The effects of psychological interventions on depression and anxiety among Chinese adults with cancer: a meta-analysis of randomized controlled studies

BMC Cancer

Lie Wang¹  Si-Meng Wang³  De-Sheng Huang²  Guang-Cong Liu⁴  Guo-Yuan Sui¹  Yi-Long Yang¹ 

[1]Department of Social Medicine, China Medical University, 92 North 2nd Road, Heping District, Shenyang 110001, PR China

[2]Department of Mathematics, School of Basic Medical Science, China Medical University, 92 North 2nd Road, Heping District, Shenyang 110001, PR China

[3]Institute of Hygiene, Zhejiang Academy of Medical Sciences, 182 Tianmushan Road, Hangzhou 310013, PR China

[4]Department of Environmental Health, School of Public Health, China Medical University, 92 North 2nd Road, Heping District, Shenyang 110001, PR China

关键词: Meta-analysis;    Chinese adults with cancer;    Anxiety;    Ddepression;    Psychological intervention;   

Others  :  1117878
DOI  :  10.1186/1471-2407-14-956

 received in 2014-06-04, accepted in 2014-12-04,  发布年份 2014

【 摘 要 】

Background

Our previous studies found the high prevalence of depression and anxiety among Chinese cancer patients, and many empirical studies have been conducted to evaluate the effects of psychological interventions on depression and anxiety among Chinese cancer patients. This study aimed to conduct a meta-analysis in order to assess the effects of psychological interventions on depression and anxiety in Chinese adults with cancer.

Methods

The four most comprehensive Chinese academic database- CNKI, Wanfang, Vip and CBM databases-were searched from their inception until January 2014. PubMed and Web of Science (SCIE) were also searched from their inception until January 2014 without language restrictions, and an internet search was used. Randomized controlled studies assessing the effects of psychological interventions on depression and anxiety among Chinese adults with cancer were analyzed. Study selection and appraisal were conducted independently by three authors. The pooled random-effects estimates of standardized mean difference (SMD) and 95% confidence intervals (CI) were calculated. Moderator analysis (meta-regression and subgroup analysis) was used to explore reasons for heterogeneity.

Results

We retrieved 147 studies (covering 14,039 patients) that reported 253 experimental-control comparisons. The random effects model showed a significant large effect size for depression (SMD = 1.199, p < 0.001; 95% CI = 1.095-1.303) and anxiety (SMD = 1.298, p < 0.001; 95% CI = 1.187-1.408). Cumulative meta-analysis indicated that sufficient evidence had accumulated since 2000–2001 to confirm the statistically significant effectiveness of psychological interventions on depression and anxiety in Chinese cancer patients. Moderating effects were found for caner type, patients’ selection, intervention format and questionnaires used. In studies that included lung cancer, preselected patients with clear signs of depression/anxiety, adopted individual intervention and used State-Trait Anxiety Inventory (STAI), the effect sizes were larger.

Conclusions

We concluded that psychological interventions in Chinese cancer patients have large effects on depression and anxiety. The findings support that an adequate system should be set up to provide routine psychological interventions for cancer patients in Chinese medical settings. However, because of some clear limitations (heterogeneity and publication bias), these results should be interpreted with caution.

【 授权许可】

   
2014 Yang et al.; licensee BioMed Central.

【 图 表 】

Figure 1.

Figure 2.

Figure 3.

Figure 4.

Figure 5.

Figure 6.

