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Background@#We evaluated the household secondary attack rate (SAR) of the omicron and delta severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants, according to the vaccination status of the index case and household contacts; further, in vaccinated index cases, we evaluated the effect of the antibody levels on household transmission. @*Methods@#A prospective cross-sectional study of 92 index cases and 197 quarantined household contacts was performed. Tests for SARS-CoV-2 variant type and antibody level were conducted in index cases, and results of polymerase chain reaction tests (during the quarantine period) were collected from contacts. Association of antibody levels in vaccinated index cases and SAR was evaluated by multivariate regression analysis. @*Results@#The SAR was higher in households exposed to omicron variant (42%) than in those exposed to delta variant (27%) (P = 0.040). SAR was 35% and 23% for unvaccinated and vaccinated delta variant exposed contacts, respectively. SAR was 44% and 41% for unvaccinated and vaccinated omicron exposed contacts, respectively. Booster dose immunisation of contacts or vaccination of index cases reduced SAR of vaccinated omicron variant exposed contacts. In a model with adjustment, anti-receptor-binding domain antibody levels in vaccinated index cases were inversely correlated with household transmission of both delta and omicron variants.Neutralising antibody levels had a similar relationship. @*Conclusion@#Immunisation of household members may help to mitigate the current pandemic.
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Vallecular cyst consisted of a unilocular cystic mass of variable size arising from the lingual surface of the epiglottis and containing clear fluid is a rare occurrence in children. Although a cyst is benign, it may cause serious airway obstruction and even death if not treated appropriately. Also, laryngomalacia is the most common congenital anomaly that causes inspiratory stridor and airway obstruction in the newborn. Symptoms typically begin to appear at around 2 to 3 weeks of age and become worse between 4 and 8 months. With a review of literature, we report two cases of vallecular cyst with symptomatic laryngomalacia in a 1-month-old female and a 2-month-old male. Both patients experienced symptom relief after undergoing endoscopic supraglottoplasty.
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Purpose@#Women are more vulnerable to post-traumatic stress (PTS) than men, causing several health problems. Nurses should understand and work with women who have experienced trauma and provide interventions to promote their physical, social, and mental health. @*Methods@#This quasi-experimental pilot study used a one-group pre-test/post-test design. Data were collected from 14 women recruited between December 2019 and May 2020 from a self-sufficiency support center in South Korea for sexually-exploited women who had experienced trauma. The program consisted of six one-on-one intervention sessions per week for six weeks. Each session averaged 60~120 minutes. Participants were assessed at pre-test, post-test, and one-month follow-up. Changes in outcome variables over time were analyzed using the Wilcoxon signed-rank and Friedman tests. @*Results@#The caring program for health promotion was divided into six sessions: understanding the self, sharing traumatic events and negative emotions, reframing the meaning of traumatic events, identifying thoughts and physical and emotional responses, developing health promotion activities, and maintaining a positive attitude during the process of change. As a result of the caring program, PTS (F = 36.33, p < .001), depression (F = 24.45, p < .001), health-promoting behaviors (F = 7.06, p = .004), and self-esteem (F = 19.74, p < .001) among the participants differed significantly at pre-test, post-test, and follow-up. @*Conclusion@#This study provides foundational information for the implementation of a theory-driven program by nurses in clinical and community settings to provide comprehensive care for women who have experienced trauma.
