Original Article

Influences of Psychological Intervention on Negative Emotion, Cancer-Related Fatigue and Level of Hope in Lung Cancer Chemotherapy Patients Based on the PERMA Framework


Background: Psychological status is a decisive factor for regulating the lung cancer chemotherapy patients’ levels of fatigue and hope. Using the PERMA (Positive Emotion, Engagement, Relationships, Meaning, and Accomplishment) framework. We aimed to explore the influences of the psychological intervention on the patients’ negative emotion, cancer-related fatigue, and level of hope.

Method: A total of 100 lung cancer chemotherapy patients admitted in Wuhan No.4 Hospital, China, from Jan 2018 to Aug 2019 were enrolled as research objects divided into the control group and observation group. Positive psychological intervention using the PERMA framework was given to the observation group. The scores of Post-Traumatic Growth Inventory (PTGI), Self-rating Anxiety Scale (SAS), Self-rating Depression Scale (SDS), Cancer Fatigue Scale (CFS), and Herth Hope Index (HHI) were evaluated and compared in the two groups.

Results: After the intervention, PTGI score in the observation group is higher than that in the control group, whereas the SAS and SDS scores are lower in the observation group than in the control group, and the differences are statistically significant (P<0.05). Score of each CFS dimension and total CFS score in the observation group are all lower than those in the control group, with statistically significant differences (P<0.05). Score of each HHI dimension and total HHI score are higher than those in the control group, and the differences are statistically significant (P<0.05).

Conclusion: Positive psychological intervention using the PERMA framework can improve the emotional and fatigue state of lung cancer chemotherapy patients and elevate their level of hope.

1. Shi JF, Wang L, Wu N, et al (2019). Clinical characteristics and medical service utiliza-tion of lung cancer in China, 2005-2014: Overall design and results from a multi-center retrospective epidemiologic survey. Lung Cancer, 128: 91-100.
2. Tan XP, Liu NN, Fu Y, et al (2018). Investi-gation of health status and influencing factors of cancer-related fatigue in pa-tients with lung cancer after chemothera-py. Pract Prev Med, 25(7): 853-6.
3. Bando T, Onishi C, Imai Y (2018). Treat-ment‐associated symptoms and coping of postoperative patients with lung cancer in Japan: Development of a model of factors influencing hope. Jpn J Nurs Sci, 15(3): 237-48.
4. Xue F, Huang F (2018). The Effect of psy-chological intervention on nutrient status of perioperative patients with lung cancer. Iran J Public Health, 47(4): 531-7.
5. Ellis MC, Diggs BS, Vetto JT, et al (2011). Intraoperative oncologic staging and out-comes for lung cancer resection vary by surgeon specialty. Ann Thorac Surg, 92(6): 1958-63.
6. Yang N, Xiao H, Cao Y, et al (2018). Influ-ence of oncology nurses’ empathy on lung cancer patients’ cellular immunity. Psychol Res Behav Manag, (11): 279-87.
7. Chia A, Kern ML, Neville BA (2020). CSR for Happiness: Corporate determinants of societal happiness as social responsi-bility. Bus Ethics, 29(3): 422-37.
8. Ryan C, Bergin M, Wells JS (2018). Theoreti-cal perspectives of adherence to web-based interventions: a scoping review. Int J Behav Med, 25(1): 17-29.
9. Samara G, Paul K (2019). Justice versus fair-ness in the family business workplace: A socioemotional wealth approach. Bus Eth-ics, 28(2): 175-84.
10. Ho SMY, Law LSC, Wang GL, et al (2013). Psychometric analysis of the Chinese ver-sion of the posttraumatic growth inven-tory with cancer patients in Hong Kong and Taiwan. Psycho Oncology, 22(3): 715-9.
11. Wang ZY, Chi YF (1984). Self-Rating Anxie-ty Scale (SAS). Shanghai Arch Psychiat, 6(2): 73-4.
12. Wang CF, Cai ZH, Xu Q (1986). Self-Rating Depression Scale-SDS in 1,340 Normal Subjects, Chin J Nerv and Ment Dis, (5): 267-8.
13. Okuyama T, Akechi T, Kugaya A, et al (2000). Development and validation of the cancer fatigue scale: A brief, three-dimensional, self-rating scale for assess-ment of fatigue in cancer patients. J Pain Symptom Manage, 19(1): 5-14.
14. Herth K (2000). Enhancing hope in people with a first recurrence of cancer. J Adv Nurs, 32(6):1431-41.
15. Breitbart W, Pessin H, Rosenfeld B, et al (2018). Individual meaning-centered psy-chotherapy for the treatment of psycho-logical and existential distress: A random-ized controlled trial in patients with ad-vanced cancer. Cancer, 124(15): 3231-9.
16. Wu GX (2020). Effect of mindfulness de-compression therapy on cancer-related fatigue and mental health of elderly wid-owed lung cancer patients with chemo-therapy, J Clin Pathol Res, 40(2): 430-6.
17. Tian J, Liu HX, Su T, et al (2018). Effects of nursing intervention based on story theo-ry on negative emotions and quality of life in cancer chemotherapy patients. Chin J Pract Nurs, 34(4): 251-5.
18. Pollard A, Burchell JL, Castle D, et al (2017). Individualised mindfulness‐based stress reduction for head and neck cancer pa-tients undergoing radiotherapy of curative intent: a descriptive pilot study. Eur J Can-cer Care, 26(2): ecc12474.
19. Lengacher CA, Reich RR, Paterson CL, et al (2016). Examination of broad symptom improvement resulting from mindful-ness-based stress reduction in breast cancer survivors: a randomized con-trolled trial. J Clin Oncol, 34(24): 2827-34.
20. Rosenfeld B, Cham H, Pessin H, et al (2018). Why is Meaning-Centered Group Psychotherapy (MCGP) effective? En-hanced sense of meaning as the mecha-nism of change for advanced cancer pa-tients. Psycho Oncology, 27(2): 654-60.
21. Jia JF, Yang LJ, Li H, et al (2018). Effect of integrated psychological intervention on hope level and coping style in patients with lung cancer receiving chemotherapy. Chin J Clin Onco and Rehabil, 25(5): 85-8.
IssueVol 50 No 4 (2021) QRcode
SectionOriginal Article(s)
DOI https://doi.org/10.18502/ijph.v50i4.5997
Positive psychology Framework Lung cancer Cancer fatigue Level of hope

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How to Cite
Tu M, Wang F, Shen S, Wang H, Feng J. Influences of Psychological Intervention on Negative Emotion, Cancer-Related Fatigue and Level of Hope in Lung Cancer Chemotherapy Patients Based on the PERMA Framework. Iran J Public Health. 2021;50(4):728-736.