| Objective:Because most patients with malignant tumors have negative emotions such as anxiety and depression during the perioperative period,which seriously affects the surgical treatment and postoperative recovery of patients,it is necessary to carry out psychological intervention on perioperative patients to make them better cooperate with the treatment,so as to achieve satisfactory results.In order to promote the rapid recovery of colorectal cancer patients after surgery,our team used Beck cognitive therapy based on WeChat platform to conduct psychological intervention on perioperative colorectal cancer patients in the early stage.This study retrospectively analyzed the influence and clinical application value of WeChat platform psychological intervention on perioperative psychological state,short-term quality of life and postoperative recovery of colorectal cancer patients.Methods:1.From July 2021 to September 2022,90 patients with laparoscopic colorectal cancer who received perioperative psychological intervention in our hospital and 90patients with colorectal cancer who did not receive psychological intervention during the same period were collected.According to whether they received psychological intervention,they were divided into exposure group and non-exposure group.2.The general anxiety scale(GAD-7),patient depression symptom group scale(PHQ-9)and quality of life scale(QLQ-C30)filled in twice before and after operation were reviewed and analyzed.The general data,operation related data and postoperative rehabilitation related data such as white blood cells,albumin and postoperative complications were collected.3.The data collected above were entered into the self-made patient information archiving table and the computer Excel table for double statistical verification,and the data were analyzed by SPSS25.0 software.According to the different data types and distribution,t test,chi-square test or non-parametric test were used to analyze the data of the two groups of patients.Univariate correlation analysis and multivariate regression analysis were used to analyze the factors affecting anxiety,depression and recent quality of life.P<0.05 was considered statistically significant.Results:1.The final effective sample size collected this time was 151 cases,74 cases in the exposed group and 77 cases in the non-exposed group.There was no significant difference in basic data,tumor status and surgery between the two groups(P>0.05).2.There was no difference in GAD-7,PHQ-9 scores and positive rates of anxiety and depression between the preoperative exposure group and the non-exposure group(P>0.05).In the non-exposed group,the postoperative GAD-7 score was lower than that before operation,but there was no difference(P>0.05),and the PHQ-9 score was lower than that before operation,the difference was significant(t=2.063,P=0.043);the scores of GAD-7 and PHQ-9 in the exposed group were significantly lower than those before operation(GAD-7:t=11.783,P<0.01;PHQ-9:t=14.741,P<0.01).The GAD-7 score of 151 patients after operation was lower than that before operation(t=8.446,P<0.001).Postoperative PHQ-9 score was significantly lower than preoperative PHQ-9 score(t=9.631,P<0.01).The postoperative GAD-7,PHQ-9 scores and the positive rates of anxiety and depression in the exposed group were significantly different from those in the non-exposed group(GAD-7:t=7.846,P<0.001).PHQ-9:t=8.670,P<0.001;anxiety:χ~2=12.444,P<0.01;depression:χ~2=17.083,P<0.001).3.Univariate correlation analysis of preoperative anxiety and depression showed that marriage and tumor stage had statistically significant effects on preoperative anxiety and depression(P<0.05).The influence of gender and age on preoperative depression was statistically significant(P<0.05).In multivariate logistic regression analysis,tumor stage(anxiety:OR=2.295,95%CI 1.421-3.708,P=0.001;depression:OR=2.006,95%CI 1.233-3.262,P=0.005)and marriage(anxiety:OR=5.552,95%CI1.102-27.958,P=0.038)had statistically significant effects on preoperative anxiety and depression.Univariate correlation analysis of postoperative anxiety and depression showed that age,tumor stage and psychological intervention had statistically significant effects on postoperative anxiety and depression(P<0.05).In multivariate logistic regression analysis,psychological intervention(anxiety:OR=0.254,95%CI 0.113-0.571,P=0.001;depression OR=0.177,95%CI 0.072-0.432,P<0.001),age((anxiety:OR=3.686,95%CI 1.458-9.323,P=0.006;depression:OR=3.243,95%CI 1.212-8.674,P=0.019),tumor stage(anxiety:OR=3.318,95%CI 1.847-5.963,P<0.001;depression:OR=2.302,95%CI 1.298-4.085,P=0.004)was statistically significant for postoperative anxiety and depression.4.There was no difference in preoperative QLQ-C30 score between the exposed group and the non-exposed group(P>0.05).In the non-exposed group,except for the scores of emotional function and economic difficulties,there were differences in the scores of other fields before and after surgery(P<0.05).In the exposure group,except for economic difficulties,there were differences in the scores of other fields before and after surgery(P<0.05).After removing the exposure factors and using surgery as the grouping basis,the postoperative QLQ-C30 scores of 151 patients were significantly different from those before surgery except for cognitive function and insomnia,loss of appetite and economic difficulties(P<0.05).Compared with the non-exposed group,there were differences in functional scales,pain and other symptom scales,total health level and insomnia and other individual items in the exposed group(P<0.05).The total health level/quality of life item was used to represent the quality of life(QOL)of the patients.The univariate correlation analysis of perioperative QOL showed that gender,tumor stage,preoperative anxiety and depression had statistically significant effects on preoperative QOL(P<0.05).The effects of age,postoperative anxiety,depression,postoperative pain,fatigue and psychological intervention on postoperative QOL were statistically significant(P<0.05).Multivariate linear regression analysis showed that gender and tumor stage had significant effects on preoperative QOL(gender:b=-4.496,t=-3.385,P=0.001;tumor staging:b=-6.149,t=-6.747,P<0.001);the effects of postoperative fatigue and psychological intervention on postoperative QOL were statistically different(fatigue:b=-0.128,t=-2.097,P=0.038;psychological intervention:b=8.886,t=5.107,P<0.001).5.There was no difference in WBC and ALB levels between the exposed group and the non-exposed group before operation(P>0.05).There were significant differences in the levels of WBC and ALB between the two groups on the third day after operation.(WBC:t=3.282,P=0.001;ALB:t=-3.548,P=0.001).There was no difference in postoperative complications,hospitalization time and hospitalization cost between the two groups(P>0.05).Conclusions:1.Beck cognitive therapy based on WeChat platform is a convenient and effective psychological intervention method,which can effectively improve the perioperative bad mood of patients with colorectal cancer,improve the short-term quality of life,reduce postoperative inflammatory response and promote postoperative recovery.2.Beck cognitive therapy based on WeChat platform is easy to master,easy to operate,and suitable for clinical work. |
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