Effect of nursing intervention based on resourcefulness theory on fertility anxiety of ovarian cancer patients

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Methods: 64 patients with ovarian cancer who were treated in hospital from May 2019 to September 2022 were selected as the study objects, and the patients were divided into control group and intervention group with 32 cases in each group by random number table. The control group was given routine nursing, and the intervention group was given nursing intervention based on the wisdom theory. The post-cancer fertility worry Scale, self-rating Depression Scale (SDS), self-rating Anxiety Scale (SAS), comprehensive Quality of Life questionnaire (GQOLI-74) and self-made nursing satisfaction questionnaire were used before and after intervention to evaluate the fertility worry, depression, anxiety, quality of life and nursing satisfaction of the two groups of patients. Results: After intervention, the fertility worry score, SDS score and SAS score of the two groups were decreased, and the fertility worry score, SDS score and SAS score of the intervention group were lower than those of the control group (P<0.05). After intervention, the material life, social function, psychological function, physical function and GQOLI-74 total score of the intervention group were significantly improved compared with the control group, and the differences were statistically significant (P<0.05). The nursing satisfaction of intervention group was higher than that of control group (P<0.05). Conclusion: Nursing intervention based on the wisdom theory can significantly reduce the fertility worries of ovarian cancer patients, relieve depression and anxiety, improve quality of life, and enhance nursing satisfaction, which is worthy of clinical reference and promotion. resourcefulness theory Nursing intervention Ovarian cancer Fertility worries Introduction Ovarian cancer is one of the common malignant tumors of the female reproductive system, with the mortality rate ranking first among gynecological malignancies [ 1 ] In China, the incidence and death rate of ovarian cancer are increasing rapidly. In China, the incidence and death rate of ovarian cancer are rapidly increasing, with about 52,000 cases of death every year, accounting for 42% of the global death rate. [ 2 ] In China, the incidence and death rate of ovarian cancer are increasing rapidly. With the comprehensive development of early cancer screening and the improvement of diagnosis and treatment level, the 5-year survival rate of cancer patients has been improved. [ 3 ] However, chemotherapy, radiotherapy, surgery and other treatments will cause a certain degree of damage or even failure of the patient's reproductive function. [ 4 ] Fertility anxiety is a term used to describe an individual's concern about reproduction. Fertility concerns refer to the individual's worries about reproduction and child rearing, including concerns about fertility, the health of the individual and his or her offspring, and child care. [ 5 ] Fertility concerns include worries about fertility, the health of the individual and their offspring, and child care. Fertility concerns not only affect the patient's mental health, but also have multiple impacts on the patient, family and society. [ 6 ] The presence of fertility concerns not only affects the patient's mental health, but also has multiple effects on the patient, family and society. Currently, the main intervention strategies for fertility concerns are fertility protection, fertility information support, and fertility counseling. [ 7 ] fertility protection, fertility information support [ 8 ] and psychosocial support. [ 9 ] The main purpose of the intervention strategy is to protect fertility, support fertility information and support psychosocial support. Intelligence is the ability of an individual to perform daily tasks independently (personal intelligence) and the ability to obtain help from the outside world when the individual is unable to perform daily tasks independently (social intelligence). [ 10 ] Social resourcefulness. Research has shown that [ 11 ] that resourcefulness can improve the quality of life of cancer patients and prevent depressive symptoms. As the comprehensive ability of people to solve psychological and social problems in daily life, intellectual resourcefulness has been widely studied by foreign scholars, and mainly focused on lymphoma patients, breast cancer patients [ 11 , 12 ] However, little research has been done in China on fertility worries and psychological status of ovarian cancer patients. The present study investigates the effects of nursing intervention based on the theory of wisdom and tactics on the fertility worries and psychological state of ovarian cancer patients, with a view to providing a new direction for the nursing care of ovarian cancer patients. Objects and Methods 1.1 Objects of study Sixty-four cases of ovarian cancer patients who entered the hospital for treatment from May 2019 to September 2022 were selected as study subjects and randomly divided into the control group (32 cases) and the intervention group (32 cases). Inclusion criteria: age 18–45 years old; diagnosed with ovarian cancer after pathological examination [ 13 ] ; able to read and fill out questionnaires on their own; with normal communication ability; informed consent to this study and have signed. Exclusion criteria: suffering from cognitive disorders, psychiatric disorders; combined with other malignant tumors; combined with autoimmune diseases, coagulation disorders; the presence of heart failure, renal failure and other serious damage to the organs. The differences in age, residence, body mass index and tumor stage between the two groups were not statistically significant (P > 0.05) and were comparable, as shown in Table 1 .The enrolled patients signed an informed consent form and were approved by the hospital ethics committee,ethics Approval Number ((L) 2019-008). Table 1 General information of patients in both groups (n=32) groups Age (years) Place of residence (urban/rural) Body mass index (kg/m 2 ) Tumor Stage (Stage I-II/Stage III-IV) control subjects 38.26±7.14 17/15 22.42±2.16 20/12 intervention group 37.88±6.79 14/18 22.17±2.09 22/10 t or χ 2 0.218 0.563 0.471 0.277 P 0.828 0.453 0.640 0.599 1.2 Nursing interventions 1.2.1 Control group Give routine nursing care: that is, give the patients health education on ovarian cancer related knowledge, guide the patients to exercise and diet, follow the doctor's prescription of medication and pay attention to rest. Provide patients with a comfortable and cozy ward environment, control the indoor humidity at about 60% and the temperature at about 26℃. Actively communicate with the patients, give them psychological guidance, and relieve their psychological pressure through comfort and encouragement. Follow-up visits were conducted once a week to understand the recovery of the patients and answer the problems encountered by the patients in a timely manner, and the intervention time was 2 months. 