A randomized controlled trial on the effects of specialized nursing based on cognitive behavioral intervention on anxiety, depression, and quality of life in patients with newly diagnosed diffuse large B-cell lymphoma
Abstract
Background: Patients with diffuse large B-cell lymphoma often experience anxiety, depression, and other negative emotions, which not only affect treatment compliance but also significantly reduce their quality of life. Exploring effective nursing intervention strategies to improve patients’ psychological state and enhance prognostic levels has become an important issue in clinical practice. Objective: To investigate the effects of specialized nursing based on cognitive behavioral intervention on anxiety, depression, and quality of life in patients with newly diagnosed diffuse large B-cell lymphoma, providing evidence-based support for clinical nursing interventions. Methods: A single-center, parallel-group, open-label randomized controlled trial design was used from January 2022 to December 2023 in the Hematology Department of Chengdu Shang Jin Nan Fu Hospital. A total of 128 diagnosed patients were recruited and randomly assigned into an experimental group and a control group according to the random number table method, with 64 cases in each group. On the basis of routine nursing, the experimental group received cognitive behavioral intervention, including group lectures, individual follow-up, and relaxation training, for 12 weeks. Anxiety, depression, and quality of life were assessed at pre-intervention (T0), 6 weeks of intervention (T1), 12 weeks of intervention (T2), and 3 months after the end of the intervention (T3). Results: There was no statistically significant difference (P > 0.05) between the two groups in terms of anxiety, depression, and quality of life scores at baseline. At 6 weeks (T1), 12 weeks (T2), and 3 months after the end of the intervention (T3), the experimental group had significantly lower anxiety and depression scores than the control group (t test, P < 0.01) and significantly higher quality of life scores than the control group (t test, P < 0.01). Repeated measures ANOVA showed a significant time × group effect for anxiety, depression, and quality of life (P < 0.001), indicating that the trend of improvement in emotional state and quality of life in the intervention group was significantly better than that in the control group. Conclusion: Specialized nursing based on cognitive behavioral intervention can significantly improve anxiety and depression in patients with newly diagnosed diffuse large B-cell lymphoma and continuously enhance their quality of life. This provides an important reference for optimizing and promoting clinical nursing models for this population.
Copyright (c) 2026 Fanrong Hu, Lan Guo, Zhihua Luo, Mingli Zeng
This work is licensed under a Creative Commons Attribution 4.0 International License.
References
1. Azizi M, Heshmatnia F, Milani H, et al. The Effectiveness of Cognitive Behavioral Therapy on Depression and Anxiety Symptoms in Breast Cancer Patients and Survivors: A Systematic Review of Interventional Studies. Brain and Behavior. 2024; (10): e70098-e70098.
2. Gandy M, Woldhuis T, Wu W, et al. Cognitive behavioral interventions for depression and anxiety in adults with neurological disorders: a systematic review and meta-analysis. Psychological Medicine. 2024; 54(12): 3237–3250. doi: 10.1017/s0033291724001995
3. Amer NA, Abdelrazek S, Eladrosy W, et al. Computer-Based Cognitive Behavioral Therapy Intervention for Depression, Anxiety, and Stress Disorders: A Systematic Review. International Journal of Cognitive Therapy. 2024; 1–34.
4. Yang Z, Han S, Zhang L, et al. Dose-Response Effects of Patient Engagement on Anxiety and Depression in a Cognitive-Behavioral Intervention: Secondary Analysis of a Pilot Randomized Controlled Trial and a Clinical Controlled Trial. AIDS and Behavior. 2024; 28(6): 1923–1935. doi: 10.1007/s10461-024-04290-6
5. Ludlow C, Wardle B, Nedeljkovic M. Cognitive behaviour therapy for pandemic-related anxiety and depression in adolescents: a pilot study of a novel intervention. Australian Psychologist. 2023; 59(1): 60–72. doi: 10.1080/00050067.2023.2257864
6. Danhauer, SC, Brenes, GA, Tooze, JA, et al. Cultural and linguistic adaptation of a telephone-based cognitive-behavioral therapy (CBT) intervention to treat depression and anxiety in Hispanic cancer survivors. Journal of Psychosocial Oncology. 2023; 42(4): 558–572. doi: 10.1080/07347332.2023.2296045
7. Liang TY, Zhou JL, Xu QW, et al. Influencing factors of fear of recurrence in lymphoma survivors and the effect of cognitive-behavioral intervention on patients’ quality of life and psychological state. Progress in Modern Biomedicine. 2022; 22(22): 4247–4251. doi: 10.13241/j.cnki.pmb.2022.22.009
8. Szigethy EM, Silfee V, Marroquin MA, et al. A Digital Cognitive-Behavioral Intervention for Depression and Anxiety Among Adolescents and Young Adults. Psychiatric Services. 2023; 74(4): 437–440. doi: 10.1176/appi.ps.202200045
9. Sun ZX, Liu HX, Jiao LY, et al. Reliability and validity of the Hospital Anxiety and Depression Scale. Chinese Journal of Clinical Physicians (Electronic Edition). 2017; (2): 198–201.
