Effect of positive psychology and PDCA on PICC management in breast cancer
Abstract
Objective: To analyze the effect of positive psychological intervention combined with PDCA circulation mode on the management of PICC catheterization in breast cancer patients undergoing chemotherapy. Methods: 140 patients with breast cancer who received PICC after surgery from June 2022 to July 2024 in our hospital were randomly divided into the control group and the observation group (70 cases each). Result: After intervention, the SAS and SDS scores of the observation group were significantly lower than those of the control group (t = 6.122, P < 0.001; t = 8.632, P < 0.001); The incidence of complications during catheterization in the observation group was 7.14%, significantly lower than the 18.57% in the control group (χ2 = 4.080, P = 0.043); Both groups of patients showed an improvement in FACT-B scores, with the observation group showing a more significant improvement compared to the control group (t = 11.237, P < 0.001); The nursing satisfaction score of the observation group was higher than that of the control group (t = 8.149, P < 0.001). Conclusion: Positive psychological intervention combined with PDCA circulation mode for patients with breast cancer undergoing PICC catheterization during chemotherapy can reduce their negative emotions, improve their quality of life, and reduce the incidence of complications of PICC catheterization.
Copyright (c) 2026 Meiya Lou, Yinke Jiang, Chenxi Sha, Yuanyuan Wang, Gaochao Wang

This work is licensed under a Creative Commons Attribution 4.0 International License.
References
1. Katsura C, Ogunmwonyi I, Kankam HK, et al. Breast cancer: presentation, investigation and management. British Journal of Hospital Medicine. 2022; 83(2): 1-7. doi: 10.12968/hmed.2021.0459
2. Yang L, Zhang X, Guo X, et al. Influencing factors and path analysis of cancer - related fatigue in breast cancer patients undergoing chemotherapy (Chinese). Chinese Evidence - Based Nursing. 2025; 11(06): 1104–1109.
3. Liang Q, Yang L, Zhou Y, et al. Current status and influencing factors of kinesiophobia in tumor patients with PICC catheterization (Chinese). Journal of Nursing Science. 2023; 38(6): 59–62.
4. Provenzano E. Neoadjuvant Chemotherapy for Breast Cancer: Moving Beyond Pathological Complete Response in the Molecular Age. Acta Medica Academica. 2021; 50(1): 88. doi: 10.5644/ama2006-124.328
5. Zhang M, Huang J, Hu W, etc The Effect of Motivational Psychological Nursing Combined with Empowerment Education on Negative Emotions and Self-Management Abilities of Patients with Gynecological Malignant Tumors Undergoing PICC Placement (Chinese). Chinese Clinical Research. 2024; 37(10): 1598–1602. doi: 10.13429/j.cnki.cjcr.2024.10.024
6. Jiang L, Chen J, Hua L, et al. The impact of family centered continuous positive psychological intervention on the postoperative psychology and quality of life of patients with breast cancer (Chinese). Chinese Journal of Clinical Health. 2025; 28(02): 234–238.
7. Li G, Cao L, Yang J, et al. The impact of positive psychological intervention in PERMA mode on postoperative patients with esophageal cancer (Chinese). International Journal of Psychiatry. 2025; 52(01): 321–324. doi: 10.13479/j.cnki.jip.2025.01.073
8. Zhang C, Chen J. Application of the PDCA cycle method in the quality management of PICC for breast cancer patients after chemotherapy (Chinese). International Journal of Nursing. 2021; 40(19): 4–9. doi: 10.3760/cma.j.cn221370-20200401-01001
9. Breast Cancer Expert Committee of the National Cancer Quality Control Center, Breast Cancer Professional Committee of the Chinese Anti - Cancer Association, Cancer Drug Clinical Research Professional Committee of the Chinese Anti - Cancer Association. Chinese Guidelines for the Standard Diagnosis and Treatment of Advanced Breast Cancer (2024 Edition) (Chinese). Chinese Journal of Oncology. 2024; 46(12): 1079–1106. doi: 10.3760/cma.j.cn112152-20241009-00435
10. Jiao G, Li T, Li X, et al. Correlation analysis of mindfulness level, negative emotions and quality of life in breast cancer patients undergoing chemotherapy. Journal of Modern Oncology. 2021; 29(1): 4–5.
