Effects of a mobile health intervention based on a multitheoretical model of health behavior change on anxiety and depression, fear of cancer progression, and quality of life in patients with differentiated thyroid cancer: A randomized controlled trial

Abstract Background Despite the high cure rate of differentiated thyroid cancer (DTC), patients endure side effects from treatment and psychological distress, impacting their quality of life. The potential of mobile health (mHealth) interventions to address these issues remains unexplored. The purpo...

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Main Authors: Xiangju Sun, Yang Jiang, Jing Wang, Siyuan Fan, Xinghua Fu, Zhi An, Xiaomei Zhu, Yibo Wu
Format: Article
Language:English
Published: BMC 2024-10-01
Series:BMC Medicine
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Online Access:https://doi.org/10.1186/s12916-024-03652-0
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author Xiangju Sun
Yang Jiang
Jing Wang
Siyuan Fan
Xinghua Fu
Zhi An
Xiaomei Zhu
Yibo Wu
author_facet Xiangju Sun
Yang Jiang
Jing Wang
Siyuan Fan
Xinghua Fu
Zhi An
Xiaomei Zhu
Yibo Wu
author_sort Xiangju Sun
collection DOAJ
description Abstract Background Despite the high cure rate of differentiated thyroid cancer (DTC), patients endure side effects from treatment and psychological distress, impacting their quality of life. The potential of mobile health (mHealth) interventions to address these issues remains unexplored. The purpose of this study is to develop an mHealth intervention based on the Multi-Theoretical Model of Health Behavior Change (MTM) and evaluate its impact on reducing anxiety, depression, fear of cancer progression, and enhancing quality of life in DTC patients. Methods A single-blind, single-center, prospective, randomized controlled trial was conducted. One hundred and eleven consecutive DTC patients from Harbin Medical University’s Fourth Hospital were enrolled from March 2023 to March 2024. Participants were randomized into a control group and an intervention group that received a 3-month mHealth intervention based on MTM theory. Outcomes were assessed using web-based questionnaires at baseline and conclusion. Results One hundred four patients with DTC completed the study, with 7 lost to follow-up (6.3%). The intervention group experienced a significant drop in PHQ-4 scores post-MTM-mHealth intervention (P < .026), with no change in the control group, demonstrating a significant difference. The intervention group also had significantly lower anxiety (P < .015) and depression (P < .032) scores compared to controls. All PHQ-4 scores improved in the intervention group except for “Little interest or pleasure in doing things.” Anxiety levels were significantly lower in the intervention group (P < .026) but remained unchanged in controls. The control group exhibited a significant increase in FCR-4 scores at follow-up, differing from the intervention group (P < 0.001). Quality of life scores did not differ at baseline but saw a significant improvement in the intervention group, while the control group experienced no significant change. The intervention group had higher VAS scores (P < .030) and greater health education satisfaction across all dimensions (P < .019). Conclusions The MTM-based mHealth intervention significantly benefits DTC patients by reducing anxiety, fear of cancer recurrence, and improving quality of life, though its effect on depression requires further investigation. Trial registration China Clinical Trial Registry ChiCTR2200064321.
