{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T16:44:20Z","timestamp":1790181860450,"version":"4.1.0"},"reference-count":67,"publisher":"JMIR Publications Inc.","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Med Internet Res"],"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n Young- to middle-aged patients with breast cancer face significant psychosocial challenges. Existing interventions often lack comprehensiveness, timely initiation, and tailoring specific to this population\u2019s unique needs.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n This study aimed to evaluate the impact of a peer-led, nurse-involved, blended online and offline peer support intervention program (PNO2PSP) on psychosocial adjustment in young- to middle-aged patients with breast cancer.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n The effectiveness of PNO2PSP was evaluated through a single-center cluster randomized controlled trial involving 70 newly diagnosed young- to middle-aged patients with breast cancer (35 in each group). The intervention group received an 8-week PNO2PSP in addition to routine care. Psychosocial adjustment, self-efficacy, social support, and coping modes were assessed presurgery and at 4, 8, and 12 weeks post surgery. Generalized estimating equations were used for intention-to-treat analyses. In-depth interviews with 9 participants explored their experiences.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Compared to the control group, the intervention group demonstrated significantly lower psychosocial adjustment scores at 8 weeks (T2; Wald\n \u03c7\u00b2<\/jats:italic>\n 1<\/jats:sub>\n =14.96;\n P<\/jats:italic>\n <.001) and 12 weeks (T3; Wald\n \u03c7\u00b2<\/jats:italic>\n 1<\/jats:sub>\n =7.49;\n P<\/jats:italic>\n =.006); social support was higher at 8 weeks (T2; Wald\n \u03c7\u00b2<\/jats:italic>\n 1<\/jats:sub>\n =7.65;\n P<\/jats:italic>\n =.006). Confrontation coping scores were higher at T2 (Wald\n \u03c7\u00b2<\/jats:italic>\n 1<\/jats:sub>\n =5.46;\n P<\/jats:italic>\n =.02), T3 (Wald\n \u03c7\u00b2<\/jats:italic>\n 1<\/jats:sub>\n =10.04;\n P<\/jats:italic>\n =.002), while avoidance coping scores were lower at T1 (Wald\n \u03c7\u00b2<\/jats:italic>\n 1<\/jats:sub>\n =8.24;\n P<\/jats:italic>\n =.004), T2 (Wald\n \u03c7\u00b2<\/jats:italic>\n 1<\/jats:sub>\n =7.45;\n P<\/jats:italic>\n =.006), and T3 (Wald\n \u03c7\u00b2<\/jats:italic>\n 1<\/jats:sub>\n =5.70;\n P<\/jats:italic>\n =.02). Qualitative findings supported these quantitative results, highlighting the program\u2019s role in facilitating psychosocial adjustment, providing vital support, boosting treatment confidence, and fostering positive coping.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n The PNO2PSP effectively improved psychosocial adjustment, social support, and positive coping in young- to middle-aged patients with breast cancer. Its scientifically validated, feasible, and patient-centered design supports its recommendation for wider clinical implementation, with continued training for peer supporters and sustained delivery of peer support.<\/jats:p>\n <\/jats:sec>","DOI":"10.2196\/86097","type":"journal-article","created":{"date-parts":[[2026,3,2]],"date-time":"2026-03-02T19:20:06Z","timestamp":1772479206000},"page":"e86097-e86097","source":"Crossref","is-referenced-by-count":1,"title":["A Peer-Led, Nurse-Involved Blended Online and Offline Peer Support Program (PNO2PSP) for Psychosocial Adjustment in Young- to Middle-Aged Patients With Breast Cancer: Cluster Randomized Clinical Trial"],"prefix":"10.2196","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5474-8001","authenticated-orcid":false,"given":"Yiheng","family":"Zhang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-1392-5208","authenticated-orcid":false,"given":"Haiyan","family":"He","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-6477-3114","authenticated-orcid":false,"given":"Ye","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-0446-5523","authenticated-orcid":false,"given":"Youxian","family":"Zhong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-9010-3921","authenticated-orcid":false,"given":"Chunhong","family":"Luo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-3093-8507","authenticated-orcid":false,"given":"Juanjuan","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-8956-8821","authenticated-orcid":false,"given":"Lili","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3989-768X","authenticated-orcid":false,"given":"Ni","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-3897-720X","authenticated-orcid":false,"given":"Shihao","family":"Sun","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9029-3078","authenticated-orcid":false,"given":"Baoyi","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1602-3445","authenticated-orcid":false,"given":"Jia","family":"Fang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1047-3683","authenticated-orcid":false,"given":"Jingwen","family":"Yan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7931-3285","authenticated-orcid":false,"given":"Meifen","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1010","published-online":{"date-parts":[[2026,4,17]]},"reference":[{"key":"R1","unstructured":"International Agency for Research on Cancer. 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