1.2.2 Intervention group The nursing intervention based on the wisdom theory was given on the basis of the control group, and the routine nursing methods were the same as those of the control group. Nursing intervention based on the intellectual theory: ① Establish an intervention team consisting of two nurse practitioners in charge, one attending physician and one doctor with psychology background. The nurse-in-charge was responsible for indicator assessment and communication, the attending physician was responsible for risk control and adjusting the treatment plan, and the psychologist was responsible for psychological state assessment. After the establishment of the team, experts from the hospital were invited to train the team members in ovarian cancer-related knowledge and intellectual theory. ② Video education: Video education starts at 4:00 p.m. every Monday through Friday and lasts for 30 minutes. It explains the causative factors and pathogenesis of ovarian cancer as well as the management and prevention of common complications, evaluates the patients' psychological status and guides them to actively control their emotions. ③Team psychological counseling: a team psychological counseling session was conducted on the third day after surgery, explaining the goals, contents and themes of the counseling, understanding in detail the patient's knowledge of the disease, correcting the patient's misperceptions in time, and improving the patient's ability to manage and control his/her emotions. On the first day after chemotherapy, patients are guided to face the next treatment with positive emotions and build up their confidence in recovery. We analyze problem-solving methods with patients from the perspectives of husband-wife relationship and intimate relationship, so as to make patients accept the reality, rebuild their image, and improve their problem-solving ability and ability to cope with the disease. The day before the patient is discharged from the hospital, the effect of the above counseling is summarized to understand the patient's psychological state, and the patient is guided to adjust his/her own state and build up confidence in recovery so that he/she can cope with interpersonal and family relationships. ④ Doctors with psychology background will assess the patients' psychological state and give them targeted interventions according to their own conditions, once a week for 30min each time. ⑤ Network information support: establish qq group or WeChat public number, the team members will understand the patients' needs through the qq group or WeChat public number, give reasonable solutions to the patients' needs, and give the patients regular guidance on the knowledge related to ovarian cancer, diet and complications care and other related guidance to patients on a regular basis. (6) Instruct patients to utilize informal assistance from patients' friends, friends and family members to obtain guidance on physical and mental health and home life; encourage patients to accept themselves and enhance their confidence in fighting the disease. The nursing intervention time is 2 months. 1.3 Effectiveness evaluation ① Fertility anxiety: The Post-Cancer Fertility Anxiety Scale [ 14 ] was used to assess the fertility anxiety of the two groups of patients, which has a score of 18–90, and the higher the score, the more serious the fertility anxiety. Psychological status: Depression and anxiety were assessed using the Self-Depression Scale (SDS) and Self-Anxiety Scale (SAS) [ 15 ] . The SDS scale has 20 items with scores ranging from 0 to 100, with higher scores indicating more severe depression, and the SAS scale has 20 items with scores ranging from 0 to 100, with higher scores indicating more severe anxiety. ③ Quality of survival: the quality of survival of the two groups of patients was assessed by using the Comprehensive Quality of Life Assessment Questionnaire (GQOLI-74) [ 16 ] , which includes four dimensions of somatic functioning, psychological functioning, social functioning, and material life, with a total of 20 factors and 74 items, and a full score of 100, with the higher score suggesting that the better the quality of survival of the patient. ④ Nursing satisfaction: the nursing satisfaction questionnaire made by the hospital was used to assess the nursing satisfaction of the two groups of patients, examining three aspects of the nursing staff's own quality, operational skills and service attitude, with a score of 0-100 points, a score of < 60 points being unsatisfactory, a score of 60 points ≤ a score of < 79 points being satisfactory, and a score of ≥ 80 points being very satisfactory. 1.4 Information collection In this study, the questionnaire method was used to collect data, and group members and uniformly trained charge nurses administered the Fertility Worry Scale, the Self-Depression Scale (SDS), the Self-Anxiety Scale (SAS), the Comprehensive Quality of Life Assessment Questionnaire (GQOLI-74), and the Nursing Care Satisfaction Survey Questionnaire to the two groups of patients before and after the intervention to evaluate and compare the patients' fertility worries, psychological condition, quality of survival, and satisfaction with care. 1.5 Statistical methods SPSS22.0 was used to analyze the data, and the measurement information was expressed as‾ χ± s. Two independent samples t-test was used for inter-group comparison, paired t-test for intra-group comparison, and chi-square test was used for the comparison of count data. Differences were considered statistically significant at P < 0.05. Results 2.1 Comparison of fertility apprehension scores between the two groups There was no statistically significant difference between the fertility apprehension scores of the two groups before the intervention (P > 0.05); after the intervention the fertility apprehension scores of the two groups decreased, and the fertility apprehension scores of the intervention group were lower than those of the control group (P < 0.05). See Table 2 . 2.2 Comparison of psychological status between the two groups The differences in SDS scores and SAS scores between the two groups before the intervention were not statistically significant (P > 0.05); the SDS scores and SAS scores of the two groups decreased after the intervention, and the SDS scores and SAS scores of the intervention group were lower than those of the control group (P < 0.05). See Table 3 . 2.3 Comparison of GQOLI-74 scores between the two groups The differences in material life, social functioning, psychological functioning, somatic functioning and GQOLI-74 total score between the two groups before the intervention were not statistically significant (P > 0.05); after the intervention, the material life, social functioning, psychological functioning, somatic functioning and GQOLI-74 total score between the two groups increased and the material life, social functioning, psychological functioning, somatic functioning and GQOLI-74 total score between the two groups were higher than those of the control group (P < 0.05). 74 total scores were higher than those of the control group (P < 0.05). See Table 4 . 2.4 Comparison of nursing care satisfaction between the two groups Nursing care satisfaction was 93.75% in the intervention group and 71.88% in the control group, which was higher than the control group (p < 0.05). See Table 5 . Discussion Ovarian cancer is a relatively common malignant tumor in hospitals, and its death rate is in the first place among gynecological malignant tumors. In recent years, the incidence rate of ovarian cancer has also been increasing year by year [17] . With the continuous development of various technologies such as radiotherapy, traditional Chinese medicine treatment and surgery, the survival rate of ovarian cancer patients has been relatively obvious compared with the past, however, due to the fear of recurrence, economic burden, trauma of surgery and chemotherapy, and the pain of the disease itself, most of the patients with ovarian cancer will have some maladaptive behaviors and negative emotions [18] . Therefore, it is essential to give effective nursing interventions for ovarian cancer. Fertility worry refers to an individual's concern about child rearing and reproduction, which can persist for a long time [19] , compared with ovarian cancer itself, fertility worry can cause great stress to patients and may also negatively affect the disease progression of ovarian cancer. The results of this study showed that the fertility worry scores of the two groups decreased after the nursing care, and the fertility worry scores of the intervention group were lower than those of the control group (P<0.05), suggesting that the nursing intervention based on the wisdom theory can reduce the fertility worry of ovarian cancer patients. Nursing intervention based on the wisdom theory can deepen the knowledge of ovarian cancer patients