【 参考文献 】

• [1]Palesh OG, Collie K, Batiuchok D, Tilston J, Koopman C, Perlis ML, Butler LD, Carlson R, Spiegel D: A longitudinal study of depression, pain, and stress as predictors of sleep disturbance among women with metastatic breast cancer. Biol Psychol 2007, 75:37-44.
• [2]Ma JLC: Factors influencing adjustment of patients suffering from nasopharynx carcinoma-implications for oncology social work. Soc Work Health Care 1997, 25:83-103.
• [3]Lauver DR, Connolly-Nelson K, Vang P: Stressors and coping strategies among female cancer survivors after treatments. Cancer Nurs 2007, 30:101-111.
• [4]Bultz BD, Carlson LE: Emotional distress: the sixth vital sign-future directions in cancer care. Psychooncology 2006, 15:93-95.
• [5]Keir ST, Swartz JJ, Friedman HS: Stress and long-term survivors of brain cancer. Support Care Cancer 2007, 15:1423-1428.
• [6]Mitchell AJ, Chan M, Bhatti H, Halton M, Grassi L, Johansen C, Meader N: Prevalence of depression, anxiety, and adjustment disorder in oncological, haematological, and palliative-care settings: A meta-analysis of 94 interview-based studies. Lancet Oncol 2011, 12:160-174.
• [7]Massie MJ: Prevalence of depression in patients with cancer. J Natl Cancer Inst Monogr 2004, 32:57-71.
• [8]Van’t Spijker A, Trijsburg RW, Duivenvoorden HJ: Psychological sequelae of cancer diagnosis: a meta-analytical review of 58 studies after 1980. Psychosom Med 1997, 59:280-293.
• [9]Stark DP, House A: Anxiety in cancer patients. Br J Cancer 2000, 83:1261-1267.
• [10]Yang YL, Liu L, Wang Y, Wu H, Yang XS, Wang JN, Wang L: The prevalence of depression and anxiety among Chinese adults with cancer: a systematic review and meta-analysis. BMC Cancer 2013, 13:393. BioMed Central Full Text
• [11]Hotopf M, Chidgey J, Addington-Hall J, Ly KL: Depression in advanced disease: a systematic review. Part 1. Prevalence and case finding. Palliat Med 2002, 16:81-97.
• [12]Miller K, Massie MJ: Depression and anxiety. Cancer J 2006, 12:388-397.
• [13]Reiche EMV, Nunes SOV, Morimoto HK: Stress, depression, the immune system and cancer. Lancet Oncol 2004, 5:617-625.
• [14]Goerling U, Odebrecht S, Schiller G, Schlag PM: Need for psychosocial care in in-patients with tumour disease. Investigations conducted in a clinic specializing in tumour surgery. Chirurg 2006, 77:41-46.
• [15]Newell S, Sanson-Fisher RW, Savolainen NJ: Systematic review of psychological therapies for cancer patients: Overview and recommendations for future research. J Natl Cancer Inst 2002, 94:558-584.
• [16]Barsevick AM, Sweeney C, Haney E, Chung E: A systematic qualitative analysis of psychoeducational interventions for depression in patients with cancer. Oncol Nurs Forum 2002, 29:73-84.
• [17]Galway K, Black A, Cantwell M, Cardwell CR, Mills M, Donnelly M: Psychosocial interventions to improve quality of life and emotional wellbeing for recently diagnosed cancer patients. Cochrane Database Syst Rev 2012, 11:CD007064.
• [18]Semple C, Parahoo K, Norman A, McCaughan E, Humphris G, Mills M: Psychosocial interventions for patients with head and neck cancer. Cochrane Database Syst Rev 2013, 7:CD009441.
• [19]Sheard T, Maguire P: The effect of psychological interventions on anxiety and depression in cancer patients: results of two meta-analyses. Br J Cancer 1999, 80:1770-1780.
• [20]Faller H, Schuler M, Richard M, Heckl U, Weis J, Küffner R: Effects of psycho-oncologic interventions on emotional distress and quality of life in adult patients with cancer: systematic review and meta-analysis. J Clin Oncol 2013, 31:782-793.
• [21]Osborn RL, Demoncada AC, Feuerstein M: Psychosocial interventions for depression, anxiety, and quality of life in cancer survivors: meta-analyses. Int J Psychiatry Med 2006, 36:13-34.
• [22]Hofmann SG, Sawyer AT, Witt AA, Oh D: The effect of mindfulness-based therapy on anxiety and depression: A meta-analytic review. J Consult Clin Psychol 2010, 78:169-183.
• [23]Luebbert K, Dahme B, Hasenbring M: The effectiveness of relaxation training in reducing treatment-related symptoms and improving emotional adjustment in acute non-surgical cancer treatment: a meta-analytical review. Psychooncology 2001, 10:490-502.
• [24]Stewart BW, Wild CP: World Cancer Report 2014. Switzerland: WHO Press; 2014.
• [25]Olivo SA, Macedo LG, Gadotti IC, Fuentes J, Stanton T, Magee DJ: Scales to assess the quality of randomized controlled trials: a systematic review. Phys Ther 2008, 88:156-175.
• [26]Jadad AR, Moore RA, Carroll D, Jenkinson C, Reynolds DJM, Gavaghan DJ, McQuay HJ: Assessing the quality of reports of randomized clinical trials: is blinding necessary? Control Clin Trials 1996, 17:1-12.
• [27]Oremus M, Wolfson C, Perrault A, Demers L, Momoli F, Moride Y: Interrater reliability of the modified Jadad quality scale for systematic reviews of Alzheimer’s disease drug trials. Dement Geriatr Cogn Disord 2001, 12:232-236.
• [28]DerSimonian R, Laird N: Meta-analysis in clinical trials. Controlled Clin Trials 1986, 7:177-188.
• [29]Cohen J: A power primer. Psychol Bull 1992, 112:155-159.
• [30]Borenstein M, Hedges L, Higgins J, Rothstein H: Introduction to meta-analysis. Oxford: Wiley; 2009.
• [31]Higgins JPT, Thompson SG, Deeks JJ, Altman DG: Measuring inconsistency in meta-analyses. BMJ 2003, 327:557-560.
• [32]Terrin N, Schmid CH, Lau J: In an empirical evaluation of the funnel plot, researchers could not visually identify publication bias. J Clin Epidemiol 2005, 58:894-901.
