The Effect Of Self-help Mindfulness-based Intervention On The Quality Of Life Of Patients Undergoing Gastric Cancer Surgery

Objective:To explore the effect of self-help mindfulness intervention on the quality of life of patients undergoing gastric cancer surgery,and to provide measures and basis for improving the quality of life of patients undergoing gastric cancer surgery.Methods:This study was a clinical non randomized controlled trial.108 patients with gastric cancer who met the inclusion criteria were selected from two wards of a tertiary A-level hospital in Jinan,Shandong Province from January 2019 to October 2019.Routine nursing and discharge follow-up in the control group,in addition,the intervention group was given 8 weeks of self-help mindfulness intervention.General situation questionnaire,clinical disease data questionnaire,the European Organization for research and treatment of cancer quality of life questionnaire C30 Version3.0,self-rating anxiety scale and medical coping modes questionnaire were used for evaluation.The above scales were scored at baseline(T0),after intervention(T1)and 4 weeks after intervention(T2).Two independent samples t-test,χ2 test and two factor repeated test ANOVA were used in the comparation of the change trend of life quality with time in intervention group and control group.Result:1.In this study,100 cases of effective data were finally collected,including 70 males(70.0%)and 30 females(30.0%);the age distribution ranged from 30 to 77 years old,with an average of 53.37±10.30 years old.;the occupation is mainly farmers and workers,accounting for 51.0%;most families earn more than 5000 RMB every month,accounting for 75.0%;the payment is mainly medical insurance,accounting for 91.0%;the family relationship is good,accounting for 97%;A total of 70 patients(70.0%)had a course of disease within 6 months;51 patients(51.0%)had preoperative complications;the main operation mode was proximal subtotal gastrectomy,accounting for 63.0%,followed by proximal subtotal gastrectomy in 29 cases(29%);there were 5 cases of stage 1,33 cases of stage II,57 cases of stage III and 5 cases of stage Ⅳ in clinicopathological stage,accounting for 5.0%,33.0%,57.0%and 5.0%respectively;5 cases of high differentiation,40 cases of moderate differentiation and 55 cases of low differentiation accounted for 5.0%,40.0%and 55.0%respectively;postoperative complications occurred in 5 patients(5.0%)and in 95 patients(95.0%)without complications..There was no significant difference between the intervention group and the control group(P>0.05).2.There was no significant difference in quality of life,anxiety and medical coping style between intervention group and control group in baseline stage(TO)(P>0.05).3.Comparison of quality of life,anxiety and medical coping between intervention group and control group after intervention.(1)Quality of life:The effect of the intervention group in general health,most functional domains(physical function,role function,emotional function,social function)and some symptom domains(fatigue,nausea and vomiting,insomnia)was significantly improved than that of the control group.At T1 and T2,the general health,physical function,role function and emotional function scores of the intervention group were significantly higher than those of the control group(the score of intervention group at T1 56.83±1.20,77.60±17.83,68.33±14.38,76.67±8.91,the score of intervention group at T2 59.00±10.49,80.40±6.23,71.00±12.51,79.33±7.76;the score of control group at T1 51.33±10.70,72.93±9.37,61.67±15.15,69.33±8.15,the score of control group at T2 52.50±10.41,74.13±8.69,63.33±14.68,71.83±9.05),the difference is statistically significant(P<0.05).At T2,the increased extent of scores in physical function in the intervention group were significantly higher than those in the control group(intervention group score 69.67±13.34,contrlo group score 62.67±15.27),the difference was statistically significant(P<0.05).At T1 and T2,the scores of tiredness,nausea,vomiting and insomnia in the intervention group were significantly lower than those in the control group(the score of intervention group at T1 25.55±7.53,19.00±11.67,16.67±16.83,the score of intervention group at T222.89±8.52,18.67±11.49,16.67±16.83;the score of control group at T1 30.44±10.24,23.67±10.69,29.33±20.91,the score of control group at T2 29.11±10.26,24.33±10.22,26.67±20.20),the difference was statistically significant(P<0.05).(2)Anxiety:At T1 and T2,the decreased extent of anxiety score in the intervention group was significantly higher than that in the control group(the score of intervention group at T1 41.48±3.50,the score of intervention group at T241.04±3.53;the score of control group at T1 48.46±4.97,the score of control group at T2 48.22±4.77),the difference was statistically significant(P<0.05).(3)Medical Coping:At T1 and T2,the increased extent of the face score in intervention group was significantly higher than that in control group(the score of intervention group at T1 20.68±1.49,the score of intervention group at T220.94±1.48;the score of control group at T1 19.02±1.42,the score of control group at T2 19.12±1.47),the difference was statistically significant(P<0.05).At T1 and T2,the avoidance and yield scores of the intervention group were significantly lower than those of the control group(the score of intervention group at T1 13.44±1.757.82±1.08,the score of intervention group at T2 13.00±1.47 7.74±1.03;the score of control group at T1 14.70±1.71 8.40±1.50,the score of control group at T214.60±1.47 8.34±1.26),the difference was statistically significant(P<0.05).4.Quality of life,anxiety and medical coping were compared between intervention group and control group before and after intervention.With the continuation of time after intervention,many index of quality of life in the intervention group,including general health,physical function,role function,emotional function,cognitive function,social function,fatigue symptoms,shortness of breath symptoms,insomnia symptoms,loss of appetite symptoms(F=40.744,41.080,22.796,49.150,12.765,28.524,31.000,5.284,29.254,6.563),the scores of SAS(F=135.722)and medical coping style,including face,avoidance and yielding(F=15.353,68.448,30.782)were significantly better than those of baseline,and the difference was statistically significant(P<0.05);many index of quality of life in the control group,including general health,physical function,role function,emotional function,social function,fatigue symptoms,insomnia symptoms(F=12.153,17.005,6.112,19.508,5.617,10.305,5.851),SAS score(F=28.772)and medical coping style score,including avoidance and yield(F=4.001,4.233)were significantly better than those of baseline,and the difference was statistically significant(P<0.05).Conclusions:1.Self-help mindfulness-based intervention can significantly improve the quality of life,mainly in the general health status,physical function,role function,emotional function,social function,as well as fatigue,nausea and vomiting,insomnia symptoms,and the effect can still be maintained four weeks after the end of the intervention,which can provide theoretical and practical basis for future research.2.Self-help mindfulness-based intervention can significantly alleviate the anxiety of patients with gastric cancer surgery and improve the medical coping style.