about the disease, enhance their ability to control their emotions, and face the disease with a calm mind, thus reducing the level of fertility anxiety of ovarian cancer patients. Related research [20] found that psychological factors affect the survival quality of cancer patients, and most of the ovarian cancer patients have different degrees of depression and anxiety during treatment, and the depression and anxiety lasts for a long time, which is easy to affect the self-perception of ovarian cancer patients, and it may also affect the effect of the treatment of ovarian cancer patients. The results of this study showed that the SDS scores and SAS scores of the two groups were reduced after nursing care, and the SDS scores and SAS scores of the intervention group were lower than those of the control group (P<0.05), suggesting that nursing intervention based on the theory of wisdom and tactics can alleviate the negative emotions of ovarian cancer patients. Hu Yanli et al. [21] found that nursing intervention based on the wisdom theory can improve the psychological state of depressed patients. Nursing intervention based on the theory of wisdom and tactics in the process of video education and team psychological counseling can enhance patients' confidence and self-awareness, correct patients' wrong cognition, and enhance patients' ability to control and manage controlled emotions, thus alleviating patients' negative emotions. The quality of survival of ovarian cancer patients can influence the occurrence of adverse events after surgical treatment of patients. The quality of survival of ovarian cancer patients has now become an important indicator, along with mortality, morbidity and clinical objective parameters, for assessing the effectiveness of ovarian cancer treatment and the extent of the impact of ovarian cancer disease [22] . The results of this study showed that the material life, social functioning, psychological functioning, somatic functioning and GQOLI-74 total score were lower in both groups before the nursing care, suggesting that the quality of life of ovarian cancer patients is generally lower, which is basically consistent with the results of the study conducted by Pan Xiujuan et al [23] . After the nursing care, the material life, social function, psychological function, somatic function and GQOLI-74 total score of both groups increased, and the material life, social function, psychological function, somatic function and GQOLI-74 total score of the intervention group were higher than those of the control group (P<0.05), which suggests that nursing care intervention based on the wisdom theory can improve the quality of survival of ovarian cancer patients. In the nursing intervention based on the theory of wisdom and tactics, an intervention team was set up, and the team members all have rich working experience, which can quickly assess the patient's condition and psychological status, and the health education and team psychological counseling can help the patients to change the wrong cognition, and the team members can understand the patient's needs at any time through the network, and reasonably satisfy the patient's needs, and the support of the relatives and the friends of the patients has enhanced the patients' trust to the medical and nursing staffs. patients' trust in healthcare personnel, which ultimately improved the survival quality of ovarian cancer patients. In addition, this study also found that the nursing satisfaction of the intervention group was 93.75%, and the nursing satisfaction of the control group was 71.88%, and the nursing satisfaction of the intervention group was higher than that of the control group (P<0.05), which suggests that nursing interventions based on the theory of resourcefulness can improve the nursing satisfaction of ovarian cancer patients. In the process of nursing intervention based on the wisdom theory, ovarian cancer patients can get support from doctors, nurses, relatives and patients' friends and other aspects, which makes ovarian cancer patients feel cared for and increases their trust in health care personnel, thus improving nursing satisfaction. In conclusion, nursing intervention based on the wisdom theory can significantly reduce the fertility worries of ovarian cancer patients, alleviate the patients' adverse psychology, improve the quality of survival and enhance the satisfaction of nursing care, and nursing intervention based on the wisdom theory can be used as an effective nursing tool for ovarian cancer patients. Declarations Ethics approval and consent to participate The study was approved by the Ethics Committee (L)2019-008 of the Second People's Hospital of Anhui Province. The study was conducted in accordance with the guidelines of good clinical Practice and the recommendations of the Declaration of Helsinki developed by the World Medical Association. Participation in this survey is voluntary, no personal data is collected and remains anonymous at all times. All potential participants received written information about the study (reason for the study, purpose, process, data protection) and had the opportunity to contact the investigator at any time during the study. Informed consent was obtained from participants prior to participating in the study. Consent for publication Not applicable. Availability of data and materials The original data in the article is included in the supplementary file. Competing interests The authors declare no competing interests. Funding This research was supported by the Anhui University Nature Foundation Project (No: ZR2021B009). Authors' contributions Ping Yin: Brewing and design research, implementation research. Xia Ding, Wen-hui Li, Ping Qu: Paper writing and revision. Wen-hui Li, Ping Qu, Na Li: Data collection and analysis. Xia Ding,Long-yu Zhang: Brewing and design research, critical review of the intellectual content of the article. Acknowledgements Not applicable. Authors' information (optional) Yin Ping, female, master, chief nurse, deputy director of Nursing Department, research direction: nursing management, nursing psychology. References SHIM S H, LIM M C, LEE D, et al. Cause-specific mortality rate of ovarian cancer in the presence of competing risks of death: a nationwide population-based cohort study [J]. J Gynecol Oncol, 2022, 33(1): e5. WANG C W, CHOW A Y, CHAN C L. The effects of life review interventions on spiritual well-being, psychological distress, and quality of life in patients with terminal or advanced cancer: A systematic review and meta-analysis of randomized controlled trials [J]. Palliat Med, 2017, 31(10): 883-94. ZENG H, CHEN W, ZHENG R, et al. Changing cancer survival in China during 2003-15: a pooled analysis of 17 population-based cancer registries [J]. Lancet Glob Health, 2018, 6(5): e555-e67. DEL-POZO-LÉRIDA S, SALVADOR C, MARTÍNEZ-SOLER F, et al. Preservation of fertility in patients with cancer (Review) [J]. 