Effects of a WeChat-Based Life Review Program for Patients With Digestive System Cancer: 3-Arm Parallel Randomized Controlled Trial

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Abstract

Background

Patients with digestive system cancer often experience psychospiritual distress. Life review is an evidence-based psychological intervention for patients with cancer, but the effects of digital life review programs are unclear, especially for patients with digestive system cancer.

Objective

We examined the effects of a WeChat-based life review program on the psychospiritual well-being of patients with digestive system cancer.

Methods

This study was a 3-arm parallel randomized controlled trial. Eligible patients with digestive system cancer were recruited from a university hospital in Fujian, China. They were randomized to a life review group and 2 control groups. All participants received routine care, and the life review group also received the 4-week WeChat-based life review program. Control group 1 also received a 4-week program of friendly visiting. Anxiety, depression, hope, and self-transcendence were measured at baseline and 2 days, 1 month, and 6 months after the intervention.

Results

A total of 150 participants were randomly allocated to the WeChat-based life review group (n=50), control group 1 (n=50), or control group 2 (n=50). The overall dropout rate was 10% (15/150), and 92% (46/50) of participants in the the life review group completed the intervention. Significant interaction effects for time and group membership were found for anxiety ( P<.001), depression ( P<.001), hope ( P<.001), and self-transcendence ( P<.001) at all follow-up time points. For anxiety and depression, the scores did not differ significantly between the life review group and control group 1 on day 2 ( P=.80 for anxiety, P=.51 for depression), but the scores were significantly lower in the life review group at month 1 and month 6 ( P=.02 for anxiety at both months 1 and 6; P=.003 and P<.001 for depression at months 1 and 6, respectively). Significant increases in hope and self-transcendence were revealed in the life review group compared to control group participants at all follow-up sessions.

Conclusions

The WeChat-based life review program was effective in reducing anxiety and depressive symptoms and in improving the level of hope and self-transcendence among patients with digestive system cancer. Though friendly visiting can also help to relieve anxiety, its effects are short-term.

Trial Registration

Chinese Clinical Trial Registry ChiCTR-IOR-17011998; https://tinyurl.com/5acycpd4

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Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries

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This article provides an update on the global cancer burden using the GLOBOCAN 2020 estimates of cancer incidence and mortality produced by the International Agency for Research on Cancer. Worldwide, an estimated 19.3 million new cancer cases (18.1 million excluding nonmelanoma skin cancer) and almost 10.0 million cancer deaths (9.9 million excluding nonmelanoma skin cancer) occurred in 2020. Female breast cancer has surpassed lung cancer as the most commonly diagnosed cancer, with an estimated 2.3 million new cases (11.7%), followed by lung (11.4%), colorectal (10.0 %), prostate (7.3%), and stomach (5.6%) cancers. Lung cancer remained the leading cause of cancer death, with an estimated 1.8 million deaths (18%), followed by colorectal (9.4%), liver (8.3%), stomach (7.7%), and female breast (6.9%) cancers. Overall incidence was from 2-fold to 3-fold higher in transitioned versus transitioning countries for both sexes, whereas mortality varied <2-fold for men and little for women. Death rates for female breast and cervical cancers, however, were considerably higher in transitioning versus transitioned countries (15.0 vs 12.8 per 100,000 and 12.4 vs 5.2 per 100,000, respectively). The global cancer burden is expected to be 28.4 million cases in 2040, a 47% rise from 2020, with a larger increase in transitioning (64% to 95%) versus transitioned (32% to 56%) countries due to demographic changes, although this may be further exacerbated by increasing risk factors associated with globalization and a growing economy. Efforts to build a sustainable infrastructure for the dissemination of cancer prevention measures and provision of cancer care in transitioning countries is critical for global cancer control.

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Is Open Access

CONSORT-EHEALTH: Improving and Standardizing Evaluation Reports of Web-based and Mobile Health Interventions

(2011)

Background Web-based and mobile health interventions (also called “Internet interventions” or "eHealth/mHealth interventions") are tools or treatments, typically behaviorally based, that are operationalized and transformed for delivery via the Internet or mobile platforms. These include electronic tools for patients, informal caregivers, healthy consumers, and health care providers. The Consolidated Standards of Reporting Trials (CONSORT) statement was developed to improve the suboptimal reporting of randomized controlled trials (RCTs). While the CONSORT statement can be applied to provide broad guidance on how eHealth and mHealth trials should be reported, RCTs of web-based interventions pose very specific issues and challenges, in particular related to reporting sufficient details of the intervention to allow replication and theory-building. Objective To develop a checklist, dubbed CONSORT-EHEALTH (Consolidated Standards of Reporting Trials of Electronic and Mobile HEalth Applications and onLine TeleHealth), as an extension of the CONSORT statement that provides guidance for authors of eHealth and mHealth interventions. Methods A literature review was conducted, followed by a survey among eHealth experts and a workshop. Results A checklist instrument was constructed as an extension of the CONSORT statement. The instrument has been adopted by the Journal of Medical Internet Research (JMIR) and authors of eHealth RCTs are required to submit an electronic checklist explaining how they addressed each subitem. Conclusions CONSORT-EHEALTH has the potential to improve reporting and provides a basis for evaluating the validity and applicability of eHealth trials. Subitems describing how the intervention should be reported can also be used for non-RCT evaluation reports. As part of the development process, an evaluation component is essential; therefore, feedback from authors will be solicited, and a before-after study will evaluate whether reporting has been improved.

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Author and article information

Contributors

Huimin Xiao:

ORCID: https://orcid.org/0000-0001-5468-301X

School of NursingFujian Medical UniversityNo 1 Xuefu North Road, University TownShangjie Town, Minhou CountyFuzhou City, Fujian Province, 350122China86 13860692061huimin_xiao@126.com

Journal

Journal ID (nlm-ta): J Med Internet Res

Journal ID (iso-abbrev): J Med Internet Res

Journal ID (publisher-id): JMIR

Title: Journal of Medical Internet Research

Publisher: JMIR Publications (Toronto, Canada )

ISSN (Print): 1439-4456

ISSN (Electronic): 1438-8871

Publication date Collection: August 2022

Publication date (Electronic): 25 August 2022

Volume: 24

Issue: 8

Electronic Location Identifier: e36000

Affiliations

[1 ] School of Nursing Fujian Medical University Fuzhou City, Fujian Province China

[2 ] The Second Affiliated Hospital of Fujian Medical University Quanzhou City, Fujian Province China

Author notes

Corresponding Author: Huimin Xiao huimin_xiao@ 123456126.com

Author information

Meihua Zheng https://orcid.org/0000-0002-6222-1031

Xiaoling Zhang https://orcid.org/0000-0002-3819-2007

Huimin Xiao https://orcid.org/0000-0001-5468-301X

Article

Publisher ID: v24i8e36000

DOI: 10.2196/36000

PMC ID: 9459832

PubMed ID: 36006665

SO-VID: 8cd02a19-466b-455e-bc34-a1e54d47f266

License:

This is an open-access article distributed under the terms of the Creative Commons Attribution License ( https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in the Journal of Medical Internet Research, is properly cited. The complete bibliographic information, a link to the original publication on https://www.jmir.org/, as well as this copyright and license information must be included.

History

Date received : 6 March 2022

Date revision requested : 7 May 2022

Date revision received : 22 May 2022

Date accepted : 29 July 2022

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