11. Zhao Y, Liu GW. Chinese chapter of the international union of angiology, peripheral vascular disease management branch of the Chinese Geriatrics society. Chinese expert consensus on the prevention and treatment of infusion catheter - related venous thrombosis (2020 edition) (Chinese). Chinese Journal of Geriatrics. 2020, 5(8): 232–236. doi: 10.19538/j.cjps.issn1005-2208.2020.04.03
12. Li L, Wu J, Huang H, et al. Correlation study on the quality of life of breast cancer patients and the severity of menopausal symptoms. Anti - Infective Pharmacy. 2023; 20(12): 1278–1283. doi: 10.13493/j.issn.1672-7878.2023.12-012
13. Leon-Ferre RA, Hieken TJ, Boughey JC. The Landmark Series: Neoadjuvant Chemotherapy for Triple-Negative and HER2-Positive Breast Cancer. Annals of Surgical Oncology. 2021; 28(4): 2111–2119. doi: 10.1245/s10434-020-09480-9
14. Oza-Gajera BP, Davis JA, Farrington C, et al. PICC line management among patients with chronic kidney disease. The Journal of Vascular Access. 2021; 24(2): 329–337. doi: 10.1177/11297298211025897
15. Han E, Li X, Wang N, et al. The effect of team intervention on the complications of patients with breast cancer who were implanted with PICC catheter after chemotherapy. Gansu Medical Journal. 2024; 43(04): 364–366. doi: 10.15975/j.cnki.gsyy.2024.04.028
16. Jia J. Application of mind mapping in early health education for breast cancer patients with PICC catheters (Chinese). Chongqing Medicine. 2022; 51(S01): 401–403.
17. Chang Q, Wang X, Du C, et al. Influence of humanistic care combined with psychological nursing on negative emotions of breast cancer patients after surgery (Chinese). International Journal of Psychiatry. 2024; 51(4): 1302–1304. doi: 10.13479/j.cnki.jip.2024.04.013
18. He R. The role of group psychotherapy in dealing with negative emotions of young breast cancer patients (Chinese). International General Practice. 2024; 5(3). doi: 10.37155/2717-5669-0503-28
19. Fávero M, Moreira D, Abreu B, et al. Psychological intervention with adult victims of sexual abuse: A comprehensive review. Clinical Psychology & Psychotherapy. 2021; 29(1): 62–80. doi: 10.1002/cpp.2598
20. Su Z, Li W, Chen H, et al. Analysis of risk factors for PICC - related venous thrombosis in breast cancer patients undergoing chemotherapy (Chinese). Guangdong Medical Journal. 2022; 43(12): 1569–1572. doi: 10.13820/j.cnki.gdyx.20211653
21. Ruano A, García-Torres F, Gálvez-Lara M, et al. Psychological and Non-Pharmacologic Treatments for Pain in Cancer Patients: A Systematic Review and Meta-Analysis. Journal of Pain and Symptom Management. 2022; 63(5): e505–e520. doi: 10.1016/j.jpainsymman.2021.12.021
22. Hoffmann A, Pilger S, Olbrecht T, et al. Qualitative evaluation of a brief positive psychological online intervention for nursing staff. Archives of Psychiatric Nursing. 2023; 44: 38–45. doi: 10.1016/j.apnu.2023.04.003
23. Zhang L, Ma N, Zheng X. The application effect of PDCA cycle management mode in central venous catheterization of peripheral vein puncture in lung cancer chemotherapy patients (Chinese). Cancer Progression. 2025; 23(08): 981–984.
24. Liu H, Liang L, Ma Y, et al. Application of positive psychology combined with multimodal exercise intervention in breast cancer patients undergoing chemotherapy (Chinese). Journal of Nursing Science. 2024; 39(11): 28–32.
25. Zhong C, Lv C. The effect of positive psychological nursing combined with cardiopulmonary rehabilitation training intervention on lung function and sleep quality in stable patients with chronic obstructive pulmonary disease (Chinese). Reflex Therapy and Rehabilitation Medicine. 2025; 6(07): 86–89. doi: 10.16344/j.cnki.10-1669/r4.2025.07.027
26. Xiong Z, Guo X, Li S, et al. Evidence summary of the risk of psychological distress and its screening in breast cancer patients (Chinese). Journal of Nursing Science. 2023; 38(10): 90–93.
27. Zhu W, Liu J, Qian H, et al. Application of continuous nursing intervention for patients with PICC catheterization undergoing tumor chemotherapy. American Journal of Translational Research. 2021; 13(6): 7207–7213.
28. Zhao M, Wang H, Bai H. The intervention effect of FMEA combined with PDCA cycle on peripheral central venous catheterization complications in bone tumor chemotherapy patients (Chinese). Chinese Medical Journal. 2024; 59(08): 923–927.
29. Lv Y, Li N. The effect of PDCA cycle intervention in patients with advanced liver cancer undergoing central venous catheterization via peripheral vein puncture (Chinese). Chinese Medical Journal. 2023; 20(33): 179–183. doi: 10.20047/j.issn1673-7210.2023.33.40
30. Zeng X, Huang X, Wang P, et al. The application of the PDCA cycle in the nutritional management of patients with nasopharyngeal carcinoma. Supportive Care in Cancer. 2023; 31(5). doi: 10.1007/s00520-023-07724-4
