The benefits of an offline to online cognitive behavioral stress management regarding anxiety, depression, spiritual well‐being, and quality of life in postoperative intrahepatic cholangiocarcinoma patients

Abstract Aim Cognitive behavioral stress management (CBSM) has been introduced for the postoperative cancer management, but its application in intrahepatic cholangiocarcinoma (ICC) is rare. This current study constructed an offline to online CBSM (OO‐CBSM) program and applying multiple assessing scales, aiming at exploring the benefits of OO‐CBSM regarding anxiety, depression, spiritual well‐being, and quality of life (QoL) in postoperative ICC patients. Methods The study randomly assigned 68 postoperative ICC patients into OO‐CBSM ( N = 34) and normal care (NC) ( N = 34) groups to undergo 10‐week interventions. Hospital anxiety‐and‐depression scale (HADS), Zung's self‐reporting anxiety scale (SAS), and depression scale (SDS), functional‐assessment of chronic‐illness therapy‐spiritual well‐being scale (FACIT‐Sp), European quality‐of‐life‐5 dimensions (EQ‐5D), and quality‐of‐life questionnaire‐core30 (QLQ‐C30) were assessed within 6 months (M). Results HADS‐anxiety scores at M3 ( P = 0.049) and M6 ( P = 0.009), SAS score at M6 ( P = 0.028), HADS‐depression score at M3 ( P = 0.043), and SDS scores at M3 ( P = 0.044) and M6 ( P = 0.028), were lower in the OO‐CBSM group versus the NC group. Meanwhile, FACIT‐Sp scores at M1 ( P = 0.042) and M6 ( P = 0.003) were higher in the OO‐CBSM group over the NC group. Besides, EQ‐5D scores at M3 ( P = 0.067) and M6 ( P = 0.087) disclosed trends to be lower in the OO‐CBSM group versus the NC group, but not statistically significant. QLQ‐C30‐global‐health scores at M3 ( P = 0.049) and M6 ( P = 0.033), and QLQ‐C30‐function score at M6 ( P = 0.046), were higher in OO‐CBSM group over NC group; but QLQ‐C30‐symptom score was not significantly different at any timepoints between them. Conclusion OO‐CBSM attenuates anxiety and depression, and advances spiritual well‐being and QoL in postoperative ICC patients, indicating its potency for the ICC postoperative management.