Effect of digital storytelling intervention on resilience, self-efficacy and quality of life among patients with non-small cell lung cancer (NSCLC): A randomized controlled trial

Effects of bibliotherapy on emotional distress, coping strategies, and resilience in adolescents with cancer: A pilot randomized controlled trial

PURPOSE

This study investigated the effects of interactive versus reading bibliotherapy using picture books on emotional distress, coping strategies, and resilience among adolescents with cancer.

METHODS

In this multicenter pilot randomized controlled trial with qualitative interviews, 27 patients aged 10-19 years diagnosed with leukemia or osteosarcoma within the past two years and undergoing treatment were randomly assigned to interactive bibliotherapy (n = 14) or reading bibliotherapy (n = 13). Each participant completed two sessions with picture books, 1-2 weeks apart. Emotional distress, coping strategies, and resilience were measured at baseline (T0), immediately post-intervention (T1), and at a one-month follow-up (T2). Interviews at T2 explored intervention effects and participant feedback.

RESULTS

At one-month follow-up, the experimental group showed significantly lower negative affect than the comparison group. No significant differences were found in positive affect, coping strategies, or resilience. Participants reported interactive bibliotherapy promoted support, emotional connection, and inner strength, while the comparison group experienced brief relaxation and distraction. Picture books resonated with illness experiences and were suitable during chemotherapy. Participants recommended more frequent sessions.

CONCLUSIONS

This study provided preliminary evidence that interactive bibliotherapy was more effective than reading bibliotherapy in alleviating emotional distress. Picture books may represent a promising psychological intervention for adolescents undergoing cancer treatment.

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CLINICALTRIALS

gov, NCT05510635.

Are digital psychological interventions for psychological distress and quality of life in cancer patients effective? A systematic review and network meta-analysis

BACKGROUND

Many cancer patients experience psychological distress and/or poor quality of life during or after their cancer treatment, yet they face multiple barriers to accessing psychological support. Digital psychological interventions represent a promising approach for addressing these barriers, however their comparative effectiveness remains uncertain.

METHODS

Nine databases were searched for randomized controlled trials (RCTs) from inception to July 2024. The primary outcomes were psychological distress and quality of life, and the secondary outcomes were measures of depression, anxiety, insomnia, fatigue, and fear of cancer recurrence in this study.

RESULTS

One hundred and thirty-six RCTs with 23,154 participants were identified. Of these interventions, three types-digitally-delivered cognitive behavioral therapy (CBT), health education, and virtual reality therapy (VRT)-demonstrated significant reductions in psychological distress compared to non-active controls. Digital CBT, narrative interventions, and VRT significantly improved quality of life compared to non-active controls. For depression, both digital CBT and VRT were superior to the non-active control group. Regarding anxiety, CBT, psychoeducation, and VRT outperformed the non-active control group. In terms of fatigue, CBT, psychoeducation, VRT, and multi-component interventions all showed enhanced efficacy compared to the non-active control group. However, only CBT exhibited significantly superior effectiveness in alleviating insomnia compared to non-active controls. Similarly, only mindfulness-based interventions significantly reduced fear of cancer recurrence compared to the non-active control condition.

CONCLUSIONS

Our results suggest that digital CBT and VRT are highly promising options for reducing psychological distress and enhancing the quality of life among cancer patients; further high-quality randomized controlled trials involving diverse populations are essential to validate these findings.

Comprehensive review of reinforcement learning in lung cancer diagnosis and treatment: Taxonomy, challenges and recommendations

Lung cancer (LuC) is one of the leading causes of death in the world, and due to the complex mechanisms and widespread metastasis, diagnosis and treatment are challenging. In recent years, the application of reinforcement learning (RL) techniques as a new tool to improve LuC diagnosis and treatment has been dramatically expanded. These techniques can potentially increase the accuracy of diagnosis and optimize treatment processes by learning from limited data and improving clinical decisions. However, RL in LuC diagnosis and treatment faces challenges such as limited access to clinical data, the complexity of algorithms, and the need for technical expertise for proper implementation. Our systematic review article aims to evaluate the latest developments in applications and challenges of using RL techniques in LuC diagnosis and treatment. The findings showed that RL has increased the accuracy of identifying disease trends by 37 % and enhancing treatment decisions by 23 %. Also, using this approach reduces data processing time by 17 % and streamlining treatment processes by 12 %. Ultimately, analyzing the current challenges and offering recommendations to researchers could help develop new strategies for improving the diagnosis and treatment of LuC.

Effect of an integrated narrative program (INP) on quality of life among patients with non-small cell lung cancer (NSCLC): An experimental trial

PURPOSE

To investigate the effectiveness of an integrated narrative program (INP) in enhancing the resilience, self-efficacy and quality of life of postoperative NSCLC patients.

METHODS

135 patients participated in this trial. 45 participants were recruited into the integrated narrative program group and received both the digital storytelling intervention and narrative therapy after a randomized controlled trial, while the control group (n = 45) received routine care and the intervention group (n = 45) underwent the digital storytelling intervention (DST). Questionnaires were administered to assess resilience, self-efficacy and quality of life at baseline (T0) (within 3 days before surgery), immediately after intervention (T1), one month post-intervention (T2), and three months post-intervention (T3). A linear mixed effects model was conducted via the intention-to-treat analysis.

RESULTS

During follow-up assessments, the INP group exhibited significantly greater increase in resilience, self-efficacy, and quality of life (all P < 0.001) compared to both DST group and control group, which were consistent with the sensitivity analysis results (all P < 0.001).

CONCLUSION

The INP was more effective than DST in improving the resilience, self-efficacy, and quality of life of postoperative NSCLC patients, and these benefits could persist for at least three months post-intervention. Due to the fact that the INP process is relatively complicated, so we recommend the use of web-based platforms for INP interventions in future clinical work.

Latent profile analysis of resilience and its influencing factors in patients with lung cancer undergoing chemotherapy

Objective

This study aims to analyze the classification characteristics of resilience in patients with lung cancer undergoing chemotherapy using latent profile analysis and explore the influencing factors and their relationship with medical coping strategies.

Methods

A questionnaire survey was conducted on 265 patients with lung cancer undergoing chemotherapy at a tertiary Grade-A hospital in Guangzhou from November 2023 to March 2024, using the General Information Questionnaire, Resilience Scale Specific to Cancer (RS-SC), Lung Cancer Chemotherapy Symptom Cluster Assessment Questionnaire, and Medical Coping Modes Questionnaire (MCMQ). Latent profile analysis was performed using Mplus 8.3 to identify resilience classifications, estimate influencing factors, and evaluate their impact on medical coping strategy selection.

Results

A total of 259 valid questionnaires were collected, with an effective response rate of 97.74%. Patients were categorized into three groups based on resilience levels: low-resilience group (20.46%), mid-resilience group (40.52%), and high-resilience group (38.97%). Multinomial logistic regression analysis revealed that education level, family per capita monthly income, and gastrointestinal and emotional symptom cluster scores were significant influencing factors for different resilience classifications (P < 0.05). Statistically significant differences were found in the scores for the confrontation and resignation dimensions of medical coping strategies across different latent profiles (P < 0.01).

Conclusions

Resilience in patients with lung cancer undergoing chemotherapy is heterogeneous, presenting in three distinct categories. Medical staff should provide tailored interventions based on the characteristics and influencing factors of each patient profile to enhance resilience and coping strategies.