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Wang XB,Fu PF,Ren HJ,et al.Effect of paclitaxel, cisplatin regimen combined with intraperitoneal hyperthermic perfusion chemotherapy on immune function and quality of life in patients with advanced ovarian cancer[J].Anhui Medical and Pharmaceutical Journal,2022,26(4):791-795. Pan XJ,Wan SX,Zhou JH.Effect of intensive psychological intervention on mentation and quality of life in patients with ovarian cancer[J].Chinese Nursing Research,2021,35(24):4484-4488. Additional Declarations No competing interests reported. Supplementary Files paperrawdata.xlsx Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-4582154","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":326962490,"identity":"9e2889fa-88a7-4d0a-840a-3d18969febcc","order_by":0,"name":"Ping Yin","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAAy0lEQVRIiWNgGAWjYBACfvbmgw8kDGzk2NgbiNQi2XMs2cCiIs2Yj+cAkVoMbuSYCVScOZw4TyKBaC0JZgw325iN2SQfb7zBUGMTTdhhZx6kPZzZxibHJp1WbMFwLC23gZAWvuMJx40l23iM2aRzzCQYGw4T1sJwILFN+m+bRGKb5BkitQicSGaTkDhjkNgmwUOkFmAgMxtIVCQYs/EA/ZJAjF/42fs/AqPyv5x8++GNNz7U2BDhFyRgQHTUIGkhVccoGAWjYBSMDAAAtVU/lS4+YYcAAAAASUVORK5CYII=","orcid":"","institution":"Nursing Department，Anhui Second People's Hospital","correspondingAuthor":true,"prefix":"","firstName":"Ping","middleName":"","lastName":"Yin","suffix":""},{"id":326962491,"identity":"6242cf81-4862-40ec-90ee-cd8c21393ade","order_by":1,"name":"Xia Ding","email":"","orcid":"","institution":"Nursing Department，Anhui Second People's Hospital","correspondingAuthor":false,"prefix":"","firstName":"Xia","middleName":"","lastName":"Ding","suffix":""},{"id":326962494,"identity":"86013f3c-358b-4af7-bbf9-2fd0937e3859","order_by":2,"name":"Wen-Hui Li","email":"","orcid":"","institution":"University of Traditional Chinese Medicine，Hefei，China","correspondingAuthor":false,"prefix":"","firstName":"Wen-Hui","middleName":"","lastName":"Li","suffix":""},{"id":326962495,"identity":"a9daaac0-f056-4a81-aa07-39c9276df273","order_by":3,"name":"Ping Qu","email":"","orcid":"","institution":"University of Traditional Chinese Medicine，Hefei，China","correspondingAuthor":false,"prefix":"","firstName":"Ping","middleName":"","lastName":"Qu","suffix":""},{"id":326962496,"identity":"ef9f6d41-d87f-41b4-a49c-4d3bb42052d7","order_by":4,"name":"Long-yu Zhang","email":"","orcid":"","institution":"Anhui Second People's Hospital","correspondingAuthor":false,"prefix":"","firstName":"Long-yu","middleName":"","lastName":"Zhang","suffix":""},{"id":326962497,"identity":"ed19b983-0d34-4f26-8727-087a298b4aa0","order_by":5,"name":"Na LI","email":"","orcid":"","institution":"Nursing Department，Anhui Second People's Hospital","correspondingAuthor":false,"prefix":"","firstName":"Na","middleName":"","lastName":"LI","suffix":""}],"badges":[],"createdAt":"2024-06-14 12:45:20","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-4582154/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-4582154/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":86224352,"identity":"4cea2b86-92d0-4305-aeb2-b00d13bdf73f","added_by":"auto","created_at":"2025-07-08 07:47:11","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":624661,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-4582154/v1/135d401d-ea0e-49cd-8c0c-a774a4823150.pdf"},{"id":60419431,"identity":"02619d4f-29d4-4c25-abb3-477fe391c810","added_by":"auto","created_at":"2024-07-16 14:26:27","extension":"xlsx","order_by":1,"title":"","display":"","copyAsset":false,"role":"supplement","size":17451,"visible":true,"origin":"","legend":"","description":"","filename":"paperrawdata.xlsx","url":"https://assets-eu.researchsquare.com/files/rs-4582154/v1/6a04134d59aa06e8ec0c5b61.xlsx"}],"financialInterests":"No competing interests reported.","formattedTitle":"Effect of nursing intervention based on resourcefulness theory on fertility anxiety of ovarian cancer patients","fulltext":[{"header":"Introduction","content":"\u003cp\u003eOvarian cancer is one of the common malignant tumors of the female reproductive system, with the mortality rate ranking first among gynecological malignancies\u003csup\u003e[\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]\u003c/sup\u003e In China, the incidence and death rate of ovarian cancer are increasing rapidly. In China, the incidence and death rate of ovarian cancer are rapidly increasing, with about 52,000 cases of death every year, accounting for 42% of the global death rate.\u003csup\u003e[\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]\u003c/sup\u003e In China, the incidence and death rate of ovarian cancer are increasing rapidly. With the comprehensive development of early cancer screening and the improvement of diagnosis and treatment level, the 5-year survival rate of cancer patients has been improved.\u003csup\u003e[\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]\u003c/sup\u003e However, chemotherapy, radiotherapy, surgery and other treatments will cause a certain degree of damage or even failure of the patient's reproductive function.\u003csup\u003e[\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]\u003c/sup\u003e Fertility anxiety is a term used to describe an individual's concern about reproduction. Fertility concerns refer to the individual's worries about reproduction and child rearing, including concerns about fertility, the health of the individual and his or her offspring, and child care.\u003csup\u003e[\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]\u003c/sup\u003e Fertility concerns include worries about fertility, the health of the individual and their offspring, and child care. Fertility concerns not only affect the patient's mental health, but also have multiple impacts on the patient, family and society.\u003csup\u003e[\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]\u003c/sup\u003e The presence of fertility concerns not only affects the patient's mental health, but also has multiple effects on the patient, family and society. Currently, the main intervention strategies for fertility concerns are fertility protection, fertility information support, and fertility counseling.\u003csup\u003e[\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]\u003c/sup\u003e fertility protection, fertility information support\u003csup\u003e[\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]\u003c/sup\u003e and psychosocial support.\u003csup\u003e[\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]\u003c/sup\u003e The main purpose of the intervention strategy is to protect fertility, support fertility information and support psychosocial support. Intelligence is the ability of an individual to perform daily tasks independently (personal intelligence) and the ability to obtain help from the outside world when the individual is unable to perform daily tasks independently (social intelligence).\u003csup\u003e[\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]\u003c/sup\u003e Social resourcefulness. Research has shown that\u003csup\u003e[\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e]\u003c/sup\u003e that resourcefulness can improve the quality of life of cancer patients and prevent depressive symptoms. As the comprehensive ability of people to solve psychological and social problems in daily life, intellectual resourcefulness has been widely studied by foreign scholars, and mainly focused on lymphoma patients, breast cancer patients\u003csup\u003e[\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e, \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e]\u003c/sup\u003e However, little research has been done in China on fertility worries and psychological status of ovarian cancer patients. The present study investigates the effects of nursing intervention based on the theory of wisdom and tactics on the fertility worries and psychological state of ovarian cancer patients, with a view to providing a new direction for the nursing care of ovarian cancer patients.\u003c/p\u003e"},{"header":"Objects and Methods","content":"\u003cp\u003e\u003cstrong\u003e1.1 Objects of study\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eSixty-four cases of ovarian cancer patients who entered the hospital for treatment from May 2019 to September 2022 were selected as study subjects and randomly divided into the control group (32 cases) and the intervention group (32 cases). Inclusion criteria: age 18\u0026ndash;45 years old; diagnosed with ovarian cancer after pathological examination\u003csup\u003e[\u003cspan class=\"CitationRef\"\u003e13\u003c/span\u003e]\u003c/sup\u003e ; able to read and fill out questionnaires on their own; with normal communication ability; informed consent to this study and have signed. Exclusion criteria: suffering from cognitive disorders, psychiatric disorders; combined with other malignant tumors; combined with autoimmune diseases, coagulation disorders; the presence of heart failure, renal failure and other serious damage to the organs. The differences in age, residence, body mass index and tumor stage between the two groups were not statistically significant (P\u0026thinsp;\u0026gt;\u0026thinsp;0.05) and were comparable, as shown in Table \u003cspan class=\"InternalRef\"\u003e1\u003c/span\u003e.The enrolled patients signed an informed consent form and were approved by the hospital ethics committee,ethics Approval Number ((L) 2019-008).