Effects Of Synchronous Cognitive Therapy Of Family Members On Psychological Status And Characteristic Of Behavior Of Perioperative Patients With Cervical Cancer

Objective:(1) To investigate the psychological status and cognitive needs of perioperative patients with cervical cancer and their caregivers, and the patients’characteristic of behavior.(2) To take cognitive intervention on the patients and their family members on the basis of the theory of psychological stress structure of multifactor and cognitive therapy in perioperative period.(3) To evaluate the effect of intervention on psychological status and characteristic of behavior.Methods:This study was a randomized controlled trial. From November2011to March2012, we conducted an investigation of90pairs of patients and their family members to confirm the method of intervention. After revising the manual and assessment tools,108hospitalized cervical cancer patients from the gynecology department of the Tumor Hospital of Hunan Province were selected to be samples and randomly divided into three groups:the patient-family group, the patient group and the controlled group, each with36patients from July2012to March2013. In the perioperative period, the patient-family group was given synchronous cognitive therapy of family members, the patient group was given cognitive therapy of patients, and the control group was only given routine care. The outcome of anxiety, depression and C type behaviors were assessed before and after the intervention by Self-rating Anxiety Scale(SAS), Self-rating Depression Scale(SDS) and C type behaviors scale to evaluate the effect of intervention.Results:1. Results of pilot study:The standard score of SAS in perioperative patients of cervical cancer was30～70(average:50.15±7.99) and47.80%of the patients showed anxiety. The standard score of SDS was40～69(average:55.06±6.01) and80.00%of the patients showed depression. The standard score of SAS in family members of the patients was25～69(average:46.20±10.09) and33.30%of the family members showed anxiety. The standard score of SDS was29～71(average:52.51±7.77) and63.30%of the patients showed depression. And the anxiety and depression of both patients and their family members were positive correlated with each other (P<0.01).2. The baseline results of intervention part indicated that the average standard score of SAS in perioperative patients with cervical cancer was50.64±7.86and75%of the patients showed anxiety, and the average standard score of SDS in perioperative patients with cervical cancer is55.03±6.15and85.19%of the patients showed depression. The results multiple linear regression indicated that the predictors of anxiety and depression were age, ways of operation and C type behaviors. The occurrence of C type behaviors was obviously higher than the normal group (P<0.01).3. Data analysis after intervention(1) Psychological status:Repeated measures analysis of both SAS and SDS standard score showed that the main effect of time were significant (P<0.001), the main effect of intervention were not significant (P>0.05), and there were significant interactions between time and interaction (P<0.001). The multi-sample analysis in paired-data showed that the differences of among the three groups were significant as a whole (for SAS:F=73.120, P<0.001; for SDS:F=85.949, P<0.001) and LSD-t test indicated that the differences among two intervention groups and control group were significant (P<0.001).(2) Characteristic of behavior:Repeated measures analysis of9dimensions of C type behaviors scale indicated that the main effect of time were not significant (P>0.05), while that of intervention and interaction of time and intervention were significant (P<0.001). The multi-sample analysis in paired-data showed that the differences of among the three groups were significant as a whole (for Optimism dimension:F=7.162, P<0.001; for Social Support dimension:F=11.946, P<0.001) and LSD-t test indicated that the differences among two intervention groups and control group were significant (P<0.001).Conclusions:1. The anxiety and depression of both periopertive patients with cervical cancer and their family members were obvious and had positive relation with each other.2. The anxiety and depression of perioperative patients with cervical cancer were evident and age, ways of operation and C type behaviors were their predictors.3. The C type behaviors of the patients were conspicuous.4. Synchronous cognitive therapy of family members could improve psychological status of the patients and had positive effect on their characteristic of behaviors.