Rational Emotive Behavior Therapy For The Pain-Fatigue-Sleep Disturbance Symptom Cluster In Patients With Non-Small Cell Lung Cancer Treated With Chemotherapy

Objective:To describe the current situation of Pain-Fatigue-Sleep Disturbance Symptom Cluster and to evaluate the relationships between pain,fatigue and sleep disturbance in patients with lung cancer.To explore the Efficacy of Rational emotive behavior therapy in non-small cell lung cancer patients treated with chemotherapy.Method:This study was a clinical randomized controlled trial.A total of 74 patients who were hospitalized at the First Hospital of Jilin University from October 2015 to October 2016 were selected as subjects.The subjects were randomly divided into intervention group and control group by computer random method.The control group was given routine care.The intervention group received a rational emotive behavioral therapy additional during one chemotherapy cycle.Participants completed baseline measures(demographics,symptom inventory)and received cognitive reconstruction and relaxation exercises.Pain,fatigue and sleep quality was measured with the Chinese version Brief Pain Inventory,Chinese version Brief Fatigue Inventory and Pittsburgh Sleep Quality Scale,respectively.Following the one month intervention,participants completed a second symptom inventory and an evaluation of rational emotional behavior therapy.Results:1.Baseline results showed that 67 patients were enrolled.34 patients were randomized to the trial group and 33 patients were randomized to the trial group.Most participants reported mild levels of fatigue,pain and sleep disturbance.All patients might have had fatigue.88.1% and 67.2% patients might had have sleep disturbance and pain,respectively.Pain interfered predominantly with emotion and work.Fatigueinterfered predominantly with enjoy of life and work.Most participants reported moderate level of sleep quality,of which Daytime dysfunction and sleep efficiency has comparatively highest score.2.Correlation analysis showed that significant correlations among the three symptoms supported the existence of the symptom cluster.The correlation coefficient between pain and fatigue,sleep disturbance was 0.675 and 0.740,respectively.The correlation coefficient between fatigue and sleep disturbance was 0.754.Significant correlations among the interference of pain,interference of fatigue and PQSI.The correlation coefficient between interference of pain and interference of fatigue,PQSI was 0.585 and 0.452,respectively.The correlation coefficient between interference of fatigue and PQSI was 0.586.3.A repeated measures analysis of variance revealed statistically significant group-by-time effects for pain,fatigue and sleep disturbance(P<0.001).Pain severity scores at 1-week significant reductions compare to control group(P<0.05).Significant reductions in pain,fatigue,and sleep disturbance severity and symptom interference were found at 1-month compared with control group(P<0.05).Conclusion:1.The severity of Symptom in pain-fatigue-sleep disturbance symptoms was in amoderate level.2.The severity and symptom interference of Pain,fatigue,sleep disturbance has significantly positive correlation.3.Rational emotional behavior therapy can reduce the severity of suffering from fatigue,fatigue and sleep disturbance,alleviate the symptoms with the interference of life,and enhance the patient sleep quality in patients with lung cancer.