\u003c/p\u003e\n\u003cp\u003eTable 1 General information of patients in both groups (n=32)\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"99%\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"24.489795918367346%\"\u003e\n \u003cp\u003egroups\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.367346938775512%\"\u003e\n \u003cp\u003eAge (years)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.346938775510203%\"\u003e\n \u003cp\u003ePlace of residence (urban/rural)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.428571428571427%\"\u003e\n \u003cp\u003eBody mass index (kg/m\u003csup\u003e2\u003c/sup\u003e )\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.367346938775512%\"\u003e\n \u003cp\u003eTumor Stage (Stage I-II/Stage III-IV)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"6.451612903225806%\" valign=\"top\"\u003e\n \u003cp\u003econtrol subjects\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.956989247311828%\" valign=\"top\"\u003e\n \u003cp\u003e38.26\u0026plusmn;7.14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.56989247311828%\" valign=\"top\"\u003e\n \u003cp\u003e17/15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.60215053763441%\" valign=\"top\"\u003e\n \u003cp\u003e22.42\u0026plusmn;2.16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.419354838709676%\" valign=\"top\"\u003e\n \u003cp\u003e20/12\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"6.451612903225806%\" valign=\"top\"\u003e\n \u003cp\u003eintervention group\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.956989247311828%\" valign=\"top\"\u003e\n \u003cp\u003e37.88\u0026plusmn;6.79\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.56989247311828%\" valign=\"top\"\u003e\n \u003cp\u003e14/18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.60215053763441%\" valign=\"top\"\u003e\n \u003cp\u003e22.17\u0026plusmn;2.09\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.419354838709676%\" valign=\"top\"\u003e\n \u003cp\u003e22/10\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"13.043478260869565%\" valign=\"top\"\u003e\n \u003cp\u003et or \u0026chi;\u003csup\u003e2\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"56.52173913043478%\" valign=\"top\"\u003e\n \u003cp\u003e0.218\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.23913043478261%\" valign=\"top\"\u003e\n \u003cp\u003e0.563\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.41304347826087%\" valign=\"top\"\u003e\n \u003cp\u003e0.471\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.782608695652174%\" valign=\"top\"\u003e\n \u003cp\u003e0.277\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"13.043478260869565%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"56.52173913043478%\" valign=\"top\"\u003e\n \u003cp\u003e0.828\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.23913043478261%\" valign=\"top\"\u003e\n \u003cp\u003e0.453\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.41304347826087%\" valign=\"top\"\u003e\n \u003cp\u003e0.640\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.782608695652174%\" valign=\"top\"\u003e\n \u003cp\u003e0.599\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003e1.2 Nursing interventions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e1.2.1 Control group Give routine nursing care: that is, give the patients health education on ovarian cancer related knowledge, guide the patients to exercise and diet, follow the doctor\u0026apos;s prescription of medication and pay attention to rest. Provide patients with a comfortable and cozy ward environment, control the indoor humidity at about 60% and the temperature at about 26℃. Actively communicate with the patients, give them psychological guidance, and relieve their psychological pressure through comfort and encouragement. Follow-up visits were conducted once a week to understand the recovery of the patients and answer the problems encountered by the patients in a timely manner, and the intervention time was 2 months.\u003c/p\u003e\n\u003cp\u003e1.2.2 Intervention group The nursing intervention based on the wisdom theory was given on the basis of the control group, and the routine nursing methods were the same as those of the control group. Nursing intervention based on the intellectual theory: ① Establish an intervention team consisting of two nurse practitioners in charge, one attending physician and one doctor with psychology background. The nurse-in-charge was responsible for indicator assessment and communication, the attending physician was responsible for risk control and adjusting the treatment plan, and the psychologist was responsible for psychological state assessment. After the establishment of the team, experts from the hospital were invited to train the team members in ovarian cancer-related knowledge and intellectual theory. ② Video education: Video education starts at 4:00 p.m. every Monday through Friday and lasts for 30 minutes. It explains the causative factors and pathogenesis of ovarian cancer as well as the management and prevention of common complications, evaluates the patients\u0026apos; psychological status and guides them to actively control their emotions. ③Team psychological counseling: a team psychological counseling session was conducted on the third day after surgery, explaining the goals, contents and themes of the counseling, understanding in detail the patient\u0026apos;s knowledge of the disease, correcting the patient\u0026apos;s misperceptions in time, and improving the patient\u0026apos;s ability to manage and control his/her emotions. On the first day after chemotherapy, patients are guided to face the next treatment with positive emotions and build up their confidence in recovery. We analyze problem-solving methods with patients from the perspectives of husband-wife relationship and intimate relationship, so as to make patients accept the reality, rebuild their image, and improve their problem-solving ability and ability to cope with the disease. The day before the patient is discharged from the hospital, the effect of the above counseling is summarized to understand the patient\u0026apos;s psychological state, and the patient is guided to adjust his/her own state and build up confidence in recovery so that he/she can cope with interpersonal and family relationships. ④ Doctors with psychology background will assess the patients\u0026apos; psychological state and give them targeted interventions according to their own conditions, once a week for 30min each time. ⑤ Network information support: establish qq group or WeChat public number, the team members will understand the patients\u0026apos; needs through the qq group or WeChat public number, give reasonable solutions to the patients\u0026apos; needs, and give the patients regular guidance on the knowledge related to ovarian cancer, diet and complications care and other related guidance to patients on a regular basis. (6) Instruct patients to utilize informal assistance from patients\u0026apos; friends, friends and family members to obtain guidance on physical and mental health and home life; encourage patients to accept themselves and enhance their confidence in fighting the disease. The nursing intervention time is 2 months. \u003cspan\u003e\u003cstrong\u003e1.3 Effectiveness evaluation\u003c/strong\u003e ① Fertility anxiety: The Post-Cancer Fertility Anxiety Scale\u003csup\u003e[\u003cspan class=\"CitationRef\"\u003e14\u003c/span\u003e]\u003c/sup\u003e was used to assess the fertility anxiety of the two groups of patients, which has a score of 18\u0026ndash;90, and the higher the score, the more serious the fertility anxiety. Psychological status: Depression and anxiety were assessed using the