| Objective: The study included cervical cancer patients as the research sample to evaluate the quality of life level of cervical cancer patients and explore the impact of fatigue and psychological consistency on quality of life,and then verifie the intermediary role of psychological consistency between fatigue and quality of life.Meta analysis was used to explore whether positive psychological intervention measures will have a positive impact on the psychological state and quality of life of cervical cancer patients,so as to guide clinical practice and future psychological intervention research.Mindfulness intervention was used to improve the quality of life and psychological state of patients with cervical cancer and promote the mental health of patients with cervical cancer.It was of great significance to determine the applicability and effectiveness of positive psychological measures for patients with cervical cancer.Methods: Firstly,310 patients recruited by Shengjing Hospital Affiliated to China Medical University and Liaoning Cancer Hospital&Institute from January 2016 to October 2020 were selected as the research objects to fill in the questionnaire face-to-face.284 valid questionnaires were collected,and the effective recovery rate was 91.6%.The baseline questionnaire and self-administered questionnaire were used to collect the general situation and psycho-social indicators of patients.The questionnaires included the cancer fatigue scale(CFS),the psychological coherence scale(SOC-13)and the quality of life scale(FACT-G).SPSS 22.0 was used for statistical analysis.ANOVA and t-test were used for univariate analysis,Pearson correlation was used for correlation analysis,logistic regression was used for multivariate analysis,and progressive resampling method was used for mediating effect analysis.The quantitative review part of this study adopted the meta-analysis method and the retrieval strategy of combining subject words and free words.The databases of Pub Med,EMBASE and psycinpo databases were covered and the deadline was July 2020.Review Manager 5.4 was used to synthesize data and analyze the final results.Mindfulness decompression was used to implement mobile medical mindfulness intervention for 8 weeks from December 2020 to July 2021 after one week of operation.55 cervical cancer patients were included in the intervention group and the control group respectively.They were followed up 8 weeks after the first questionnaire survey.A total of 86 people completed the second questionnaire survey,with a follow-up rate of 78.2%.The follow-up rate was consistent with the sample rate calculation setting of this study.Finally,the total number of samples included in the analysis of variables in T1 stage was 110,and the total number of samples included in the analysis of the effect of positive psychological intervention in T2 stage was 86,including 51 in the intervention group and 35 in the control group.The observation indexes were collected by the quality of life scale(Fact-Cx),the center for flow regulation Depression Rating Scale(CES-D)and the self rating Anxiety Scale(SAS).The data were entered and statistically analyzed by SPSS 22.0.The mean and standard deviation were used to statistically describe the data;the paired sample t-test was used to compare the changes of variables in the group before and after the intervention.Results: The cross-sectional results of the first part showed that the fatigue of cervical cancer patients was negatively correlated with the quality of life and the four dimensions of quality of life(physiological status,social / family status,emotional status and functional status)(P<0.01).Psychological consistency was positively correlated with quality of life and the four dimensions of quality of life(physiological status,social / family status,emotional status and functional status)(P<0.01).There was a negative correlation between fatigue and psychological consistency(P<0.01).Fatigue was an important factor affecting the quality of life of patients with cervical cancer(?=-0.592,P<0.01),accounting for 31.7% of the total variation.After adding the sense of psychological consistency,an additional 12.0% of the variation was added to the sense of fatigue(?=-0.361,P<0.01),sense of psychological consistency(?=0.420,P<0.01)had a significant effect on the quality of life of patients with cervical cancer.At the same time,the regression coefficient of fatigue decreased from-0.592 to-0.361,which was statistically significant,indicating that psychological consistency may play a partial intermediary role between fatigue and quality of life.The mediating effect of psychological consistency between fatigue and quality of life was-0.581(95% CI [-0.813,-0.368]),indicating that psychological consistency played a partial mediating role between fatigue and quality of life.Fatigue was an important factor affecting the physiological status of quality of life in patients with cervical cancer(?=-0.568,P<0.01),accounting for 31.0% of the total variation.After adding the sense of psychological consistency,an additional 3.0% of the variation was added to reduce the sense of fatigue(?=-0.454,P<0.01),sense of psychological consistency(?