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spelling doaj-art-37b9c20ad97a4fd59b309342cdaea6122025-08-20T02:17:53ZengBMCBMC Medicine1741-70152024-10-0122111710.1186/s12916-024-03652-0Effects of a mobile health intervention based on a multitheoretical model of health behavior change on anxiety and depression, fear of cancer progression, and quality of life in patients with differentiated thyroid cancer: A randomized controlled trialXiangju Sun0Yang Jiang1Jing Wang2Siyuan Fan3Xinghua Fu4Zhi An5Xiaomei Zhu6Yibo Wu7Clinical Pharmacy, The Fourth Affiliated Hospital of Harbin Medical UniversityJitang College, North China University of Science and TechnologySchool of Public Health, Peking UniversityDepartment of Preventive Medicine, Yanjing Medical College, Capital Medical UniversityThe Fourth School of Clinical Medicine, Harbin Medical UniversityEcological Environment College, Chengdu University of TechnologyDepartment of Pharmacy, Beidahuang Group General HospitalSchool of Public Health, Peking UniversityAbstract Background Despite the high cure rate of differentiated thyroid cancer (DTC), patients endure side effects from treatment and psychological distress, impacting their quality of life. The potential of mobile health (mHealth) interventions to address these issues remains unexplored. The purpose of this study is to develop an mHealth intervention based on the Multi-Theoretical Model of Health Behavior Change (MTM) and evaluate its impact on reducing anxiety, depression, fear of cancer progression, and enhancing quality of life in DTC patients. Methods A single-blind, single-center, prospective, randomized controlled trial was conducted. One hundred and eleven consecutive DTC patients from Harbin Medical University’s Fourth Hospital were enrolled from March 2023 to March 2024. Participants were randomized into a control group and an intervention group that received a 3-month mHealth intervention based on MTM theory. Outcomes were assessed using web-based questionnaires at baseline and conclusion. Results One hundred four patients with DTC completed the study, with 7 lost to follow-up (6.3%). The intervention group experienced a significant drop in PHQ-4 scores post-MTM-mHealth intervention (P < .026), with no change in the control group, demonstrating a significant difference. The intervention group also had significantly lower anxiety (P < .015) and depression (P < .032) scores compared to controls. All PHQ-4 scores improved in the intervention group except for “Little interest or pleasure in doing things.” Anxiety levels were significantly lower in the intervention group (P < .026) but remained unchanged in controls. The control group exhibited a significant increase in FCR-4 scores at follow-up, differing from the intervention group (P < 0.001). Quality of life scores did not differ at baseline but saw a significant improvement in the intervention group, while the control group experienced no significant change. The intervention group had higher VAS scores (P < .030) and greater health education satisfaction across all dimensions (P < .019). Conclusions The MTM-based mHealth intervention significantly benefits DTC patients by reducing anxiety, fear of cancer recurrence, and improving quality of life, though its effect on depression requires further investigation. Trial registration China Clinical Trial Registry ChiCTR2200064321.https://doi.org/10.1186/s12916-024-03652-0Differentiated thyroid cancermHealthMTMPHQ-4FCR-4Anxiety depression
spellingShingle Xiangju Sun
Yang Jiang
Jing Wang
Siyuan Fan
Xinghua Fu
Zhi An
Xiaomei Zhu
Yibo Wu
Effects of a mobile health intervention based on a multitheoretical model of health behavior change on anxiety and depression, fear of cancer progression, and quality of life in patients with differentiated thyroid cancer: A randomized controlled trial
BMC Medicine
Differentiated thyroid cancer
mHealth
MTM
PHQ-4
FCR-4
Anxiety depression
title Effects of a mobile health intervention based on a multitheoretical model of health behavior change on anxiety and depression, fear of cancer progression, and quality of life in patients with differentiated thyroid cancer: A randomized controlled trial
title_full Effects of a mobile health intervention based on a multitheoretical model of health behavior change on anxiety and depression, fear of cancer progression, and quality of life in patients with differentiated thyroid cancer: A randomized controlled trial
title_fullStr Effects of a mobile health intervention based on a multitheoretical model of health behavior change on anxiety and depression, fear of cancer progression, and quality of life in patients with differentiated thyroid cancer: A randomized controlled trial
title_full_unstemmed Effects of a mobile health intervention based on a multitheoretical model of health behavior change on anxiety and depression, fear of cancer progression, and quality of life in patients with differentiated thyroid cancer: A randomized controlled trial
title_short Effects of a mobile health intervention based on a multitheoretical model of health behavior change on anxiety and depression, fear of cancer progression, and quality of life in patients with differentiated thyroid cancer: A randomized controlled trial
title_sort effects of a mobile health intervention based on a multitheoretical model of health behavior change on anxiety and depression fear of cancer progression and quality of life in patients with differentiated thyroid cancer a randomized controlled trial
topic Differentiated thyroid cancer
mHealth
MTM
PHQ-4
FCR-4
Anxiety depression
url https://doi.org/10.1186/s12916-024-03652-0
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