• [33]Begg CB, Mazumdar M: Operating characteristics of a rank correlation test for publication bias. Biometrics 1994, 50:1088-1101.
• [34]Egger M, Smith GD, Schneider M, Minder C: Bias in meta-analysis detected by a simple, graphical test. BMJ 1997, 315:629-634.
• [35]Lau J, Antman EM, Jimenez-Silva J, Kupelnick B, Mosteler F, Chalmers TC: Cumulative meta-analysis of therapeutic trials for myocardial infarction. N Engl J Med 1992, 327:248-254.
• [36]Zhu HY, Deng SH, Zhang P, Li DZ: Effect of PDCA circulation in psychological intervention on anxiety and depression of patients with lung cancer. J Clinical Res 2013, 30:1324-1326. (in China)
• [37]Wang DS, LI GL, Chen JH, Liu XM: Effects of psychological interventions in cancer patients undergoing radiotherapy. Chinese J Clinical Psychology 2011, 19:561-563. (in China)
• [38]Zhong TP, Zheng HJ, Zhu R: A randomized controlled trial of psychological interventions in cancer patients undergoing radiotherapy. Guangdong Medical J 2003, 24:57-58. (in China)
• [39]Wang GF, Shi YG, Ma GL, Han X, Tian AL: Preliminary approach to the therapy of relaxative imagination and subconscious music revulsion supplemented to radio therapy on cancer. J Henan Medical College for Staff and Workers 2000, 12:3-5. (in China)
• [40]Xu XR: Health education and psychological nursing in cancer patients after surgery. Guide of China Medicine 2010, 8:134-136. (in China)
• [41]Liu LJ, Liu JH, Li JJ: Effects of psychological interventions among cancer patients. Medical Information 2011, 24:444-445. (in China)
• [42]Yang LZ, Mao WQ, Hou AZ, Xie CG, He Y, Cao CS: A comparative study of group mental interference on cancer patients in recovery period. China J Cancer Prevention and Treatment 2002, 9:452-453. (in China)
• [43]Liu AM, Gan XL: Effect of background music on psychological state of malignant tumor patients under radionuclide bone imaging. J Luzhou Medical College 2013, 36:401-403. (in China)
• [44]Lian XH, Cao KJ, He ZM, Chen ZM, Qin HY, Xian MC: Clinical study on psychological nursing of patients with nasopharyngeal carcinoma undergoing radiotherapy. Chin Nurs Res 2003, 17:65-67. (in China)
• [45]Cheng H, Zhang H, Liu XY: Effects of comprehensive psychotherapy on nasopharyngeal carcinoma patients. Cancer Research and Clinic 2010, 22:554-556. (in China)
• [46]Liu QF, Sun GM, An Y, Qin YX: Effects of short-term psychological intervention on depression and anxiety among cancer patients in perioperative period. Medical Information 2010, 5:704-705. (in China)
• [47]Wu XR, Dong JW: Study on psychological nursing care of malignant tumor patients complicated with anxiety or depression. Chin Nurs Res 2011, 25:54-55. (in China)
• [48]Liu JH: Mental nursing intervention for patients with malignant tumors. China Medical Herald 2012, 9:125-126. (in China)
• [49]Jiang WJ, Liu YD, Hou W: Effect of relax training on the psychological status and quality of life in patients undergoing partial laryngectomy. Chinese J Nursing Education 2012, 9:27-29. (in China)
• [50]Qian AH, Cai CP: Psychological nursing intervention on patients with gynecology malignant tumor undergoing chemotherapy. J Practical Oncology 2007, 21:596-598. (in China)
• [51]Chen J: Psychological status, quality of life and related psychological intervention in patients with gynecological malignancies. West China Medical J 2012, 27:259-261. (in China)
• [52]Liu L, Lin XH, Zhao YM, He XX, Li GY: The psychological aspects of patient of gynecological malignant tumor after operation and the effects of psychological nursing in these patients. Maternal and Child Health Care of China 2008, 23:157-158. (in China)
• [53]Wang HF: Psychological care among patients with gynecological malignancies. Chinese Community Doctors 2013, 15:340. (in China)
• [54]Huang LL, Su XN, Shi KF, Wang XL: Effects of individual psychological intervention on negative emotion of cancer patients before surgery. J Qilu Nursing 2008, 14:27-28. (in China)
• [55]Feng JX: Effects of individual nursing intervention on anxious emotion of breast cancer patients during surgery. Chinese J Clinical Rational Drug Use 2012, 5:133-134. (in China)
• [56]Ye S: Effects of nursing intervention on anxiety of patients with gynecological malignancies during surgery in perioperative period. Medical Information 2011, 24:4809-4810. (in China)
• [57]Liu QT, Shao Y, Bi XX: Effect of nursing intervention on the psychology and quality of life in radiotherapy for patients with bone metastases. Hainan Medical J 2013, 24:2331-2333. (in China)
• [58]Zheng YQ: Effects of nursing intervention plus paroxetine on depression, anxiety and quality of life in cancer patients. J Qiqihar University of Medicine 2012, 33:517-518. (in China)
• [59]Wu MH, Chen XH, Liu AQ, Wu YY, He XH: A clinical study on psychological nursing intervention to improve psychological status of patients with advanced cancer undergoing chemotherapy. Chinese J Clinical Oncology and Rehabilitation 2007, 14:85-87. (in China)
• [60]Sun MJ, Ding FM, Zang L: Effect of psychological intervention on negative emotions of cancer patients during chemotherapy. China Medical Herald 2012, 9:136-137. (in China)
• [61]Du LN, Wang GH, Cheng Y, Liu Y, Yuan L, Zheng SM: Active cognition-behavior therapy of breast cancer chemotherapy patients’ psychological status and the influence on the quality of life. Chinese J Modern Nursing 2011, 17:3249-3252. (in China)