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Purpose@#This study aimed to investigate the oncologic outcomes and prognostic factors of salvage treatments in patients with recurrent oropharyngeal squamous cell carcinoma (OPSCC) after radiotherapy (RT)-based treatment. @*Materials and Methods@#A cancer registry was used to retrieve the records of 337 patients treated with definitive RT or concurrent chemoradiotherapy (CRT) from 2008 to 2018 at a single institution. The poor-responder group (PRG) was defined as patients with residual or recurrent disease after primary treatment, and the oncologic outcomes for each salvage treatment method were analyzed. In addition, prognostic indicators of recurrence-free survival (RFS) and overall survival (OS) were identified in patients who underwent salvage treatment. @*Results@#After initial (C)RT, the PRG comprised 71 of the 337 patients (21.1%): 18 patients had residual disease, and 53 had recurrence after primary treatment (mean time to recurrence 19.5 months). Of these, 63 patients received salvage treatment (surgery 57.2%, re-(C)RT 23.8%, and chemotherapy 19.0%), and the salvage success rate was 47.6% at the last follow-up. The overall 2-year OS for salvage treatments was 56.4% (60.8% for the salvage surgery group and 46.2% for the salvage re-(C)RT). Salvage surgery patients with negative resection margins had better oncologic outcomes than those with close/positive resection margins. Using multivariate analyses, locoregional recurrence and residual disease after primary surgery were associated with poor outcome after salvage treatment. In Kaplan-Meier analyses, p16 status was significantly associated with OS in the initial treatment setting but not in the salvage setting. @*Conclusion@#In recurrent OPSCC after RT-based treatment, successful salvage was achieved in 56.4% patients who had undergone salvage surgery and radiation treatment. Salvage treatment methods should be selected carefully, given recurrence site as a prognostic factor for RFS.
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Background@#The interest in Clostridioides difficile infection (CDI) has increased, and the choice of assays became wider since the first national survey in Korea on CDI diagnosis in 2015. We conducted a survey of the domestic CDI assays with more varied questions to understand the current situation in Korea. @*Methods@#In April 2018, about 50 questions on the current status of CDI assays and details on implementation and perceptions were written, and a survey questionnaire was administered to laboratory medicine specialists in 200 institutions. @*Results@#One-hundred and fifty institutions responded to the questionnaire, of which 90 (60.0%) including one commercial laboratory, performed CDI assays. The toxin AB enzyme immunoassay (toxin AB EIA), nucleic acid amplification test (NAAT), and C. difficile culture, glutamate dehydrogenase assay, alone or in combination with other assays, were used in 75 (84.3%), 52 (58.4%), 35 (36.0%), and 23 (25.8%), respectively, and 65 (73.0%) institutions performed a combination of two or more assays. The sensitivity of toxin AB EIA was more negatively perceived, and that on specificity was more positively perceived. The perception of sensitivity and specificity of NAAT was mostly positive. Perception on the algorithm test projected it as useful but in need of countermeasures. Sixty-three (73.3%) institutions responded that they performed surveillance on CDI. @*Conclusion@#This study provides useful evidence on the current status of CDI laboratory diagnosis in Korea as well as on items that require improvement and is thought to aid in standardizing and improving the CDI laboratory diagnosis in Korea.
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Purpose@#The purpose of this study was to assess the dimensional change of 3D-printed dentures after post-curing. @*Materials and Methods@#The upper and lower dentures were designed in Exocad DentalCAD software and exported as STL files. The upper and lower dentures were printed from 10 STL files using a DLP-type dental 3D printer. The printed upper and lower dentures were cleaned, and a scan file was created using a model scanner before and after post-curing. The dimensional change was evaluated by superimposing the scanned denture files before and after post-curing and measuring the distance between measurement points on the denture. SPSS was used for statistics, and the level of significance was 5%. @*Results@#The maxillary denture reduced in size during post-curing, with the most notable color change occurring in the posterior palatal region. The reduction in anteroposterior maxillary denture length (A-D, A-E, A-F), as well as the distance between the first molars on both sides (B-C), was statistically significant. After post-curing, the mandibular denture showed more noticeable color change in the posteriorly buccal and lingual region. The decrease of length on the posterior (A-M, A-D, A-E, A-L, A-H, A-I, H-I) and lingual (J-K, L-M) sides of the denture were statistically significant. @*Conclusion@#There was significant dimensional change in both the length and width of the 3D-printed maxillary and mandibular dentures after post-curing in this experiment. Consequently, it is seemed necessary to develop post-curing techniques and materials that reduce such denture deformation.
