Objective To build a clinical prediction models (CPMs) for severe CRF of cervical cancer (CC) patients, and conduct online 8-week mindfulness-based stress reduction (MBSR). Design Single-centre, cross-sectional, randomized controlled trial. Setting Gynecological clinic of a tertiary hospital in Shenyang. Population 284 patients, and 100 patients with severe CRF included in randomized controlled trial. Methods Patients were divided into construction group and validation group to verify the accuracy of CPMs. All patients participated in online 8-week MBSR and were followed up for 3 and 6 months. Main outcome measures The primary outcome were the accuracy of the CPMs and effectiveness of MBSR on CRF at 6 month. Secondary outcomes included the influencing factors of CRF, effectiveness of MBSR on sense of coherence, coping style, and perceived social support. Results In the CPMs: the C-Index was 0.921; the sensitivity was 0.821; the specificity was 0.900; the accuracy was 0.857; the AUC was 0.916; the area under the ROC curve was greater than 0.8; the calibration curve fitted well (P<0.05); and the net benefit of applying the model to most thresholds was good in DCA. At 6 months, CRF was from 37.70 to 31.25; SOC was from 55.07 to 64.17; ways to face was from 19.20 to 20.95; and ways to yield was from 12.10 to 8.90 in MBSR group (P<0.01). Conclusion The CPMs could be used as a prediction and evaluation tool for severe CRF, and the online 8-week MBSR can effectively improve the CRF of CC patients.

Objective: To explore the effect of anxiety, depression and hypertension on quality of life (QOL) of patients with gynecological tumor and the interaction among them, and the moderating effect of social support. Design: Cross-sectional design Setting: December 2019 to July 2020, the COVID-19 outbreak phase. Population or Sample: A total of 695 gynecological cancer patients were collected. Methods: The study used the Self-Rating Anxiety Scale (SAS), the Self-Rating Depression Scale (SDS), the Functional Assessment of Cancer Therapy Genera tool (FACT-G), and the Multidimensional Scale of Perceived Social Support Scale (MSPSS). Regression analysis and the simple slope analysis were conducted. Results: QOL of patients with anxiety and hypertension had seriously deteriorated [OR=10.297, 95%CI (5.647-18.775)]. And QOL of patients with depression and hypertension also had seriously deteriorated [OR=11.846, 95%CI (6.597-21.271)]. Calculated by crossover analysis, the synergy index, attributable proportion and relative excess risk due to interact of anxiety and hypertension were1.698,0.371 and 3.822, and the correlation index of interaction between depression and hypertension were 1.475, 0.295, and 3.493. The Social Support &Depression interaction term and Social Support &Anxiety interaction term were negatively correlated with QOL (p<0.01), and explained an extra 5.7% and 5.6% of the variance respectively (p<0.01). Conclusion: Anxiety, depression and hypertension have interaction on the QOL of patients with gynecological tumors. Social support can significantly moderate the relationship between depression, anxiety and QOL respectively. Funding: National Key R&D Program of China (Grant #2018YFC1311600). Keywords: quality of life, depression, anxiety, social support, hypertension, moderating effect