A Peer-Led, Nurse-Involved Blended Online and Offline Peer Support Program (PNO2PSP) for Psychosocial Adjustment in Young- to Middle-Aged Patients With Breast Cancer: Cluster Randomized Clinical Trial.

Abstract

Young- to middle-aged patients with breast cancer face significant psychosocial challenges. Existing interventions often lack comprehensiveness, timely initiation, and tailoring specific to this population's unique needs. This study aimed to evaluate the impact of a peer-led, nurse-involved, blended online and offline peer support intervention program (PNO2PSP) on psychosocial adjustment in young- to middle-aged patients with breast cancer. The effectiveness of PNO2PSP was evaluated through a single-center cluster randomized controlled trial involving 70 newly diagnosed young- to middle-aged patients with breast cancer (35 in each group). The intervention group received an 8-week PNO2PSP in addition to routine care. Psychosocial adjustment, self-efficacy, social support, and coping modes were assessed presurgery and at 4, 8, and 12 weeks post surgery. Generalized estimating equations were used for intention-to-treat analyses. In-depth interviews with 9 participants explored their experiences. Compared to the control group, the intervention group demonstrated significantly lower psychosocial adjustment scores at 8 weeks (T2; Wald χ²1=14.96; P<.001) and 12 weeks (T3; Wald χ²1=7.49; P=.006); social support was higher at 8 weeks (T2; Wald χ²1=7.65; P=.006). Confrontation coping scores were higher at T2 (Wald χ²1=5.46; P=.02), T3 (Wald χ²1=10.04; P=.002), while avoidance coping scores were lower at T1 (Wald χ²1=8.24; P=.004), T2 (Wald χ²1=7.45; P=.006), and T3 (Wald χ²1=5.70; P=.02). Qualitative findings supported these quantitative results, highlighting the program's role in facilitating psychosocial adjustment, providing vital support, boosting treatment confidence, and fostering positive coping. The PNO2PSP effectively improved psychosocial adjustment, social support, and positive coping in young- to middle-aged patients with breast cancer. Its scientifically validated, feasible, and patient-centered design supports its recommendation for wider clinical implementation, with continued training for peer supporters and sustained delivery of peer support.