Application of WeChat-based cognitive behavioural stress management for early-stage cervical cancer patients: a randomised controlled study

This randomised controlled study was aimed at investigating the effects of WeChat-based cognitive behavioural stress management (WB-CBSM) on the mental health of patients with early-stage cervical cancer treated with surgical resection.
A total of 184 patients with early-stage cervical cancer were randomised to receive either WB-CBSM (n = 92) or normal care (NC) (n = 92) for 8 weeks.
Compared with the NC group, the WB-CBSM group exhibited reduced Hospital Anxiety and Depression Scale (HADS)–anxiety scores at months (M)1 (t = 2.022, P = 0.045), M3 (t = 2.575, P = 0.011), and M6 (t = 2.709, P = 0.007); anxiety rates at M3 (χ2 = 4.834, P = 0.028) and M6 (χ2 = 5.182, P = 0.023); HADS–depression scores at M3 (t = 2.069, P = 0.040) and M6 (t = 2.449, P = 0.015); and depression rates at M6 (χ2 = 4.268, P = 0.039). Moreover, the WB-CBSM group showed increased Functional Assessment of Chronic Illness Therapy–Spiritual Well-Being scale scores at M1 (t = −2.001, P = 0.047), M3 (t = −2.281, P = 0.024), and M6 (t = −3.501, P = 0.001); the Quality of Life Questionnaire-Core 30 (QLQ-C30) global health score at M3 (t = −2.034, P = 0.043) and M6 (t = −2.426, P = 0.016); and QLQ-C30 function score at M3 (t = −2.009, P = 0.046). However, the groups exhibited decreased EuroQol-5 dimension scores at M3 (t = 2.056, P = 0.041) and M6 ((t = 2.242, P = 0.026) and QLQ-C30 symptom scores at M1 (t = 2.026, P = 0.044) and M3 (t = 2.210, P = 0.028).
WB-CBSM reduced anxiety and depression and improved the spiritual well-being and quality of life of patients with early-stage cervical cancer treated with surgical resection.
Patients with cervical cancer usually need to cope with mental health problems after surgery due to physical recovery and lack of social communication. Effective nursing care is thus essential for these patients. This study included 184 patients with early-stage cervical cancer who underwent surgical resections. Patients were randomised to receive WeChat-based cognitive behavioural stress management (WB-CBSM) (n = 92) or normal care (NC) (n = 92) for 8 weeks. WB-CBSM decreased anxiety scores at month (M) 1, M3, and M6; it also reduced depression scores at M3 and M6 compared with NC. Moreover, WB-CBSM increased spiritual well-being at M1, M3, and M6 and improved quality of life from the aspects of global health at M3 and M6, function at M3, and symptoms at M1 and M3. In summary, WB-CBSM improves psychological health and quality of life of patients with early-stage cervical cancer treated with surgical resection.

本随机对照试验旨在探讨基于微信的认知行为压力管理（WeChat-based Cognitive Behavioural Stress Management, WB-CBSM）对接受手术切除治疗的早期宫颈癌患者心理健康的影响。
共计184例早期宫颈癌患者被随机分为WB-CBSM组（n=92）与常规护理组（normal care, NC，n=92），干预周期为8周。
与常规护理组相比，WB-CBSM组在第1个月（M1，t=2.022，P=0.045）、第3个月（M3，t=2.575，P=0.011）及第6个月（M6，t=2.709，P=0.007）的医院焦虑抑郁量表（Hospital Anxiety and Depression Scale, HADS）焦虑维度得分更低；在M3（χ²=4.834，P=0.028）与M6（χ²=5.182，P=0.023）的焦虑检出率更低；在M3（t=2.069，P=0.040）与M6（t=2.449，P=0.015）的HADS抑郁维度得分更低；且在M6（χ²=4.268，P=0.039）的抑郁检出率更低。此外，WB-CBSM组在M1（t=-2.001，P=0.047）、M3（t=-2.281，P=0.024）及M6（t=-3.501，P=0.001）的慢性病治疗功能评估-精神健康量表（Functional Assessment of Chronic Illness Therapy–Spiritual Well-Being Scale）得分更高；在M3（t=-2.034，P=0.043）与M6（t=-2.426，P=0.016）的QLQ-C30整体健康得分更高；且在M3（t=-2.009，P=0.046）的QLQ-C30功能维度得分更高。但两组在M3（t=2.056，P=0.041）与M6（t=2.242，P=0.026）的欧洲五维健康量表（EuroQol-5 Dimension, EQ-5D）得分均有所下降，且在M1（t=2.026，P=0.044）与M3（t=2.210，P=0.028）的QLQ-C30症状维度得分均有所下降。
WB-CBSM可降低接受手术切除治疗的早期宫颈癌患者的焦虑与抑郁水平，并改善其精神健康与生活质量。
宫颈癌患者术后常因身体恢复需求及社交匮乏面临心理健康问题，因此针对此类患者的有效护理干预至关重要。
本研究纳入184例接受手术切除的早期宫颈癌患者，将其随机分为WB-CBSM组（n=92）与NC组（n=92），干预周期为8周。
与NC组相比，WB-CBSM可降低患者在M1、M3及M6的焦虑得分，同时降低其在M3与M6的抑郁得分。
此外，WB-CBSM可提升患者在M1、M3及M6的精神健康水平，并从多维度改善其生活质量：包括M3与M6的整体健康状况、M3的功能状态，以及M1与M3的症状表现。
综上，WB-CBSM可改善接受手术切除治疗的早期宫颈癌患者的心理健康水平与生活质量。