Effect of cognitive behavior therapy based on the health education pathway on psychology of Chinese papillary thyroid carcinoma patients: A randomized controlled trial

Abstract

Purpose: Our main aim was to explore whether cognitive behavior therapy based on the health education pathway (CBT-HEP) can effectively alleviate the psychological problems of papillary thyroid carcinoma (PTC) patients after 131I treatment.Methods: Eligible PTC patients were prospectively included (July 1, 2019-February 1, 2021). The baseline demographic characteristics questionnaire, the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30), the Distress Thermometer (DT), the Hamilton Anxiety Scale (HAMA), and the Patient Health Questionnaire-9 (PHQ-9)needed to be completed. Patients with a DT score ≥ 4 were randomly enrolled in further intervention trials. Patients received CBT-HEP and casual conversation (CC) in different groups.Results: A total of 357 PTC patients were investigated in this study, 48 and 49 patients were included in the CBT-HEP and CC groups, respectively. The DT, HAMA, and PHQ-9 scores before and after intervention and after six months of follow-up were 5.19, 10.29, 5.60; 2.50, 5.44, 3.38; 1.67, 3.98, 2.79 (CBT-HEP) and 4.84, 8.16, 3.76; 4.39, 8.53, 4.63; 3.63, 8.14, 4.37 (CC), respectively. DT, HAMA, and PHQ-9 scores decreased more significantly in the CBT-HEP group. Women, living alone, hypothyroidism, sadness, anxiety, tingling in hands/feet, breathing, concern about the treatment effect and radiation safety significantly increased the likelihood of a severe DT score.Conclusion: CBT-HEP is effective in relieving distress, anxiety and depression in PTC patients. In addition, PTC patients with the above characteristics have a poorer quality of life and should receive more attention.Registration: ChiCTR1900025852; registration date, September 11, 2019