Effects Of Mindfulness-based Stress Reduction Therapy On Self-perceived Burden And Sleep In Patients With Colorectal Cancer

Objective:To assess the self-perceived burden and sleep status of patients suffering from colorectal cancer.Based on the mindfulness-based stress reduction therapy,to establish intervention programs and measures to improve negative emotions in colorectal cancer patients;to explore the intervention effects of mindfulness-based stress reduction therapy on self-perceived burden and sleep in patients with colorectal cancer;to verify its applicability and effectiveness;to provide empirical support and evidence-based basis for improving negative mood and sleep status of colorectal cancer patients.Methods:A total of 86 patients with colorectal cancer who were treated in the Oncology Department of a grade-a general hospital in Jilin Province from June to December 2021 were selected as the research objects by convenient sampling method.A non-contemporaneous control was adopted.Totally,43 patients who were given conventional care instructions were enrolled in the control group,and 43 patients who were given routine nursing instruction and mindfulness-based stress reduction therapy were included in the intervention group.Before and after intervention,the general data questionnaire,self-Perceived Burden Scale,Pittsburgh Sleep Quality Scale and sleep bracelet were used to evaluate the sample characteristics,self-perceived burden level,sleep quality,and actual sleep time of patients in the two groups.The effects of mindfulness-based stress reduction therapy on self-perceived burden and sleep were evaluated at 4 weeks and 8 weeks after intervention.IBM SPSS Statistics 25.0 software was used for statistical analysis.Meanwhile,Descriptive Statistics,T test,Chi-square test,rank sum test,repeated measurement analysis of variance and generalized estimation equation were used for data description and analysis.Results:1.Comparison between the two groups before interventionFinally,86 subjects were included in this study,there was no significant difference in general data between the two groups（P > 0.05）.Before intervention,the self-perceived burden of the control group was mild（63.6%）,moderate（29.5%）and severe（4.5%）,and the self-perceived burden of the intervention group was mild（65.9%）,moderate（27.3%）and severe（4.5%）.For the total score of self-perceived burden of the two groups and the comparison of various dimensions,there were no significant differences（P > 0.05）.The total score of sleep quality in both groups was about 8 points,and there were no significant differences between the total score of sleep quality and the score of each dimension between the two groups（P > 0.05）.The actual total sleep time of the control group was（410.16±103.72）minutes,and that of the intervention group was（404.91±107.28）minutes.There were no significant differences in the actual total sleep time and all dimensions between the two groups（P > 0.05）.2.Intervention effect（1）Time effect comparisonAfter 8 weeks of intervention,repeated measurement analysis of variance was conducted for self-perceived burden and actual sleep time of patients in the two groups.The results proved that the total score of self-perceived burden,physical burden score and emotional burden score of patients in the two groups were significantly different from those before intervention（P < 0.001）.The actual total sleep time,deep sleep time and light sleep time of the two groups were significantly different from those before intervention（P < 0.05）.The sleep quality score of the two groups was analyzed by generalized estimation equation,and the results revealed that the total score of sleep quality,subjective sleep quality score,sleep time score and sleep duration score of the two groups were significantly different from those before intervention（P < 0.05）.（2）Comparison of effects between groupsAfter 4 weeks of intervention,the total self-perceived burden score,physical burden score,emotional burden score and financial burden score of the control group were（26.17±8.04）,（13.90±4.07）,（9.52±3.92）and（2.74±1.33）respectively.In the intervention group,the total score of self-perceived burden was（23.81±6.88）,the score of physical burden was（12.90±3.30）,the score of emotional burden was（8.38±3.45）,and the financial burden score was（2.52±1.42）.There were no statistically significant differences between the total score of self-perceived burden and each dimension between the two groups（P > 0.05）.After8 weeks of intervention,the total self-perceived burden score,physical burden score,emotional burden score and financial burden score of the control group were（24.5±6.51）,（13.07±3.76）,（8.98±3.26）and（2.45±1.21）respectively.The total self-perceived burden score,physical burden score,emotional burden score and financial burden score in the intervention group were（20.45 ± 5.24）,（10.98 ± 2.99）,（7.00 ± 2.13）and（2.48 ± 1.44）respectively.There were statistically significant differences between the total self-perceived burden score,physical burden score and emotional burden score between the two groups（P< 0.05）.The repeated measurement analysis of variance was conducted for the self-perceived burden scores of patients in the two groups at different time points,and the results demonstrated that there were statistically significant differences between the total score of self-perceived burden,physical burden score and emotional burden score among groups（P <0.05）.After 4 and 8 weeks of intervention,the total score of sleep quality,subjective sleep quality score,sleep time score and continuous sleep time score of the intervention group were significantly different from those of the control group（P < 0.05）.The sleep quality scores of the two groups at different time points were analyzed by generalized estimation equation,and the results indicated that there were statistically significant differences in the total score of sleep quality,subjective sleep quality score,sleep time score and sleep duration score（P < 0.05）.After 4 weeks of intervention,the light sleep time of the control group was（288.19±83.59）minutes,and the light sleep time of the intervention group was（244.00±64.07）minutes,and the difference between the two groups was statistically significant（P <0.05）.After 8 weeks of intervention,the light sleep time of the control group was（271.24±72.33）minutes,and the light sleep time of the intervention group was（242.14 ± 57.40）minutes,and the difference between the two groups was statistically significant（P < 0.05）.The repeated measurement analysis of variance was performed for the actual sleep time at different time points in the two groups,and the results suggested that there was statistically significant difference in light sleep time between the two groups（P < 0.05）,while there were no statistically significant differences in total sleep time,deep sleep time,rapid eye movement time and waking times between the two groups（P > 0.05）.（3）Comparison of time and intergroup effectsAfter 8 weeks of intervention,repeated measurement analysis of variance was conducted on the self-perceived burden and actual sleep time of patients in the two groups at different time points.The results showed that the total score of self-perceived burden and the score of each dimension,the actual total sleep time,deep sleep time,light sleep time,rapid eye movement time and waking times,there were no significant differences in time and interaction between groups（P > 0.05）.The sleep quality scores of the two groups at different time points were analyzed by generalized estimation equation,based on the results,there were no statistical significances in the total score of sleep quality,the scores of each dimension,the time and the interaction effect between the two groups（P > 0.05）.Conclusions:1.The self-perceived burden of colorectal cancer patients is mainly mild to moderate,and the patients have serious sleep quality problems.2.Mindfulness-based stress reduction therapy significantly reduced the overall level of self-perceived burden,physical burden and emotional burden in colorectal cancer patients.3.Mindfulness-based stress reduction therapy can effectively improve the overall sleep quality,time to fall asleep,subjective sleep quality,duration of sleep and actual light sleep time in patients with colorectal cancer.