Breast Cancer Research and Treatment

, Volume 178, Issue 1, pp 95–103 | Cite as

Effects of cyclic adjustment training delivered via a mobile device on psychological resilience, depression, and anxiety in Chinese post-surgical breast cancer patients

  • Kaina Zhou
  • Jin Li
  • Xiaomei LiEmail author
Clinical trial



Psychological resilience is an important ability for women with breast cancer to cope effectively with depression and anxiety. However, the demands of long-term hospital-based psychological rehabilitation interventions are not met in mainland China, where shorter hospital stays and longer home rehabilitation are common. This study examines whether a cyclic adjustment training (CAT) intervention delivered via a mobile device can improve psychological resilience, and reduce depression and anxiety symptoms, in a population of post-surgical women with breast cancer.


Women with breast cancer were recruited through convenience sampling from a general hospital in Xi’an, and randomly allocated to an intervention group (n = 66), receiving CAT plus routine nursing care for 12 weeks, or a control group (n = 66), receiving only routine nursing care. The primary outcome was psychological resilience. Resilience, anxiety, and depression were measured using the Connor-Davidson Resilience Scale (CD-RISC), Self-Rating Anxiety Scale (SAS), and Self-Rating Depression Scale (SDS), respectively. A linear mixed model was applied to analyze the effects.


Patients in the CAT group displayed significantly improved psychological resilience, anxiety, and depression scores (F = 19.53, P < 0.001; F = 31.85, P < 0.001; F = 26.32, P < 0.001), respectively, compared to the control group.


The CAT had positive effects on improving psychological resilience and reducing the symptoms of anxiety and depression, supporting its use as an effective psychological management and intervention strategy in the early stages of long-term rehabilitation of post-surgical women with breast cancer.

Trial registration ChiCTR-IOR-16008253, registered 9 April 2016.


Breast neoplasms Resilience Psychological Anxiety Depression 



Cyclic adjustment training


Connor-Davidson Resilience Scale


Self-Rating Anxiety Scale


Self-Rating Depression Scale


Roy Adaptation Model



We thank the breast surgical department, first affiliated hospital of Xi’an Jiaotong University for their support.

Author contributions

KZ, JL, and XL designed the study and the intervention program. JL and XL performed the intervention. KZ performed data collection, analysis, and interpretation, and manuscript preparation. KZ, JL, and XL revised the manuscript. All authors approved the manuscript before submission.


The study was funded by China Postdoctoral Science Foundation (Grant No. 2018M643678) and National Natural Science Foundation of China (Grant No. 81502700).

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

The trial protocol received ethical approval from the Biomedical Ethics Committee of Xi’an Jiaotong University Health Science Centre and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. All experiments were performed complying with the current laws of the country.

Informed consent

Written informed consent was obtained from each recruited patient before the intervention and questionnaire survey.

Supplementary material

10549_2019_5368_MOESM1_ESM.docx (15 kb)
Supplementary material 1 (DOCX 15 kb)


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.School of NursingXi’an Jiaotong University Health Science CentreXi’anChina

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