Application Effects of Feedback-Based Health Education Combined With Psychological Support Nursing Based on the Rosenthal Effect in Patients With Postoperative Anxiety and Depression Following Gynecological Malignancy Surgery

Abstract

Background: To investigate the application effects of feedback-based health education combined with psychological support nursing, based on the Rosenthal effect, in patients experiencing anxiety and depression after gynecological malignancy surgery.

Methods: This retrospective study included 150 patients treated at Qingdao Municipal Hospital (September 2023–September 2025), divided into a control group (n = 75, routine care) and a study group (n = 75, combined intervention). Outcomes assessed at baseline and 3 months post-care included negative emotions(Cancer Fatigue Scale (CFS), Depression Anxiety and Stress Scale-21 (DASS-C21)), psychological resilience (10-item Connor-Davidson Resilience Scale (CD-RISC-10)), post-traumatic growth (Posttraumatic Growth Inventory (PTGI)), self-disclosure (Distress Disclosure Index (DDI)), coping modes (Medical Coping Modes Questionnaire (MCMQ)), self-care agency (Exercise of Self-Care Agency Scale (ESCA)), and spiritual well-being (European Organisation for Research and Treatment of Cancer Quality of Life QuestionnaireSpiritual Well-Being 32 (EORTC QLQ-SWB32)). Twoway repeated-measures analysis of variance (ANOVA) with Bonferroni correction was used.

Results: Using two-way repeated-measures ANOVA with Bonferroni post-hoc multiple comparison correction, intragroup comparisons revealed significant post-care reductions in CFS scores, all DASS-C21 subscale scores, and the avoidance and resignation domains of the MCMQ relative to baseline values in both cohorts (all adjusted p < 0.001). Concurrently, marked elevations were observed in scores for the CD-RISC-10, PTGI, DDI, the MCMQ confrontation domain, ESCA, and all domains of the EORTC QLQ-SWB32 within each group post-treatment (all adjusted p < 0.001). Intergroup analysis at the post-care timepoint indicated that patients in the study group achieved significantly lower scores on the CFS, DASS-C21 subscales, and the MCMQ avoidance and resignation subscales, coupled with significantly superior scores on the CD-RISC-10, PTGI, DDI, MCMQ confrontation subscale, ESCA, and EORTC QLQ-SWB32 subscales, when compared to their counterparts in the control group (all adjusted p < 0.001).

Conclusions: The combined nursing protocol was associated with reduced negative emotions, improved coping, and enhanced resilience, growth, self-disclosure, spiritual well-being, and self-care in this population, suggesting clinical promise. However, causal inference is limited by the retrospective, non-randomized design.