The Application Of Emotional Expression Group Psychological Counseling For Ovarian Cancer Patients In Postoperative Chemotherapy Phase

Objective:This study aimed to analyze the Type C behavior pattern and its influence in ovarian cancer patients undergoing postoperative chemotherapy,and to explore an effective psychological intervention for these patients.Methods:1.From January to June 2019,questionnaire surveys and scale evaluations were conducted for ovarian cancer patients undergoing postoperative chemotherapy in the chemoradiotherapy ward of West China Second Hospital.The Type C behavior patterns was assessed using the Cancer Behavior Scale,while the emotion and quality of life were evaluated using the Self-Rating Depression Scale,Self-Rating Anxiety Scale,and Functional Assessment of Cancer Therapy-Ovarian Cancer.Data on the cancer antigen 125(CA125)and chemotherapy side effects were retrieved from medical records.The correlations among these factors were analyzed.2.From July to December 2019,newly admitted patients with ovarian cancer undergoing postoperative chemotherapy were randomly divided into three groups using a random number table.All groups underwent routine clinical treatment and health education.The emotional release group received emotional release group counseling(including two sessions each of painting and sandplay therapies),while the rational emotive group received rational emotive therapy group counseling over four sessions.Scales measurements were taken and clinical indicators were recorded.The differences of intervention outcomes were compared.3.From January to June 2020,newly admitted patients with ovarian cancer undergoing postoperative chemotherapy were randomly divided into two groups using a random number table.While undergoing routine clinical treatment,the painting group received four rounds of painting therapies and the sandplay group received four rounds of sandplay therapies.Scales measurements were taken and clinical indicators were recorded.The differences of intervention outcomes between the two groups were compared.Results:1.The scores of “anxiety” and “depression” on Cancer Behavior Scale were 42.07±7.63 and 42.71±8.56,while the scores of “anger”,“anger inward”,and“emotional control” were 24.00(22.00,27.00),15.00(14.00,18.00),and 18.00(16.00,22.00),which were significantly higher than those in the Chinese norms.The Spearman’s rank correlation coefficient of the “emotional control” score with respect to CA125 was 0.55,while that with regard to hematologic side effects of chemotherapy was 0.49;the “anger inward” score according to CA125 was 0.46,while that according to hematologic side effects of chemotherapy was 0.49.The first canonical correlation coefficient between the Cancer Behavior Scale scores and the Functional Assessment of Cancer Therapy-Ovarian Cancer scale scores was0.95.2.There was no significant change in the control group.In the emotional release group,Type C behavior(F=51.67,P<0.001 for “anger inward” item and F=144.26,P<0.001 for “control” item),depression(F=35.20,P<0.001),anxiety(F=30.45,P<0.001),cancer antigen 125(P=0.001)and hematologic system side effects(P=0.03)decreased,and quality of life was improved(F=18.61,P<0.001).In the rational emotive group,Type C behavior(F=3.27,P=0.03 for “anger inward” item and F=43.81,P<0.001 for “control” item)and anxiety(F=5.39,P=0.007)increased.3.The scores of “anger turned inward”(P=0.027)(after the third round of intervention)and the value of CA125(P=0.017)(after the second round of intervention)in the painting group were lower than those in the sandplay group;the hematologic system side effects of chemotherapy in the sandplay group were alleviated(P=0.011),while there was no significant change in the painting group(P=0.309).There were no other statistically significant differences between the two groups.Conclusion:1.The Type C behavior pattern is a very importat characteristic of ovarian cancer patients undergoing postoperative chemotherapy and has close correlations with patients’ psychosomatic status and quality of life.Thus,it should be a focus of psychological interventions in ovarian cancer patients.2.Emotional release group counseling can significantly improve the psychosomatic state and quality of life of patients with ovarian cancer undergoing postoperative chemotherapy.It is more effective than rational emotive therapy commonly used at present.