The effect of an empowerment program on ruminative thoughts, fatigue, and psychological resilience of cancer survivors: A randomized controlled trial

Purpos Cancer survivors in remission often experience intrusive rumination, cancer-related fatigue, and reduced psychological resilience, which may hinder daily functioning and recovery. This study evaluated the effects of a 10-week online empowerment program designed to reduce intrusive rumination and fatigue while enhancing deliberate rumination and psychological resilience. Methods A randomized controlled trial was conducted with 62 cancer survivors assigned to an intervention or waitlist control group. The intervention comprised ten weekly 90-min Zoom sessions integrating psychoeducation, cognitive-behavioral therapy, acceptance and commitment therapy, mindfulness, and relaxation techniques. Outcomes were assessed at baseline, post-intervention, and 3-month follow-up using the Event-Related Rumination Inventory, Cancer Fatigue Scale, and Connor–Davidson Resilience Scale. Primary analyses followed the intention-to-treat principle using linear mixed-effects models. Results The 62 participants had a mean age of 49.98 ± 9.32 years, and 93.5% were female. Significant group × time interactions were observed for intrusive rumination (F = 5.711, p = .005), deliberate rumination (F = 6.303, p = .003), cancer-related fatigue (F = 7.349, p = .001), and psychological resilience (F = 4.205, p = .020). Across the three measurement points, intrusive rumination and cancer-related fatigue decreased in the intervention group, while deliberate rumination and psychological resilience increased, with different trajectories observed in the control group. Conclusions The empowerment program improved intrusive rumination, cancer-related fatigue, deliberate rumination, and psychological resilience among cancer survivors. Empowerment-based interventions may represent feasible nursing strategies for psychosocial support during remission.