Effects of cognitive behavioral therapy on psychological adjustment in Chinese pediatric cancer patients receiving chemotherapy: A randomized trial

Ping Zhang, Lin Mo, Joseph Torres, Xiaoyan Huang, Ping Zhang, Lin Mo, Joseph Torres, Xiaoyan Huang

Abstract

Background: Cognitive behavioral therapy (CBT) has been widely used in pediatric cancer patients to promote psychological adjustment (PA). Considering the diversity of region and culture in China, its effect in Chinese population is not well defined. Therefore, our study is to explore the effect of CBT on improving PA in Chinese pediatric cancer patients receiving chemotherapy.

Methods: One hundred four Chinese pediatric cancer patients receiving chemotherapy were divided into CBT group and control group randomly and equally. The resilience and negative mood were applied to evaluate the ability of psychological adjustment (PA). The Conner-Davidson Resilience Scale (CD-RISC) and depression anxiety stress scale (DASS) were employed to measure resilience and negative mood before and after intervention. The SPSS 22.0 software was used to analyze data.

Results: Prior to the intervention, the ability of psychological adjustment between 2 groups showed no significant difference (P > .05 for all). After intervention, the total CD-RISC score was significantly higher (56.09 ± 7.29 vs 44.75 ± 5.40), whereas the scores of depression (4.57 ± 2.94 vs 7.25 ± 4.25), anxiety (5.83 ± 3.07 vs 8.66 ± 4.92), stress (7.51 ± 4.33 vs 11.17 ± 4.25) were obviously lower in CBT group than those in the control group (P < .05 for all). Moreover, the decline of negative mood score in Yolk sac tumor children was the most evident in CBT group. While the resilience changes of cancer children in stage III was most obvious.

Conclusions: CBT can effectively help Chinese pediatric cancer patients modify distorted cognition to have a positive attitude towards cancer and chemotherapy. This treatment enhances resilience and relieves negative mood, which results in good psychological adjustment ability, especially in Yolk sac tumor and stage III. It has a beneficial effect on better treatment cooperation and high long-term quality of life.

Conflict of interest statement

The authors have no conflicts of interests to disclose.

Figures

Figure 1
Figure 1
Study process flowchart.
Figure 2
Figure 2
Comparison of psychological resilience and negative mood scores of various cancer types and stages in cognitive behavioral therapy (CBT) group during different intervention times. A: the changes of negative mood scores in various cancer types, B: the changes of resilience scores in various cancer types; C: the changes of negative mood scores in various cancer stages; D: the changes of resilience scores of various cancer stages.
Figure 2 (Continued)
Figure 2 (Continued)
Comparison of psychological resilience and negative mood scores of various cancer types and stages in cognitive behavioral therapy (CBT) group during different intervention times. A: the changes of negative mood scores in various cancer types, B: the changes of resilience scores in various cancer types; C: the changes of negative mood scores in various cancer stages; D: the changes of resilience scores of various cancer stages.

