A study on the influence of applied psychological nursing intervention on psychological stress and quality of life of terminally ill elderly cancer patients
Abstract
Objective: To investigate the effects of psychological nursing combined with palliative care on psychological stress and quality of life in elderly patients with malignant tumors. Methods: A total of 120 terminally ill elderly patients with malignant tumors were randomly assigned to an observation group (n = 60) or a control group (n = 60). The control group received palliative care, whereas the observation group received psychological nursing in addition to palliative care. Psychological stress and quality of life were compared between groups after the intervention. Statistical analyses were performed using SPSS 26.0, employing t-tests or χ2 tests as appropriate. Results: After the intervention, both groups showed significant reductions in pain intensity, pain beliefs, and the impact of pain on activities, along with increased satisfaction with pain control. The observation group demonstrated significantly greater improvements than the control group (P < 0.05). Quality-of-life scores increased significantly in both groups, with larger improvements in the observation group (P < 0.05). Sleep indicators also improved: actual sleep duration increased, sleep latency shortened, and Pittsburgh Sleep Quality Index scores decreased, with more pronounced changes in the observation group (P < 0.05). Furthermore, scores for anxiety (HAMA), depression (HAMD), cancer-related fatigue, and dignity-related dimensions (social support, spiritual peace, independence, psychological status, and symptom distress) all decreased significantly in both groups, with greater reductions in the observation group (P < 0.05). Conclusion: Psychological nursing combined with palliative care significantly reduces psychological stress, relieves pain, improves cancer-related fatigue, enhances sleep quality, and promotes dignity among terminally ill elderly patients with malignant tumors. This integrated approach shows considerable clinical value.
Copyright (c) 2026 Leilei Gao, Qun Shen, Jingqian ang
This work is licensed under a Creative Commons Attribution 4.0 International License.
References
1. Bray F, Laversanne M, Sung H, et al. Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA: A Cancer Journal for Clinicians. 2024; 74(3): 229–263. doi: 10.3322/caac.21834
2. Kühne F, Meinders C, Mohr H, et al. Psychological treatments for pain in cancer patients: a systematic review on the current state of research. Schmerz (Berlin, Germany), 2016, 30(6): 496–509. doi: 10.1007/s00482-016-0169-7.
3. Baczewska B, Block B, Kropornicka B, et al. Hope in Hospitalized Patients with Terminal Cancer. International Journal of Environmental Research and Public Health. 2019; 16(20): 3867. doi: 10.3390/ijerph16203867
4. Zimmermann C, Swami N, Krzyzanowska M, Leighl N, et al. Perceptions of palliative care among patients with advanced cancer and their caregivers. CMAJ. 2016;188(10): E217–E227. doi: 10.1503/cmaj.151171
5. Torabizadeh C, Jafari S, Momennasab M. Patient’s Dignity: Viewpoints of Patients and Nurses in Hospitals. Hospital Topics. 2021; 99(4): 187–197. doi: 10.1080/00185868.2021.1897487
6. Washington KT, Wilkes CM, Rakes CR, et al. Relationships among Symptom Management Burden, Coping Responses, and Caregiver Psychological Distress at End of Life. Journal of Palliative Medicine. 2018; 21(9): 1234–1241. doi: 10.1089/jpm.2017.0584
7. Tang ST, Chang W, Chen J, et al. Associations of prognostic awareness/acceptance with psychological distress, existential suffering, and quality of life in terminally ill cancer patients’ last year of life. Psycho-Oncology. 2015; 25(4): 455–462. doi: 10.1002/pon.3943
8. Wen F, Chen J, Chou W, et al. Quality of life and psychological distress are differentially associated with distinct symptom‐functional states in terminally ill cancer patients’ last year of life. Psycho-Oncology. 2018; 27(9): 2111–2118. doi: 10.1002/pon.4775
9. Tatum PE, Mills SS. Hospice and Palliative Care: An Overview. Medical Clinics of North America. 2020; 104(3): 359–373. doi: 10.1016/j.mcna.
