Effects Of Mindfulness-Based Stress Reduction（MBSR） On Resilience In Patients With First-Diagnosed Pulmonary Nodules

Objective:1.to understand the current status of psychological resilience and its influencing factors in patients with first-visit pulmonary nodules.2.To explore the effect of mindfulness-based stress reduction on the application of psychological resilience,negative emotions,medical coping and fear of disease progression in patients with first-visit pulmonary nodules,with the aim of providing intervention support for improving psychological resilience in patients with first-visit pulmonary nodules.Methods:1.A study of the current status of psychological resilience in patients with first-visit pulmonary nodules.A questionnaire survey was conducted in a tertiary care hospital in Jilin from October 2020 to May 2021 among 180 patients with first-visit pulmonary nodules who met the inclusion and exclusion criteria.156 valid questionnaires were returned,with a valid return rate of 86.67%.The General Information Questionnaire,the Psychological Resilience Scale（CD-RIS）,the Hospital Anxiety and Depression Scale（HADS）,the Medical Coping Scale（MCCQ）,and the Fear of Disease Progression Simple Scale（Fo P-Q-SF）were used as study instruments to understand the current psychological resilience of patients with first-visit pulmonary nodules and to analyze the correlation between psychological resilience and other measured variables in patients with first-visit pulmonary nodules.2.A class experimental study of the effect of mindfulness-based stress reduction on patients with first-visit pulmonary nodules.Eighty patients with first-visit pulmonary nodules who met the inclusion and exclusion criteria were selected from the crosssectional survey and divided into an experimental group（n=40）and a control group（n=40）.As three patients in the experimental group withdrew voluntarily in the middle of the study,one person lost contact and did not complete the intervention,and two patients in the control group were lost to follow-up.In the final group,36 people were in the experimental group and 38 people were in the control group.The control group was given routine follow-up education with the physician,and the experimental group was given online positive stress reduction therapy for 6 weeks.Before and after the intervention,the general information questionnaire,psychological resilience scale,hospital anxiety and depression scale,medical coping scale,and fear of disease progression simple scale were used to score and analyze the effect of mindfulness-based stress reduction on the psychological resilience and negative emotions of patients with first diagnosis of pulmonary nodules.3.IBM SPSS24.0 software was used for statistical analysis.Statistical methods included independent sample t-test,one-way ANOVA,Pearson correlation analysis,multi-factor analysis,chi-square test,and paired t-test.Statistical significance was judged at P<0.05.Results:1.status survey: the psychological resilience level of patients with first diagnosis of pulmonary nodules（56.68±11.37）was lower than that of our normative model（65.4±13.9）,with a score range of 31-81.Psychological resilience level was negatively correlated with anxiety,depression,yielding to coping,avoidance of confrontation and fear of disease progression（P< 0.05）and positively correlated with confrontation of coping（P < 0.05）.2.Intervention comparison.（1）Before intervention: no statistically significant differences in general information,psychological resilience,anxiety and depression,medical coping style,and total score of fear of disease progression between the experimental and control groups（P> 0.05）.（2）After the intervention: the total psychological resilience scores were（58.64±6.40）and（49.50±6.22）in the experimental and control groups,respectively,with statistically significant differences（P<0.05）;the anxiety scores were（8.72±1.81）and（10.76±2.74）,respectively,with statistically significant differences（P<0.05）;the depression scores were（7.50±1.32）and（10.76±2.74）,respectively.（7.50±1.32）and（8.66±2.22）respectively,with statistically significant differences（P<0.05）;confrontation scores were（21.14±3.26）and（18.24±3.48）respectively,with statistically significant differences（P<0.05）;avoidance scores were（11.42±2.29）and（15.87±3.01）respectively,with statistically significant differences（P <0.05）The differences were statistically significant（P< 0.05）;the yielding coping scores were（10.39 ± 1.71）and（13.63 ± 2.40）,respectively,with statistically significant differences（P < 0.05）;the total fear of disease progression scores were（29.86 ± 6.27）and（36.71 ± 7.57）,respectively,with statistically significant differences（P < 0.05）.Conclusion:1.the psychological resilience of patients with first-visit pulmonary nodules is lower than our norm,at a medium-low level,influenced by age,education,anxiety,depression,confrontation,and fear of disease progression.2.The higher the level of psychological resilience of patients with first-visit pulmonary nodules,the lower their anxiety,depression,submission to facing,avoidance of facing,and higher facing coping.3.The intervention results showed that by implementing psychological care interventions based on mindfulness-based stress reduction,the psychological resilience and coping level of patients with first-visit pulmonary nodules could be effectively improved,and the anxiety and depression and fear of disease progression of patients with first-visit pulmonary nodules were alleviated,and the method could be integrated into daily life to actively cope with disease events,helping patients with first-visit pulmonary nodules to improve their psychological resilience,adopt a positive coping approach,and reduce anxiety,depression,and fear of disease progression.