Effects of a multi-component positive psychological intervention on negative emotions, fatigue and quality of life in patients with breast cancer during initial chemotherapy: a randomized controlled trial.

PURPOSE: To evaluate the efficacy of a nurse-led positive psychological intervention on negative emotions, cancer-related fatigue (CRF), and quality of life (QOL) in patients with breast cancer receiving initial chemotherapy.

METHODS

In this two-group repeated-measures randomized clinical trial, 110 patients from a Chinese tertiary hospital were randomized to the intervention or control groups (55 each). The intervention group received a 3-week nurse-led PERMA-model intervention, while the control group received routine care. Generalized Anxiety Disorder Scale, Patient Health Questionnaire, Brief Fatigue Inventory, and Functional Assessment of Cancer Therapy-Breast Questionnaires (FACT-B) were used to assess anxiety, depression, CRF and QOL at baseline (T0), post-intervention (T1), and 1-month follow-up (T2). Generalized estimating equation models analyzed intervention effects based on the intention-to-treat principle.

RESULTS

The intervention group demonstrated significant reduction in anxiety at T1 (MMD = -5.70 95%CI [-7.64, -3.76], p < 0.001) with sustained effects at T2 (MMD = -2.88 [-4.89, -0.86], p = 0.005). Similar patterns emerged for depression (T1: MMD = -5.33 [-7.39, -3.28], p < 0.001; T2: MMD = -3.56 [-5.56, -1.47], p = 0.001) and CRF (T1: MMD = -16.19 [-24.79, -7.90], p < 0.001; T2: MMD = -10.09 [-16.65, -3.52], p = 0.003). FACT-B total scores (T1: MMD = 23.54 [13.87, 33.20], p < 0.001; T2: MMD = 15.68 [8.02, 23.34], p < 0.001) and all dimensions except Functional Well-Being improved significantly in the intervention group.

CONCLUSIONS

Positive psychological intervention alleviates negative emotions and CRF while improving QOL in patients with breast cancer starting chemotherapy. Therefore, integrating such interventions may optimize clinical chemotherapy management.