• [62]Hu JE, Yan Y: Application and effect of group psychotherapy in patients with cancer. China Medical Herald 2011, 8:55-57. (in China)
• [63]Li JN, Tang HY, Fu HL: Effects of structural group psychotherapy to the mood and QOL in thyroid cancer radionuclear therapy patients. China J Health Psychology 2009, 17:243-245. (in China)
• [64]Shen BY, Liu JW, Liu S: Impact of the individualized whole period nursing care on the perioperative psychological status of cancer patients. J Qilu Nursing 2011, 17:13-14. (in China)
• [65]Zhu ML, Wang CJ, Xie L, Li HF: Psychological intervention on depression of elderly patients with digestive cancer. Chinese J Postgraduates of Medicine 2011, 34:60-61. (in China)
• [66]Yang ZX: Nursing intervention on depression state of elderly patients with digestive tumor. Chinese J Practical Nursing 2012, 28:69-70. (in China)
• [67]Cao WB, Li P: The effect of psychological interventions on mood of cancer patients. China J Health Psychology 2011, 19:1433-1434. (in China)
• [68]Zhu J, Hu JE: Application of strengthened psychological intervention in depression and anxiety of radical resection for gynecological malignancies. International J Nursing 2012, 31:2348-2349. (in China)
• [69]Wen XX, Liang SM: Psychological characteristics and psychological intervention of young patients with cancer undergoing chemotherapy. Modern Preventive Medicine 2007, 34:331-333. (in China)
• [70]Yang H, Yuan W, Liu XL, Huang Y: Effect of psychological intervention on malignant tumor patients treated with whole body thermotherapy. Foreign Medical Science Section of Medgeography 2012, 33:203-206. (in China)
• [71]Guo YS, Lai YG, Zhong JY, Liu JX, Guo YW, Wu DY: Cognitive therapy on patients with malignant tumor common clinical observation. Chinese J Medical Guide 2010, 12:2052-2053. (in China)
• [72]Li XR, Xia D, Xu LX, Yu H: Pre-operative psychological analysis and post-operative psychological intervention in patients with breast cancer. China Modern Medicine 2012, 19:102-105. (in China)
• [73]Yang YL, Zhao GZ, Xiong Y, Li L: Clinical effective observation on psychological therapy in patients with breast cancer. J Modern Medicine & Health 2012, 28:664-665. (in China)
• [74]Du LH: Community-based interventions on gynecologic malignancy patients with psychological and pain effect. China Health Care & Nutrition 2013, 23:4395. (in China)
• [75]Wang HF, Niu ME, Jin MJ, Meng HY, Li M: Contrasted study of supportive group psychotherapy for 68 patients with advanced cancer. J Nurses Training 2006, 21:583-585. (in China)
• [76]Li Z, Zhang HM, Zhang HY: Psychological intervention on mental health of perioperative patients with cancers. Chin Ment Health J 2002, 16:147-148. (in China)
• [77]Lv XZ, Ding F, Wu HM: Psychological intervention on psychological state and quality of life of perioperative patients with cervical cancer. Maternal & Child Health Care of China 2011, 26:2397-2399. (in China)
• [78]Li F, Yang JJ, Wang HN, Tan QR, Zhang HW, Wang WZ: Influential factors and non-pharmacal intervention strategies for anxious and depressive state of patients with gastrointestinal tumors in perioperative period. J Fourth Military Medical University 2009, 30:264-267. (in China)
• [79]Yang LJ: Influence of systematic nursing intervention on living quality of gynecological cancer patients during chemotherapy. Chin Nurs Res 2008, 22:1883-1884. (in China)
• [80]Mao XH, Li YH, Li YT, Zhu QF, Dai YG, Dong HX: Psychological adjustment and stress of nursing intervention mode on malignant tumor patients psychological status and influence of long-term prognosis. Liaoning J Traditional Chinese Medicine 2013, 40:1002-1003. (in China)
• [81]Guan JY, Li Y, Luo QY: Effect of psychological Intervention on the bladder irrigation chemotherapy after the operation of bladder cancer. China Clinical Practical Medicine 2010, 4:237-238. (in China)
• [82]Zhai HP, Cheng Z, Zhu ZL: Effect of psychological intervention on mental health status and quality of life of patients with nasopharyngeal carcinoma. Occupation and Health 2013, 29:2035-2037. (in China)
• [83]Yang QJ, Wang XQ: Study on the impact of psychological intervention on life quality of malignant tumor patients treated with chemotherapy. China J Chinese Medicine 2012, 27:396-397. (in China)
• [84]Zhao LB, Zhang Y, Li L, Li WW, Zhou WG, Wang Q: Effects of psychological intervention on anxiety, depression and quality of life in cancer patients. J Neuroscience and Mental Health 2012, 12:488-490. (in China)
• [85]Han L, Lu HH, Li CH, Zheng GW, Zhao LB, Zhang ZG, Song CQ, Lu GL: Effects of psychological intervention on anxiety, depression and pain in cancer patients. J Neuroscience and Mental Health 2012, 12:506-508. (in China)
• [86]Huang J, Zhao C, Chen XY: Effects of psychological intervention on negative emotion and quality of life in lung cancer patients undergoing chemotherapy. Shandong Medical J 2010, 50:50-51. (in China)
• [87]Liu YH, Yang XH, Ren XY, Bin J, Xiong Y, Liu WZ: Effects of psychological intervention on anxiety, depression and quality of life in lung cancer patients undergoing chemotherapy. Shanxi Medical J 2010, 39:415-417. (in China)
• [88]Xu YH: Effects of psychological intervention on gynecological cancer patients before and after operation. Maternal & Child Health Care of China 2007, 22:4393-4394. (in China)
• [89]Li XM: Treatment function of psychology intervenes to the malignant tumor of the gynecology. Chinese J Practical Medicine 2009, 36:8-9. (in China)
