Effects of Behavioral Activation on Negative Emotions, Cancer-related Symptoms and Clinical Indicators in Cancer Patients

Cohort 1:

Inclusion criteria:

(Patients who)

* Had to meet the diagnostic criteria for esophageal or gastric cancer through clinical, pathological, and imaging examinations,
* Should have no history of prior psychological intervention,
* Karnofsky Performance Status (KPS) score should be equal to or greater than 80 points,
* Were required to complete the questionnaire independently or with assistance from others if needed,
* Were consistently admitted to the hospital for tumor treatment, with an average time interval of approximately one month between each hospitalization,
* Were reporting stigma and its possible causes, the average score of the Social Impact Scale exceeded 1,
* Were of legal age, 18 years or older.

Exclusion criteria:

(Patients who)

* With severe intellectual disabilities or other communication difficulties that hindered normal interaction,
* With an expected survival time of less than 4 months,
* Were Cachexia or severely debilitated,
* With fractures, serious heart dysfunction, or significant comorbidities involving the liver, kidneys, and other organs/tissues,
* With early esophageal or gastric cancer (tumor tissue has not infiltrated the muscularis propria layer),
* With a history of using psychotropic or psychoactive drugs.

Cohort 2:

Inclusion criteria:

(Patients who)

* Had to meet the diagnostic criteria for esophageal or gastric cancer through clinical, pathological, and imaging examinations,
* Should have no history of prior psychological intervention,
* Karnofsky Performance Status (KPS) score should be equal to or greater than 80 points,
* Were required to complete the questionnaire independently or with assistance from others if needed,
* Were consistently admitted to the hospital for tumor treatment, with an average time interval of approximately one month between each hospitalization,
* Psychological Distress Thermometer (DT) score should be equal to or greater than 4 points,
* Were of legal age, 18 years or older.

Exclusion criteria:

(Patients who)

* With severe intellectual disabilities or other communication difficulties that hindered normal interaction,
* With an expected survival time of less than 4 months,
* Were Cachexia or severely debilitated,
* With fractures, serious heart dysfunction, or other severe medical conditions,
* With a history of using psychotropic or psychoactive drugs.

Cohort 3:

Inclusion criteria:

* Age ≥18 years with sufficient hearing and vision capabilities,
* Good activity ability, KPS score ≥80,
* No history of psychological intervention,
* Clear diagnosis of colorectal cancer with an expected survival of ≥6 months,
* Hospital Anxiety and Depression Scale (HADS) depression score ≥8,
* Sufficient ability to record and communicate independently or with family help,
* Regular hospital visits for treatment or examination.

Exclusion Criteria:

* Known neurological diseases affecting cognition,
* Previous use of medication to improve cognitive function,
* Combined with other severe chronic diseases or organ damage.

Termination Criteria:

* Severe adverse events or reactions making it difficult to continue intervention,
* Physical or mental symptoms worsen, or new symptoms emerge, making it impossible to continue intervention,
* The patient wishes to stop the intervention,
* More than three weeks between sessions,
* Use of psychotropic drugs at the discretion of the attending physician during the intervention or waiting period,
* Meeting exclusion criteria during the waiting period,
* Other reasons deemed necessary by the attending physician to stop the intervention.

Cohort 4:

Inclusion criteria:

* Diagnosis of primary non-small cell lung cancer confirmed through clinical, pathological, and imaging examinations, and awareness of their condition;
* Absence of prior psychological interventions;
* PFS score of ≥1;
* Age of 18 years or older at the time of diagnosis and possessing adequate audiovisual capabilities to complete the questionnaire and intervention procedures.

Exclusion criteria:

* Individuals with severe intellectual disabilities or communication impairments;
* Patients with an estimated survival time of less than 4 months;
* Patients with fractures, severe cardiac insufficiency, or other serious medical conditions.

Termination criteria:

* Occurrence of serious adverse events or reactions hindering intervention continuation;
* Patient's expressed desire to discontinue the intervention;
* Inter-meeting intervals of at least three weeks;
* Regular usage of fatigue or psychotropic medications as deemed appropriate by the attending physician during program implementation or the waiting period;
* Compliance with exclusion criteria during the waiting period;
* Any other reasons determined necessary by the attending physician to cease the intervention.

