The Impact of PERMA Integrated Care on Positive Psychological Factors and Symptom Burden in Patients Undergoing Concurrent Chemoradiotherapy for Cervical Cancer: A PRO Study

Objective Patients undergoing postoperative concurrent chemoradiotherapy (CCRT) for cervical cancer frequently experience severe psychological distress. This study aimed to break through the limitations of conventional care by constructing and validating a novel, integrated nursing intervention model grounded in the PERMA framework of positive psychology. The model synergized multidisciplinary resources with digital technology to systematically enhance patients' psychological resilience, alleviate distress, and ultimately optimize their quality of life and treatment outcomes.

Methods We conducted a quasi-experimental study. A total of 160 patients were allocated into two groups. The control group (n=80, recruited from January to June 2022) received routine nursing care. The observation group (n=80, recruited from July to December 2022) received the PERMA-based positive psychology intervention, which provided structured activities across its five core components: Positive Emotion (P), Engagement (E), Relationships (R), Meaning (M), and Achievement (A). This intervention was supported by a multidisciplinary team (MDT) and a digital platform for dynamic assessment, personalized content delivery, and progress tracking. Key outcomes, including psychological distress (DT), resilience (CD-RISC), well-being (PERMA), and anxiety/depression (HADS), were compared between the two groups at baseline, mid-CCRT, end-CCRT, and at a 3-month post-treatment follow-up.

Results The observation group demonstrated statistically significant improvements compared to the control group. Specifically, they reported significantly lower scores on the DT and HADS scales (p<0.01), and significantly higher scores on the CD-RISC and PERMA well-being scales (including all its sub-dimensions) at mid-intervention, post-intervention, and the 3-month follow-up (p<0.05).

Conclusion The PERMA-based integrated care model not only effectively alleviated psychological distress but also empowered patients to cultivate resilience and experience post-traumatic growth. This approach successfully translates the modern, patient-centered concept of prioritizing the "health experience" into clinical practice, providing a robust reference for future psychosocial interventions in oncology.