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Background and Objectives@#Airway reconstruction surgery in children is still challenging, especially in cases of combined subglottic and posterior glottic stenosis (PGS). The aim of this study was to review the underlying reasons of failure in open airway reconstruction surgeries performed for children with combined subglottic and PGS.Subjects and Method We reviewed medical records of seven children who received more than two open airway reconstruction surgeries to finally achieve and maintain decannulation status for more than one year. Twenty-two reconstructive surgeries were performed and they consisted of 19 laryngotracheal reconstruction (LTR), 2 cricotracheal resection with end-toend anastomosis (CTR) and one extended CTR. For each patient, the following potential causes of failure were evaluated; preoperative evaluation (PE), type of reconstruction (TR), single vs. double staging (SDS), type of stent (TS), and perioperative optimization (PO). @*Results@#The median age of patients at the time of surgery was 32 months (range, 4-64 months). Successful decannulation was achieved after the median open surgery of three (range, 2-5 times for each patient). Recognized causes of failure were as follows: 8 insufficient PE, 10 inadequate TR, 3 improper SDS, 8 ill-chosen TS, and 2 inappropriate PO. @*Conclusion@#PE of dynamic airway is important, especially vocal fold mobility and tracheomalacia. Types of reconstruction should be carefully decided after full consideration of potential causes of failure, and adequate laryngotracheal stent is essential.
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Background@#The incidence of community-associated (CA) Clostridioides difficile infection (CDI) has increased in Korea. In this study, we evaluated CA-CDI risk factors in terms of clinical features and ribotype considering its region-specific molecular epidemiology. @*Methods@#A retrospective case-control study was performed on two groups of CDI patients:127 subjects with CA-CDI and 265 subjects with healthcare-associated (HA)-CDI. Risk factors for CA-CDI were evaluated in terms of clinical and microbiological features such as toxin type and ribotype. @*Results@#A comparison of the two groups of CDI patients revealed that inflammatory bowel disease, diarrhea, abdominal pain, and fever were more closely associated with CA-CDI. The toxin types and ribotypes of C. difficile were similar between the two groups. After adjusting for variables, no risk factors were identified for CA-CDI compared with HA-CDI. @*Conclusion@#Specific risk factors for CA-CDI were not identified in this study.
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Background@#There has been a marked increase in the mortality rate associated with Clostridioides difficile infection (CDI) globally since 2003, with the emergence of binary toxinproducing ribotype 027 strains. However, the molecular epidemiology of C. difficile shows regional differences and ribotype 027 is not common in Korea. In this study, the risk factors for severe CDI were evaluated, while considering the region-specific molecular epidemiology. @*Methods@#A retrospective case-control study was performed. Cases (n = 149) included patients with severe CDI or severe complicated CDI. Controls (n = 155) consisted of patients with nonsevere CDI. @*Results@#Advanced age (odds ratio [OR] = 1.017, P = 0.0358), a history of chemotherapy (OR = 2.695, P = 0.0464), and ribotype 002 (OR = 3.406, P = 0.0231) were statistically significant factors associated with severe CDI in a multivariate analysis. @*Conclusion@#Ribotype 002 was found to be a significant risk factor for severe CDI in this study.Therefore, the surveillance of C. difficile ribotypes is recommended to monitor the spread of high-risk clones.
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Purpose@#The purpose of this study was to examine the psychological distress related to quality of life (QoL) of patients with colorectal cancer receiving 5-fluorouracil (5-FU) chemotherapy at home with disposable Elastomeric infusion pumps. @*Methods@#In this study, 179 colorectal outpatients were recruited between September 2019 and January 2021. National Cancer Center Psychological Symptom Inventory scores, general self-efficacy, and the EORTC QLQ-C30 scores were measured. Data were analyzed using Independent t-test, One-way ANOVA with Bonferroni post hoc analysis, and hierarchical multiple linear regression with the SPSS/WIN 26.0 programs. @*Results@#The overall prevalence of psychological distress was 52.0% in colorectal patients. In multiple regression, psychological distress (β=-.20, p=.005), appetite loss (β=-.20, p=.001), chemotherapy cycles (β= .19, p=.002), fatigue (β=-.16, p=.035), physical functioning (β=-.16, p=.024), and emotional functioning (β=-.15, p=.025) were significant factors of QoL, and the final model explained 45.0% of the total variance of QoL. @*Conclusion@#Supporting patients toward decreased psychological distress and increased physical and emotional functioning, especially in the first or second cycle of chemotherapy, could be used to improve their QoL. To consider the thresholds for clinical importance, it is necessary to increase the interpretation of psychological distress in clinical practice and further research.
