Association of risk-based nursing on self-management efficacy and complications in patients with cervical small cell carcinoma undergoing radiotherapy

Background Cervical small cell carcinoma (SCCC) represents an uncommon, highly aggressive malignancy with pronounced radiotherapy-related toxicity. The present research was conducted to assess the impact of a risk-based nursing (RBN) model on self-management efficacy, complications, and quality of life (QOL) in SCCC patients undergoing radical pelvic radiotherapy. Methods This single-center retrospective controlled investigation enrolled SCCC patients undergoing radical pelvic radiotherapy from January 2020 and June 2025. Patients were divided into a conventional nursing (CN) group and an RBN group according to the care model received. Outcomes were assessed at baseline and one month after radiotherapy completion, including self-management efficacy, medical coping modes, radiation-induced complications, anxiety and depression, QOL, and nutritional indicators. Results A total of 138 patients were analyzed (CN, n = 68; RBN, n = 70). After the nursing period, the RBN group had significantly greater self-efficacy ratings (positive attitude: 30.22 vs 28.36, P = 0.003; self-stress reduction: 26.55 vs 25.12, P = 0.008; self-determination: 13.12 vs 12.35, P = 0.002). RBN also reduced avoidance and surrender coping, and increased confrontation (P < 0.05). The incidences of radiation proctitis (5.71% vs 16.18%, P = 0.048) and grade ≥2 skin reactions (7.14% vs 20.59%, P = 0.022) were lower in RBN. Anxiety and depression scores were significantly decreased (P = 0.004 and P = 0.027). Physical function (71.35 vs 68.42, P = 0.011) and nutritional indices (serum albumin: 38.03 vs 36.55 g/L, P = 0.022; hemoglobin: 115.42 vs 111.35 g/L, P = 0.020) improved. Conclusion Risk-based nursing is associated with improved self-management efficacy, reduced radiation proctitis and skin toxicity, alleviated psychological distress, and preserved nutritional status in SCCC patients undergoing radiotherapy.