Effects of nurse-led exercise and cognitive behavioral intervention on reducing cancer-related fatigue in patients with medium advanced hepatocellular carcinoma

Objective To investigate the feasibility of a nurse-led exercise and cognitive behavioral intervention for medium-advanced hepatocellular carcinoma patients with cancer-related fatigue, sleep quality and depression outcomes. Methods A total of seventy-nine medium-advanced hepatocellular carcinoma patients were enrolled in this study, the patients were randomly assigned to intervention group and control group. The control group given conventional nursing intervention, intervention group received exercise and cognitive behavioral therapy. The baseline characteristics between two groups were compared, the fatigue outcome was measured by the Piper Fatigue Scale at before intervention, after a 2-week intervention, after a 6-week intervention. Besides, depression and sleep quality were measured using the self-rating depression scale and the Pittsburgh sleep quality index questionnaire, respectively. Results After 2-week and 6-week of intervention, the fatigue scores in the intervention group (4.14±0.40 and 3.91±0.37) were markedly higher than in the control group (4.94±0.38 and 5.03±0.44) (t=9.116,12.195, all P<0.05). Moreover, the intervention group (44.74±6.01) points and (41.30±7.43) points demonstrated lower scores of depressions compared to the control group (50.53±7.49) and (48.39±6.16) after 2-week and 6-week of intervention (t=3.771,4.630, all P<0.05). The intervention group (7.25±0.36) points and (6.29±0.96) points also showed lower scores of sleep quality when compared to the control group (8.86±0.57) points and (7.86±0.91) points after 2-week and 6-week of intervention (t=2.013, 2.189, all P<0.05). Conclusion Nurse-delivered exercise and cognitive behavioral intervention have benefits in helping medium-advanced hepatocellular carcinoma patients to decrease cancer-related fatigue, depressive symptoms, and improving their quality of sleep. Key words: Hepatocellular neoplasm; Transcatheter arterial chemoembolization; Cancer-related fatigue; Depression; Sleep quality