一项从线下到线上的认知行为压力管理关爱计划能有效改善肝细胞癌术后患者的心理压力、精神健康和生活质量。
An offline to online cognitive behavioral stress management caring program effectively improves psychological pressure, spiritual well-being, and quality of life in postoperative hepatocellular carcinoma patients.
作者信息
Liu Yueping, Sun Meiling
机构信息
Department of General Surgery, The Second Affiliated Hospital of Harbin Medical University, Harbin, 150086, China.
Department of Nursing Care, The Second Affiliated Hospital of Harbin Medical University, Harbin, 150086, China.
出版信息
Clin Res Hepatol Gastroenterol. 2023 Oct;47(8):102195. doi: 10.1016/j.clinre.2023.102195. Epub 2023 Aug 9.
BACKGROUND
This study designed an offline to online cognitive behavioral stress management (OOCBSM) caring program, intending to investigate its effect on mental health and quality of life (QoL) using multiple scales in postoperative hepatocellular carcinoma (HCC) patients.
METHODS
254 postoperative HCC patients were randomly (1:1) allocated into OOCBSM (included a 10-week offline CBSM and subsequent online CBSM until M6) and normal care (NC) groups (10-week NC). Hospital anxiety-and-depression scale (HADS), Zung's self-reporting anxiety (SAS) and depression scale (SDS), FACIT-SP, European quality-of-life-5 dimensions (EQ-5D), and quality-of-life questionnaire-core30 (QLQ-C30) were assessed over 6 months (M).
RESULTS
HADS-defined-anxiety rates at M3 (P = 0.036) and M6 (P = 0.025), SAS-defined-anxiety rate at M6 (P = 0.049), HADS-defined-depression rates at M3 (P = 0.026) and M6 (P = 0.049), and SDS-defined-depression rates at M3 (P = 0.015) and M6 (P = 0.043) were all lower in OOCBSM group compared to NC group. Furthermore, FACIT-SP scores at M1 (P = 0.004), M3 (P = 0.003), and M6 (P<0.001) were higher in OOCBSM group compared with NC group. EQ-5D scores at M1 (P = 0.025) and M3 (P = 0.030) but not M6 (P = 0.128), and QLQ-C30-symptom score at M3 (P = 0.014) but not M1 (P = 0.198) and M6 (P = 0.058) were lower in OOCBSM group versus NC group; QLQ-C30-global-health-status scores at M3 (P = 0.027) and M6 (P = 0.001) but not M1 (P = 0.312), QLQ-C30-function scores at M3 (P = 0.005) and M6 (P = 0.001) but not M1 (P = 0.084) were higher in OOCBSM group versus NC group. Patients with younger ages or higher education benefited more from OOCBSM.
CONCLUSION
OOCBSM improves psychological pressure, spiritual well-being, and QoL in postoperative HCC patients, especially in those with younger ages or higher education.
背景
本研究设计了一种从线下到线上的认知行为压力管理（OOCBSM）关爱计划，旨在使用多种量表调查其对肝细胞癌（HCC）术后患者心理健康和生活质量（QoL）的影响。
方法
254例HCC术后患者被随机（1:1）分为OOCBSM组（包括为期10周的线下认知行为压力管理及随后直至M6的线上认知行为压力管理）和常规护理（NC）组（为期10周的常规护理）。在6个月（M）内评估医院焦虑抑郁量表（HADS）、zung氏自评焦虑量表（SAS）和抑郁量表（SDS）、功能性癌症治疗-精神健康量表（FACIT-SP）、欧洲五维健康量表（EQ-5D）以及生活质量问卷核心30项（QLQ-C30）。
结果
与NC组相比，OOCBSM组在M3（P = 0.036）和M6（P = 0.025）时HADS定义的焦虑率、M6时SAS定义 的焦虑率（P = 0.049）、M3（P = 0.026）和M6（P = 0.049）时HADS定义的抑郁率以及M3（P = 0.015）和M6（P = 0.043）时SDS定义的抑郁率均较低。此外，与NC组相比，OOCBSM组在M1（P = 0.004）、M3（P = 0.003）和M6（P<0.001）时的FACIT-SP评分更高。OOCBSM组在M1（P = 0.025）和M3（P = 0.030）时的EQ-5D评分低于NC组，但M6时（P = 0.128）并非如此；OOCBSM组在M3时（P = 0.014）的QLQ-C30症状评分低于NC组，但M1时（P = 0.198）和M6时（P = 0.058）并非如此；OOCBSM组在M3（P = 0.027）和M6（P = 0.001）时的QLQ-C30总体健康状况评分高于NC组，但M1时（P = 0.312）并非如此，OOCBSM组在M3（P = 0.005）和M6（P = 0.001）时的QLQ-C30功能评分高于NC组，但M1时（P = 0.084）并非如此。年龄较小或受教育程度较高的患者从OOCBSM中获益更多。
结论
OOCBSM可改善HCC术后患者的心理压力、精神健康和生活质量，尤其是年龄较小或受教育程度较高的患者。
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