorial unpleasant experience of a psychological, social, spiritual, and/or physical nature that may interfere with one's ability to cope effectively with cancer, physical symptoms and treatment. Psychological distress is common and affects the prognosis of cancer patients. Lung cancer accounted for 11.4 % of all new cancer cases and 18 % of all cancer mortality for 36 cancers in 185 countries. The prevalence of distress among Chinese lung cancer patients ranged from 10.1 % to 61.29 %. However, the existing intervention studies on the psychological distress in lung cancer patients are limited and intervention results may be different.
To explore the psychological outcomes of a nurse-led systematic intervention program based on the stress-induced situation, affective, bodily, and cognitive reactions framework for patients with lung cancer undergoing operation at anxiety and depression.
A randomized clinical trial.
Thoracic surgery ward in a tertiary hospital in China.
Lung cancer patients undergoing surgery.
This is a 12-month longitudinal randomized controlled study in a tertiary hospital in China. A total of 240 lung cancer patients were randomly divided into either the control group or the intervention group. The nurse-led systematic intervention contents include psychological education, intervention measures based on the stress-induced situation, affective, bodily, and cognitive reactions framework, issuance of daily lifestyle cards, and regular follow-ups. The Hospital Anxiety and Depression Scale, Functional Assessment of Chronic Illness Therapy-Fatigue Scale, and Satisfaction with Life Scale were used for the baseline assessment within 48 h upon admission. The same assessment was performed respectively at 1, 3, 6 and 12 months after the intervention started. The effects of the systematic interventions on depression, anxiety, fatigue, and life satisfaction were tested by a linear mixed effects model.
Overall time-by-group interaction effects were significantly different with regard to anxiety, depression, and fatigue after controlling for the covariates, while a significant time-by-group interaction effect was not found for life satisfaction. Changes for anxiety and depression scores at 6 and 12 months after initiation of the intervention were significantly greater in the intervention group compared with those in the control group (t = 3.046, p = 0.002, t = 3.190, p = 0.001; t = 3.735, p = 0.000, t = 2.979, p = 0.002), whereas scores for fatigue were significantly higher in the intervention group at 6 and 12 months (t = -3.096, p = 0.002, t = -2.784, p = 0.005).
The systematic intervention program based on the stress-induced situation, affective, bodily, and cognitive reactions framework may effectively relieve anxiety, depression, and fatigue in lung cancer patients undergoing surgery.
This study was registered on December 22, 2019 with the registration number ChiCTR1900028487, and the date of first recruitment was Jan 5, 2020.
心理困扰是一种多因素的不愉快体验，具有心理、社会、精神和/或身体性质，可能会干扰患者有效应对癌症、身体症状和治疗的能力。心理困扰很常见，会影响癌症患者的预后。肺癌在 185 个国家的 36 种癌症中占所有新癌症病例的 11.4%，占所有癌症死亡人数的 18%。中国肺癌患者的心理困扰发生率为 10.1%至 61.29%。然而，针对肺癌患者心理困扰的现有干预研究有限，干预结果可能有所不同。
基于压力诱导的情况、情感、身体和认知反应框架，探讨护士主导的系统干预方案对接受手术的肺癌患者焦虑和抑郁的心理结局。
随机临床试验。
中国一家三级医院的胸外科病房。
接受手术的肺癌患者。
这是一项在中国一家三级医院进行的为期 12 个月的纵向随机对照研究。共有 240 名肺癌患者被随机分为对照组或干预组。护士主导的系统干预内容包括心理教育、基于压力诱导的情况、情感、身体和认知反应框架的干预措施、发放日常生活方式卡和定期随访。入院后 48 小时内进行医院焦虑和抑郁量表、慢性疾病治疗-疲劳量表和生活满意度量表的基线评估。在干预开始后 1、3、6 和 12 个月分别进行了相同的评估。采用线性混合效应模型检验系统干预对抑郁、焦虑、疲劳和生活满意度的影响。
在控制了协变量后，整体时间-组交互效应在焦虑、抑郁和疲劳方面差异有统计学意义，而在生活满意度方面差异无统计学意义。干预 6 个月和 12 个月时，干预组的焦虑和抑郁评分变化明显大于对照组（t=3.046，p=0.002，t=3.190，p=0.001；t=3.735，p=0.000，t=2.979，p=0.002），而干预组在 6 个月和 12 个月时的疲劳评分明显较高（t=-3.096，p=0.002，t=-2.784，p=0.005）。
基于压力诱导的情况、情感、身体和认知反应框架的系统干预方案可能有效缓解接受手术的肺癌患者的焦虑、抑郁和疲劳。
本研究于 2019 年 12 月 22 日在中国临床试验注册中心注册，注册号为 ChiCTR1900028487，首次招募日期为 2020 年 1 月 5 日。
