Positive psychological resources and support needs among patients with gastric cancer experiencing fear of cancer recurrence during chemotherapy: a qualitative study

Abstract

To explore positive psychological resources and support needs among patients with gastric cancer undergoing chemotherapy who experience fear of cancer recurrence (FCR), guided by the Positive Emotion, Engagement, Relationships, Meaning, and Accomplishment (PERMA) model. A qualitative descriptive study was conducted with 15 patients with gastric cancer undergoing chemotherapy who were recruited using purposive sampling from the Department of Oncology at a tertiary Grade A hospital in Nanchang, China. Data were collected between May and June 2026 through face-to-face semi-structured interviews and analyzed using directed content analysis. The five PERMA dimensions served as a priori categories, while open coding was applied to data that could not be accommodated within the framework. The study was reported in accordance with the Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist. Six categories comprising 17 subcategories were identified: positive emotional resources and psychological reassurance needs; engagement resources and needs for tailored activity participation; relationship resources and interpersonal support needs; meaning reconstruction and reflection on life; accomplishment resources and self-efficacy support needs; and needs for specialized identification and management of FCR. Patients described multidimensional positive psychological resources across the PERMA domains, together with related support needs and additional FCR-specific needs. These findings suggest that future supportive care programs may benefit from considering patients’ existing psychological resources, support preferences, and FCR-specific needs.