Objective: To systematically review the core characteristics, multi-dimensional influencing factors, and mechanisms of psychological problems in patients with advanced colorectal cancer undergoing chemotherapy. This study aims to comprehensively summarize the efficacy differences of existing psychological intervention programs, thereby providing evidence-based support for clinical precision psychological management and future research. Methods: Guided by a conceptual framework encompassing “Problem–Influencing Factors–Mechanisms– Interventions–Future Directions”. We searched 9 databases (including PubMed, The Cochrane Library, CINAHL, and CNKI) for relevant Chinese and English literature published in the past three years. Information from the literature was qualitatively synthesized and quantitatively analyzed based on inclusion and exclusion criteria. Key conclusions were extracted, and cross-study comparative perspectives were supplemented. Results: Psychological problems in patients with advanced colorectal cancer undergoing chemotherapy presented a “three primary and three secondary” characteristic profile. The primary problems included cancer-related fatigue (CRF, incidence 62%~78%), anxiety (38%~55%), and depression (32%~48%). The secondary problems were sleep disorders (45%~60%), spiritual distress (28%~35%), and body image disturbance (25%~32%). Their development is interactively influenced by four categories of factors: patient-specific factors (resilience, self-compassion), treatment-related factors (severity of side effects), social support (family involvement), and disease-related factors (progression rate). These problems are further exacerbated through a four-stage vicious cycle: “physical discomfort→cognitive bias→emotional deterioration→treatment nonadherence.” Among existing interventions, the combined program of “family-participatory cognitive-behavioral nursing + precision nutrition intervention” demonstrated the optimal efficacy, reducing anxiety scores by 15.2 points, CRF scores by 18.6 points, and improving chemotherapy adherence to 96.3%. Conclusion: Psychological problems in patients with advanced colorectal cancer undergoing chemotherapy are complex and diverse. There is a need to select targeted, precision interventions based on “population heterogeneity.” Future research should conduct large-sample, multi-center studies to establish a long-term evidence chain linking “psychological intervention to survival benefit.”
Sun et al. (2026) studied this question.