The Impact of Rosenthal Effect-Based Psychological Nursing on Psychological State, Self-Efficacy, and Quality of Life in Patients Undergoing Total Hysterectomy for Uterine Fibroids: A Randomized Controlled Trial

Abstract

Background: Patients undergoing hysterectomy for uterine fibroids often experience significant psychological distress that impairs recovery and quality of life. While psychological support is recognized as important, structured and feasible nurse-led interventions remain underutilized. Objective: To evaluate the efficacy of a structured psychological nursing intervention based on the Rosenthal effect in reducing self-perceived burden and improving psychological state, self-efficacy, and quality of life in patients undergoing total hysterectomy for uterine fibroids. Methods: A prospective, single-blind, randomized controlled trial was conducted with 160 patients scheduled for total hysterectomy. Participants were randomly assigned to either the intervention group (n=80), which received two structured sessions of Rosenthal effect-based psychological nursing in addition to routine care, or the control group (n=80), which received routine care only. The primary outcome was the change in Self-Perceived Burden Scale (SPBS) scores from baseline to 3-month follow-up. Secondary outcomes included anxiety (SAS), depression (SDS), self-esteem (RSE), self-efficacy (GSES), quality of life (SF-36), physiological stress markers (serum cortisol, HRV), postoperative recovery indicators, and patient satisfaction (NSNS). Results: The intervention group showed a significantly greater reduction in SPBS scores over time compared to the control group (group × time interaction, p < 0.001). Significant improvements were also observed in secondary outcomes, including anxiety, self-esteem, self-efficacy, and quality of life at 3-month follow-up (all p < 0.01). Physiological stress markers (cortisol and HRV) improved more in the intervention group. The intervention group also demonstrated earlier ambulation, shorter hospital stays, lower pain scores, and higher nursing satisfaction and treatment adherence (all p < 0.05). Conclusion: A Rosenthal effect-based psychological nursing intervention was associated with reduced self-perceived burden and more favorable psychological, physiological, and selected clinical recovery outcomes in patients undergoing hysterectomy for uterine fibroids. This feasible, nurse-led model may provide a practical strategy for strengthening expectation-oriented psychological support within routine perioperative nursing care.