Effects of cognitive behavior therapy combined with Baduanjin in patients with colorectal cancer

Table 1 Comparison of general information between the two groups of patients, n (%)

	Experimental group (n = 27)	Control group (n = 28)	P value
Mean age (range, yr)	52 (44-60)	51 (40-62)	0.516
Gender
Male	19 (70.4)	21 (75)	0.70
Female	8 (29.6)	7 (25)
Years of education
< 9	8 (29.6)	9 (32.2)	0.747
9-12	15 (55.6)	13 (46.4)
> 12	4 (14.8)	6 (21.4)
Marital status
Married	20 (74.1)	24 (85.7)	0.555
Unmarried	2 (7.4)	1 (3.6)
Divorced	5 (18.5)	3 (10.7)
Clinical stage
I	3 (11.1)	2 (7.2)	0.763
II	11 (40.8)	10 (35.7)
III	13 (48.1)	16 (57.1)
Chemotherapy
XELOX	12 (44.4)	10 (35.7)	0.509
FOLOX	15 (55.6)	18 (64.3)
Mean BMI (kg/m2)	22.56 (20.38-24.05)	22.71 (21.22-24.19)	0.561
Mean MMSE score	24 (22-27)	24 (22-27)	0.765

XELOX: Capecitabine combined with oxaliplatin; FOLOX: Oxaliplatin combined with calcium folinate and deoxyfluoruridine; BMI: Body mass index; MMSE: Mini-mental State Examination.

Table 2 Quality of life, cognitive function, and cancer-related fatigue scores at baseline (n = 55)

Item	Scale score range	Actual score range	Actual score	Score percentage (%)
Quality of life
FACT-C total score	0-144	36-131	81.65 ± 23.27	56.72
Physiological status	0-28	6-25	15.38 ± 4.47	54.93
Social/family status	0-28	9-28	19.05 ± 4.57	68.04
Emotional status	0-24	6-24	14.93 ± 4.08	62.21
Functional status	0-28	5-26	12.69 ± 4.46	45.32
Additional attention score	0-36	10-30	19.84 ± 4.87	55.11
Cognitive function
FACT-Cog total score	38-132	47-108	80.15 ± 10.97	60.72
Corrected cognitive impairment	18-72	26-57	46.62 ± 4.98	64.75
Cognitive ability	0-28	7-22	14.76 ± 3.21	52.14
Other’s evaluation	4-16	5-16	10.51 ± 2.28	65.69
Impact on quality of life	4-16	4-13	8.25 ± 2.08	51.75
CRF
CFS total score	0-60	22-46	34.47 ± 6.59	57.45
Physical fatigue	0-28	11-28	18.09 ± 3.23	64.61
Emotional fatigue	0-16	6-15	8.85 ± 1.82	55.31
Cognitive fatigue	0-16	3-12	7.53 ± 2.05	47.06

FACT-C: Functional assessment of cancer therapy – colorectal; FACT-Cog: Functional assessment of cancer therapy-cognitive function; CRF: Cancer-related fatigue; CFS: Cancer fatigue scale.

Table 3 Comparison of cancer-related fatigue tests in different dimensions (mean ± SD)

Group	Physical fatigue	Emotional fatigue	Cognitive fatigue
Experimental group (n = 27)
Baseline	17.56 ± 3.53	8.67 ± 1.78	7.37 ± 2.09
3 mo	15.78 ± 2.85b,e	7.59 ± 1.67b,d	6.59 ± 1.65a,d
6 mo	15.19 ± 2.66b,e	6.59 ± 1.47b,c,e	6.33 ± 1.66b,e
Control group (n = 28)
Baseline	18.61 ± 2.82	9.04 ± 1.80	7.57 ± 2.06
3 mo	18.43 ± 3.71	8.61 ± 1.69	7.79 ± 2.08
6 mo	18.46 ± 3.31	8.68 ± 1.91	7.68 ± 1.83

Intra-group comparison before and after intervention:

^aP < 0.05.

^bP < 0.01 vs baseline.

^cP < 0.01 vs 3 mo.

Comparison between experimental group and control group at different time:

^dP < 0.05.

^eP < 0.01, experimental group vs control group at baseline/3 mo/6 mo.