10. Erden S, Güler S, Tura İ, et al. Evaluating patient outcomes in postoperative pain management according to the revised American Pain Society Patient Outcome Questionnaire (APS-POQ-R). Applied Nursing Research. 2023; 73: 151734. doi: 10.1016/j.apnr.2023.151734
11. Cella DF, Tulsky DS, Gray G, et al. The Functional Assessment of Cancer Therapy Scale: Development and Validation of the General Measure. Journal of Clinical Oncology. 2023; 41(35): 5335–5344. doi: 10.1200/jco.22.02775
12. Sancho-Domingo C, Carballo JL, Coloma-Carmona A, et al. Brief version of the Pittsburgh Sleep Quality Index (B-PSQI) and measurement invariance across gender and age in a population-based sample. Psychological Assessment. 2021; 33(2): 111–121. doi: 10.1037/pas0000959
13. Mula M, Iudice A, La Neve A, et al. Validation of the Hamilton Rating Scale for Depression in adults with epilepsy. Epilepsy & Behavior. 2014; 41: 122–125. doi: 10.1016/j.yebeh.2014.08.029
14. Maier W, Buller R, Philipp M, et al. The Hamilton Anxiety Scale: reliability, validity and sensitivity to change in anxiety and depressive disorders. Journal of Affective Disorders. 1988; 14(1): 61–68. doi:10.1016/0165-0327(88)90072-9
15. Thong MSY, van Noorden CJF, Steindorf K, et al. Cancer-Related Fatigue: Causes and Current Treatment Options. Current Treatment Options in Oncology. 2020; 21(2). doi: 10.1007/s11864-020-0707-5
16. Lam LT, Chang H, Natashia D, et al. Self‐report instruments for measuring patient dignity: A psychometric systematic review. Journal of Advanced Nursing. 2022; 78(12): 3952–3973. doi: 10.1111/jan.15436
17. Huynh L, Moore J. Palliative and end-of-life care for the older adult with cancer. Current Opinion in Supportive & Palliative Care. 2021; 15(1): 23–28. doi: 10.1097/spc.0000000000000541
18. Silva S, Bártolo A, Santos IM, et al. Towards a Better Understanding of the Factors Associated with Distress in Elderly Cancer Patients: A Systematic Review. International Journal of Environmental Research and Public Health. 2022; 19(6): 3424. doi: 10.3390/ijerph19063424
19. Linden W, Vodermaier A, MacKenzie R, et al. Anxiety and depression after cancer diagnosis: Prevalence rates by cancer type, gender, and age. Journal of Affective Disorders. 2012; 141(2–3): 343–351. doi: 10.1016/j.jad.2012.03.025
20. Breitbart W, Rosenfeld B, Gibson C, et al. Meaning‐centered group psychotherapy for patients with advanced cancer: a pilot randomized controlled trial. Psycho-Oncology. 2009; 19(1): 21–28. doi: 10.1002/pon.1556
21. Wisesrith W, Sukcharoen P, Sripinkaew K. Spiritual Care Needs of Terminal Ill Cancer Patients. Asian Pacific Journal of Cancer Prevention. 2021; 22(12): 3773–3779. doi: 10.31557/apjcp.2021.22.12.3773
22. Currow DC, Agar MR, Phillips JL. Role of Hospice Care at the End of Life for People With Cancer. Journal of Clinical Oncology. 2020; 38(9): 937–943. doi: 10.1200/jco.18.02235
23. Malakian A, Mohammed S, Fazelzad R, et al. Nursing, psychotherapy and advanced cancer: A scoping review. European Journal of Oncology Nursing. 2022; 56: 102090. doi: 10.1016/j.ejon.2021.102090
24. Sharafi S, Ziaee A, Dahmardeh H. What are the outcomes of hospice care for cancer patients? A systematic review. Supportive Care in Cancer. 2022; 31(1). doi: 10.1007/s00520-022-07524-2
25. Huang L, Zhang C, Xu J, et al. Function of a Psychological Nursing Intervention on Depression, Anxiety, and Quality of Life in Older Adult Patients With Osteoporotic Fracture. Worldviews on Evidence-Based Nursing. 2021; 18(4): 290–298. doi: 10.1111/wvn.12518
26. Li ZF, Liu MJ. The Application and Influence of Hospice Care Among Patients with Advanced Esophageal Cancer [Corrigendum]. International Journal of General Medicine. 2022; 15: 299–300. doi: 10.2147/ijgm.s354931
27. Ehde DM, Dillworth TM, Turner JA. Cognitive-behavioral therapy for individuals with chronic pain: Efficacy, innovations, and directions for research. American Psychologist. 2014; 69(2): 153–166. doi: 10.1037/a0035747
28. Stanton AL, Revenson TA, Tennen H. Health Psychology: Psychological Adjustment to Chronic Disease. Annual Review of Psychology. 2007; 58(1): 565–592. doi: 10.1146/annurev.psych.58.110405.085615
29. Deleemans JM, Mather H, Spiropoulos A, et al. Recent Progress in Mind–Body Therapies in Cancer Care. Current Oncology Reports. 2023; 25(4): 293–307. doi: 10.1007/s11912-023-01373-w
30. Quinn B, Connolly M. Spirituality in palliative care. BMC Palliative Care. 2023; 22(1). doi: 10.1186/s12904-022-01116-x
