A total of 100 patients who had surgery for esophageal cancer at Sun Yat-sen University Cancer Center from January 2018 to January 2019 were selected to participate in the study using a simple randomization method. Inclusion criteria: 1) Patients who had a radical mastectomy for esophageal cancer; 2) Age between 18 and 80 years old; 3) No cognitive impairment. Exclusion criteria: 1) The patients who have mental disorders or are unwilling to cooperate with this study. 2) With the combination of other serious illnesses. 3) Recently suffered other major trauma. One hundred patients were randomly divided into experimental and control groups, in which patients in the control group were discharged according to the conventional teaching of discharge nursing, and patients in the experimental group were intervened according to the psychological resilience theory on the basis of the conventional teaching. The study was approved by the Ethics Committee of our hospital and all subjects signed the Informed Consent Form.

The statistical analysis was performed using the statistical software SPSS26.0. The measurement data were described by mean ± standard deviation (M ± SD), and the enumeration data were expressed by frequency and rate. The independent sample T-test was used for comparison between groups, and the Chi-square test was applied for comparison of rates and constituent ratios. P < 0.05 indicated statistically significant difference.

Esophageal cancer is a common malignant tumor in China, and patients with esophageal cancer often experience negative emotions such as anxiety and depression due to factors such as fear of adverse effects of the disease and related events after discharge [6]. Especially, most patients are still in a fasting state after discharge and need to rely on family members to help with enteral nutrition infusion, therefore, patients are often in anxiety at the time of discharge both for fear of not being able to adapt to their home environment after discharge and that their family members cannot perform their role as caregivers, resulting in

physical changes and rehabilitation failure. Psychological resilience, a research variable in positive psychology, plays an important role in the adaptive process of patients. The relevant studies have shown that the patient’s psychological resilience is at a low level after esophageal cancer surgery, and those with a heavier physical and emotional burden are more likely to experience negative emotions with lower prognostic confidence, leading to a decrease in their psychological resilience [7]. Rutter’s psychological resilience development model contains the following four mechanisms: 1) Mitigation of crisis factor shocks. 2) Mitigation of negative chain reactions. 3) Improvement of self-efficacy and self-esteem. 4) Opportunities for development [8]. In this study, we developed effective nursing interventions through this model: This intervention helps patients to increase their confidence and generate positive emotions by eliminating patients’ concerns about relevant unfavorable factors, reducing their negative emotions, as well as improving self-care capabilities by raising the awareness of caregivers so that patients can get more support. The experimental results of this study also proved that the above nursing interventions were effective in improving the patients’ psychological resilience level: the variation showed statistical significance in the control group compared to the experimental group after the intervention P = 0.028 < 0.05.

It is shown in Table 3 that as the level of psychological resilience increased in the experimental group, the level of PTG also increased significantly, P = 0.027 < 0.05, the variation showed statistical significance. Individuals with high psychological resilience can cope with the impact of crisis factors more effectively and produce more positive growth in response to the impact of crisis factors, such as PTG [9], as PTG can strengthen the confidence, hope, physical and mental health of patients in response to the disease by empowering them to recover and grow from the trauma themselves [10] [11]. Esophageal cancer, as a major incident, causes serious physical and psychological trauma to patients during diagnosis and treatment, resulting in different degrees of negative emotions, which seriously affect their psychological health and quality of life [12]. In particular, patients have more complications when they are hospitalized, and they still have a series of symptoms after discharge, which often intensify their suffering, affect their quality of life, and even shorten their lifespan [13]. Moreover, the improvement of the patient’s psychological resilience can significantly increase the level of PTG in the patient, thus making the patient become more positive and outgoing with persistent hope, which in turn improves their quality of life.

In conclusion, the nursing intervention developed according to the Rutter’s psychological development model can effectively improve the level of psychological resilience of the patients, allowing them to achieve better growth after discharge after experiencing the traumatic events of the disease; it can improve the quality of life of the patients after discharge and promote their physical and mental rehabilitation. Therefore, the nursing intervention model in this article is scientifically effective and should be applied further in nursing practice.