Self-Depression Scale (SDS) and Self-Anxiety Scale (SAS)\u003csup\u003e[\u003cspan class=\"CitationRef\"\u003e15\u003c/span\u003e]\u003c/sup\u003e. The SDS scale has 20 items with scores ranging from 0 to 100, with higher scores indicating more severe depression, and the SAS scale has 20 items with scores ranging from 0 to 100, with higher scores indicating more severe anxiety. ③ Quality of survival: the quality of survival of the two groups of patients was assessed by using the Comprehensive Quality of Life Assessment Questionnaire (GQOLI-74)\u003csup\u003e[\u003cspan class=\"CitationRef\"\u003e16\u003c/span\u003e]\u003c/sup\u003e, which includes four dimensions of somatic functioning, psychological functioning, social functioning, and material life, with a total of 20 factors and 74 items, and a full score of 100, with the higher score suggesting that the better the quality of survival of the patient. ④ Nursing satisfaction: the nursing satisfaction questionnaire made by the hospital was used to assess the nursing satisfaction of the two groups of patients, examining three aspects of the nursing staff\u0026apos;s own quality, operational skills and service attitude, with a score of 0-100 points, a score of \u0026lt;\u0026thinsp;60 points being unsatisfactory, a score of 60 points\u0026thinsp;\u0026le;\u0026thinsp;a score of \u0026lt;\u0026thinsp;79 points being satisfactory, and a score of \u0026ge;\u0026thinsp;80 points being very satisfactory.\u003cbr\u003e\u003c/span\u003e\u003cspan\u003e\u003cstrong\u003e1.4 Information collection\u003c/strong\u003e\u003cbr\u003e\u003c/span\u003e\u003c/p\u003e\n\u003cp\u003eIn this study, the questionnaire method was used to collect data, and group members and uniformly trained charge nurses administered the Fertility Worry Scale, the Self-Depression Scale (SDS), the Self-Anxiety Scale (SAS), the Comprehensive Quality of Life Assessment Questionnaire (GQOLI-74), and the Nursing Care Satisfaction Survey Questionnaire to the two groups of patients before and after the intervention to evaluate and compare the patients\u0026apos; fertility worries, psychological condition, quality of survival, and satisfaction with care.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e1.5 Statistical methods\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eSPSS22.0 was used to analyze the data, and the measurement information was expressed as\u0026oline; \u0026chi;\u0026plusmn; s. Two independent samples t-test was used for inter-group comparison, paired t-test for intra-group comparison, and chi-square test was used for the comparison of count data. Differences were considered statistically significant at P\u0026thinsp;\u0026lt;\u0026thinsp;0.05.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003e\u003cstrong\u003e2.1 Comparison of fertility apprehension scores between the two groups\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThere was no statistically significant difference between the fertility apprehension scores of the two groups before the intervention (P\u0026thinsp;\u0026gt;\u0026thinsp;0.05); after the intervention the fertility apprehension scores of the two groups decreased, and the fertility apprehension scores of the intervention group were lower than those of the control group (P\u0026thinsp;\u0026lt;\u0026thinsp;0.05). See Table \u003cspan class=\"InternalRef\"\u003e2\u003c/span\u003e.\u003c/p\u003e\n\u003cp\u003e\u003cimg 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\"\u003e\u003cbr\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e2.2 Comparison of psychological status between the two groups\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe differences in SDS scores and SAS scores between the two groups before the intervention were not statistically significant (P\u0026thinsp;\u0026gt;\u0026thinsp;0.05); the SDS scores and SAS scores of the two groups decreased after the intervention, and the SDS scores and SAS scores of the intervention group were lower than those of the control group (P\u0026thinsp;\u0026lt;\u0026thinsp;0.05). See Table \u003cspan class=\"InternalRef\"\u003e3\u003c/span\u003e.\u003c/p\u003e\n\u003cp\u003e\u003cimg src=\"https://myfiles.space/user_files/122228_c8a1650c59388082/122228_custom_files/img1721139777.png\"\u003e\u003cbr\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e2.3 Comparison of GQOLI-74 scores between the two groups\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe differences in material life, social functioning, psychological functioning, somatic functioning and GQOLI-74 total score between the two groups before the intervention were not statistically significant (P\u0026thinsp;\u0026gt;\u0026thinsp;0.05); after the intervention, the material life, social functioning, psychological functioning, somatic functioning and GQOLI-74 total score between the two groups increased and the material life, social functioning, psychological functioning, somatic functioning and GQOLI-74 total score between the two groups were higher than those of the control group (P\u0026thinsp;\u0026lt;\u0026thinsp;0.05). 74 total scores were higher than those of the control group (P\u0026thinsp;\u0026lt;\u0026thinsp;0.05). See Table \u003cspan class=\"InternalRef\"\u003e4\u003c/span\u003e.\u003c/p\u003e\n\u003cp\u003e\u003cimg 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\"\u003e\u003cbr\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e2.4 Comparison of nursing care satisfaction between the two groups\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNursing care satisfaction was 93.75% in the intervention group and 71.88% in the control group, which was higher than the control group (p\u0026thinsp;\u0026lt;\u0026thinsp;0.05). See Table \u003cspan class=\"InternalRef\"\u003e5\u003c/span\u003e.\u003c/p\u003e\n\u003cp\u003e\u003cimg src=\"https://myfiles.space/user_files/122228_c8a1650c59388082/122228_custom_files/img1721139807.png\"\u003e\u003cbr\u003e\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eOvarian cancer is a relatively common malignant tumor in hospitals, and its death rate is in the first place among gynecological malignant tumors. In recent years, the incidence rate of ovarian cancer has also been increasing year by year\u003csup\u003e[17]\u003c/sup\u003e . With the continuous development of various technologies such as radiotherapy, traditional Chinese medicine treatment and surgery, the survival rate of ovarian cancer patients has been relatively obvious compared with the past, however, due to the fear of recurrence, economic burden, trauma of surgery and chemotherapy, and the pain of the disease itself, most of the patients with ovarian cancer will have some maladaptive behaviors and negative emotions\u003csup\u003e[18]\u003c/sup\u003e . Therefore, it is essential to give effective nursing interventions for ovarian cancer.\u003c/p\u003e\n\u003cp\u003eFertility worry refers to an individual\u0026apos;s concern about child rearing and reproduction, which can persist for a long time\u003csup\u003e[19]\u003c/sup\u003e , compared with ovarian cancer itself, fertility worry can cause great stress to patients and may also negatively affect the disease progression of ovarian cancer.\u0026nbsp;The results of this study showed that the fertility worry scores of the two groups decreased after the nursing care, and the fertility worry scores of the intervention group were lower than those of the control group (P\u0026lt;0.05), suggesting that the nursing intervention based on the wisdom theory can reduce the fertility worry of ovarian cancer patients. Nursing intervention based on the wisdom theory can deepen the knowledge of ovarian cancer patients about the disease, enhance their ability to control their emotions, and face the disease with a calm mind, thus reducing the level of fertility anxiety of ovarian cancer patients.