Incremental Patient Care Program Decreases Anxiety, Reduces Depression and Improves the Quality of Life in Patients with Colorectal Cancer Receiving Adjuvant Chemotherapy

Colorectal cancer (CRC) is a serious disease that may lead to the occurrence of anxiety and depression; however, at present, little is known about the role of care intervention in the mental health of patients with CRC receiving adjuvant chemotherapy. Hence, an incremental patient care program (IPCP) was designed and its effects on anxiety, depression and quality of life (QoL) in patients with CRC receiving adjuvant chemotherapy was assessed. A total of consecutivel 298 patients with CRC who had undergone surgery were recruited for the present randomized, controlled study. Patients were randomly assigned to the IPCP group or the control group at a 1:1 ratio. In the IPCP group, patients received IPCP and conventional care, whereas in the control group, patients received only conventional care. The sp ecific interventions included in IPCP were patient health education, physical exercise, telephone counseling, regular examinations and care activities. Anxiety, depression and QoL were assessed using the Hospital Anxiety and Depression Scale (HADS) and the European Organization for Research and Treatment of Cancer QoL Questionnaire (QLQ-C30) scale. IPCP slightly decreased the anxiety grade at month (M) 6 compared with that of the controls (P=0.070). The IPCP group exhibited a significant improvement in the HADS depression score at M6 vs. M0 (P<0.001), and the depression grade was reduced in the IPCP group compared with that in the controls (P=0.037). Regarding QoL, the QLQ-C30 global health status score at M6 vs. M0 was increased (P=0.035) and the QLQ-C30 symptoms score at M6 vs. M0 was decreased (P=0.002) in the IPCP group compared with that in the controls, but no difference was observed in the QLQ-C30 function score between the two groups. Subgroup analysis by tumor-nodes-metastasis stage (II or III) demonstrated similar trends to those mentioned above. In conclusion, participation in the IPCP led to a slight decrease in anxiety, and contributed to a significant reduction in depression and an improvement in QoL in patients with CRC receiving adjuvant chemotherapy.