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The Effectiveness of Digital Intervention on Psychological Resilience in Postoperative Breast Cancer Patients During
Xin He1, Qianyu Zhang1, Liping Wang1,2
1School of Public Health and Nursing, Hangzhou Normal University, No. 2318 Yuhangtang Road, Hangzhou Normal University Cangqian Campus, Hangzhou, Zhejiang, 311121, China, 86 57128861971.
Background:
Patients with breast cancer during postoperative chemotherapy intervals commonly experience psychological distress and reduced resilience while recovering at home. Digital mindfulness interventions may provide accessible psychological support during this vulnerable period; however, evidence regarding tailored interventions for postoperative patients with breast cancer during chemotherapy intervals remains limited.
Objective:
This study aimed to examine the effectiveness of a digital intervention on psychological resilience in postoperative patients with breast cancer during chemotherapy intervals.
Methods:
A quasi-experimental study with repeated measures was conducted from October 2021 to June 2022. A total of 80 eligible participants were recruited from the Department of Breast Surgery at a tertiary hospital in Zhejiang Province, China, and 71 completed the study. The control group received routine discharge instructions and nursing follow-ups, whereas the intervention group additionally received an 8-week digital psychological resilience intervention. Outcomes were assessed at baseline (T0), 3 months post intervention (T1), and 6 months post intervention (T2). The measures included the Connor-Davidson Resilience Scale (CD-RISC), Hospital Anxiety and Depression Scale (HADS), Social Support Rating Scale (SSRS), Breast Cancer Survivor Self-Efficacy Scale (BCSSS), and Functional Assessment of Cancer Therapy-Breast (FACT-B). Independent-samples t tests, chi-square tests, and repeated-measures ANOVA were performed using SPSS (version 26.0; IBM Corp).
Results:
No statistically significant baseline differences were observed between the two groups in the outcome measures. At T1, the intervention group had higher CD-RISC scores than the control group (mean 67.58, SD 11.41 vs mean 62.09, SD 10.18; P=.036) and higher BCSSS scores (mean 42.36, SD 3.59 vs mean 39.23, SD 4.90; P=.003). However, these between-group differences were no longer statistically significant at T2 (P>.05). Significant time effects and group×time interaction effects were observed for both psychological resilience and self-efficacy (P<.05). HADS scores were lower in the intervention group than in the control group at both T1 (mean 11.78, SD 1.48 vs mean 15.86, SD 1.54; P<.001) and T2 (mean 9.69, SD 1.51 vs mean 12.03, SD 1.42; P<.001), with significant time, group, and group×time interaction effects (P<.05). For SSRS and FACT-B scores, no statistically significant between-group differences were found at T1 or T2 (P>.05), although both scales showed significant time effects (P<.05).
Conclusions:
The digital psychological resilience intervention effectively alleviated anxiety and depression in postoperative patients with breast cancer during chemotherapy intervals. It also significantly enhanced their psychological resilience and self-efficacy in the early postintervention phase. Although the improvements in psychological resilience and self-efficacy did not remain statistically superior to those of the control group at the 6-month endpoint, the intervention improved the recovery trajectory of the patients and provided significant short-term benefits during the early postintervention period. Future research should explore strategies to maintain these gains over the long term.