• [90]Wang SX: The influence of psychological intervention on anxiety, depression and the quality of lives of patients with ovarian cancer. International J Nursing 2010, 29:52-54. (in China)
• [91]Li D, Zhang HJ, Guo LH: Influence of psychological intervention on depression and anxiety emotions and quality of life of postoperative ovarian cancer patients. Chin Nurs Res 2010, 24:1460-1461. (in China)
• [92]Shi LX, Gong XY, Yang JY: Effects of psychological intervention on negative emotion of ovarian tumor patients with surgery. Int J Nursing 2012, 31:1680-1682. (in China)
• [93]Wang F: Effect of psychotherapy on depression and gastrointestinal reactions in patients with breast cancer undergoing chemotherapy. Xinjiang Medical J 2004, 34:126-127. (in China)
• [94]Zhang CY, Yu RY: Effect of psychological intervention on negative psychological of breast cancer chemotherapy patients. China J Health Psychology 2011, 19:1322-1323. (in China)
• [95]Meng RF, Liu RH, Wang SJ, Wang MY, Fu JM, Liu JL, Ding YX: Study on the effect of psychological intervention in three step ladder pain relief for patients with later cancer. Nursing Practice and Research 2011, 8:129-130. (in China)
• [96]Zhang JM: Effect of psychological intervention on quality of life of cancer patients in advanced stage. Nursing Practice and Res 2013, 10:131-132. (in China)
• [97]Zhang H: Clinical study on the effect of psychological intervention on psychological state of patients with later cancer. Guide of China Medicine 2012, 10:116. (in China)
• [98]Liu YH, Yang XH, Ren XY, Xiong Y, Bin J: Influence of psychological intervention on negative emotion and immune function of patients with digestive tract tumor. J Clinical Res 2012, 29:825-827. (in China)
• [99]Li SY, Huang MH, You QY: Influence of psychological intervention on depression and anxiety of patients with digestive system malignancy during first chemotherapy. Fujian Medical J 2008, 30:145-146. (in China)
• [100]Zhou L: Influence of psychological intervention on quality of life among patients with hematologic tumors. J Qilu Nursing 2008, 14:40-41. (in China)
• [101]Lou SH, Li L, Ma DP, Fa WL: Effect of psychotherapy on depression and gastrointestinal reactions in tumor patients undergoing chemotherapy. J Nursing Science 2003, 18:748-749. (in China)
• [102]Huang Y: Effect of psychotherapy on immunologic function in tumor patients after chemotherapy. Modern J Integrated Traditional Chinese and Western Med 2011, 20:4553-4554. (in China)
• [103]Xing NL: Effects of mental intervention on peri-operative anxiety-depression state of patients with carcinoma cervicis. J Clinical Psychosomatic Dis 2007, 13:435-436. (in China)
• [104]Geng Y, Zhao YN, Li KZ, Wu DD, Liu XF, Liu Y, Yan XH, Zhou HP, Wang H: Clinical observation of mental intervention for anxiety-depression in patients with cancer. J Modern Oncology 2010, 18:1412-1414. (in China)
• [105]Zhan XH, Cheng XM: Influence of psychological intervention techniques on quality of life of advanced non-small cell lung cancer patients. Chin Nurs Res 2010, 24:2127-2128. (in China)
• [106]Ji FP: Effect of nursing psychological intervention on the malignant tumor patients’ negative emotions. J Shandong Medical College 2008, 30:318-320. (in China)
• [107]Cheng K, Wang J, Jia YJ: Clinical observation on effect of mental intervention on increasing quality of life in patients with malignant tumor. Tianjin J Traditional Chinese Med 2006, 23:462-464. (in China)
• [108]Shi YF, Ren XY, Jiang YJ: Application of psychological intervention in pain relief of cancer patients. Cancer Res and Clinic 2010, 22:570-572. (in China)
• [109]Zheng YB, Zhuang TY, Wang JY: Study on psychological intervention in cancer patients with postoperative psychonosema. J Modern Oncology 2007, 15:86-87. (in China)
• [110]Deng LL, Lv HF, Yang N: Effect of psychotherapy on psychological state in cancer patients after chemotherapy. Chinese J Rehabilitation Medicine 2007, 22:168-169. (in China)
• [111]Li XQ: Effect of psychological nursing on psychological state in cancer patients during chemotherapy. Chinese J Practical Nursing 2010, 26:44-45. (in China)
• [112]Liu JH: Effect of psychological nursing on quality of life among malignant tumor patient with anxiety. Medical Information 2013, 26:370. (in China)
• [113]Mao XL, Zhang CH, Lin Y: Effects of mental nursing on the depression and anxiety of the malignancy patient. Progress in Modern Biomedicine 2008, 8:2598-2600. (in China)
• [114]Zhang YQ: Effect of psychological nursing on psychological state of gynecologic malignancy patients before and after operation. China Practical Medical 2013, 8:236-237. (in China)
• [115]Xu XC: Influence of psychological care on anxiety and depression feelings of postoperative patients with digestive system malignant tumor. Chin Nurs Res 2004, 18:243-244. (in China)
• [116]Zheng L, Gao W, Yang M: Effect of psychological nursing care on anxiety and depression of patients with tumor during radiotherapy. J Qilu Nursing 2008, 14:1-2. (in China)
• [117]Ci YK, Tao FY, Hou J: Effect of psychological nursing intervention on psychological state of cancer patients before chemotherapy. World Health Digest 2013, 10:86-87. (in China)
• [118]Xia Y: The effect of mental nursing on mental status of cancer patients before interventional therapy. Modern Clinical Nursing 2009, 8:50-52. (in China)
