A Standardized Psychological Intervention Procedure for Ovarian Cancer Patients Based on the Lazarus Stress Coping Model

Summary

This study develops a standardized psychological intervention protocol for ovarian cancer patients using the Lazarus stress coping model. Integrating cognitive-behavioral strategies and counseling, the protocol significantly reduces anxiety and depression and improves emotional regulation, demonstrating clinical feasibility and reproducibility.

Abstract

Ovarian cancer patients often experience substantial psychological distress, which negatively affects treatment adherence and recovery; however, standardized psychological interventions remain limited in oncology care. To address this gap, this study develops and evaluates a standardized psychological intervention protocol based on the Lazarus stress coping model, aiming to reduce anxiety and depression and enhance coping capacity during chemotherapy. A randomized controlled pilot trial involving 70 participants was conducted, with patients randomly assigned to an intervention group (n = 35) receiving the protocol alongside chemotherapy or a control group (n = 35) receiving chemotherapy alone. The protocol integrates cognitive restructuring, emotional regulation training, coping skills education, and structured counseling into standard oncology care. Psychological distress and coping capacity were assessed using validated psychometric tools, including the Hospital Anxiety and Depression Scale (HADS), Self-Rating Depression Scale (SDS), and Self-Rating Anxiety Scale (SAS), and data were analyzed using independent-sample t-tests and chi-square tests. Results showed a significant reduction in combined anxiety-depression scores in the intervention group (from 11.77 ± 1.75 to 5.86 ± 1.78, p < 0.01), alongside improved emotional regulation and coping capacity. Positive but non-significant trends were also observed in embryological outcomes and clinical pregnancy rates (38.57%). These findings demonstrate that the proposed protocol is reproducible, theory-driven, and clinically feasible, offering potential to improve psychological well-being and treatment-related outcomes for ovarian cancer patients.

Introduction

Ovarian cancer is among the most aggressive gynecological malignancies, frequently diagnosed at advanced stages because of subtle early symptoms and the absence of effective screening strategies¹. Standard treatment typically combines surgery with platinum-based chemotherapy², yet despite significant clinical advances, ovarian cancer remains the leading cause of death among gynecological cancers and ranks as the fifth most common cause of cancer-related mortality in women, with an increasing incidence observed in younger populations³. These epidemiological trends underscore the urgent need to impr....

Protocol

This study was approved by the Ethics Committee of Baotou Central Hospital (Approval No.: 2025-YJS-076). Written informed consent was obtained from all participants before enrollment. All procedures were conducted in accordance with the Declaration of Helsinki and institutional guidelines for human research. The reagents and the equipment used are listed in the Table of Materials.

1. Study design and participants

1. Study overview
   A randomized controlled trial (RCT) was conducted to evaluate the effectiveness of a standardized psychological intervention protocol based on the Lazarus stress c....

Results

Baseline demographic and clinical characteristics were comparable between the intervention and control groups (Table 1). There were no significant differences in age, body mass index, years of infertility, baseline follicle-stimulating hormone (FSH) levels, antral follicle count (AFC), gonadotropin stimulation time, or gonadotropin dosage (all p > 0.05). This indicates that the two groups were balanced prior to the intervention.

After the 8-week intervention, patie.......

Discussion

This study developed and evaluated a standardized psychological intervention protocol for ovarian cancer patients grounded in the Lazarus stress coping model, integrating cognitive-behavioral strategies, emotional regulation training, coping-skills education, and structured counseling into oncology care. Prior studies investigating psychological interventions for ovarian cancer have been constrained by methodological limitations, including small sample sizes that reduce generalizability, a lack of longitudinal assessment.......

Materials

List of materials used in this article

Name	Company	Catalog Number	Comments
Beck’s Cognitive Therapy Manual (3rd edition)	Guilford Press, New York, NY, USA	ISBN 9781462520428	Standardized script for cognitive restructuring exercises
Clinician-Rated Coping Ability Scale	Adapted for clinical use; no standardized publisher		Assessment tool for clinician evaluation of coping capacity
Guided Visualization Script	Adapted from standardized guided imagery interventions		Scripted visualization exercises for coping training
Hospital Anxiety and Depression Scale (HADS)	Zigmond & Snaith, 1983, Acta Psychiatr Scand	DOI:10.1111/j.1600-0447.1983.tb09716.x	Validated psychometric scale for anxiety and depression assessment
Mindfulness-Based Breathing Script	Kabat-Zinn, Mindfulness-Based Stress Reduction (MBSR), University of Massachusetts Medical School	ISBN 9780385303125	Mindfulness breathing protocol for emotional regulation
Progressive Muscle Relaxation Script/Audio	Adapted from Jacobson (1938); freely available clinical script	DOI:10.1037/11313-000	Guided relaxation protocol for emotional regulation
Role-play Behavioral Simulation	Developed by study investigators; standardized clinical protocol		Coping skills training scenarios tailored to chemotherapy-related stressors
Self-Rating Anxiety Scale (SAS)	Zung, 1971, Acta Psychiatr Scand	DOI:10.1111/j.1600-0447.1971.tb02070.x	Standardized instrument for anxiety self-assessment
Self-Rating Depression Scale (SDS)	Zung, 1965, Archives of General Psychiatry	DOI:10.1001/archpsyc.1965.01720310065008	Standardized instrument for depression self-assessment
SPSS Statistics v26.0	IBM Corp., Armonk, NY, USA	RRID:SCR_019096	Statistical analysis software for data processing