Effects of a symptom voice diary intervention program in patients with acute leukemia: a randomized controlled trial
In brief
Voice diary program reduces anxiety and depression in acute leukemia patients
In a randomized trial of 70 adults undergoing intensive chemotherapy, a multicomponent voice diary intervention lowered anxiety, depression, psychological distress, and improved quality of life and self-management compared with usual care. Most participants found it helpful, yet only about one-third would continue using it on their own, highlighting the need for larger studies to confirm benefits and sustain use.
- Journal
- European journal of oncology nursing : the official journal of European Oncology Nursing Society (Q1)
- Published
- 10 September 2026
- Study design
- Randomized controlled trial
- Evidence level
- Level 1, High (CEBM 1b)
- Authors
- Zhangjie Li, Chengyang Li, Xinyue Fang, Wenkui Xu, Chunfeng Wang, Yong Wu, et al.
- PMID
- 42759071
- DOI
- 10.1016/j.ejon.2026.103315
Why clinicians should know about it
- Picked for Hematology (top studies of the week, 20 September 2026): RCT symptom voice diary improves anxiety in acute leukemia
Abstract
PURPOSE: To evaluate a multicomponent symptom voice diary intervention for adult acute leukemia patients facing severe symptom burden and psychological distress during intensive chemotherapy. The primary outcome was anxiety; secondary outcomes included depression, psychological distress, health-related quality of life (QoL), and general self-management. METHODS: A two-arm, parallel-group randomized controlled trial was conducted among adults newly diagnosed with acute leukemia. Participants were randomly assigned to a symptom voice diary intervention group (combining the diary tool with enhanced professional attention) or a usual care control group. Outcomes were self-reported at baseline, four weeks, and eight weeks, with data collected by a blinded research assistant. A modified intention-to-treat (mITT) approach and Generalized Estimating Equation (GEE) models were utilized for longitudinal analysis. RESULTS: Of 70 enrolled patients, 67 were included in the mITT analysis. The GEE omnibus tests revealed statistically significant between-group main effects favoring the intervention for the primary outcome of anxiety (Wald χ2 = 22.681, p < .001), as well as secondary outcomes including depression (Wald χ2 = 9.224, p = .002), health-related quality of life (Wald χ2 = 12.890, p < .001), general self-management (Wald χ2 = 6.366, p = .012), and psychological distress (Wald χ2 = 6.413, p = .011). While 81.3% of intervention completers found the program helpful and not burdensome, only 34.4% expressed the intention to continue using the diary independently after the intervention. CONCLUSIONS: The multicomponent symptom voice diary intervention demonstrated significant short-term efficacy in improving psychological and self-management outcomes in adults with acute leukemia. Future large-scale, attention-matched trials are needed to isolate the diary-specific effects and develop strategies for long-term sustainability. TRIAL REGISTRATION: Registered in the China Clinical Trial Registry on 16 February 2023 (ChiCTR2300068363).
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.