\u003c/p\u003e\n\u003cp\u003eRelated research\u003csup\u003e[20]\u003c/sup\u003e found that psychological factors affect the survival quality of cancer patients, and most of the ovarian cancer patients have different degrees of depression and anxiety during treatment, and the depression and anxiety lasts for a long time, which is easy to affect the self-perception of ovarian cancer patients, and it may also affect the effect of the treatment of ovarian cancer patients. The results of this study showed that the SDS scores and SAS scores of the two groups were reduced after nursing care, and the SDS scores and SAS scores of the intervention group were lower than those of the control group (P\u0026lt;0.05), suggesting that nursing intervention based on the theory of wisdom and tactics can alleviate the negative emotions of ovarian cancer patients. Hu Yanli et al.\u003csup\u003e[21]\u003c/sup\u003e found that nursing intervention based on the wisdom theory can improve the psychological state of depressed patients. Nursing intervention based on the theory of wisdom and tactics in the process of video education and team psychological counseling can enhance patients\u0026apos; confidence and self-awareness, correct patients\u0026apos; wrong cognition, and enhance patients\u0026apos; ability to control and manage controlled emotions, thus alleviating patients\u0026apos; negative emotions.\u003c/p\u003e\n\u003cp\u003eThe quality of survival of ovarian cancer patients can influence the occurrence of adverse events after surgical treatment of patients. The quality of survival of ovarian cancer patients has now become an important indicator, along with mortality, morbidity and clinical objective parameters, for assessing the effectiveness of ovarian cancer treatment and the extent of the impact of ovarian cancer disease\u003csup\u003e[22]\u003c/sup\u003e . The results of this study showed that the\u0026nbsp;material life, social functioning, psychological functioning, somatic functioning and GQOLI-74 total score were lower in both groups before the nursing care, suggesting that the quality of life of ovarian cancer patients is generally lower, which is basically consistent with the results of the study conducted by Pan Xiujuan et al\u003csup\u003e[23]\u003c/sup\u003e . After the nursing care, the material life, social function, psychological function, somatic function and GQOLI-74 total score of both groups increased, and the material life, social function, psychological function, somatic function and GQOLI-74 total score of the intervention group were higher than those of the control group (P\u0026lt;0.05), which suggests that nursing care intervention based on the wisdom theory can improve the quality of survival of ovarian cancer patients. In the nursing intervention based on the theory of wisdom and tactics, an intervention team was set up, and the team members all have rich working experience, which can quickly assess the patient\u0026apos;s condition and psychological status, and the health education and team psychological counseling can help the patients to change the wrong cognition, and the team members can understand the patient\u0026apos;s needs at any time through the network, and reasonably satisfy the patient\u0026apos;s needs, and the support of the relatives and the friends of the patients has enhanced the patients\u0026apos; trust to the medical and nursing staffs. patients\u0026apos; trust in healthcare personnel, which ultimately improved the survival quality of ovarian cancer patients. In addition, this study also found that the nursing satisfaction of the intervention group was 93.75%, and the nursing satisfaction of the control group was 71.88%, and the nursing satisfaction of the intervention group was higher than that of the control group (P\u0026lt;0.05), which suggests that nursing interventions based on the theory of resourcefulness can improve the nursing satisfaction of ovarian cancer patients. In the process of nursing intervention based on the wisdom theory, ovarian cancer patients can get support from doctors, nurses, relatives and patients\u0026apos; friends and other aspects, which makes ovarian cancer patients feel cared for and increases their trust in health care personnel, thus improving nursing satisfaction.\u003c/p\u003e\n\u003cp\u003eIn conclusion, nursing intervention based on the wisdom theory can significantly reduce the fertility worries of ovarian cancer patients, alleviate the patients\u0026apos; adverse psychology, improve the quality of survival and enhance the satisfaction of nursing care, and nursing intervention based on the wisdom theory can be used as an effective nursing tool for ovarian cancer patients.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cul start=\"12\"\u003e\n \u003cli\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/li\u003e\n\u003c/ul\u003e\n\u003cul\u003e\n \u003cli\u003eThe study was approved by the Ethics Committee (L)2019-008 of the Second People\u0026apos;s Hospital of Anhui Province. The study was conducted in accordance with the guidelines of good clinical Practice and the recommendations of the Declaration of Helsinki developed by the World Medical Association. Participation in this survey is voluntary, no personal data is collected and remains anonymous at all times. All potential participants received written information about the study (reason for the study, purpose, process, data protection) and had the opportunity to contact the investigator at any time during the study. Informed consent was obtained from participants prior to participating in the study.\u003c/li\u003e\n\u003c/ul\u003e\n\u003cul start=\"12\"\u003e\n \u003cli\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/li\u003e\n\u003c/ul\u003e\n\u003cul\u003e\n \u003cli\u003eNot applicable.\u003c/li\u003e\n\u003c/ul\u003e\n\u003cul start=\"12\"\u003e\n \u003cli\u003e\u003cstrong\u003eAvailability of data and materials\u003c/strong\u003e\u003c/li\u003e\n\u003c/ul\u003e\n\u003cul\u003e\n \u003cli\u003eThe original data in the article is included in the supplementary file.\u003c/li\u003e\n\u003c/ul\u003e\n\u003cul start=\"12\"\u003e\n \u003cli\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003c/li\u003e\n\u003c/ul\u003e\n\u003cul\u003e\n \u003cli\u003eThe authors declare no competing interests.\u003c/li\u003e\n\u003c/ul\u003e\n\u003cul start=\"12\"\u003e\n \u003cli\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/li\u003e\n\u003c/ul\u003e\n\u003cul\u003e\n \u003cli\u003eThis research was supported by the Anhui University Nature Foundation Project (No: ZR2021B009).\u003c/li\u003e\n\u003c/ul\u003e\n\u003cul start=\"12\"\u003e\n \u003cli\u003e\u003cstrong\u003eAuthors\u0026apos; contributions\u003c/strong\u003e\u003c/li\u003e\n\u003c/ul\u003e\n\u003cul\u003e\n \u003cli\u003ePing Yin: \u0026nbsp;Brewing and design research, implementation research.\u003c/li\u003e\n \u003cli\u003eXia Ding, Wen-hui Li, Ping Qu: Paper writing and revision.\u003c/li\u003e\n \u003cli\u003eWen-hui Li, Ping Qu, Na Li: Data collection and analysis.\u003c/li\u003e\n \u003cli\u003eXia Ding,Long-yu Zhang: Brewing and design research, critical review of the intellectual content of the article.\u003c/li\u003e\n\u003c/ul\u003e\n\u003cul start=\"12\"\u003e\n \u003cli\u003e\u003cstrong\u003eAcknowledgements\u003c/strong\u003e\u003c/li\u003e\n\u003c/ul\u003e\n\u003cul\u003e\n \u003cli\u003eNot applicable.\u003c/li\u003e\n\u003c/ul\u003e\n\u003cul start=\"12\"\u003e\n \u003cli\u003e\u003cstrong\u003eAuthors\u0026apos; information (optional)\u003c/strong\u003e\u003c/li\u003e\n\u003c/ul\u003e\n\u003cul\u003e\n \u003cli\u003eYin Ping, female, master, chief nurse, deputy director of Nursing Department, research direction: nursing management, nursing psychology.\u003c/li\u003e\n\u003c/ul\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eSHIM S H, LIM M C, LEE D, et al. Cause-specific mortality rate of ovarian cancer in the presence of competing risks of death: a nationwide population-based cohort study [J]. J Gynecol Oncol, 2022, 33(1): e5.