Non-Inferiority Study on the Precise Implementation of Multidisciplinary Continuous Nursing Intervention in Patients...

To explore the precise implementation methods of multidisciplinary continuous nursing intervention in patients with breast cancer experiencing negative emotions.

About 30-40% of breast cancer patients have negative emotions, and negative emotions can increase the risk of breast cancer death. Team psychological intervention is helpful to improve negative emotions. How to effectively and accurately implement the multidisciplinary continuous nursing model needs further research.We designed a retrospective analysis of 750 patients with breast cancer in our hospital was made. Their baseline characteristics and follow-up data, pre-treatment self-rating anxiety scale (SAS) scores, and scores in the follow-up period after the treatment (SAS_A) were included in the analysis to verify the correlation between an SAS_A score and a prognosis. Risk prediction models were established for the SAS_A score, and they were screened and verified. A non-inferiority study was conducted through the models to explore the feasibility of the precise multidisciplinary continuous nursing intervention in patients with breast cancer experiencing negative emotions.

The prognosis could be distinguished with the SAS_A scores; AUC = 0.8306, a p-value of <0.0001, and cut-off = 53.5. Based on the Kaplan-Meier (K-M) analysis, the rate of no disease progression of the group with relatively high SAS_A scores was significantly lower than that with relatively low SAS_A scores and a p-value of <0.0001. A regression analysis was conducted to screen variables including income, operation, family, religion, and SAS scores. The fit.select.v1.lrm model was established, and its concordance index (C-index) was 0.676 (0.622, 0.729). Based on the model calibration curve, Prob = 0.4 was selected. In accordance with the non-inferiority design, the minimum 95% confidence interval (CI) of the mean value difference of the two groups should be greater than the cut-off value. If λ = 20%, the cut-off value was 1.316, and 95% CI was (1.198, 1.4336); the possibility of non-inferiority was refused, but their mean value difference was very close.

It is feasible to precisely implement the multidisciplinary continuous nursing intervention in patients with breast cancer experiencing negative emotions based on the prediction model, but further study is required.