Intervention Of Computerized Cognitive Behavioral Therapy On Perioperative Psychosomatic Symptoms In Patients With Gastric Cancer

Objective:(1)To construct a computerized cognitive-behavioral intervention scheme for perioperative psychosomatic symptoms in patients with gastric cancer.(2)To apply and evaluate the effect of computerized cognitive behavioral therapy on perioperative psychosomatic symptoms in patients with gastric cancer,and to provide reference and basis for clinical nursing practice of patients with gastric cancer.(3)To deeply understand the experience and feeling of gastric cancer patients receiving computerized cognitive behavioral intervention,and to provide theoretical basis for the promotion and improvement of computerized cognitive behavioral intervention program in the later period.Methods:(1)Scheme construction: Based on literature search and clinical investigation results,a computerized cognitive behavioral intervention scheme for perioperative psychosomatic symptoms of patients with gastric cancer was developed.Convene an expert meeting to further revise the intervention program.(2)Intervention study: Convenience sampling method was used to select 76 gastric cancer patients who were going to undergo surgery in the gastrointestinal surgery department of a Grade-III hospital in Shanxi Province from September 2021 to May 2022 as the research objects.According to the admission time,the patients were divided into control group and experimental group,with 38 cases in each group.The control group was given routine nursing,and the experimental group was given psychosomatic intervention program of computerized cognitive behavioral therapy on the basis of routine nursing.The Self-rating Anxiety Scale(SAS),Self-rating Depression Scale(SDS)and Athens Insomnia Scale(AIS)were used to compare the anxiety,depression and sleep status of the two groups before and after the intervention.Visual analogue scale(VAS)was used to compare the pain degree of the two groups at different time points after surgery,and to compare the postoperative recovery of the two groups.(3)Qualitative research: Objective sampling method was adopted to select 10 gastric cancer patients receiving computerized cognitive behavioral therapy and conduct semi-structured interviews on them.Colaizzi’s 7-step analysis was used to analyze the data,and the interview data were coded,analyzed and themes were extracted.Results:(1)Scheme construction: A total of 9 experts were invited to attend the expert meeting,and the authority coefficient was 0.883.The research team summarized the expert opinions and made full reference to form the final intervention plan.The intervention plan included 10 themes,including disease knowledge,psychological preparation,surgical introduction,sleep management,pain management,sports rehabilitation,nutrition management,others,negative emotion management,and discharge guidance.The intervention was carried out in 5 stages around the entire perioperative period,each stage consisted of cognitive therapy,cognitive consolidation and behavioral therapy,and each intervention lasted 20-30 minutes.(2)The results of the intervention study showed that:(1)There was no significant difference in the general data(gender,age,surgical method)between the two groups(P>0.05).(2)Before intervention,there was no significant difference in anxiety,depression and sleep scores between the two groups(P>0.05).(3)After intervention,anxiety,depression and sleep scores of experimental group were lower than those of control group,and the difference was statistically significant(P<0.05).(4)At different time points after surgery,the pain score of experimental group was lower than that of control group,the difference was statistically significant(P<0.05).(5)The first time to get out of bed,the first time to exhaust gas and the postoperative hospitalization days of experimental group were shorter than those of control group,and the difference was statistically significant(P<0.05).(3)The qualitative research results showed that: a total of 10 interviewees were included in the study,and 3 topics and 7 sub-topics were summarized and extracted.The subjects were patients’ attitude,evaluation of feelings and self-experience towards computerized cognitive behavioral intervention.The corresponding subthemes were active participation and negative treatment;The content is practical and the form is effective;Improvement of psychosomatic symptoms,cognitive changes,behavioral changes.Computerized cognitive behavioral therapy is convenient and effective,but medical staff should fully evaluate patients when developing computerized cognitive behavioral intervention programs to meet patients’ individual and diverse needs.At the same time,a remote cognitive behavioral therapy platform is established to achieve continuing care.Conclusion:Computerized cognitive behavioral therapy can improve perioperative psychosomatic symptoms such as anxiety,depression,postoperative pain and sleep disorders in patients with gastric cancer,shorten postoperative hospital stay and accelerate postoperative recovery process.The program is worthy of clinical application and promotion.