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Purpose@#This study aimed to investigate gender differences as ecological factors associated with depression of single-parents who lived with minors. @*Methods@#This study was secondary data analysis using national data from the 2018 Single Parent Family Survey, including 2,427 participants (1,575 mothers and 852 fathers). Data were analyzed using SPSS/MAC 26.0 program for the descriptive analysis, independent t-tests, chi-squared tests, and binary logistic regression. @*Results@#The depression groups were identified as 17.4% for women and 11.0% for men based on Patient Health Questionnaire-9. In logistic regression, single mothers’ depression was significantly associated with low income, unemployment, low education level, parenting difficulties, a sense of distance from family, and family discrimination experiences. However, single fathers’ depression was significantly associated with low income, unemployment, and parenting difficulties. @*Conclusion@#Our study findings suggest that depression interventions should be tailored to different gender groups of the single-parents, specifically socio-emotional factors should be considered for the single mother group.
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Purpose@#The purpose of this study was to identify effects of Handoff Education using Concept mapping and PASS-BAR (HECPAR) on clinical reasoning competence, self-efficacy for handoff, and handoff performance of new nurses. @*Methods@#Participants were randomly allocated into an experimental group (n=20) and control group (n=21). The experimental group received HECPAR which consisted of a one hour lecture, case based clinical practicum, and mentoring for a week. The control group received the usual informal handoffs education from senior nurses. Clinical reasoning competence, self-efficacy for handoff, and handoff performance were measured before and a week after HECPAR. Data were analyzed using Mann-Whitney U test, independent t-test, Fisher’s exact test, and chi-sqaure test. Results: The experimental group showed significant improvement in clinical reasoning competence (z=-2.29, p=.022), handoff performance (z=-2.23, p=.026), and self-efficacy of handoff (t=3.47, p=.001) compared to the control group. @*Conclusion@#The results indicate that HECPAR is effective in improving clinical reasoning competence, self-efficacy for handoff, and handoff performance by new nurses. In addition, integrating concept mapping, PASS-BAR, and mentoring proved beneficial for handoff education for new nurses.
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Purpose@#The purpose of this study was to investigate the factors related to the problem drinking in young adult women who lived and drank alone. @*Methods@#This online survey (N=291) was conducted using a questionnaire from February to April 2020. Data were analyzed using SPSS/WIN 25.0 program for the descriptive analysis, independent t-tests, one-way ANOVA, and a binary logistic regression. @*Results@#In this study, the problem drinking group was identified as 72.9%. In logistic regression, the significant factors of problem drinking were women who had: (1) experience of drinking alone were high socioeconomic status (OR=3.90, 95% CI: 1.04~14.58, p=.043); (2) negative alcohol expectancy (OR=1.03, 95% CI: 1.00~1.06, p=.028); (3) significant depression (OR=2.40, 95% CI: 1.04~5.54, p=.041); and (4) 3-5 standard drinks per drink (OR=6.58, 95% CI: 2.06~21.06, p=.001), once or twice a week (OR=4.55, 95% CI: 1.71~12.09, p=.002). @*Conclusion@#Our study findings suggest that mental health interventions should be developed to help one-person household women with problem drinking considering comprehensively integrating mental health factors, residential and lifestyle characteristics, and drinking context.
