This study aimed to evaluate the clinical effects of combining focused psychological care with enteral nutrition in colorectal cancer (CRC) patients undergoing chemotherapy. Specifically, it assessed the impact on anxiety, depression, psychological resilience, nutritional status, complication rates, and quality of life. A retrospective cohort design was employed, involving 157 CRC patients who received first-time chemotherapy at the oncology department between May 2019 and October 2024. The patients were divided into 2 groups: an observation group (80 patients) receiving focused psychological care combined with enteral nutrition, and a control group (77 patients) receiving routine nursing care. Anxiety and depression were measured using the self-assessment anxiety scale and the self-assessment depression scale, while psychological resilience was assessed using the Connor-Davidson resilience scale (CD-RISC). Nutritional status was evaluated using the subjective global assessment, body mass index, serum albumin (ALB), prealbumin (PA), total protein, and triceps skinfold thickness. Complication rates and quality of life were measured using the EORTC QLQ-C30 scale. Statistical analysis revealed no significant differences between the groups in terms of demographic or disease characteristics. Following the intervention, the observation group showed significantly lower self-assessment anxiety scale and self-assessment depression scale scores (P <.001), as well as substantial improvements in psychological resilience (P <.001). Nutritional indices, including body mass index, subjective global assessment, PA, total protein, and ALB, were significantly better in the observation group compared to the control group (P <.05). Additionally, the incidence of complications such as nausea, vomiting, loss of appetite, bloating, diarrhea, and phlebitis was significantly lower in the observation group (P <.05). Furthermore, quality of life outcomes, including emotional and functional well-being, were notably improved in the observation group compared to the control group (P <.05). These findings suggest that the combination of focused psychological care and enteral nutrition effectively improves anxiety, depression, psychological resilience, and nutritional status in CRC patients undergoing chemotherapy. This approach also reduces complication rates and enhances overall quality of life, underscoring its significant clinical value. It is recommended that this comprehensive nursing model be integrated into clinical practice to improve treatment adherence and enhance patient quality of life.