| Objective:To design and develop a computerized cognitive behavioral therapy software(CCBT),for the regulation of psychosomatic symptoms in patients with laryngeal cancer,and to apply CCBT to perioperative patients with laryngeal cancer,and to evaluate its effect in improving anxiety and depression,insomnia and quality of life of patients with laryngeal cancer.Methods:This study is divided into two parts:The first part: Through the method of literature analysis and group meeting,the content and module of the software are determined,and then cooperate with software company to design and develop CCBT software.The second part: Clinical intervention,using the method of objective sampling,82 patients who were scheduled to undergo total or partial laryngectomy for laryngeal cancer in the Department of Otorhinolaryngology head and neck surgery of two Grade3 A Hospitals in Shanxi Province from August 2019 to July 2020 were selected as subjects.They were strictly divided into two groups according to the random number table,the intervention group(n = 41)and the control group(n = 41).The control group was given routine nursing measures in the perioperative period of laryngeal cancer,while the intervention group was intervened with CCBT software on the basis of routine perioperative nursing of laryngeal cancer.The Chinese version of State anxiety scale(S-AI),Patient Health Questionnaire-9(PHQ-9),Athens Insomnia scale((AIS))and Functional Assessment of Cancer Therapy Head and Neck(FACT-H&N)were used to evaluate the effect of the two groups at 3 days before operation,1 day before operation,2 days after operation,4 days after operation and 2 days after operation,and 1-2 days before discharge.Results:1.Complete the design and development of CCBT software.The CCBT has two parts: the patient terminal and the medical terminal.The patient terminal include: psychosomatic symptom screening,cognitive therapy,cognitive consolidation,behavioral relaxation training,psychological nursing satisfaction survey and other functions.The medical terminal includes two parts:patient management and task management.patient management is mainly used to establish patient personal information files,including name,sex,age,hospitalization number,diagnosis,mode of operation,etc;Task management is used to view and analyze the results of psychosomatic screening of patients,to understand the progress of treatment,and so on.After internal trial operation,it can run normally.2.The CCBT has been applied in perioperative patients with laryngeal cancer,and achieved good results.(1)Baseline data: a total of 80 patients completed the test and all the data were investigated,including 40 patients in the intervention group and 40 patients in the control group.The baseline data of the two groups before intervention were compared,and there was no significant difference between the two groups(P > 0.05).(2)The results of anxiety study showed:there were significant differences in the scores of State anxiety scale(S-AI)at five different time points in perioperative period(F=292.581,P < 0.05),and both groups showed an upward trend and then a downward trend.There was an interactive effect between time and group factors(F=11.533,P < 0.05),which indicated that the trend of anxiety state of the two groups was different with time.There was no significant difference in the score of state anxiety between the two groups before intervention(P>0.05).After five times of intervention,the score of anxiety in the intervention group was significantly lower than that in the control group,and the difference was statistically significant(P<0.05).(3)The results of depression study showed:there were significant differences in the scores of Patient Health Questionnaire-9(PHQ-9)at five different time points in perioperative period(F=183.975,P<0.05),and both groups showed an upward trend and then a downward trend.There was an interactive effect between time and group factors(F=11.266,P<0.05),which indicated that the trend of depression of the two groups was different with time.There was no significant difference in the score of PHQ-9 between the two groups before intervention(P>0.05).After five times of intervention,the score of PHQ-9 in the intervention group was significantly lower than that in the control group,and the difference was statistically significant(P<0.05).(4)The results of insomnia study showed:there were significant differences in the scores of Athens Insomnia Scale(AIS)at five different time points in perioperative period(F=143.133,P< 0.05),and both groups showed an upward trend and then a downward trend.There was an interactive effect between time and group factors(F=15.681,P<0.05),which indicated that the trend of insomnia of the two groups was different with time.There was no significant difference in the score of AIS between the two groups before intervention(P>0.05).After five times of intervention,the score of AIS in the intervention group was significantly lower than that in the control group,and the difference was statistically significant(P< 0.05).(5)The study on the quality of life showed:there were significant differences in the total score and each dimension score of FACT-H&N among the patients at five different time Points in perioperative period(F=310.934,P< 0.05;F=52.862,P<0.05;F=58.939,P< 0.05;F=49.175,P< 0.05;F=263.604,P< 0.05;F=53.230,P< 0.05),and the total score and each dimension score of the two groups decreased at first and then increased(P< 0.05).There were interactive effects between time and factors between the two groups(F=23.452,P<0.05;F=2.993,P < 0.05;F=3.595,P <0.05;F=5.507,P < 0.05;F=10.613,P < 0.05,F= 11.045,P < 0.05),which indicated that the trends of the quality of life and the scores of each dimension in the two groups were different with the change of time.There was no significant difference in the scores between the two groups before intervention(P>0.05).After five interventions,the scores in the intervention group were significantly higher than those in the control group,and the difference was statistically significant(P < 0.05).Conclusion:As a standardized,vivid and practical psychological intervention,the computerized cognitive behavioral therapy software developed in this study can be well applied to patients.It not only helps patients master more disease-related knowledge and psychosomatic relaxation skills,but also effectively improves the perioperative anxiety,depression and insomnia symptoms of patients with laryngeal cancer,and improves the quality of life of patients to a certain extent.Therefore,it can be considered as a low-intensity psychological intervention,which can be promoted in clinical practice. |
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