Effects and mechanisms of CBT-based psychological nursing for anxiety/depression in diabetes-pancreatic cancer patients
Abstract
Background: Type 2 diabetes mellitus (T2DM) complicated by pancreatic cancer is associated with a high prevalence of anxiety and depression, yet current treatments predominantly focus on physiological management. Consequently, there is an urgent need for effective psychological nursing interventions to address emotional distress and improve overall patient outcomes. Objective: The objective of this study is to explore the impact of psychological nursing interventions grounded in Cognitive Behavioral Therapy (CBT) on alleviating anxiety and depression symptoms in patients with Type 2 diabetes mellitus (T2DM) who are also facing complications from pancreatic cancer. Additionally, we aim to examine the cognitive regulation mechanisms involved in this process. Methods: A prospective randomized controlled trial was carried out with 78 patients diagnosed with type 2 diabetes mellitus (T2DM) who also had pancreatic cancer. The participants were randomly assigned to either an intervention group or a control group, each consisting of 39 individuals. The control group received standard medical care and routine nursing, while the intervention group participated in a 12-week cognitive-behavioral therapy (CBT) psychological nursing intervention alongside standard care, followed by a 12-month follow-up. Various factors, including anxiety, depression, cognitive regulation strategies, quality of life, self-efficacy, and clinical indicators, were evaluated at baseline, after the intervention, and during the follow-up period. The effectiveness of the intervention was analyzed using repeated measures analysis of variance. Results: The patients in the intervention group experienced a marked reduction in anxiety (HADS-A) and depression (HADS-D) scores when compared to the control group, with a statistically significant difference (p < 0.001). Additionally, there was a notable enhancement in cognitive regulation abilities, as evidenced by higher scores on the Cognitive Emotion Regulation Questionnaire (CERQ) and lower scores on the Automatic Thoughts Questionnaire (ATQ) relative to the control group (p < 0.001). Over time, both quality of life (measured by the EORTC QLQ-C30) and self-efficacy (assessed by the GSES) scores showed significant improvement, with clear distinctions between the two groups (p < 0.001). Furthermore, clinical indicators such as fasting blood glucose, HbA1c, and CA19-9 levels demonstrated more substantial improvements in the intervention group compared to the control group (p < 0.01). Conclusion: CBT psychological nursing significantly alleviated anxiety and depression symptoms in patients with T2DM complicated by pancreatic cancer, optimized cognitive regulation mechanisms, improved quality of life and self-efficacy, and indirectly enhanced metabolic and tumor marker levels. These findings underscore its significant clinical application value.
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