• [119]Liu SQ: Effect of psychological nursing on psychological status of cancer patients before interventional therapy. World Latest Med Information 2013, 13:462-463. (in China)
• [120]Guan J, Jie XX: Clinical observation of psychological nursing intervention improving mental status of hospitalized malignant tumor patients. Chinese Community Doctors 2011, 13:282-283. (in China)
• [121]Gu XL: Application of psychological nursing improving cancer patients’ quality of life. Health Must-Read Magazine 2012, 11:352. (in China)
• [122]Jin JY, Zhu YA: Effects of psychological and behavior intervention on patients with non-small cell lung cancer during chemotherapy. J Practical Med 2008, 24:1341-1342. (in China)
• [123]Guan HM, Sun J, Li GM: Effect of psychotherapy on quality of life and emotion of cancer patients. J Clinical Rehabilitative Tissue Engineering Res 2002, 6:3088. (in China)
• [124]Wang Y, Xiao WM: Effects of psychological intervention on anxiety and depression in cancer patients. J Taishan Medical College 2012, 33:117-118. (in China)
• [125]Zheng W, Gao ZH, Tian X: Effects of catharsis therapy and cognitive therapy on psychological status in elderly patients with medium or advanced cancer. Chin J Gerontol 2008, 28:1108-1110. (in China)
• [126]Tang XY, Mao SY, Luo F, Zhou YQ: Effects of selective psychological intervention on cytokine and unhealthy emotion in patients with breast cancer. J Chongqing Medical University 2010, 35:730-733. (in China)
• [127]Jia YY: The intervention of stabilization technology on the psychological stress of patients with esophageal carcinoma during the stage of operation. Master’s Thesis. The general hospital of Chinese People's Liberation Army, Internal Medicine Department; 2012. (in China)
• [128]Kang R: Effects of mental intervention on relieving pain among patients with breast cancer of the advanced stage. Master’s Thesis. Shanxi Medical University, Social Medicine Department; 2007. (in China)
• [129]Li WF: A study on the effect of individual health education on improving the sleeping and anxiety and depression of tumor patients with treatment of microwave ablation survey. Master’s Thesis. Shandong University, Nursing Department; 2012. (in China)
• [130]Li YH: Influence of psychological intervention on depression and handling of patients after Miles operation for rectal cancer. Master’s Thesis. University of South China, Oncology Department; 2011. (in China)
• [131]Liu L: Study of psychological intervention on emotional disorder and correlative immune indices in patients with cervical cancer in perioperative stage. Master’s Thesis. Changchun University of Chinese Medicine, Nursing Department; 2011. (in China)
• [132]Liu XT: Psycho-behavior intervention on emotional disorder and the changes of T lymphocyte subsets in patients with ovarian cancer. Master’s Thesis. ChongQing Medical University, Nursing Department; 2008. (in China)
• [133]Qiu ZY: Effect of mental interventions to lung-cancer-patients’ psychosomatic status and immune function who undergo chemotherapy. Master’s Thesis. Jilin University, Clinical Medicine Department; 2009. (in China)
• [134]Sun HT: The influence of psychotherapy on the quality of life and the emotion in radio-therapeutic cancer patients. Master’s Thesis. Xinjiang Medical University, Psychiatry and Mental Health Department; 2009. (in China)
• [135]Wei SQ: Breast cancer patients and TH11TH2 emotional and relationship psychological intervention experimental research. Master’s Thesis. ShanXi Medical University, Epidemiology and Health Statistics Department; 2012. (in China)
• [136]Yang L: The effect of group psychotherapy on emotion and quality of life to women who underwent modified radical mastectomy. Master’s Thesis. China Medical University, Psychiatry and Mental Health Department; 2008. (in China)
• [137]Yu LY: Effects of the entire psychological intervention on the mental symptoms and quality of life of patients with nasopharyngeal carcinoma after radiotherapy. Master’s Thesis. Hunan University of Chinese Medicine, Integrated Western and Chinese Medicine Major Department; 2013. (in China)
• [138]Zhang J: The effect of psychological intervention on hope and relative factors in the breast cancer patients. PhD thesis . Harbin Medical University, Social Medicine and Health Management Departmen; 2010. in China
• [139]Zhang PH: Study of depression status in cancer patients and relative psychological intervention. Master’s Thesis. ShiHeZi University, Nursing Department; 2009. (in China)
• [140]Zhou LJ: Study of effects of personalized music intervention on depression and anxiety among breast cancer patients during chemotherapy. Master’s Thesis. Central South University, Nursing Department; 2009. (in China)
• [141]Zheng XL, Liu JH, Wang LH: Lmplement of psychological intervention for tumor patients with clinical practice guidelines for the psychological care. J Nursing Science 2011, 26:67-69. (in China)
• [142]Zhang LM, Yang J, Jiang LM, Ma XM, Sun JZ: Psychological study of the semi-structured group counseling on patients with malignant tumor. China Health Care & Nutrition 2013, 23:1035-1036. (in China)
• [143]Liu AM, Jia T, Liu XM, Han XP: Music relaxing therapy on psychological status of the patients with malignant tumors subject to radiofrequency heat therapy. J Nursing Science 2006, 21:60-61. (in China)
