Home-based Psychological Nursing Interventions for Improvement of Sleep Quality and Psychological Health in Patients with Hypopharyngeal Carcinoma Undergoing Surgical Resections: a Randomized Trial

Background: The primary aim of this study was to determine the efficacy of a psychological nursing intervention for improving sleep quality and alleviating anxiety and depression among hypopharyngeal carcinoma patients undergoing surgical resections. Methods: A total of 140 hypopharyngeal carcinoma patients undergoing surgical resections in our hospital from January 2017 to December 2020 were included and randomly assigned to a standard nursing group or psychological nursing group, with 70 cases per group. Sleep quality was assessed using the Pittsburgh sleep quality index (PSQI). The severity of anxiety symptoms and depressive disorders were evaluated using Zung's self-rating anxiety scale (SAS) and self-rating depression scale (SDS). The functional assessment of cancer therapy-general scale (FACT-G) tool was used to evaluate the quality of life. Fear of progression (FoP) was also scored. Results: Participants with hypopharyngeal carcinoma in the psychological nursing group demonstrated greater improvements in the primary outcome of global sleep quality (P=0.002) at postintervention compared to the participants in the standard nursing group. The psychological nursing group participants showed remarkably greater improvements in the subscale scores of global sleep quality characteristics (secondary outcomes) including daytime dysfunction (P < 0.001), subjective sleep quality (P=0.029), and sleep latency (P=0.006) at postintervention compared to those receiving standard nursing. Psychological nursing group participants had lower SAS and SDS scores compared to those in the standard nursing group (P<0.001). The results revealed that participants who received psychological nursing intervention exhibited higher scores of all FACT-G subscales and lower scores of FoP compared to participants receiving standard nursing intervention (both P<0.001). The global sleep quality scores shared positive associations with scores of SAS, SDS, and FoP (r=0.518, r=0.572, and r=0.395, respectively, P<0.001). Conclusions: These data provide evidence that home-based psychological nursing intervention could improve sleep quality and alleviate anxiety and depression among hypopharyngeal carcinoma patients undergoing surgical resections.