References

    1. Ahmad SS, Reinius MA, Hatcher HM, et al. Anticancer chemotherapy in teenagers and young adults: managing long term side effects. BMJ 2016;354:i4567.
    1. Wallace WH, Thompson L, Anderson RA. Long term follow-up of survivors of childhood cancer: summary of updated SIGN guidance. BMJ 2013;346:f1190.
    1. Brotman MA, Kircanski K, Leibenluft E. Irritability in Children and Adolescents. Annu Rev Clin Psychol 2017;13:317.
    1. Ridder DD, Geenen R, Kuijer R, et al. Psychological adjustment to chronic disease. Lancet 2008;372:246–55.
    1. Molina Y, Yi JC, Martinez-Gutierrez J, et al. Resilience among patients across the cancer continuum: diverse perspectives. Clin J Oncol Nurs 2014;18:93–101.
    1. Eicher M, Ribi K. Interprofessional, psycho-social intervention to facilitate resilience and reduce supportive care needs for patients with cancer: Results of a noncomparative, randomized phase II trial. Psycho-oncology 2018;27:1833–9.
    1. Wu X, Zhang X, Wang Q, et al. The research progress of cancer patient's psychological resilience intervention. Clin J Nurs 2017;52:316–20.
    1. Shina KJ, Lee YJ, Suh PG, et al. Molecular mechanisms underlying psychological stress and cancer. Curr Pharm Des 2016;22:2389–402.
    1. Zhong X, Wang J. Research progress and prospect of psychological resilience in cancer patients. Chin J Nurs 2013;48:380–2.
    1. Lu H, Zhu L, Shen N. Investigation of symptoms in children and teenagers with cancer. J Nurs Sci 2012;27:9–12.
    1. Liu J, Yuan c. The element of Chinese culture in cancer care research and its implication. Chin J Nurs 2012;27:93–6.
    1. Kichler JC, Kaugars AS. Topical review: applying positive development principles to group interventions for the promotion of family resilience in pediatric psychology. J Pediatr Psychol 2015;40:978–80.
    1. Zhang P, Mo L, Li X, et al. Effect of different psychological interventions on negative emotion in children with malignant tumors: a network meta analysis. J Chongqing Med Univ 2017;42:1208–13.
    1. Thompson RD, Delaney P, Flores I, et al. Cognitive-behavioral therapy for children with comorbid physical illness. Child Adolesc Psychiatr Clin N Am 2011;20:329–48.
    1. Watson Handbook of Psychotherapy in Cancer Care. Hoboken, New Jersey: John Wiley & Sons, Ltd; 2011.
    1. Yu X, Lau JTF, Mak WWS, et al. Factor structure and psychometric properties of the Connor-Davidson Resilience Scale among Chinese adolescents. Compr Psychiatry 2011;52:218–24.
    1. Zhang F, Liu Z, Ma z, et al. Application of the short version of depression-anxiety-stress assessment on students after earthquake. Chin J Behav Med Brain Sci 2016;25:82–5.
    1. Ye Y. Research progress on psychological resilience of inpatient children. J Qilu Nurs 2017;23:74–7.
    1. Wu LM, Sheen JM, Shu HL, et al. Predictors of anxiety and resilience in adolescents undergoing cancer treatment. J Adv Nurs 2013;69:158–66.
    1. Wen Y, Liu Q, Zhang F, et al. Mental resilience tested with the Resilience Scale for Chinese Adolescents (RSCA)in Chinese children: a meta-analysis. Chin Mental Health J 2015;29:826–32.
    1. Chen CM, Chen YC, Wong TT. Comparison of resilience in adolescent survivors of brain tumors and healthy adolescents. Cancer Nurs 2014;37:373–81.
    1. Tillery R, Long A, Phipps S. Child perceptions of parental care and overprotection in children with cancer and healthy children. J Clin Psychol Med Settings 2014;21:165–72.
    1. Mellblom AV, Ruud E, Loge JH, et al. Do negative emotions expressed during follow-up consultations with adolescent survivors of childhood cancer reflect late effects? Patient Educ Couns 2017;100:2098–101.
    1. Yuan J, Liu Y, Yang M. The influences of emotional coping style and cognitive training on the adolescents’ susceptibility to affective disturbances. Adv Psychol Sci 2014;22:1062–74.
    1. Zhan Q, Li D. The mediating effect of regulatory emotional self-efficacy on family harmony and resilience in adolescent. Chin Mental Health J 2017;31:554–6.
    1. Qiu X, Liu X. The moderating effect of psychological resilience between family structure and children's peer relationship. Chin J Behav Med Brain Sci 2017;26:450–3.
    1. Dupuis LL, Sung L, Molassiotis A, et al. 2016 updated MASCC/ESMO consensus recommendations: prevention of acute chemotherapy-induced nausea and vomiting in children. Support Care Cancer 2017;25:323–31.
    1. Totadri S. Prophylaxis and management of antineoplastic drug induced nausea and vomiting in children with cancer. Pediatr Hematol Oncol J 2016;1:50–5.
    1. Yan Q. Biological Rhythms and the HPA Axis in Psychoneuroimmunology. Bern, Switzerland: Springer International Publishing; 2016.
    1. Lutgendorf SK, Andersen BL. Biobehavioral approaches to cancer progression and survival: mechanisms and interventions. Am Psychol 2015;70:186–97.
    1. Rosenberg AR, Bradford MC, Barton KS, et al. Hope and benefit finding: results from the PRISM randomized controlled trial. Pediatr Blood Cancer 2018;66:e27485.

Source: PubMed

스폰서 및 공동 작업자

건강 상태

약물 개입

3
구독하다