Engagement with WeChat-Based Remote Psychological Counseling and Patient-Reported Outcomes After Uterine Artery...

Psychological symptoms and impaired quality of life may persist after uterine artery embolization (UAE), while sustained in-person support can be difficult to access. We examined whether self-selected engagement with a WeChat-based counseling program was associated with patient-reported outcomes after UAE.

This single-center retrospective cohort included 267 women who underwent UAE for uterine fibroids in China and selected WeChat follow-up. Engagement was classified by the 12-month mean completion percentage across individual counseling, educational messages, and professionally moderated support groups: low (<50%), medium (50-79%), or high (≥80%). The primary outcome was WHOQOL-BREF quality of life at 12 months; PHQ-9 depression, GAD-7 anxiety, and PSQI sleep scores were secondary outcomes. Mixed-effects models evaluated longitudinal associations.

At 12 months, mean WHOQOL-BREF scores were 74.2, 78.4, and 74.9 in the low-, medium-, and high-engagement groups. The adjusted medium-versus-low difference in change from baseline was 3.98 points (95% CI 3.39-4.57), within the 3-5-point clinical-importance range. PHQ-9 differences in change were statistically significant but smaller than the 5-point minimum clinically important difference. PSQI change did not differ significantly between groups.

Within a self-selected WeChat cohort, engagement level was associated with change in quality of life, depressive symptoms, and anxiety symptoms, but not sleep quality. Selection bias, reverse causation, residual confounding, and the absence of a non-WeChat comparator preclude causal or dosing conclusions. Prospective trials should test individualized intervention intensity and clinical benefit.