=0.210,P<0.01)had a significant effect on the dimension of physiological status of quality of life in patients with cervical cancer.At the same time,the regression coefficient of fatigue decreased from-0.568 to-0.454,which was statistically significant,indicating that psychological consistency may play a partial intermediary role between fatigue and the physiological status of quality of life.The mediating effect of psychological consistency between fatigue and physiological status of quality of life in cancer patients was-0.123,95% CI(-0.198,-0.057),indicating that psychological consistency had some mediating effect between fatigue and physiological status of quality of life.Fatigue was an important factor affecting the quality of life and social / family status of cervical cancer patients(?=-0.183,P<0.01),accounting for 3.0% of the total variation.After adding the sense of psychological consistency,the amount of variation increased by 8.3%(?=0.349,P<0.01),and had a significant impact on the dimension of social / family status of quality of life in patients with cervical cancer.At the same time,the regression coefficient of fatigue decreased from-0.183 to-0.014,and there was no statistical significance,which preliminarily showed that psychological consistency may play a complete intermediary role between fatigue and the dimension of social / family status of quality of life.Fatigue was an important factor affecting the emotional dimension of quality of life in patients with cervical cancer(?=-0.484,P<0.01),accounting for 22.6% of the total variation.After adding the sense of psychological consistency,an additional 2.4% of the variation was added to the sense of fatigue(?=-0.383,P<0.01),sense of psychological consistency(?= 0.188,P<0.01)had a significant effect on the emotional dimension of quality of life in patients with cervical cancer.At the same time,the regression coefficient of fatigue decreased from-0.484 to-0.383,which was statistically significant,indicating that psychological consistency may play a partial intermediary role between fatigue and emotional status of quality of life.The mediating effect of psychological consistency between fatigue and quality of life emotional status was-0.081,95% CI(-0.146,-0.017),indicating that psychological consistency played a partial mediating role between fatigue and quality of life emotional status.Fatigue was an important factor affecting the quality of life and functional status of cervical cancer patients(?=-0.279,P<0.01),accounting for 7.0% of the total variation.After adding the sense of psychological consistency,an additional 8.0% variation was added to improve the sense of psychological consistency(?=0.343,P<0.01),and had a significant effect on the dimension of quality of life and functional status of cervical cancer patients.At the same time,the regression coefficient of fatigue decreased from-0.279 to-0.090,and there was no statistical significance,which preliminarily showed that psychological consistency may play a complete intermediary role between fatigue and the functional status of quality of life.The mediating effect of psychological consistency between fatigue and quality of life functional status was-0.221,95% CI(-0.320,-0.133),and the value of c' effect was not significant(P>0.05),indicating that psychological consistency played a complete mediating role between fatigue and quality of life functional status.In the second part,the results of meta-analysis showed that through the retrieval of three main databases(Pub Med,EMBASE,and Psych INFO),the effects of systematic psychological intervention on anxiety,depression and stress of gynecological cancer patients were evaluated.After relevant psychological intervention,the patients' anxiety and depression were significantly improved,but there was no significant change in stress.Due to the high heterogeneity of the analysis results,subgroup analysis was carried out according to race,sample size,intervention time and disease type.The results showed that there was no significant difference between subgroups.In addition,the funnel diagram of the three effect quantities suggests that there was a large publication bias in the study.The results of mindfulness decompression psychological intervention in the third part showed that the researchers were randomly divided into observation group and control group.In T1(before intervention),there was no significant difference between the two groups in physiological status,social / family status,emotional status,functional status,additional attention and total score of quality of life(P>0.05).At T2(post intervention)stage,the physiological status dimension and total score of quality of life in the observation group were higher than those in the control group,and the improvement effect of the observation group was significantly better than that of the control group(P<0.05).There was no significant difference in depression and anxiety scores between the two groups before intervention(P>0.05).After 8 weeks of intervention,the depression scores of the two groups were significantly improved compared with those before the intervention.The improvement effect of the observation group was significantly better than that of the control group(P<0.05).Conclusion: In cervical cancer patients,fatigue and psychological consistency are the influencing factors of quality of life.At the same time,psychological consistency plays an intermediary role between fatigue and quality of life.Meta analysis showed that psychological intervention measures had a positive impact on the mental health and quality of life of gynecological cancer patients,and also had a certain inhibitory effect on negative emotions.Mindfulness intervention research shows that 8-week group intervention has a positive impact on the quality of life of cervical cancer patients,and can effectively improve the level of depression. |
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