• [144]Cai GR, Li PW, Jiao LP, Hao YX, Sun GX, Lu L: Clinical observation of music therapy combined with anti-tumor drugs in treating 116 cases of tumor patients. Chinese J Integrated Traditional and Western Medicine 2001, 21:891-894. (in China)
• [145]Fu YZ, Dai DL, Zhou X, Liang QH: Investigation of music therapy in improving anxiety and depression of breast cancer patients of the advanced stage during FEC chemotherapy. Chinese J Misdiagnostics 2009, 9:8312-8313. (in China)
• [146]Li MF, Tian DF, Yu LY, Liu G: Effects of an early psychological intervention on anxiety and depression of nasopharyngeal cancer patients after radiotherapy. J Clinical Res 2012, 29:1164-1165. (in China)
• [147]Yuan ML, Wu JJ: Effects of early psychological interventions for patients with advanced cancer on psychological status and quality of life. Guangzhou Medical J 2013, 44:27-29. (in China)
• [148]Wu L, Wang SJ: Psychotherapy improving depression and anxiety of patients treated with chemotherapy combined with radiotherapy. J Clinical Rehabilitative Tissue Engineering Res 2003, 7:2462-2463. (in China)
• [149]Li L, Wang WL, Zhou LH, Huang XH: Effect of therapeutic communication on postoperative anxiety and depression in patients with gynecological cancer. Anhui Medical and Pharmaceutical J 2011, 15:1621-1623. (in China)
• [150]Zheng JH, Zheng CL, Guo HP: Influence of therapeutic communication system on depression emotion of postoperative tumor patients undergoing chemotherapy. Chinese J Practical Nursing 2012, 28:5-8. (in China)
• [151]Han QY, Liu FZ: Effects of psychotherapy on negative emotions of cancer patients. International J Nursing 2007, 26:515-517. (in China)
• [152]Huang LT, Qin QL, Qiu XY, Shi YF: Effects of comprehensive mental intervention on anxiety and depression of cancer patients. Youjiang Medical J 2011, 39:323-324. (in China)
• [153]Zhao Y, Zhang JR, Wang SM: Comprehensive psychotherapy for anxiety and distress of patients with cancer. Chin Ment Health J 2000, 14:422-423. (in China)
• [154]Ren BY, Tang SY, Liu XF, Zhang J, Zhang L, Deng C, Huang XP, Liu HW, Ran WH, Li G: Effect of comprehensive psychotherapy on psychology of cancer patients. China Pharmacy 2010, 21:2107-2108. (in China)
• [155]Bu XM, Wang X, Cao LJ, Zhu GC: Effect of comprehensive relaxation training on anxiety and depression in patients with hepatic carcinoma. J Clinical Rehabilitative Tissue Engineering Res 2005, 9:16-17. (in China)
• [156]Chen DF, Peng YH, Mo XS, You XM, Zhong L, Chen SX, Li LQ: Evaluation the affect of psychological counseling intervention on the immune function in the preoperative anxiety patients with liver cancer. Chinese J Modern Nursing 2009, 15:2360-2364. (in China)
• [157]Dai YH, Hou AH, Qu SP: Impact of psychological nursing on cancer patients’ anxiety and coping style. J Nursing Science 2011, 26:77-78. (in China)
• [158]Fan FL, Pan HL: Effect of therapeutic communication in the treatment of anxiety of patients with radiation therapy and chemotherapy after cervical cancer surgery. Chinese Clinical Nursing 2012, 4:58-59. (in China)
• [159]Fu ZZ, Wang Y, Cheng SH, Bi R, Zhang LJ, Gu T, Cao JL: Anxiety status and nursing care intervention on cancer patients suffering from pain. Chinese J Coal Industry Medicine 2010, 13:608-609. (in China)
• [160]Han FM: Effect of psychological intervention anxiety of patients with breast cancer. Nursing Practice and Res 2008, 5:103-104. (in China)
• [161]Jiang JF, Chen LJ, Lao YC, Xu L, Chen MZ, Chen ZB, Cen SF, Liu ZH: Impact of imagery relaxation therapy on relieving chemotherapy-induced nausea and vomiting. J Guangxi Medical University 2008, 25:981-982. (in China)
• [162]Jiao GH, Qiu XJ, Xu MH: Effect of psychological counseling on anxiety and coping styles of ovarian cancer patients before the operation. J Guangdong Medical College 2011, 29:505-507. (in China)
• [163]Li HP, Du H, Zhang RF: Influence of effective communication on anxiety of patients with Miles operation for rectal cancer. Chinese J Misdiagnostics 2008, 8:1068-1069. (in China)
• [164]Lou SH, Hao YF, Ma DP: Clinical research of effect of psychotherapy on anxiety and gastrointestinal reactions in cancer patients undergoing chemotherapy. Chinese J Rehabilitation Medicine 2005, 20:604-605. (in China)
• [165]Ni BQ, Chen RX, Zheng LC, Wu MJ, Wu JW: Effect of psychotherapy on the quality of life of cancer patients undergoing thermo-chemotherapy. J Modern Oncology 2007, 15:857-860. (in China)
• [166]Pang XY, Wang X: Clinical assessment of psychological intervention in patients with breast cancer before and after operation. Shanxi Medical J 2007, 36:935-936. (in China)
• [167]Su X, Wang WL: Effect of therapeutic communication on preoperative anxiety in patients with gastrointestinal cancer. Chinese J Nursing 2010, 45:869-872. (in China)
• [168]Tian LH, Guan J, Wang JL, Long L, Hu KQ, He KL, Liu H, Zhan HM: Clinical outcome of cluster change nursing intervention in nursing anxiety for the therioma patients. Nursing Practice and Res 2013, 10:4-5. (in China)
• [169]Wang RM, Lu HC, Chen M: Effects of psychological intervention anxiety and postoperative recovery of patients with colorectal cancer during perioperative period. Chinese J Misdiagnostics 2008, 8:5575-5576. (in China)
• [170]Wu JQ, Zhang XL: Effect of nursing intervention on anxiety of patients with gastric carcinoma. Chinese Medicine Modern Distance Education of China 2010, 8:126. (in China)
• [171]You TH, Wang R, Yan XY: Effect of cognitive behavioral therapy on anxiety of breast cancer patients during chemotherapy. J Practical Medicine 2010, 26:689-690. (in China)
