Research on nurse-led psychological stress intervention pathways for oral cancer patients under a remote dental collaborative model
Abstract
To explore the construction and effectiveness of nurse-led psychological stress intervention pathways for oral cancer patients under a remote dental collaborative model. A randomized controlled trial design was adopted, with 319 oral cancer patients treated at a tertiary hospital in Xuzhou from July to September 2023 as study subjects, randomly assigned to an intervention group (n = 80) and a control group (n = 80). The intervention group received a 12-week nurse-led psychological stress intervention under remote collaborative model, while the control group received routine care. Assessment tools including the Perceived Stress Scale (PSS-14), Hospital Anxiety and Depression Scale (HADS), and World Health Organization Quality of Life Brief Scale (WHOQOL-BREF) were employed, with measurements conducted at baseline, 4 weeks, 8 weeks, 12 weeks of intervention, and 24-week follow-up period. Structural equation modeling was used to analyze mediating effects and moderating factors of the intervention. PSS-14 scores in the intervention group decreased from baseline (33.2 ± 8.9) to end of intervention (21.5 ± 6.2), representing a 35.2% reduction (p < 0.001); HADS anxiety and depression scores improved by 36.8% and 36.1% respectively; quality of life scores increased by 26.4%. Repeated measures analysis of variance showed statistically significant between-group differences (p < 0.001), with all effect sizes reaching large effect standards. Mediation analysis revealed that cognitive change, coping strategy improvement, and enhanced social support were the primary pathways through which the intervention exerted its effects, with mediation effects accounting for 38.6% of total effects. The remote collaborative model was significantly superior to traditional models in terms of cost-effectiveness, time efficiency, and service accessibility. Factors such as age, education level, and technology acceptance had moderating effects on intervention outcomes. Nurse-led psychological stress intervention under a remote dental collaborative model can significantly improve the psychological health status of oral cancer patients, demonstrating good feasibility, effectiveness, and acceptability, and providing an innovative service model for psychological support of oral cancer patients.
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