Authors
Lili Zhao, Meng Lv
Published in
Frontiers in public health. Volume 14. Pages 1876981. Epub Jul 27, 2026.
Abstract
To examine the association between Emotional Freedom Techniques (EFT) combined with psychological nursing and anticipatory grief-related psychological outcomes in breast cancer patients undergoing chemotherapy, and to provide real-world evidence for clinical psychological nursing practice.
A retrospective cohort study design was adopted, enrolling 158 breast cancer patients who received chemotherapy in our hospital from August 2023 to December 2024. Propensity score matching (PSM) was performed using a 1:1 nearest-neighbor matching method with a caliper width of 0.2 standard deviations of the logit of the propensity score. The matched variables included age, cancer stage, chemotherapy-related clinical characteristics, comorbidities, and baseline psychological assessment scores. After matching, 79 patients were retained in each cohort: a combined-intervention cohort (EFT plus psychological nursing, n = 79) and a conventional-nursing cohort (n = 79). Because the intervention was a behavioral and psychological nursing intervention, patients and intervention providers could not be blinded. Therefore, this study did not use a true double-blind design. To reduce assessment and analytical bias, outcome assessors who were not involved in intervention delivery reviewed the psychological assessment data, and statistical analysis was performed using coded group labels. The primary outcome was the post-intervention total score of the Preparatory Grief in Advanced Cancer Patients (PGAC) scale. Secondary outcomes included post-intervention anxiety and depression scores measured by the Self-Rating Anxiety Scale (SAS) and Self-Rating Depression Scale (SDS), psychological resilience dimension scores, hope level measured by the Herth Hope Index (HHI), coping strategies measured by the Medical Coping Modes Questionnaire (MCMQ), cancer-related fatigue measured by the Piper Fatigue Scale (PFS), and quality of life measured by the Quality of Life Questionnaire (QoLQ).
After PSM, baseline clinical characteristics and pre-intervention psychological scores were balanced between the two matched cohorts, with all SMDs <0.10. For the predefined primary outcome, the post-intervention PGAC total score was lower in the combined-intervention cohort than in the conventional-nursing cohort (40.56 ± 2.17 vs. 58.94 ± 3.37; MD = -18.38, 95% CI: -19.27 to -17.49; Cohen's d = -6.48; P < 0.001). Secondary analyses showed lower post-intervention anxiety, depression, avoidance, surrender, and fatigue scores, as well as higher psychological resilience, hope, confrontation, and quality-of-life scores in the combined-intervention cohort. P values, MDs, 95% CIs, and Cohen's d values are reported in the corresponding Results subsections.
In this retrospective cohort study, receipt of EFT combined with psychological nursing was associated with lower anticipatory grief scores and more favorable psychological outcomes among breast cancer patients undergoing chemotherapy. These associations may be related to improved psychological resilience, higher hope levels, and more adaptive coping strategies. The combined program may represent a potentially useful psychological nursing approach for the comprehensive care of breast cancer patients, although causal effects require confirmation in prospective randomized studies.
PMID:
42577200
Bibliographic data and abstract were imported from PubMed on 11 Aug 2026.
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