• [172]Yu YR: Effect of psychological intervention on anxiety of breast cancer patients. China Health Care & Nutrition 2013, 8:65. (in China)
• [173]Cao YF: Nursing research of music relaxation intervention after radical mastectomy. J Qiqihar University of Medicine 2011, 32:3189-3190. (in China)
• [174]Zhao X, Zhang LM: The effects of therapeutic communication system on preoperative anxiety in patients with gynecologic cancer. Mod Hosp 2011, 11:87-89. (in China)
• [175]Zheng HH, Fan AX, Long L, Liu LH, Fan XH: Influence of preoperative psychological intervention on preoperative anxiety of patients with malignant tumor. Anti-Tumor Pharmacy 2012, 2:235-237. (in China)
• [176]Zhou GX: Effects of psychological, cognitive and behavioral intervention on surgical patients with breast cancer. Today Nurse 2010, 4:68-69. (in China)
• [177]Cao SQ, Jiang YH: Evaluation of the effect of psychological intervention in lung cancer patients. J Clinical Psychosomatic Dis 2011, 17:367-368. (in China)
• [178]Mu YJ, Xie Y, Xue L, Chai YJ, Zhang YJ, Hao XY: Effect of nursing intervention on anxiety before transurethral resection of bladder tumor. Med Res and Educ 2012, 29:48-51. (in China)
• [179]Guo Z, Tang H, Li H, Tan SK, Feng KH, Huang YC, Bu Q, Jiang W: The benefits of psychosocial interventions for cancer patients undergoing radiotherapy. Health Qual Life Outcomes 2013, 11:121. BioMed Central Full Text
• [180]Zhou KN, Li XM, Yan H, Dang SN, Wang DL: Effects of music therapy on depression and duration of hospital stay of breast cancer patients after radical mastectomy. Chin Med J 2011, 124:2321-2327.
• [181]Qiu JY, Chen WJ, Gao XF, Xu Y, Tong HQ, Yang M, Xiao ZP, Yang M: A randomized controlled trial of group cognitive behavioral therapy for Chinese breast cancer patients with major depression. J Psychosom Obstet Gynaecol 2013, 34:60-67.
• [182]Li XM, Zhou KN, Yan H, Wang DL, Zhang YP: Effects of music therapy on anxiety of patients with breast cancer after radical mastectomy: a randomized clinical trial. J Adv Nurs 2012, 68:1145-1155.
• [183]Yang RT, Huang XW: Meta-analysis of the effects of psychological intervention on physical and mental condition in cancer patients. China Caner 2009, 18:187-190. (in China)
• [184]Jiang XM, Mi DH, Wang HQ, Zhang L: Mental intervention for cancer patients with depression: a systematic review of randomized controlled trials. Chinese J Evidence-based Medicine 2010, 10:352-355. (in China)
• [185]Martire LM, Lustig AP, Schulz R, Miller GE, Helgeson VS: Is it beneficial to involve a family member? a meta-analysis of psychosocial interventions for chronic illness. Health Psychol 2004, 23:599-611.
• [186]Demyttenaere K, Bruffaerts R, Posada-Villa J, Gasquet I, Kovess V, Lepine JP, Angermeyer MC, Bernet S, de Girolamo G, Morosini P, Polidori G, Kikkawa T, Kawakami N, Ono Y, Takeshima T, Uda H, Karam EG, Fayyad JA, Karam AN, Mneimneh ZN, Medina-Mora ME, Borges G, Lara C, de Graaf R, Ormel J, Gureje O, Shen YC, Huang YQ, Zhang MY, Alonso L, et al.: Prevalence, severity, and unmet need for treatment of mental disorders in the World Health Organization World Mental Health Surveys. JAMA 2004, 291:2581-2590.
• [187]Yang YL, Liu L, Wang XX, Wang Y, Wang L: Prevalence and associated positive psychological variables of depression and anxiety among Chinese cervical cancer patients: a cross-sectional study. PLoS One 2014, 9:e94804.
• [188]Schneider S, Moyer A, Knapp-Oliver S, Sohl S, Cannella D, Targhetta V: Pre-intervention distress moderates the efficacy of psychosocial treatment for cancer patients: a meta-analysis. J Behav Med 2010, 33:1-14.
• [189]Wetherell JL, Unützer J: Adherence to treatment for geriatric depression and anxiety. CNS Spectr 2003, 8:48-59.
• [190]Chen WQ, Zheng RS, Zhang SW, Zhao P, Li GL, Wu LY, He J: Report of incidence and mortality in China cancer registries, 2009. Chin J Cancer Res 2013, 25:10-21.
• [191]Lebel S, Devins GM: Stigma in cancer patients whose behavior may have contributed to their disease. Future Oncol 2008, 4:717-733.
• [192]Carlsen K, Jensen AB, Jacobsen E, Krasnik M, Johansen C: Psychosocial aspects of lung cancer. Lung Cancer 2005, 47:293-300.
• [193]Zabora J, Brintzenhofeszoc K, Curbow B, Hooker C, Piantadosi S: The prevalence of psychological distress by cancer site. Psychooncology 2001, 10:19-28.
• [194]Katz MR, Irish JC, Devins GM, Rodin GM, Gullane PJ: Psychosocial adjustment in head and neck cancer: the impact of disfigurement, gender and social support. Head Neck 2003, 25:103-112.
• [195]Zheng Y, Wu CX, Zhang ML: The epidemic and characteristics of female breast cancer in China. China Oncology 2013, 23:561-569. (in China)
• [196]Brintzenhofe-Szoc KM, Levin TT, Li Y, Kissane DW, Zabora JR: Mixed anxiety/depression symptoms in a large cancer cohort: prevalence by cancer type. Psychosomatics 2009, 50:383-391.
• [197]Group Therapy or Individual Therapy http://web4health.info/en/answers/therapy-group-vs-individual.htm webcite
• [198]Shaffer CS, Shapiro J, Sank LI, Coghlan DJ: Positive changes in depression, anxiety, and assertion following individual and group cognitive behavior therapy intervention. Cognit Ther Res 1981, 5:149-157.
• [199]Jacobsen PB, Jim HS: Psychosocial interventions for anxiety and depression in adult cancer patients: achievements and challenges. CA Cancer J Clin 2008, 58:214-230.