A Nurse-Led Narrative Intervention to Improve Psychological Resilience, Posttraumatic Growth, and Meaning in Life in Breast Cancer Patients Undergoing Chemotherapy: A Randomized Controlled Trial

Background: Breast cancer patients undergoing chemotherapy often experience psychological distress and impaired positive psychological adaptation. However, evidence regarding nurse-led narrative nursing in this population remains limited. Objectives: To evaluate the short-term effects of a nurse-led narrative intervention on psychological resilience, posttraumatic growth (PTG), and meaning in life (MIL) among women with breast cancer undergoing chemotherapy. Methods: This randomized controlled trial was conducted at a tertiary hospital in Inner Mongolia, China, from May 15 to August 31, 2025. Sixty-eight eligible patients with stage I–III breast cancer undergoing postoperative chemotherapy were allocated 1:1 to the narrative nursing group or the control group using a random-number table; 66 completed the study. The narrative nursing group received three nurse-led narrative sessions plus routine psychological care, whereas the control group received routine psychological care alone. The primary outcome was psychological resilience, and the secondary outcomes were PTG and MIL. Outcomes were assessed at admission and after the third chemotherapy cycle using the Connor-Davidson Resilience Scale, Posttraumatic Growth Inventory, and Meaning in Life Questionnaire. Normality and homogeneity of variance were assessed using the Shapiro-Wilk test and Levene’s test. Independent-samples t tests and chi-square tests were used for between-group comparisons. Treatment effects were estimated from change scores as mean differences (MDs) with 95% confidence intervals. Results: Baseline characteristics were comparable between groups (all P > 0.050). After the third chemotherapy cycle, the narrative nursing group had higher psychological resilience (63.48 ± 4.11 vs. 59.00 ± 3.64, P < 0.001), PTG (64.70 ± 7.16 vs. 56.12 ± 7.85, P < 0.001), and MIL (48.39 ± 4.00 vs. 44.33 ± 6.00, P = 0.002) than the control group. Analyses of changes from baseline to post-intervention showed significant treatment effects on psychological resilience (MD = 3.87, 95% CI: 2.72, 5.02; P < 0.001), PTG (MD = 6.79, 95% CI: 4.83, 8.75; P < 0.001), and MIL (MD = 4.24, 95% CI: 3.02, 5.46; P < 0.001). Conclusions: Narrative nursing improved psychological resilience, PTG, and MIL among patients with breast cancer receiving chemotherapy in this single-center trial. These findings support narrative nursing as a feasible psychosocial intervention in oncology care.