\u003c/li\u003e\n\u003cli\u003eWANG C W, CHOW A Y, CHAN C L. The effects of life review interventions on spiritual well-being, psychological distress, and quality of life in patients with terminal or advanced cancer: A systematic review and meta-analysis of randomized controlled trials [J]. Palliat Med, 2017, 31(10): 883-94.\u003c/li\u003e\n\u003cli\u003eZENG H, CHEN W, ZHENG R, et al. Changing cancer survival in China during 2003-15: a pooled analysis of 17 population-based cancer registries [J]. Lancet Glob Health, 2018, 6(5): e555-e67.\u003c/li\u003e\n\u003cli\u003eDEL-POZO-L\u0026Eacute;RIDA S, SALVADOR C, MART\u0026Iacute;NEZ-SOLER F, et al. Preservation of fertility in patients with cancer (Review) [J]. Oncol Rep, 2019, 41(5): 2607-14.\u003c/li\u003e\n\u003cli\u003eMURPHY D, KLOSKY J L, REED D R, et al. The importance of assessing priorities of reproductive health concerns among adolescent and young adult patients with cancer [J]. Cancer, 2015, 121(15): 2529-36.\u003c/li\u003e\n\u003cli\u003eMAHMOOD S, DRAKELEY A, HOMBURG R, et al. Fertility Preservation in Female Patients with Cancer [J]. Clin Oncol (R Coll Radiol), 2022, 34(8): 508-13.\u003c/li\u003e\n\u003cli\u003ePILEGAARD S P, SCHMIDT L, STORMLUND S, et al. Psychosocial wellbeing shortly after allocation to a freeze-all strategy compared with a fresh transfer strategy in women and men: a sub-study of a randomized controlled trial [J]. Hum Reprod, 2023, 38(11): 2175-86.\u003c/li\u003e\n\u003cli\u003eXIAO Y, LI J, LEI J, et al. Qualitative study of the fertility information support experiences of young breast cancer patients [J]. Eur J Oncol Nurs, 2023, 62: 102275.\u003c/li\u003e\n\u003cli\u003eTAKEUCHI E, SHIMIZU M, MIYATA K, et al. A Content Analysis of Multidimensional Support Needs Regarding Fertility Among Cancer Patients: How Can Nonphysician Health Care Providers Support? [J]. J Adolesc Young Adult Oncol, 2019, 8(2): 205-11.\u003c/li\u003e\n\u003cli\u003eZAUSZNIEWSKI J A, LAI C Y, TITHIPHONTUMRONG S. Development and testing of the Resourcefulness Scale for Older Adults [J]. J Nurs Meas, 2006, 14(1): 57-68.\u003c/li\u003e\n\u003cli\u003eWANG R, TANG H, CUI P, et al. The influence of resourcefulness on the family functioning of young- and middle-aged lymphoma patients in China: a cross-sectional study [J]. Fam Pract, 2024.\u003c/li\u003e\n\u003cli\u003eHUANG C Y, GUO S E, HUNG C M, et al. Learned resourcefulness, quality of life, and depressive symptoms for patients with breast cancer [J]. Oncol Nurs Forum, 2010, 37(4): E280-7.\u003c/li\u003e\n\u003cli\u003eKonstantinopoulos PA, Matulonis UA. Clinical and translational advances in ovarian cancer therapy. Nat Cancer. 2023 Sep;4(9):1239-1257.\u003c/li\u003e\n\u003cli\u003eQiao TT，Chen DD，Zheng W,et al.Translation and reliability and validity of the Chinese version of the Reproductive Concerns After Cancer scale(RCAC)[J].Chinese Journal of Nursing,2016,51(12):1509-1514.\u003c/li\u003e\n\u003cli\u003eShen ZQ,Han TG,Zhuang RS,etal. Anxiety and depression in health educator and the influencing factors during the normalization period of COVID-19 epidemic[J].Modern Preventive Medicine,2022,49(22):4174-4179.\u003c/li\u003e\n\u003cli\u003ePaulo LT, Len CA, Hilario MO,et al.Fatigue in children with juvenile idiopathic arthritis: reliability of the \u0026quot;Pediatric Quality of Life Inventory-Multidimensional Fatigue Scale\u0026quot;[J].Rheumatol Int, 2015, 35(1):133-139.\u003c/li\u003e\n\u003cli\u003eMorden CR, Farrell AC, Sliwowski M,et al.Chromosome instability is prevalent and dynamic in high-grade serous ovarian cancer patient samples[J].Gynecol Oncol, 2021,161(3):769-778. \u003c/li\u003e\n\u003cli\u003eLi ZM,Pang Y,Li JJ,et al.A randomized controlled trial of group psychotherapy on emotions and quality of life in patients with gynecological cancer in convalescence stage[J].Chinese Mental Health Journal,2020,34(12):977-982.\u003c/li\u003e\n\u003cli\u003eZhang HM,Sun XC,Ma HM.Psychological Experience of Reproductive Concerns in Young Cancer Patients：A Qualitative Meta-synthesis[J].Journal of Nursing,2022,29(2):51-56.\u003c/li\u003e\n\u003cli\u003eNi XM,Ge LN.Effect of comprehensive intervention on the emotion， coping styles and the HRQOL of patients with ovarian cancer during the period of chemotherapy[J].New Medicine,2019,50(3):192-196.\u003c/li\u003e\n\u003cli\u003eHu YL,Wang J,Wu HL,et al.Application effect of psychological education courses based on resourcefulness theory in patients with depression[J].Chinese Journal Modern Nursing,2021,27(14):1889-1893.\u003c/li\u003e\n\u003cli\u003eWang XB,Fu PF,Ren HJ,et al.Effect of paclitaxel, cisplatin regimen combined with intraperitoneal hyperthermic perfusion chemotherapy on immune function and quality of life in patients with advanced ovarian cancer[J].Anhui Medical and Pharmaceutical Journal,2022,26(4):791-795.\u003c/li\u003e\n\u003cli\u003ePan XJ,Wan SX,Zhou JH.Effect of intensive psychological intervention on mentation and quality of life in patients with ovarian cancer[J].Chinese Nursing Research,2021,35(24):4484-4488.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"resourcefulness theory, Nursing intervention, Ovarian cancer, Fertility worries","lastPublishedDoi":"10.21203/rs.3.rs-4582154/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-4582154/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eObjective: \u003c/strong\u003eTo explore the effect of nursing intervention based on resourcefulness theory on fertility anxiety of ovarian cancer patients.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods: \u003c/strong\u003e64 patients with ovarian cancer who were treated in hospital from May 2019 to September 2022 were selected as the study objects, and the patients were divided into control group and intervention group with 32 cases in each group by random number table. The control group was given routine nursing, and the intervention group was given nursing intervention based on the wisdom theory. The post-cancer fertility worry Scale, self-rating Depression Scale (SDS), self-rating Anxiety Scale (SAS), comprehensive Quality of Life questionnaire (GQOLI-74) and self-made nursing satisfaction questionnaire were used before and after intervention to evaluate the fertility worry, depression, anxiety, quality of life and nursing satisfaction of the two groups of patients.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults: \u003c/strong\u003eAfter intervention, the fertility worry score, SDS score and SAS score of the two groups were decreased, and the fertility worry score, SDS score and SAS score of the intervention group were lower than those of the control group (P\u0026lt;0.05). After intervention, the material life, social function, psychological function, physical function and GQOLI-74 total score of the intervention group were significantly improved compared with the control group, and the differences were statistically significant (P\u0026lt;0.05). The nursing satisfaction of intervention group was higher than that of control group (P\u0026lt;0.05).\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion: \u003c/strong\u003eNursing intervention based on the wisdom theory can significantly reduce the fertility worries of ovarian cancer patients, relieve depression and anxiety, improve quality of life, and enhance nursing satisfaction, which is worthy of clinical reference and promotion.\u003c/p\u003e","manuscriptTitle":"Effect of nursing intervention based on resourcefulness theory on fertility anxiety of ovarian cancer patients","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-07-16 14:26:23","doi":"10.21203/rs.3.rs-4582154/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"a58c1ebc-b89f-4081-a905-ed1375a0044b","owner":[],"postedDate":"July 16th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2025-07-08T07:39:02+00:00","versionOfRecord":[],"versionCreatedAt":"2024-07-16 14:26:23","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-4582154","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-4582154","identity":"rs-4582154","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}