Evaluation report
Integrated Telemedicine and Psychological Counseling for Mental Health Outcomes in HCC Patients: A Multi-center Cohort Study
Jiang F, Liang X, Jin S, Li Y, Cai T et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study is not relevant to child well-being. It examines mental health outcomes in adult hepatocellular carcinoma (HCC) patients receiving telemedicine and psychological counseling in China. The research evaluates how different levels of participation in a WeChat-based intervention affect depression, anxiety, quality of life, and sleep in cancer patients aged 18 and above.
Key points
- Study population was adult HCC patients, not children
- Moderate participation in telemedicine-counseling was associated with improvements in depression, quality of life, distress, and sleep at 12 months
- Clinical meaningfulness was limited, with improvements falling short of published thresholds for depression and sleep quality
- Selection bias noted: 28.1% of screened patients refused assessments and were excluded
- Observational design precludes causal inference
Limitations
This study focuses exclusively on adult cancer patients and is therefore outside the scope of child well-being research. The observational design, selection bias from excluding nearly 30% of screened participants, and digitally selected cohort limit the generalizability of findings even within the adult population studied.
Abstract
Abstract Objective Digital health interventions show promise for improving psychological outcomes in cancer patients, yet evidence in hepatocellular carcinoma (HCC) populations remains limited. This study examined the association between telemedicine-counseling participation levels and mental health outcomes in HCC patients undergoing interventional therapy. Methods This multi-center retrospective cohort study included 349 HCC patients from two tertiary hospitals in Fujian Province, China (January 2022-December 2023). Of 540 initially screened, 152 (28.1%) refused assessments and were excluded. Patients received integrated WeChat-based telemedicine and psychological counseling. Participation was defined a priori by completion rates (low < 50%, moderate 50–79%, high > = 80%). Outcomes (PHQ-9, GAD-7, WHOQOL-BREF, PSQI, FACT-Hep, NCCN Distress Thermometer) were assessed at baseline, 1, 3, 6, and 12 months. Linear mixed-effects models adjusted for 29 covariates; Benjamini-Hochberg FDR correction (q < 0.05) was applied across outcome families. Results At 12 months, moderate participation was associated with significant improvements in depression (PHQ-9: beta=-3.0, P < 0.001), quality of life (WHOQOL-BREF: beta = 4.2, P < 0.001), distress (DT: beta=-1.2, P < 0.001; proportion above clinical threshold decreased from 64.2% to 48.5%), and sleep (PSQI: beta=-2.1, P = 0.012). These effects fell short of published MCID thresholds for PHQ-9 (5 points) and PSQI (3 points). Anxiety (GAD-7) showed no significant group differences. Disease-specific quality of life (FACT-Hep) paradoxically decreased (beta=-12.0, P = 0.012). Child-Pugh class A patients (n = 296) derived the greatest benefits. Conclusion In this selected, digitally connected HCC cohort, moderate participation in integrated telemedicine and psychological counseling was associated with statistically significant improvements in depression, quality of life, distress, and sleep, though most fell short of published clinical meaningfulness thresholds. The observational design precludes causal inference; selection bias from excluding 28% of screened patients limits generalizability. Prospective randomized studies are warranted.