Effect of perioperative psychological nursing on anxiety, depression, and recovery in colorectal cancer surgery: A prospective study

doi:10.5498/wjp.v16.i6.116339

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World Journal of Psychiatry

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2220-3206

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

Prospective Study

Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.

World J Psychiatry. Jun 19, 2026; 16(6): 116339
Published online Jun 19, 2026. doi: 10.5498/wjp.v16.i6.116339

Effect of perioperative psychological nursing on anxiety, depression, and recovery in colorectal cancer surgery: A prospective study

Jian-Dan Pan, Dan-Feng Cai, Jing Ma, Mei Hu, Ke-Ping Zhang, Jian-Te Li

Jian-Dan Pan, Dan-Feng Cai, Jing Ma, Mei Hu, Ke-Ping Zhang, Jian-Te Li, Department of Anorectal Surgery, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, Zhejiang Province, China

Author contributions: Pan JD contributed to the study conception, data collection, and manuscript drafting; Cai DF participated in patient recruitment, data analysis, and interpretation; Ma J contributed to the statistical analysis and literature review; Hu M was responsible for the clinical data management and postoperative follow-up; Zhang KP assisted in the design of the psychological nursing interventions and quality control; Li JT designed and supervised the study, critically revised the manuscript for important intellectual content, and approved the final version for submission; and all authors have read and approved the final manuscript and agree to be accountable for all aspects of this study.

AI contribution statement: The author declares that no AI-assisted tools were used in the preparation, writing, revision, data analysis, result interpretation, and image generation of this manuscript. The author assumes full responsibility for all aspects of this research.

Supported by the 2024 Zhejiang Province Key Discipline Construction Project of Traditional Chinese Medicine, No. 2024-XX-52.

Institutional review board statement: This study was approved by the Medical Ethics Committee of the Second Affiliated Hospital of Wenzhou Medical University, No. 2021-K-201-03.

Clinical trial registration statement: The authors confirm that the absence of trial registration does not affect the integrity, transparency, or validity of the study findings.

Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.

Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.

CONSORT 2010 statement: The authors have read the CONSORT 2010 Statement, and the manuscript was prepared and revised according to the CONSORT 2010 Statement.

Data sharing statement: No data available.

Corresponding author: Jian-Te Li, MD, Department of Anorectal Surgery, The Second Affiliated Hospital of Wenzhou Medical University, No. 109 Xueyuan West Road, Lucheng District, Wenzhou 325000, Zhejiang Province, China. lijiante_wz@sina.cn

Received: December 5, 2025
Revised: January 5, 2026
Accepted: February 24, 2026
Published online: June 19, 2026
Processing time: 174 Days and 0.9 Hours

Abstract

BACKGROUND

Patients with colorectal cancer (CRC) frequently experience significant anxiety and depression during the perioperative period. Such psychological distress can adversely affect postoperative pain, recovery trajectory, and quality of life. However, evidence supporting the efficacy of structured perioperative psychological nursing interventions remains limited. We hypothesized that targeted psychological nursing interventions would reduce negative emotional states and improve postoperative recovery outcomes in patients undergoing CRC surgery.

AIM

To investigate perioperative psychological nursing intervention effects on anxiety, depression, postoperative pain, and recovery quality in patients undergoing CRC surgery.

METHODS

This prospective randomized controlled trial was conducted at the Second Affiliated Hospital of Wenzhou Medical University from January 2021 to September 2025. In total, 150 patients with CRC were randomly assigned to the intervention or control groups (n = 75 per group). The intervention group received comprehensive perioperative psychological nursing comprising cognitive-behavioral guidance, emotional counseling, relaxation training, and individualized health education. The control group received standard nursing care. Anxiety and depression were assessed using the Hospital Anxiety and Depression Scale. Secondary outcomes included postoperative pain (visual analog scale), time to first ambulation, length of hospital stay, and postoperative quality of life. Statistical analyses were performed using independent t-tests and χ² tests.

RESULTS

Compared with the control group, the intervention group showed significantly lower postoperative anxiety (6.92 ± 3.86 vs 3.61 ± 1.67, P < 0.001) and depression scores (7.24 ± 4.02 vs 3.95 ± 1.89, P < 0.001). Mean pain intensity on postoperative day 3 was reduced (5.13 ± 1.22 vs 3.74 ± 1.09, P < 0.01). Patients in the intervention group ambulated earlier (1.9 ± 0.6 days vs 2.6 ± 0.7 days, P < 0.01) and had shorter hospital stays (9.7 ± 2.4 days vs 11.3 ± 2.8 days, P < 0.05). Quality-of-life scores at discharge were significantly higher (78.5 ± 9.2 vs 67.3 ± 10.6, P < 0.001). No adverse psychological events were observed.

CONCLUSION

Perioperative psychological nursing effectively reduces anxiety and depression, alleviates postoperative pain, and accelerates recovery in patients with CRC.

Keywords: Colorectal cancer; Perioperative nursing; Psychological intervention; Anxiety; Depression; Recovery outcomes

Core Tip: Patients with colorectal cancer commonly experience perioperative anxiety and depression, which can impair recovery and prolong hospitalization. This prospective randomized controlled trial demonstrated that structured perioperative psychological nursing - including cognitive-behavioral guidance, emotional counseling, relaxation training, and individualized education - significantly reduced anxiety, depression, and postoperative pain while promoting earlier ambulation, shorter hospital stays, and improved quality of life. Integrating psychological care into standard perioperative nursing may effectively enhance both physical and emotional recovery in patients with colorectal cancer.