Table 1.
Characteristics of the included studies on colorectal cancer.
| Study/Reference | Study design | Sample size | Cancer type | Assessment for anxiety | Nursing interventional methods and protocols | Main findings |
|---|---|---|---|---|---|---|
| (14) Brazil | RCT | 50 patients | Colorectal cancer | STAI | Therapeutic listening intervention. Protocol: In the preoperative period, patients had half-hour to talk to the investigators about their experience with hospitalization for cancer treatment. |
The therapeutic listening intervention did not cause differences on the state anxiety and surgical fears compared to the control group. |
| (15) China | Longitudinal study | 67 patients | Colorectal cancer | HADS | Ascertaining and meeting personalized psychosocial needs. Protocol: NA. |
Nearly 50.0% of participants were identified to have anxiety disorder before the surgery, while the number decreased to 37.3% in postoperative period. The different was significant (P<0.05). Age and educational background were the significant variables that influenced anxiety before and after surgery. |
| (17) China | Cohort | 130 patients | Rectal cancer | SAS | Predictive nursing. Protocol: Preoperatively, the patients and their families were educated about rectal cancer; evaluating the patients’ psychological states and eliminating their anxiety; multimedia mode was applied to explain stoma care, diet indexes, bathing mode, and exercise mode. |
The SAS scores were significantly lower in the predictive nursing group than the control group (P < 0.05). |
| (27) Turkey | RCT | 63 patients | Colorectal cancer | STAI | Progressive relaxation exercises. Protocol: The progressive relaxation exercises were applied in patients for 15min preoperatively and on postoperative days 1, 2, and 3 after breathing exercise training. |
As compared to the routine care, progressive relaxation exercises could significantly reduce postoperative pain, the rate of using opioid analgesic, and anxiety levels on postoperative day 0 (all P<0.05). |
| (21) China | Cohort | 120 patients | Rectal cancer | SAS and HAMA | Psychological interventions in the nursing care. Protocol: 1. Preoperative psychological care; 2. Provided regular cleaning stoma; 3. Guided the patients could manage their stomas independently; 4. Diet and nutrition education; 5. Individualized psychological intervention; 6. Home care was taught before the discharge. |
The SAS and HAMA scores in the study group were significantly lower than the control group (all P < 0.05). Psychological interventions in the nursing care could alleviate the patients’ bad moods, improve the quality of life, elevate the sleep durations. |
| (22) China | Cohort | 110 patients | Colon cancer | HAMA | Comprehensive nursing. Protocol: 1. Preoperative nursing: understood the patient’s physical state, medical and surgical history, systematic health education and psychological counseling; 2. Intraoperative nursing: cooperated with physicians in performing surgery-related nursing during the surgery; 3. Postoperative nursing: set comfortable position after surgery, appropriate exercise, and rigorous care. |
The HAMA scores in the study group were significantly lower than those in the control group (P<0.05). Comprehensive nursing could significantly reduce the postoperative complication rate (9% vs 25%), increase the gastrointestinal quality of life index (GIQLI) score, and improve the prognosis. |
| (23) China | RCT | 60 patients | Colorectal cancer | SAS | Comprehensive nursing care. Protocol: Positioning of colostomy before surgery, close observation of vital signs, psychological nursing intervention, instruction of correct nursing methods, and enhancement in patients’ self-care ability. |
Compared to the preoperative period, the SAS scores were significantly improved after comprehensive nursing care, which was superior to the control group (P < 0.05). This comprehensive care could promote postoperative recovery, decline the postoperative complications, and improve quality of life. |
| (25) Netherlands | Prospective monocenter study | 50 patients | Colorectal cancer | NA | Implementing perioperative music. Protocol: A tailored implementation strategy of perioperative music intervention by calculating a median knowledge score. |
Postoperative anxiety scores were lower than that of preoperative period (4.5 vs 3.0 scores). Perioperative music intervention was effective in reducing perioperative anxiety. Identifying the facilitating factors for implementing music might be more prominent. |
| (30) China | RCT | 100 patients | Colorectal cancer | STAI | Continuous nursing care. Protocol: WeChat, Tencent QQ, and Tencent conference software were applied. 1. The patients were encouraged to post daily self-care methods and photographs or videos of existing problems after surgery. 2. Video lectures on the latest progress in colostomy- or ileostomy-related treatment and the new ostomy products and introductions. 3. Nursing materials that help the patients return to social life. |
Compared to the control group, patients under continuous care had significantly lower mean STAI scores (both state anxiety and trait anxiety), indicating lower levels of anxiety after interventions. |
STAI, State-Trait Anxiety Inventory; HADS, Hospital Anxiety and Depression Scale; SAS, self-rating anxiety scale; HAMA, Hamilton anxiety scale.