10. Wang JP, Chen ZG, Lin WJ, Cui JN. The measurement of quality of life in Chinese cancer patients—Trial of EORTC QLQ-C30 in China. Acta Psychologica Sinica. 2000; 32(4): 438–442.
11. Kirk MA, Pirbaglou M, Weerasekera R, et al. Effectiveness of online cognitive behavioral interventions that include mindfulness for clinically-diagnosed anxiety and depressive disorders: A systematic review and meta-analysis. International Journal of Mental Health. 2021; 51(3): 235–266. doi: 10.1080/00207411.2021.1959807
12. Wu MS, Wickham RE, Chen SY, et al. Examining the Impact of Digital Components Across Different Phases of Treatment in a Blended Care Cognitive Behavioral Therapy Intervention for Depression and Anxiety: Pragmatic Retrospective Study. JMIR Formative Research. 2021; 5(12): e33452. doi: 10.2196/33452
13. Lawler K, Earley C, Timulak L, et al. Dropout from an Internet-Delivered Cognitive Behavioral Therapy Intervention for Adults with Depression and Anxiety: Qualitative Study. JMIR Formative Research. 2021; 5(11): e26221. doi: 10.2196/26221
14. Zhang N, Xie XS, Liu CF, Li GP. The effect of cognitive-behavioral intervention on psychological resilience and quality of life in patients with malignant lymphoma. Cancer Progress. 2021; 12: 1276–1279+1283.
15. Feng AM, Wang D, Feng LM, et al. Clinical efficacy and safety of olanzapine combined with cognitive-behavioral intervention for improving psychiatric and behavioral symptoms of dementia. Chinese Journal of Health Psychology. 2021; 12: 1764–1768. doi: 10.13342/j.cnki.cjhp.2021.12.002
16. Wang CY, Guo GH, Wang J. Effects of cognitive-behavioral nursing intervention on disease cognition, quality of life, and chemotherapy-related adverse reactions in lymphoma patients. Qilu Journal of Nursing. 2021; 3: 58–60.
17. Zhang Z, Zeng XJ, Huang XX, Kuang QH. Application of a cognitive-behavioral intervention program in fear of disease progression in patients with non-Hodgkin’s lymphoma. Qilu Journal of Nursing. 2021; 1: 11–14.
18. Venkatesan A, Rahimi L, Kaur M, et al. Digital Cognitive Behavior Therapy Intervention for Depression and Anxiety: Retrospective Study. JMIR Mental Health. 2020; 7(8): e21304. doi: 10.2196/21304
19. Marco JH, Alonso S, Andani J. Early intervention with cognitive behavioral therapy reduces sick leave duration in people with adjustment, anxiety and depressive disorders. Journal of Mental Health. 2020; 29(3), 247–255.
20. Fan GP, Zhao HC. Effects of cognitive-behavioral intervention on the emotional state and quality of life in patients with laryngeal cancer. Nursing Research. 2019; 16: 2910–2912.
21. Gu YW, Zhang P, Liu WJ, et al. Effects of group cognitive-behavioral intervention combined with WeChat on the quality of life of community cancer patients. Shanghai Journal of Preventive Medicine. 2018; 30(6): 487–492. doi: 10.19428/j.cnki.sjpm.2018.18629