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Purpose@#The aims of this systematic review were to identify the study protocol of Virtual Reality Therapy (VRT) and review the effect of VRT among patients with Post-Traumatic Stress Disorder (PTSD). @*Methods@#This review followed the guideline of Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). A systematic literature search was conducted using 12 electronic databases including gray literature with no limit of publication year. Search terms included relevant terms regarding “PTSD”, “trauma”, and “VRT”. Among 265 studies extracted through PRISMA, 20 studies were selected and evaluated for quality assessment using the Risk of Bias tool of Cochrane’s collaboration. @*Results@#The majority of the literature focused on combat veterans and war situations (95%).Usually, each session usually took 60~120 minutes of VRT in 10~20 sessions for 5~10 weeks. The VRT equipment and contents were individually designed considering patients’ traumatic experiences. Most of the studies reported the positive effects associated to reduced levels of PTSD (80%) and related symptoms, such as, depression (45%) and anxiety (25%). @*Conclusion@#Based on our findings, further studies are required to evaluate VRT in people with PTSD, after improving study design and standardizing protocols.
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Purpose@#The purpose of this study was to examine the effect of nursing record education on the knowledge and performance of nursing record of nurses at small- and medium-sized hospitals. @*Methods@#The participants were 62 nurses working in two small- and medium-sized hospitals. Thirty-two nurses comprised the experimental group, and 30 nurses comprised the control group. Nursing record education was provided for the experimental group. Data were analyzed by x2-test and t-test analysis using the IBM SPSS statistics 25.0 Program. @*Results@#After education, the knowledge (t=2.43, p=.019), performance (t=2.19, p=.033) and behavior scores (t=2.42, p=.018) on nursing record were significantly higher in the experimental group than in the control group. Based on this result, nursing record education is an effective intervention to improve nurses’ knowledge and performance in writing nursing records in small- and medium-sized hospitals. @*Conclusion@#We suggest the development of a systematic and standardized education program on nursing record including its legal aspects, for nurses in small- and medium-sized hospitals. The results of this study can be used as basic data for developing a nursing record education program for small- and medium-sized hospitals.
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Purpose@#The purpose of this study was to examine the effects of non-pharmacological interventions (NPIs) on depression among patients with lung cancer. @*Methods@#A systematic review and meta-analysis were conducted focusing on randomized controlled trials (RCTs) and quasi-experimental studies. A literature search was performed through PubMed, EMBASE, CINAHL, PsycINFO, Cochrane Library, and five Korean databases in November 2020. Data were analyzed using the Comprehensive Meta-Analysis Ver. 3.0 and Review Manager Ver. 5.4 programs. @*Results@#A total of 37 studies, including 25 RCTs and 12 quasi-experimental studies, were identified; 27 studies reported data suitable for meta-analysis. In meta-analysis, the overall effect sizes for NPIs of RCTs and quasi-experimental studies were −0.61 (95% confidence interval (CI): −0.90, −0.31) and −0.40 (95% CI: −0.59, −0.21), respectively. Among the types of NPI in RCTs, the effect size of psychological therapy was the largest with −0.68 (95% CI: −1.13, −0.23). In addition, information & communication technology (ICT) had a larger effect size of −0.68 (95% CI: −1.13, −0.23), compared to face-to-face intervention. @*Conclusion@#NPIs may have a significant effect in reducing depressive symptoms in patients with lung cancer. It is suggested that further studies develop and apply structured NPIs considering intervention components such as type and mode of ICT delivery.
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Purpose@#The purpose of this study was to investigate the factors related to the problem drinking in young adult women who lived and drank alone. @*Methods@#This online survey (N=291) was conducted using a questionnaire from February to April 2020. Data were analyzed using SPSS/WIN 25.0 program for the descriptive analysis, independent t-tests, one-way ANOVA, and a binary logistic regression. @*Results@#In this study, the problem drinking group was identified as 72.9%. In logistic regression, the significant factors of problem drinking were women who had: (1) experience of drinking alone were high socioeconomic status (OR=3.90, 95% CI: 1.04~14.58, p=.043); (2) negative alcohol expectancy (OR=1.03, 95% CI: 1.00~1.06, p=.028); (3) significant depression (OR=2.40, 95% CI: 1.04~5.54, p=.041); and (4) 3-5 standard drinks per drink (OR=6.58, 95% CI: 2.06~21.06, p=.001), once or twice a week (OR=4.55, 95% CI: 1.71~12.09, p=.002). @*Conclusion@#Our study findings suggest that mental health interventions should be developed to help one-person household women with problem drinking considering comprehensively integrating mental health factors, residential and lifestyle characteristics, and drinking context.
