Character Strengths-Based Intervention for Enhancing Self-esteem and Quality of Life and Alleviating Depression in Female Patients With Breast Cancer: A Randomized Controlled Trial

Background: – Character strengths–based intervention (CSI) has the potential to enhance self-esteem and reduce depression, leading to improved quality of life (QoL) for breast cancer patients. Objective: – To explore the effects of an evidence-based and culturally appropriate CSI among Chinese female patients with breast cancer and their perceptions of the CSI. Methods: – This study was a multisite assessor-blinded randomized controlled trial. The CSI underwent multiple stages of modeling as cultural tailoring, supported by a self-produced booklet and self-monitoring tool for patients. The outcomes were assessed at baseline (T0), immediately postintervention (T1), and 1 month postintervention (T2). Qualitative interviews were conducted to explore the experience and opinions among the CSI group. Results: – One hundred twenty-two participants were randomly assigned to receive either the CSI (the CSI group; n = 61) or an “early memories” program (the control group; n = 61). The results showed that the CSI significantly increased self-esteem and QoL at T1 and T2. In addition, the CSI significantly reduced depressive symptoms at T1 and T2. The qualitative findings encompassed 5 themes: acceptability of the CSI, perceived benefits of the CSI, facilitators of application of the CSI, barriers to application of the CSI, and recommendations for the CSI. Conclusion: – This study demonstrated that the CSI enhanced self-esteem and QoL and alleviated the depressive symptoms of the CSI group. Implications for Practice: – This study highlights the viability of nurses serving as implementers of the CSI and reveals the importance of professional training and resource support for nurses. Copyright © 2025 Wolters Kluwer Health, LLC. All rights reserved.