Effects of the standardized communication system based on circadian rhythm regulation in psychological distress of adolescent and young adult cancer patients: A randomized controlled trial

Abstract

Background: Multiple factors of psychological distress in adolescent and young cancer patients continue to be unearthed, suggesting the warranted exploration of interventions that meet individualized psychological needs and are integrated into daily lives to alleviate their psychological distress.

Objective: To investigate the effects of the standardized communication system based on circadian rhythm regulation on psychological distress in adolescent and young adult cancer patients.

Design: A three-arm randomized controlled trial.

Setting and participants: A total of 129 adolescent and young adult cancer patients with psychological distress were recruited from the Third Xiangya Hospital of Central South University from January 2022 to May 2023.

Methods: Participants were randomly divided into three groups. Both intervention groups received eight standardized communication system intervention topics, while the control group received only routine psychological care. The difference between the two intervention groups was that the duration of the intervention in the intervention group 2 was matched to the three types of circadian rhythm of the study participants. The primary outcomes of psychological distress, anxiety, and depression, as well as the secondary outcomes of sleep quality and quality of life, were measured four times at baseline, immediately after completing the intervention, and one month versus three months after completing the intervention. The generalized estimating equations were used to compare the effects of the intervention across the three groups.

Results: In one month after the intervention, the two intervention groups significantly reduced psychological distress, anxiety, and depression, and improved the quality of sleep and quality of life in adolescent and young adult cancer patients compared to the control group (P < 0.01). Meanwhile, the intervention group 2 was more effective than the intervention group 1 in reducing psychological distress (-1.20, CI, -1.82 to -0.57, P < 0.001) and improving sleep quality (-1.72, CI, -2.83 to -0.62, P < 0.001) of patients. Moreover, the effects persisted three months after completing the intervention (P < 0.05).

Conclusions: The standardized communication system interventions can effectively alleviate psychological distress, anxiety, and depression, and improve sleep quality and quality of life in adolescent and young adult cancer patients. In addition, the standardized communication system based on circadian rhythm regulation is more advantageous in improving the psychological distress and sleep quality of adolescent and young adult cancer patients than the standardized communication system intervention.

Registration: The study was registered in the Chinese Clinical Trial Registry on January 3, 2022 (ChiCTR2200055230).

Keywords: Adolescent and young adult cancer patients; Circadian rhythm; Psychological distress; Standardized communication system.