The Effects Of Cognitive Behavioral Intervention On The Illness Uncertainty, Coping Styles And Emotion Of Breast Cancer Patients Undergoing Chemotherapy

Objectives To measure the uncertainty in illness, coping style and emotion of breast cancer patients undergoing chemotherapy, to explore the effects of cognitive and behavioral intervention on the uncertainty in illness, coping styles and emotion of breast cancer patients undergoing chemotherapy to prove the effectiveness of cognitive and behavioral intervention through clinical practice.Methods This study was a randomized controlled trail of psychological intervention.88 patients with breast cancer in Xiangya hospital and Tumor Hospital of Hunan Provincial were selected to be samples. Convenient sampling and group matching were used,90 participants were divided into two groups.43 in the intervention group and 45 in the control group. Subjects in the intervention group were received cognitive behavioral intervention in addition to routine care in hospital. The intervention was implemented for 30-60 minutes every week for 12 weeks. Patients in control group were given routine care only. The outcome of uncertainty, coping styles and emotion were evaluated at 4 weeks and 12 weeks during the intervention, to analysis the effectiveness of cognitive behavioral intervention.Results (1) The level of uncertainty in illness in patients with breast cancer were 97.13±10.58, the patients with moderate uncertainty accounted for 96.6%.(2) The total uncertainty was significantly negative correlation to confrontive, supportant coping styles and positive correlation to fatalistic coping, anxiety, depression, anger, fatigue, confusion and TMD.(3) At 4 weeks, there was a significant decrease in scores of total uncertainty, "ambiguity" uncertainty, depression, angry, confusion and TMD (P<0.05) in comparison with baseline measures of the interventional group. There was a significant increase in scores of depression in comparison with baseline measures of the control group. There were significant differences between two groups in total uncertainty, "ambiguity" uncertainty, "unpredictability" uncertainty, "lack of information" uncertainty, anxiety, depression, anger, fatigue, confusion and TMD(P<0.05),but there were no statistically significant differences between both groups for the scores of eight kinds of coping styles(P>0.05).(4) At 12 weeks, in comparison with baseline measures of the interventional group, there was a significant decrease in scores of total uncertainty, "ambiguity" uncertainty, "unpredictability" uncertainty, "lack of information" uncertainty, the coping styles which including emotive, fatalistic, evasive, anxiety, and the emotion which including depression, anger, fatigue, confusion and TMD(P<0.05), while there were a significant increase in the score of palliative coping and suppotant coping. Compared with baseline measures of the control group, there was a significant increase in scores of depression, while there were no significant changes in other varieties(P>0.05). There were significant decrease in the scores of total uncertainty, every factor of uncertainty, the coping styles which including emotive coping, fatalistic coping, evasive coping, and the emotion which including anxiety, depression, anger, fatigue, confusion, TMD(P<0.05) compared to the control group, while a increase in the scores of optimistic coping and suppotant coping(P<0.05).Conclusion①Cognitive behavioral intervention could decrease the level of illness uncertainty of breast cancer patients undergoing chemotherapy.②After the intervention, interventional group patients tent to use more supportant and optimistic coping styles and less use of evasive, emotive and fatalistic coping styles, while control group patients tent to use more evasive coping style.③After the intervention, patients with anxiety, depression, fatigue, anger, confusion and the overall mood was clearly relieved.