Effects of a nurse-led positive psychology intervention on sexual function, depression and subjective well-being in postoperative patients with early-stage cervical cancer: A randomized controlled trial

Background: Sexual dysfunction is a common long-term complication of cervical cancer and its treatment. However, due to traditional Chinese culture, there are few studies on interventions to improve sexual function in China. Objectives: To evaluate the effectiveness of a nurse-led positive psychology intervention on sexual function, depression and subjective well-being amongst postoperative patients with early-stage cervical cancer. Design: A randomized controlled trial. Settings and Methods: Patients who had undergone radical hysterectomy for early-stage cervical cancer and were followed up in gynaecological clinics were recruited via convenience sampling from three tertiary hospitals in Chongqing, China. Patients who met the inclusion criteria and agreed to participate (N = 91) were randomly assigned to a nurse-led positive psychology intervention (intervention group, n = 46) or usual care (control group, n = 45). The Female Sexual Function Index, Self-rating Depression Scale and Index of Well-being were used to assess sexual function, depression and subjective well-being, respectively, at baseline and 3 and 6 months after the intervention. Data were analysed by the chi-square test, Mann-Whitney U test, t-test and Pearson correlation analysis. Results: Compared with participants in the control group, participants in the intervention group showed significant improvements in sexual function (mean difference [MD]: -3.95, P = 0.005 at 3 months post-intervention; MD: -4.36, P = 0.001 at 6 months post-intervention). In addition, at 3 and 6 months after the intervention, the number of patients with improvements in their levels of depression and well-being in the intervention group was higher than that in the control group (P<0.05). The Pearson correlation analysis results showed that there was a negative correlation between sexual function and level of depression in patients (r = -0.612, P<0.001) and that sexual function was positively correlated with subjective well-being (r = 0.638, P<0.001). Conclusion: The intervention group experienced significant improvements in sexual function, depression and subjective well-being. These findings suggest that a nurse-led positive psychology intervention should be implemented for postoperative patients with early-stage cervical cancer. (C) 2020 The Authors. Published by Elsevier Ltd.