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Purpose@#The aims of this systematic review were to identify the study protocol of Virtual Reality Therapy (VRT) and review the effect of VRT among patients with Post-Traumatic Stress Disorder (PTSD). @*Methods@#This review followed the guideline of Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). A systematic literature search was conducted using 12 electronic databases including gray literature with no limit of publication year. Search terms included relevant terms regarding “PTSD”, “trauma”, and “VRT”. Among 265 studies extracted through PRISMA, 20 studies were selected and evaluated for quality assessment using the Risk of Bias tool of Cochrane’s collaboration. @*Results@#The majority of the literature focused on combat veterans and war situations (95%).Usually, each session usually took 60~120 minutes of VRT in 10~20 sessions for 5~10 weeks. The VRT equipment and contents were individually designed considering patients’ traumatic experiences. Most of the studies reported the positive effects associated to reduced levels of PTSD (80%) and related symptoms, such as, depression (45%) and anxiety (25%). @*Conclusion@#Based on our findings, further studies are required to evaluate VRT in people with PTSD, after improving study design and standardizing protocols.
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Purpose@#The purpose of this study was to examine the effect of nursing record education on the knowledge and performance of nursing record of nurses at small- and medium-sized hospitals. @*Methods@#The participants were 62 nurses working in two small- and medium-sized hospitals. Thirty-two nurses comprised the experimental group, and 30 nurses comprised the control group. Nursing record education was provided for the experimental group. Data were analyzed by x2-test and t-test analysis using the IBM SPSS statistics 25.0 Program. @*Results@#After education, the knowledge (t=2.43, p=.019), performance (t=2.19, p=.033) and behavior scores (t=2.42, p=.018) on nursing record were significantly higher in the experimental group than in the control group. Based on this result, nursing record education is an effective intervention to improve nurses’ knowledge and performance in writing nursing records in small- and medium-sized hospitals. @*Conclusion@#We suggest the development of a systematic and standardized education program on nursing record including its legal aspects, for nurses in small- and medium-sized hospitals. The results of this study can be used as basic data for developing a nursing record education program for small- and medium-sized hospitals.
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Purpose@#The purpose of this study was to examine the effects of non-pharmacological interventions (NPIs) on depression among patients with lung cancer. @*Methods@#A systematic review and meta-analysis were conducted focusing on randomized controlled trials (RCTs) and quasi-experimental studies. A literature search was performed through PubMed, EMBASE, CINAHL, PsycINFO, Cochrane Library, and five Korean databases in November 2020. Data were analyzed using the Comprehensive Meta-Analysis Ver. 3.0 and Review Manager Ver. 5.4 programs. @*Results@#A total of 37 studies, including 25 RCTs and 12 quasi-experimental studies, were identified; 27 studies reported data suitable for meta-analysis. In meta-analysis, the overall effect sizes for NPIs of RCTs and quasi-experimental studies were −0.61 (95% confidence interval (CI): −0.90, −0.31) and −0.40 (95% CI: −0.59, −0.21), respectively. Among the types of NPI in RCTs, the effect size of psychological therapy was the largest with −0.68 (95% CI: −1.13, −0.23). In addition, information & communication technology (ICT) had a larger effect size of −0.68 (95% CI: −1.13, −0.23), compared to face-to-face intervention. @*Conclusion@#NPIs may have a significant effect in reducing depressive symptoms in patients with lung cancer. It is suggested that further studies develop and apply structured NPIs considering intervention components such as type and mode of ICT delivery.