Table 4 Comparison of cognitive function tests in different dimensions (mean ± SD)

Group	Corrected cognitive impairment	Cognitive ability	Others’ evaluation	Impact on quality of life
Experimental group (n = 27)
Baseline	47.19 ± 4.14	14.96 ± 3.47	10.93 ± 2.24	8.81 ± 2.08
3 mo	50.26 ± 3.96b,e	17.11 ± 3.64b,d	11.26 ± 2.33a	9.37 ± 2.66e
6 mo	54.22 ± 6.80b,c,e	18.30 ± 4.26b,c,e	12.22 ± 2.28b,c,e	10.81 ± 2.73b,c,e
Control group (n = 28)
Baseline	46.07 ± 5.73	14.57 ± 2.87	10.11 ± 2.25	7.71 ± 1.94
3 mo	46.21 ± 5.37	14.68 ± 3.22	10.14 ± 2.17	7.32 ± 2.02
6 mo	46.25 ± 6.92	14.86 ± 3.50	10.21 ± 2.35	7.43 ± 2.01

Intra-group comparison before and after intervention:

^aP < 0.05.

^bP < 0.01 vs baseline.

^cP < 0.01 vs 3 mo.

Comparison between experimental group and control group at different time:

^dP < 0.05.

^eP < 0.01, experimental group vs control group at baseline/3 mo/6 mo.

Table 5 Comparison of quality of life tests in different dimensions (mean ± SD)

Group	Physiological status	Social/family status	Emotional status	Functional status	Additional attention score
Experimental group (n = 27)
Baseline	16.19 ± 3.48	19.85 ± 4.92	15.41 ± 4.41	13.78 ± 4.29	11.54 ± 4.36
3 mo	17.67 ± 3.96b,d	20.59 ± 4.73d	17.11 ± 4.47b,d	14.74 ± 4.78e	22.41 ± 6.08a,d
6 mo	18.70 ± 4.15b,e	21.48 ± 4.57b,c,e	17.48 ± 4.64b,d	16.00 ± 4.84b,c,e	24.85 ± 6.56b,c,e
Control group (n = 28)
Baseline	14.61 ± 5.18	18.29 ± 4.14	14.46 ± 3.76	11.64 ± 4.44	19.14 ± 4.28
3 mo	14.89 ± 5.72	17.75 ± 4.40	14.32 ± 3.49	11.32 ± 4.28	18.71 ± 5.61
6 mo	14.25 ± 5.29	18.14 ± 4.61	14.46 ± 3.75	11.54 ± 4.36	19.11 ± 5.63

Intra-group comparison before and after intervention:

^aP < 0.05.

^bP < 0.01 vs baseline.

^cP < 0.01 vs 3 mo.

Comparison between experimental group and control group at different time:

^dP < 0.05.

^eP < 0.01, experimental group vs control group at baseline/3 mo/6 mo.

Table 6 Correlation analysis between quality of life and cancer-related fatigue and cognitive dysfunction in experimental group

Item	FACT-C total score
	r	P value
CFS total score	-0.733	< 0.000
Physical fatigue	-0.439	0.023
Emotional fatigue	-0.487	0.011
Cognitive fatigue	-0.642	< 0.000
FACT-Cog total score	0.753	< 0.000
Corrected cognitive impairment	0.663	< 0.000
Cognitive ability	0.624	0.001
Other’s evaluation	0.186	0.342
Impact on quality of life	0.40	0.023

FACT-C: Functional assessment of cancer therapy – colorectal; FACT-Cog: Functional assessment of cancer therapy-cognitive function; CFS: Cancer fatigue scale.

Table 7 Stepwise regression analysis results of quality of life scores

Variable	Regression coefficient	SE	Standard regression coefficient	t	P value	Collinearity Statistics
						Tolerance	VIF
Constant	4.923	1.429		3.209	0.004
FACT-Cog Total score	0.375	0.149	0.464	2.512	0.019	0.447	2.235
CRF total score	-0.585	0.278	-0.388	-2.103	0.046	0.651	1.535

FACT-Cog: Functional assessment of cancer therapy-cognitive function; CRF: Cancer-related fatigue.