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  • A Peer-Led, Nurse-Involved Blended Online and Offline Peer Support Program (PNO2PSP) for Psychosocial Adjustment in Young- to Middle-Aged Patients With Breast Cancer: Cluster Randomized Clinical Trial

Background: Young- to middle-aged patients with breast cancer face significant psychosocial challenges. Existing interventions often lack comprehensiveness, timely initiation, and tailoring specific to this population’s unique needs. Objective: This study aimed to evaluate the impact of a peer-led, nurse-involved, blended online and offline peer support intervention program (PNO2PSP) on psychosocial adjustment in young- to middle-aged patients with breast cancer. Methods: The effectiveness of PNO2PSP was evaluated through a single-center cluster randomized controlled trial involving 70 newly diagnosed young- to middle-aged patients with breast cancer (35 in each group). The intervention group received an 8-week PNO2PSP in addition to routine care. Psychosocial adjustment, self-efficacy, social support, and coping modes were assessed presurgery and at 4, 8, and 12 weeks post surgery. Generalized estimating equations were used for intention-to-treat analyses. In-depth interviews with 9 participants explored their experiences. Results: Compared to the control group, the intervention group demonstrated significantly lower psychosocial adjustment scores at 8 weeks (T2; Wald =14.96; <.001) and 12 weeks (T3; Wald =7.49; =.006); social support was higher at 8 weeks (T2; Wald =7.65; =.006). Confrontation coping scores were higher at T2 (Wald =5.46; =.02), T3 (Wald =10.04; =.002), while avoidance coping scores were lower at T1 (Wald =8.24; =.004), T2 (Wald =7.45; =.006), and T3 (Wald =5.70; =.02). Qualitative findings supported these quantitative results, highlighting the program’s role in facilitating psychosocial adjustment, providing vital support, boosting treatment confidence, and fostering positive coping. Conclusions: The PNO2PSP effectively improved psychosocial adjustment, social support, and positive coping in young- to middle-aged patients with breast cancer. Its scientifically validated, feasible, and patient-centered design supports its recommendation for wider clinical implementation, with continued training for peer supporters and sustained delivery of peer support. Trial Registration: Chinese Clinical Trial Registry ChiCTR2300076471; https://www.chictr.org.cn/showprojEN.html?proj=198622

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