Cohort 5:

Inclusion criteria:

* Meet the diagnostic criteria for primary NSCLC through clinical, pathological, and imaging examinations and are aware of their diagnosis;
* Have not received any prior psychological intervention;
* Have a FCRI-SF score of ≥13 points;
* Are 18 years of age or older at the time of diagnosis and have sufficient auditory and visual abilities to complete the questionnaire tests and intervention procedures.

Exclusion criteria:

* Individuals with severe cognitive impairments or other communication difficulties;
* Patients with an estimated survival time of less than 4 months;
* Patients with fractures, severe cardiac insufficiency, or other serious comorbidities.

Termination criteria:

* Serious adverse events or adverse reactions that make it difficult to continue the intervention;
* Patient requests to discontinue the intervention;
* At least three weeks elapsing between sessions;
* Regular use of fatigue or psychotropic medications, as determined by the attending physician, during the implementation of the program or during the waiting period;
* Meeting the exclusion criteria during the waiting period;
* Other reasons deemed necessary by the attending physician to discontinue the intervention.

Cohort 6:

Inclusion criteria:

* Meet the diagnostic criteria for digestive system cancers (esophageal cancer, gastric cancer, or colorectal cancer) through clinical, pathological, and imaging examinations;
* Karnofsky Performance Status (KPS) score should be equal to or greater than 80 points;
* Systematic treatments naive ( e. g., chemotherapy, anti-angiogenic drugs, targeted drugs, and immunotherapy);
* Presence of at least one measurable lesion according to the Response Evaluation Criteria in Advanced Solid Tumors version 1.1 (RECIST v1.1);
* Receiving PD-1/PD-L1 inhibitors monotherapy or combination with chemotherapy;
* Informed and agreed to participate in the study;
* Required to complete the questionnaire independently or with assistance from others if needed;
* Legal age, 18 years or older.

Exclusion criteria:

* Oncogene-driver positive;
* Resectable early esophageal or gastric cancer (tumor tissue has not infiltrated the muscularis propria layer);
* Combined with other malignant tumors in the past 3 years;
* Concurrent acute or chronic psychiatric disorders;
* Current receiving anti-depressive or anti-anxiety therapy or other psychotropic drugs;
* Previous treatment with other clinical drug trials;
* Patients with symptomatic brain metastasis;
* Severe intellectual disabilities or other communication difficulties that hindered normal interaction.

Termination criteria:

* Serious adverse events or adverse reactions that make it difficult to continue the intervention;
* Patient requests to discontinue the intervention;
* Regular use of psychotropic or psychoactive drugs, as determined by the attending physician, during the implementation of the program or during the waiting period;
* Other reasons deemed necessary by the attending physician to discontinue the intervention.

Cohort 7:

Inclusion criteria:

* Meet the diagnostic criteria for NSCLC through clinical, pathological, and imaging examinations;
* Karnofsky Performance Status (KPS) score should be equal to or greater than 80 points;
* Unresectable locally advanced, metastatic, or recurrent stage ⅢB-Ⅳ based on AJCC TNM staging 8th edition;
* Systematic treatments naive ( e. g., chemotherapy, anti-angiogenic drugs, targeted drugs, and immunotherapy);
* Presence of at least one measurable lesion according to the Response Evaluation Criteria in Advanced Solid Tumors version 1.1 (RECIST v1.1);
* Receiving PD-1/PD-L1 inhibitors monotherapy or combination with chemotherapy;
* Informed and agreed to participate in the study;
* Required to complete the questionnaire independently or with assistance from others if needed;
* Legal age, 18 years or older.

Exclusion criteria:

* Oncogene-driver positive;
* Combined with other malignant tumors in the past 3 years;
* Concurrent acute or chronic psychiatric disorders;
* Current receiving anti-depressive or anti-anxiety therapy or other psychotropic drugs;
* Previous treatment with other clinical drug trials;
* Patients with symptomatic brain metastasis;
* Severe intellectual disabilities or other communication difficulties that hindered normal interaction.

Termination criteria:

* Serious adverse events or adverse reactions that make it difficult to continue the intervention;
* Patient requests to discontinue the intervention;
* Regular use of psychotropic or psychoactive drugs, as determined by the attending physician, during the implementation of the program or during the waiting period;
* Other reasons deemed necessary by the attending physician to discontinue the intervention.