| Cancer has become an increasingly serious global public health problem.Cancer patients experience significant psychological distress and physical symptoms such as depression,anxiety,fatigue,pain,and sleep disturbances during diagnosis and treatment.These symptoms significantly affect the daily functioning and cancer treatment process of patients and may reduce their quality of life and survival rate.Therefore,providing effective interventions to alleviate the psychosomatic symptoms of cancer patients is crucial.Among numerous interventions,Internet-based Acceptance and Commitment Therapy(iACT)is considered a promising therapy to relieve the psychosomatic symptoms of cancer patients,and it is receiving increasing attention from researchers and practitioners.However,the intervention of iACT for cancer patients is still in its early stages in China.Therefore,this study comprehensively used meta-analysis and randomized controlled trials to investigate the intervention of iACT on the psychosomatic symptoms of cancer patients.First,it identified the effectiveness and influencing factors of internet psychological therapy interventions for cancer patients and further developed a mobile iACT app to test its acceptability,feasibility,and effectiveness in intervening the psychosomatic symptoms of cancer patients.Study 1 aims to provide comprehensive evidence of the effects of internet psychological interventions on the psychosomatic symptoms of cancer patients and explore the influencing factors of internet-based interventions for cancer patients,laying a foundation for the development and further research of internet psychological interventions.Study 1 used a systematic review and meta-analysis method,based on the screening results of 9 databases,including 68 clinical randomized controlled trials(RCTs)of internet psychological therapy interventions for cancer patients,involving 10,797 cancer patients.The meta-analysis results showed that internet psychological interventions can significantly alleviate the depression(g =-0.26,95% CI: [-0.4;-0.06],p < 0.05),anxiety(g =-0.37,95% CI: [-0.67,-0.08],p < 0.05),fatigue(g =-0.25,95%CI: [-0.46,-0.03],p < 0.05),sleep(g =-0.41,95% CI: [-0.66,-0.16],p < 0.01),and quality of life(g = 0.16,95% CI: [0.03,0.28],p < 0.05)of cancer patients,but it has no significant effect on pain relief(g =-0.11,95% CI: [-0.26,0.04],p > 0.05).Subgroup analysis results showed that the intervention format significantly moderated the intervention effect on anxiety(p = 0.001),while the country significantly moderated the intervention effect on fatigue(p = 0.04),and therapist guidance and support moderated the intervention effect on pain(p = 0.04)and quality of life(p = 0.001).Intervention duration and intervention unit had no significant effect on the intervention effect(ps >0.05).Study 2 aims to explore the feasibility,acceptability,and effectiveness of the Internet-based Acceptance and Commitment Therapy(ACT)intervention for addressing the physical and psychological symptoms of cancer patients.Based on Study 1,Study 2developed a smartphone intervention program using ACT to alleviate the symptoms of cancer patients.Adult cancer patients were recruited both online and offline,and those who met the inclusion criteria and provided informed consent were randomly assigned to either the networked ACT intervention group or the conventional treatment group in a 1:1ratio.Measurements included acceptability,feasibility,cancer patient physical and psychological symptoms,and quality of life.The intervention lasted for two weeks,and online assessments were conducted for all participants before randomization,during the intervention(one week after),and after the intervention(two weeks after).A total of 60 cancer patients were randomly assigned to the networked ACT group(n = 30)or the conventional treatment group(n = 30).The study results showed a recruitment rate of55.04% and a retention rate of 70%,while 63.33% of patients who received ACT intervention completed it,and all patients were moderately satisfied with the intervention,demonstrating feasibility and acceptability.In addition,patients who received ACT intervention had significantly lower levels of psychological distress(F = 7.391,p =0.001),depression(F = 7.504,p = 0.001),anxiety(F = 6.941,p = 0.002),and fatigue(F= 4.218,p = 0.020)compared to the control group,but changes in pain,sleep,and overall quality of life were not significant(ps > 0.05).In conclusion,networked psychological intervention can be considered as a possible and effective supplementary approach in clinical practice to better manage the physical and psychological symptoms of cancer patients.When developing networked psychological interventions,therapist guidance and support can be added,and individual interventions can be used as much as possible to improve treatment effectiveness.At the same time,the number and duration of interventions can be reduced to reduce the burden on cancer patients.Networked Acceptance and Commitment Therapy is feasible and acceptable for alleviating the physical and psychological symptoms of cancer patients and has shown preliminary efficacy,but larger randomized controlled trials are needed in the future. |
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