The Impact of Symptom Management Nursing Intervention on the QoL of Patients With Advanced Lung Cancer: Mediation of Self-management Efficacy and Regulation of Psychological Resilience

June 25, 2026 updated by: Jie Zeng

Dahua Hospital, Xuhui District, Shanghai

Symptom management nursing intervention can improve the self-management efficacy, psychological resilience, and QoL of patients with advanced lung cancer.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

Self management efficacy is an important mediating variable in the impact of Symptom management nursing intervention on patients' quality of life. Psychological resilience plays a negative moderating role in the effect of Symptom management nursing intervention. Late stage lung cancer patients with low psychological resilience can obtain more significant self management efficacy and quality of life improvement from Symptom management nursing intervention, and are the key beneficiaries of the intervention.

Study Type

Interventional

Enrollment (Actual)

176

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • China
    • Shanghai Municipality
      • Shanghai, Shanghai Municipality, China, 200031
        • Dahua Hospital, Xuhui District, Shanghai

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • According to the diagnostic criteria of primary lung cancer [9], the clinical stage was stage ⅢB-Ⅳ
  • aged 18-75 years old
  • Karnofsky performance status (KPS) ≥60 and expected survival ≥3 months
  • Patients had clear consciousness and normal cognitive function, and could complete the questionnaire independently or with the assistance of the researcher
  • have basic communication skills and can cooperate to complete the whole intervention
  • Patients or their families informed and signed the consent form.

Exclusion Criteria:

  • primary malignant tumors in other parts
  • history of severe heart, liver, kidney and other important organ failure, severe infection or mental illness
  • Unable to cooperate with the study due to cognitive impairment, visual and hearing impairment
  • participating in other similar nursing intervention studies.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Other
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Other: Routine nursing group
Patients in the routine group were given routine care, including disease monitoring, medication care, diet and nutrition guidance, basic life care, routine health education on admission and discharge, symptomatic treatment of patients' discomfort symptoms, telephone follow-up twice a week to understand the patient's condition, and no systematic and personalized SM nursing intervention.
Other: routine nursing group
Patients in the routine group were given routine care, including disease monitoring, medication care, diet and nutrition guidance, basic life care, routine health education on admission and discharge, symptomatic treatment of patients' discomfort symptoms, telephone follow-up twice a week to understand the patient's condition, and no systematic and personalized SM nursing intervention.
Other: standardized systematic SM nursing group
On the basis of routine nursing, implementation of systematic SM nursing intervention for 8 weeks, the specific content is as follows: (1) The intervention group was established. (2) Baseline assessment and file establishment (within 24 hours of admission).(3) Implementation of core intervention (1st to 8th week).
Other: standardized systematic SM nursing group
On the basis of routine nursing, implementation of systematic SM nursing intervention for 8 weeks, the specific content is as follows: (1) The intervention group was established. (2) Baseline assessment and file establishment (within 24 hours of admission).(3) Implementation of core intervention (1st to 8th week).

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Change in Quality of Life as measured by the Functional Assessment of Cancer Therapy-Lung (FACT-L) Scale
Time Frame: Baseline (within 24 hours of admission) and at 8 weeks (immediately post-intervention)
The Functional Assessment of Cancer Therapy-Lung (FACT-L) scale will be used to assess changes in quality of life in patients with advanced lung cancer. The scale consists of 36 items across five domains: physical health status, social and family conditions, emotional well-being, functional capability, and lung cancer-specific supplementary concerns. Each item is scored on a 0-4 Likert scale, with total scores ranging from 0 to 144. Higher scores indicate better quality of life. The scale has demonstrated good reliability and validity in Chinese populations (Cronbach's α = 0.88-0.92).
Baseline (within 24 hours of admission) and at 8 weeks (immediately post-intervention)

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Change in Self-Management Efficacy as measured by the Strategies Used by People to Promote Health (SUPPH) Scale
Time Frame: Baseline (within 24 hours of admission) and at 8 weeks (immediately post-intervention)
The SUPPH scale will be used to assess changes in disease self-management efficacy. The scale includes 28 items across three dimensions: Positive Attitude, Self-Applied Stress Reduction, and Independent Decision-Making. Each item is scored on a 1-5 Likert scale, with total scores ranging from 28 to 140. Higher scores indicate greater self-management efficacy. The Chinese version has excellent reliability (Cronbach's α = 0.96 for the total scale).
Baseline (within 24 hours of admission) and at 8 weeks (immediately post-intervention)
Change in Psychological Resilience as measured by the Connor-Davidson Resilience Scale (CD-RISC)
Time Frame: Baseline (within 24 hours of admission) and at 8 weeks (immediately post-intervention)
The CD-RISC will be used to assess changes in psychological resilience. The scale measures three dimensions-Tenacity, Self-Improvement, and Optimism-using 25 items. Each item is rated on a 0-4 scale, with total scores ranging from 0 to 100. Higher scores indicate stronger psychological resilience. The Chinese version has demonstrated good reliability (Cronbach's α = 0.91).
Baseline (within 24 hours of admission) and at 8 weeks (immediately post-intervention)

Other Outcome Measures

Outcome Measure
Measure Description
Time Frame
Mediating Effect of Self-Management Efficacy on the Relationship between Symptom Management Intervention and Quality of Life
Time Frame: Assessed at 8 weeks (post-intervention) using post-intervention scores
This outcome will examine whether self-management efficacy (SUPPH score) mediates the relationship between the symptom management nursing intervention (group assignment) and quality of life (FACT-L score). The mediating effect will be analyzed using the PROCESS macro with bootstrap resampling (5,000 iterations). Indirect effect, direct effect, and total effect will be calculated with 95% confidence intervals. An effect is considered significant if the 95% CI does not include zero.
Assessed at 8 weeks (post-intervention) using post-intervention scores

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Jie Zeng

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

June 10, 2023

Primary Completion (Actual)

October 27, 2024

Study Completion (Actual)

December 12, 2025

Study Registration Dates

First Submitted

June 25, 2026

First Submitted That Met QC Criteria

June 25, 2026

First Posted (Actual)

July 1, 2026

Study Record Updates

Last Update Posted (Actual)

July 1, 2026

Last Update Submitted That Met QC Criteria

June 25, 2026

Last Verified

June 1, 2026

More Information

Terms related to this study

Other Study ID Numbers

  • 20230509

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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