Effects of different intervention methods on psychological flexibility, negative emotions and sleep quality in chronic hepatitis B

Ying Zheng; Xiao-Wei Wang; Chen-Xi Xia

doi:10.5498/wjp.v13.i10.753

Effects of different intervention methods on psychological flexibility, negative emotions and sleep quality in chronic hepatitis B

World J Psychiatry. 2023 Oct 19;13(10):753-762. doi: 10.5498/wjp.v13.i10.753.

Authors

Ying Zheng¹, Xiao-Wei Wang¹, Chen-Xi Xia²

Affiliations

¹ Department of Infection, The First People's Hospital of Wenling, Wenling 317500, Zhejiang Province, China.
² Department of Infection, The First People's Hospital of Wenling, Wenling 317500, Zhejiang Province, China. xiachx001@163.com.

Abstract

Background: Patients with chronic hepatitis B (CHB) experience various problems, including low psychological flexibility, negative emotions, and poor sleep quality. Therefore, effective nursing interventions are required to reduce adverse events. Acceptance and commitment therapy (ACT) combined with enabling cognitive-behavioral education (ECBE) can improve patients' psychological and sleep. Therefore, we speculate that this may also be effective in patients with CHB.

Aim: To investigate the effects of different intervention methods on psychological flexibility, negative emotions, and sleep quality in patients with CHB.

Methods: This retrospective study examined clinical and evaluation data of 129 patients with CHB. Intervention methods were divided into a conventional group (routine nursing, n = 69) and a combination group (ACT combined with ECBE, n = 60). We observed changes in psychological flexibility, negative emotions, sleep quality, and self-care ability in both groups. Observation items were evaluated using the Acceptance and Action Questionnaire-2^nd Edition (AAQ-II), Self-Rating Anxiety Scale (SAS), Self-Rating Depression Scale (SDS), Pittsburgh Sleep Quality Index (PSQI), and Exercise of Self-Care Agency Scale (ESCA).

Results: Compared with the conventional group, the AAQ-II score of the combined group was lower (F_{between-group effect} = 8.548; F_{time effects} = 25.020; F_{interaction effects} = 52.930; all P < 0.001), the SAS score (t = 5.445) and SDS score (t = 7.076) were lower (all P < 0.001), as were the PSQI dimensions (t_{sleep quality} = 4.581, t_{fall sleep time} = 2.826, t_{sleep time} = 2.436, t_{sleep efficiency} = 5.787, t_{sleep disorder} = 5.008, t_{hypnotic drugs} = 3.786, t_{daytime dysfunction} = 4.812); all P < 0.05). The ESCA scores for all dimensions were higher (t_{health knowledge level} = 6.994, t_self-concept = 5.902, t_{self-responsibility} = 19.820, t_{self-care skills} = 8.470; all P < 0.001).

Conclusion: ACT combined with ECBE in patients with CHB can improve psychological flexibility and sleep quality, alleviate negative emotions, and improve self-care.

Keywords: Acceptance and commitment therapy; Chronic hepatitis B; Empowerment cognitive-behavioral education; Negative emotion; Psychological flexibility; Sleep quality.