International journal of nursing studiesSep 27, 2025

Effects of a daily rhythm-based communication system on psychological distress in young cancer patients

Circadian Biology Weekly Brief ↗PubMed ↗DOI ↗

Updated Jun 28, 2026

Abstract

Essence

In adolescent and young adult cancer patients with psychological distress, a circadian rhythm-matched communication intervention reduced distress and improved sleep more than routine care and more than the same intervention without circadian matching.

Evidence

Three-arm randomized controlled trial in 129 patients at a single hospital found both intervention groups improved distress, anxiety, depression, sleep quality, and quality of life at 1 month versus control, with greater distress and sleep gains in the circadian-matched arm that persisted to 3 months.

Caveat

This was a single-center trial with 129 participants and only 3 months of follow-up, so the results may not generalize broadly or show longer-term effects.

Simplified

BACKGROUND: Multiple factors of psychological distress in adolescent and young cancer patients continue to be unearthed, suggesting the warranted exploration of interventions that meet individualized psychological needs and are integrated into daily lives to alleviate their psychological distress.

OBJECTIVE: To investigate the effects of the standardized communication system based on circadian rhythm regulation on psychological distress in adolescent and young adult cancer patients.

DESIGN: A three-arm randomized controlled trial.

SETTING AND PARTICIPANTS: A total of 129 adolescent and young adult cancer patients with psychological distress were recruited from the Third Xiangya Hospital of Central South University from January 2022 to May 2023.

METHODS: Participants were randomly divided into three groups. Both intervention groups received eight standardized communication system intervention topics, while the control group received only routine psychological care. The difference between the two intervention groups was that the duration of the intervention in the intervention group 2 was matched to the three types of circadian rhythm of the study participants. The primary outcomes of psychological distress, anxiety, and depression, as well as the secondary outcomes of sleep quality and quality of life, were measured four times at baseline, immediately after completing the intervention, and one month versus three months after completing the intervention. The generalized estimating equations were used to compare the effects of the intervention across the three groups.

RESULTS: In one month after the intervention, the two intervention groups significantly reduced psychological distress, anxiety, and depression, and improved the quality of sleep and quality of life in adolescent and young adult cancer patients compared to the control group (P < 0.01). Meanwhile, the intervention group 2 was more effective than the intervention group 1 in reducing psychological distress (-1.20, CI, -1.82 to -0.57, P < 0.001) and improving sleep quality (-1.72, CI, -2.83 to -0.62, P < 0.001) of patients. Moreover, the effects persisted three months after completing the intervention (P < 0.05).

CONCLUSIONS: The standardized communication system interventions can effectively alleviate psychological distress, anxiety, and depression, and improve sleep quality and quality of life in adolescent and young adult cancer patients. In addition, the standardized communication system based on circadian rhythm regulation is more advantageous in improving the psychological distress and sleep quality of adolescent and young adult cancer patients than the standardized communication system intervention.

REGISTRATION: The study was registered in the Chinese Clinical Trial Registry on January 3, 2022 (ChiCTR2200055230).