The Effect Of Short-term Body Scanning Mindfulness Training On Psychosomatic Response In Perioperative Period Of Patients With Lung Cancer

ObjectiveThis study aims to explore the effect of short-term body scanning mindfulness training on psychosomatic response(sleep disturbance,subjective sleep quality,pain,emotional distress,fatigue)in perioperative period of patients with lung cancer.MethodsA total of 140 lung cancer patients to be operated on in the department of thoracic surgery of a specialized hospital in Shandong Province from March to December 2019 were selected as study subjects.They were grouped according to their ward,and patients in one ward were randomly selected as the intervention group.Patients in another ward with the same ward management model served as the control group,with 70 cases in each.The patients in control group were given routine care,and the patients in intervention group were received short-term mindfulness training on body scanning based on routine care.The general information questionnaire,sleep disorders and subjective sleep quality components in the Pittsburgh Sleep Quality Index,Numeric Rating Scale,Emotional distress self-design scale and Visual Analogue Scale were used to evaluate the psychosomatic reactions of the two groups of patients in 1 day before the operation,the day of the operation,1,3,5,7 and 14 days after the operation.The software SPSS 22.0 was used for data sorting and analysis.The statistical methods of baseline data analysis included descriptive statistics,independent sample t-test,and chi-square test;the intervention effect was evaluated using generalized estimation equations and repeated measures ANOVA.Result1.Comparison of general data of two groups of perioperative patients with lung cancer at baselineThe age range of 140 lung cancer patients was 38-72 years old,with an average age of(55.35±7.18)years;104 males,accounting for 74.3%;disease duration>1 month,accounting for 52.1%;TNM staging of patients with stage Ⅰ and Ⅱ accounted for 60.0%Among the 70 cases in the intervention group,70%were male,with an average age of(55.11±6.52)years.There were 70 cases in the control group,73%of whom were male；the average age was(55,59±7.83)years.The results of independent sample t-test and chi-square test showed that there were differences in economic status(P<0.001)and chronic history(P=0.033)between the two groups in the baseline period,while there were no statistically significant differences in other demographic and disease data(Ps>0.05).Demographic and disease data with intergroup differences were controlled during statistical analysis to ensure the comparability of the two groups2.Comparison of psychosomatic response in two groups of perioperative patients with lung cancer at baselineThe incidence of sleep disorders between the intervention group(difficulty falling asleep:10%,awakening at night:27.1%,early awakening:24.3%,snoring:65.7%,feeling cold/hot during sleep:1.4%,breathing difficulty during sleep:17.1%)and the control group(difficulty falling asleep:17.1%,awakening at night:30.0%,early awakening:28.6%,snoring:75.7%.feeling cold/hot during sleep:0.0%,breathing difficulty during sleep:12.9%)was no statistical difference(P>0.05)during the baseline period;the incidence of poor subjective sleep quality in both groups was 11.4%,and there was no statistical difference between two groups(P>0.05).There were no statistical differences in symptoms of emotional distress(1.04±0.19 VS 1.09±0.20),fatigue(0.97±0.16 VS 1.36±0.21)or pain(0.04±0.04 VS 0.17±0.09)between the intervention group and the control group at baseline(P>0.05)3.The effects of short-term body scanning mindfulness training on psychosomatic response of lung cancer patients during perioperative periodThe incidence of sleep disturbance and poor subjective sleep quality in the intervention group and the control group in the perioperative period showed a similar inverted "U"-shaped change,reaching a peak at 3 days after surgery,and the intervention group was lower than the control group.Since the sleep-related variables were all bivariate variables,the generalized estimation equation was used to compare the statistical differences between the two groups in the changes of sleep disorders and subjective sleep quality over time,with general information about the differences between the two groups at baseline,such as economic status and whether they have chronic diseases were controlled.The results showed that the groups effect,time effect,and group-time interaction effect of trouble falling asleep,wake up,wake up at night,sleep feel cold/heat and sleep breathing disorders were statistically significant(F group=197.599～1734.030,Ftime=360.707～7219.905,Finteraction=458.119～3214.544,P<0.001),and snoring items only on the time effect and the group effect was statistically significant(F groups=24.006,F time=27.407,P<0.001).There was no statistical significance on group-time interaction effect(F interaction=7.731,P=0.258).The group,time and group-time interaction effects of subjective sleep quality were statistically significant(F group=1457.715,F time=2520.317,F interaction=1675.956,P<0.001)..The scores of pain,emotional distress,and fatigue in the intervention group and the control group all showed similar inverted "U"-shaped changes during the perioperative period,reaching a peak at 3-5 days after surgery,and the intervention group’s score was lower than the control group.Since pain,fatigue and emotional distress were continuous variables,repeated measures ANOVA was used to compare the statistical differences of the three symptoms over time between the intervention group and the control group,with general information about the differences between the two groups at baseline,such as economic status and whether they have chronic diseases were controlled.The results showed that the group effect,time effect,and group-time interaction effect of pain were statistically significant(F group=34.442,F time=76.067,F interaction=15.672,P<0.001).The group effect,time effect and group-time interaction effect of emotional distress were all statistically significant(F group=80.952,F time=126.473,F interaction=36.985,P<0.001).The group effect,time effect and group-time interaction effect of fatigue were statistically significant(F group=82.003,F time=161.703,F interaction=39.847,P<0.001).Conclusions1.During the perioperative period,lung cancer patients generally have psychosomatic reactions such as sleep disturbance,poor subjective sleep quality,pain,fatigue,and emotional distress.2.Short-term body scanning mindfulness training can significantly improve the psychosomatic responses of lung cancer patients during the perioperative period,which verifies the feasibility and effectiveness of this method,and provides guidance for clinical practice.