Effects of a mobile health intervention based on a multitheoretical model of health behavior change on anxiety and depression, fear of cancer progression, and quality of life in patients with differentiated thyroid cancer: A randomized controlled trial.

IF 7 1区 医学 Q1 MEDICINE, GENERAL & INTERNAL BMC Medicine Pub Date : 2024-10-15 DOI:10.1186/s12916-024-03652-0
Xiangju Sun, Yang Jiang, Jing Wang, Siyuan Fan, Xinghua Fu, Zhi An, Xiaomei Zhu, Yibo Wu
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Abstract

Background: Despite the high cure rate of differentiated thyroid cancer (DTC), patients endure side effects from treatment and psychological distress, impacting their quality of life. The potential of mobile health (mHealth) interventions to address these issues remains unexplored. The purpose of this study is to develop an mHealth intervention based on the Multi-Theoretical Model of Health Behavior Change (MTM) and evaluate its impact on reducing anxiety, depression, fear of cancer progression, and enhancing quality of life in DTC patients.

Methods: A single-blind, single-center, prospective, randomized controlled trial was conducted. One hundred and eleven consecutive DTC patients from Harbin Medical University's Fourth Hospital were enrolled from March 2023 to March 2024. Participants were randomized into a control group and an intervention group that received a 3-month mHealth intervention based on MTM theory. Outcomes were assessed using web-based questionnaires at baseline and conclusion.

Results: One hundred four patients with DTC completed the study, with 7 lost to follow-up (6.3%). The intervention group experienced a significant drop in PHQ-4 scores post-MTM-mHealth intervention (P < .026), with no change in the control group, demonstrating a significant difference. The intervention group also had significantly lower anxiety (P < .015) and depression (P < .032) scores compared to controls. All PHQ-4 scores improved in the intervention group except for "Little interest or pleasure in doing things." Anxiety levels were significantly lower in the intervention group (P < .026) but remained unchanged in controls. The control group exhibited a significant increase in FCR-4 scores at follow-up, differing from the intervention group (P < 0.001). Quality of life scores did not differ at baseline but saw a significant improvement in the intervention group, while the control group experienced no significant change. The intervention group had higher VAS scores (P < .030) and greater health education satisfaction across all dimensions (P < .019).

Conclusions: The MTM-based mHealth intervention significantly benefits DTC patients by reducing anxiety, fear of cancer recurrence, and improving quality of life, though its effect on depression requires further investigation.

Trial registration: China Clinical Trial Registry ChiCTR2200064321.

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基于健康行为改变多理论模型的移动健康干预对分化型甲状腺癌患者的焦虑和抑郁、对癌症进展的恐惧以及生活质量的影响:随机对照试验
背景:尽管分化型甲状腺癌(DTC)的治愈率很高,但患者仍要忍受治疗带来的副作用和心理困扰,从而影响他们的生活质量。移动医疗(mHealth)干预措施在解决这些问题方面的潜力仍有待开发。本研究旨在开发一种基于健康行为改变多元理论模型(MTM)的移动医疗干预措施,并评估其对减少 DTC 患者焦虑、抑郁、对癌症进展的恐惧以及提高生活质量的影响:进行了一项单盲、单中心、前瞻性随机对照试验。从 2023 年 3 月到 2024 年 3 月,哈尔滨医科大学附属第四医院连续招募了 111 名 DTC 患者。参与者被随机分为对照组和干预组,干预组接受为期 3 个月的基于 MTM 理论的移动医疗干预。在基线和结束时使用网络问卷对结果进行评估:144 名 DTC 患者完成了研究,其中 7 人失去了随访机会(6.3%)。干预组在接受基于 MTM 的移动医疗干预后 PHQ-4 评分明显下降(P 结论:基于 MTM 的移动医疗干预对 DTC 患者的治疗效果非常重要:基于 MTM 的移动医疗干预能显著降低 DTC 患者的焦虑、对癌症复发的恐惧,并改善其生活质量,但其对抑郁症的影响还需进一步研究:试验注册:中国临床试验注册中心 ChiCTR2200064321。
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来源期刊
BMC Medicine
BMC Medicine 医学-医学:内科
CiteScore
13.10
自引率
1.10%
发文量
435
审稿时长
4-8 weeks
期刊介绍: BMC Medicine is an open access, transparent peer-reviewed general medical journal. It is the flagship journal of the BMC series and publishes outstanding and influential research in various areas including clinical practice, translational medicine, medical and health advances, public health, global health, policy, and general topics of interest to the biomedical and sociomedical professional communities. In addition to research articles, the journal also publishes stimulating debates, reviews, unique forum articles, and concise tutorials. All articles published in BMC Medicine are included in various databases such as Biological Abstracts, BIOSIS, CAS, Citebase, Current contents, DOAJ, Embase, MEDLINE, PubMed, Science Citation Index Expanded, OAIster, SCImago, Scopus, SOCOLAR, and Zetoc.
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