{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T18:35:06Z","timestamp":1792089306925,"version":"4.4.0"},"reference-count":48,"publisher":"Wiley","issue":"19","license":[{"start":{"date-parts":[[2024,10,15]],"date-time":"2024-10-15T00:00:00Z","timestamp":1728950400000},"content-version":"vor","delay-in-days":14,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Medicine"],"published-print":{"date-parts":[[2024,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>The objective of this study is to investigate the efficacy of behavioral activation (BA), a novel psychological intervention, in ameliorating psychological distress and anxiety symptoms among patients diagnosed with esophageal and gastric cancer, as well as the mediating role of self\u2010efficacy between BA and psychological distress.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A total of 139 patients diagnosed with esophageal and gastric cancer were recruited in China from March 2023 to October 2023 and randomly assigned to either the BA plus care as usual group (BA+CAU group) or the care as usual group (CAU group). Pre\u2010 and post\u2010intervention questionnaires, including the Psychological Distress Thermometer (DT), Generalized anxiety disorder 7\u2010item (GAD\u20107) Scale, General Self\u2010Efficacy Scale (GSES) and the activation subscale of Behavioral Activation for Depression Scale (BADS\u2010A), were administered.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Generalized estimating equation analyses revealed that, compared to usual care alone, combining BA with usual care significantly ameliorated psychological distress, anxiety as well as improved self\u2010efficacy and activation. The mediation analysis revealed that self\u2010efficacy served as a mediator in the relationship between activation and psychological distress.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>BA primarily based on telephone or WeChat can not only directly ameliorates psychological distress and anxiety symptoms in patients with esophageal cancer and gastric cancer but also indirectly alleviates psychological distress by enhancing self\u2010efficacy. The study also demonstrates the potential of BA in cancer patients, a skill that can be effectively acquired by primary care workers without specialized training and implemented more flexible.<\/jats:p><jats:p><jats:bold>Trial Registration:<\/jats:bold> NCT06348940<\/jats:p><\/jats:sec>","DOI":"10.1002\/cam4.70314","type":"journal-article","created":{"date-parts":[[2024,10,15]],"date-time":"2024-10-15T12:19:35Z","timestamp":1728994775000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Impacts and Pathways of Behavioral Activation on Psychological Distress Among Patients Diagnosed With Esophageal and Gastric Cancer in China: A Randomized Controlled Trial"],"prefix":"10.1002","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7747-4883","authenticated-orcid":false,"given":"Runze","family":"Huang","sequence":"first","affiliation":[{"name":"Department of Oncology The Second Affiliated Hospital of Anhui Medical University  Hefei Anhui China"},{"name":"Anhui Medical University  Hefei Anhui China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anlong","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Oncology The Second Affiliated Hospital of Anhui Medical University  Hefei Anhui China"},{"name":"Anhui Medical University  Hefei Anhui China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Han","family":"Ge","sequence":"additional","affiliation":[{"name":"Anhui Medical University  Hefei Anhui China"},{"name":"School of Nursing Anhui Medical University  Hefei Anhui China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lijun","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Oncology The Second Affiliated Hospital of Anhui Medical University  Hefei Anhui China"},{"name":"Anhui Medical University  Hefei Anhui China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ling","family":"Cheng","sequence":"additional","affiliation":[{"name":"Medical Intensive Care Unit The First Affiliated Hospital of Anhui University of Chinese Medicine  Hefei Anhui China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mingjun","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Oncology The Second Affiliated Hospital of Anhui Medical University  Hefei Anhui China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6422-1257","authenticated-orcid":false,"given":"Huaidong","family":"Cheng","sequence":"additional","affiliation":[{"name":"Department of Oncology The Second Affiliated Hospital of Anhui Medical University  Hefei Anhui China"},{"name":"The Third School of Clinical Medicine Southern Medical University  Guangzhou People's Republic of China"},{"name":"Department of Oncology Shenzhen Hospital of Southern Medical University  Shenzhen Guangdong China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,10,15]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.6004\/jnccn.2019.0048"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbcan.2021.188665"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/pon.4464"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41380-019-0595-x"},{"key":"e_1_2_12_6_1","first-page":"CD008729","article-title":"Psychological Interventions for Women With Non\u2010Metastatic Breast Cancer","volume":"1","author":"Jassim G. 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