CLINICAL TRIAL article
Front. Psychol.
Sec. Psycho-Oncology
Volume 16 - 2025 | doi: 10.3389/fpsyg.2025.1511622
Systematic Interventions Based on the Stress-Induced Situation, Affective, Bodily, and Cognitive Reactions Framework to Mitigate Psychological Distress in Lung Cancer Patients Post-thoracoscopic Surgery: A Randomised Clinical Trial
Provisionally accepted
- 11.Department of Thoracic Surgery, The Second Affiliated Hospital of Army Medical University, Chongqing, China, Chongqing, China
- 2Department of Medical Psychology, Department of Medical Psychology, The Second Affiliated Hospital of Army Medical University, Chongqing, China, Chongqing, China
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Objective: To evaluate the efficacy of a multi-component intervention based on the Situational, Affective, Bodily, and Cognitive (SABC) stress-response model in reducing psychological distress and enhancing quality of life among post-thoracoscopic lung-cancer patients. Methods: In this single-centre, assessor-masked, parallel-group randomised controlled trial, 240 patients were randomised (1:1) to either a 12-month SABC intervention (n = 120) or standard care (n = 120) by means of computer-generated, sealed-envelope allocation. Outcome assessors were blinded to group assignment. The intervention comprised psycho-education, SABC-based skills training, a daily-habits checklist and scheduled follow-up. Psychological distress was measured with the NCCN Distress Thermometer (DT); quality of life was assessed with the EORTC QLQ-C30 at baseline and at 1, 3, 6 and 12 months post-surgery. Linear mixed-effects models were used, under both intention-to-treat (ITT) and per-protocol analyses, to test time-by-group interactions.Results: Time-by-group interactions favoured the intervention group for physical (ITT: F = 5.632, P < 0.001; PP: F = 6.084, P < 0.001), role (ITT: F = 3.325, P = 0.010; PP: F = 2.675, P = 0.031) and emotional functioning (ITT: F = 5.543, P < 0.001; PP: F = 5.566, P < 0.001), and for the distress thermometer (ITT: F = 3.791, P = 0.005; PP: F = 5.258, P < 0.001). Social functioning improved in the ITT analysis only (P = 0.016); fatigue improved in the per-protocol analysis only (P = 0.008). No significant differences were observed for cognitive functioning, nausea and vomiting, pain, dyspnoea, insomnia, appetite loss, constipation, diarrhoea, financial difficulties or global health status ( P > 0.05).A structured SABC-informed intervention significantly improves functional domains and reduces psychological distress in early-stage lung-cancer survivors after thoracoscopic surgery. Limitations include recruitment from a single tertiary centre and exclusion of patients with severe comorbidities, which may limit generalisability to broader clinical populations.
Keywords: Lung Neoplasms, Thoracoscopic surgery, psychological distress, Quality of Life, Cognitive-behavioural therapy
Received: 15 Oct 2024; Accepted: 11 Aug 2025.
Copyright: © 2025 Tang, Liu, He, Peng, Luo, Zheng and Zhang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Qingling Zhang, Department of Medical Psychology, Department of Medical Psychology, The Second Affiliated Hospital of Army Medical University, Chongqing, China, Chongqing, China
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