| Objective : To explore the impact on the process of psychological distress, anxiety, depression status and quality of life in cancer patients during chemotherapy cycles by the combination of individual and group psychological intervention.Method: Using controlled experimental design, 128 patients with cancer were divided into intervention group and control group with 64 cases in each group. They signed the consent contract, received interviews, registered basic information at admission from January 2014 to December 2014. All data were collected by the trained and qualified nurse counselors.Patients in psychological intervention group accept individual and group psychological intervention during chemotherapy cycles. Individualized psychological intervention model included cognitive behavioral intervention, listening, meditation, relaxation training, exercise and diet strategies.In the first cycle of chemotherapy, patients received individualized 10 times psychological intervention. Individual psychological intervention was started on the first day of chemotherapy by the psychological intervention nurse, 40 ~ 50 minutes every time, totally 5 days. Patients were urged to do self-training homework in other days, 20~30 minutes every time, once a day. Individual psychol- ogical intervention pattern was repeated in the second cycle of chemotherapy. Group psychological intervention was began in the first week of chemothe- rapy, lasting for 8 weeks, 50 ~ 60 minutes every time, Once a week for one theme. There were 8 main theme activities. Each group psychological interven ion group consists of 8 to 10 individuals, 2 of them were the psychology- cal intervention nuresek, others were malignant tumor patients. Patients in the control group were only informed with basic chemotherapy knowledge and conventional care without any of psychological intervention the study period.Investigations were conducted in patients of the two groups using questionnaires, applications psychological distress thermometer(DT), Self-Rating Anxiety Scale(SAS), Self-Rating Depression Scale(SDS), the core quality of life questionnaire(QLQ-C30). General survey were scored at baseline and after two cycles of conventional treatment. The questionnaire and scoring were carried out for psychological intervention group on the day after interview and 8 weeks after the comprehensive psychological intervention, while for control group, on the first day of admission and the day after 2 cycles chemotherapy(eighth weeks). Interview nurses would teach patients to fill out the questionnaire and score.Result:1 Comparison of general information between the two groups before intervention: based on a voluntary, 128 patients met the inclusion criteria, joined psychological intervention group and control group. There were 64 cases in the control group f, including 27 male, 37 female, mean age 51.83 ± 8.89; 25 patients with lung cancer, 13 cases of breast cancer, colorectal cancer seven cases, the other 19 cases. The intervention group also had 64 patients, including 25 male, female 39, mean age 50.38 ± 9.31; 20 patients with lung cancer, 24 cases of breast cancer, colorectal cancer eight cases, the other 12 cases. There was no significant difference between the two groups on gender, age, disease type, disease stage, educational level, economic status, alcohol consumption and smoking history T(P> 0.05). The difference on payment manners was statistically significant(X2 = 7.90, P = 0,02). Six cases in control group and two cases of psychological intervention group were excluded by re-evaluation in the 8th week.2 Comparison of psychological problems between the two groups before the intervention: Psychological distress thermometer(DT): DT mean was 3.61 ± 2.00 in control group, 3.91 ± 2.37 in intervention group(t =-0.07, P = 0.45), there was no significant difference between the two groups; Depression: the mean was 45.96 ± 11.71 in the control group, 49.10 ± 14.40 in the intervention group(t =-1.36, P = 0.18) The difference was not significant; Anxiety: the mean was 41.04 ± 9.92 in the control group, 44.04 ± 11.06 in the intervention group(t=-1.62, P = 0.11), there was no difference between the two groups. Quality of life: it showed no significant difference in the core scale between the intervention group and the control group(QLQ-C30) within all of the 14 fields.3 Comparison within the control group before and after the health education intervention: DT(t =2.89, P = 0.005), depression(t=2.32,P= 0.022), anxiety(t =2.89, P =0.005), the differences were statistically significant, the core quality of life scale(QLQ-C30) pain(Z=-1.743, P=0.081), shortness of breath(Z=-2.676, P=0.007), diarrhea(Z=-2.064, P=0.039), there was significant difference.4 Comparison within the intervention group before and after the comprehensive psychological intervention: DT(t=4.08, P = 0.000), depression(t = 4.98, P=0.000), anxiety(t= 5.36, P=0.000), the difference was statistically significant. Core Quality of Life Scale(QLQ-C30) in role function(Z=-3.819, P = 0.000), cognitive function(Z =-2.357, P = 0.018), fatigue(Z=-2.438, P = 0.015), pain(Z=-2.066, P=0.039), appetite loss(Z=-2.171, P=0.030).5 Comparison of the means in the intervention groups and control groups before and after the intervention: In the control groups, DT difference-0.53 ± 1.14, In the intervention groups-1.26±2.43(t=2.06, P=0.041); the difference between SDS-3.02±8.29,-7.03±11.55(t=2.32, P=0.022);former SAS difference-2.87±6.49, In the intervention groups-5.91±8.67(t= 2.16, P= 0.033), the two groups at heart pain, anxiety, depression, before and after the intervention significantly different. Core Quality of Life Scale(QLQ-C30), and cognitive function before the intervention-2.30±20.65, after the intervention 5.65 ± 17.06(Z=-2.294, P=0.022), loss of appetite before intervention 6.90 ± 27.04, after the intervention-8.07±28.75(Z=-2.880, P = 0.004), overall quality of life before the intervention 0.57 ± 17.30, 8.33±21.34 after intervention(Z=-2.534, P=0.011) in the intervention group increased the overall quality of life, there was significant difference. Scores in intervention group on physical function, role function, emotional function, social function, fatigue, pain, shortness of breath, insomnia, field of symptom score decreased, functional areas were rised, that most of the quality of life in intervention group had a rising tendency, reflecting in the overall life quality score. Raised scores on constipation, diarrhea, nausea and vomiting rose, were possibly related to chemotherapy.Conclusions:1 Psychological conditions in cancer patients after health education before chemotherapy and standardized chemotherapy could also be improved.2 Implementation of comprehensive psychological intervention had a significant positive effect on the general health status of quality of life during chemotherapy for patients with cancer. There was an upward trend in most areas.3 The improvement in intervention group by comprehensive psycholo- gical intervention on psychological distress, anxiety, depression and negative emotions, improve the overall quality of life was more significant than that in control group by simply implementing health education. |
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