Effects of a nurse-led multi-theoretical-model-based exercise program on psychological, sleep and cognitive function in lymphoma patients: A randomized controlled trial.

PURPOSE: Chemotherapy often leads to psychological distress, sleep disturbance, and cognitive decline in lymphoma patients. Exercise may help alleviate these symptoms, but high-quality evidence remains limited. The study aimed to examine the effects of a nurse-led multi-theoretical-model-based exercise program (MTM-EP) on psychological distress, sleep quality, and cognitive function in lymphoma patients undergoing chemotherapy. METHODS: In this assessor-blinded randomized controlled trial, ninety patients with lymphoma were randomly assigned to either an intervention group receiving a 36-week nurse-led multi-theoretical-model-based exercise program or a control group receiving usual care. Assessments were conducted at baseline (T0), immediately post-intervention (T1), and at 1-, 3-, and 6-month follow-ups (T2-4). Outcomes included anxiety, depression, fear of cancer progression, sleep quality, and cognitive function. Data were analyzed using repeated-measures analysis of variance. RESULTS: An intention-to-treat analysis was performed including all 90 randomized participants. Missing outcome data were handled using multiple imputation under the Missing at Random assumption. Compared with controls, the intervention group demonstrated substantial reductions in anxiety, depression, and fear of progression, along with sustained improvements in sleep quality and objective cognition across six months (all P < 0.001). High adherence rates (>80%) were observed for both aerobic and resistance components. CONCLUSIONS: The nurse-led MTM-EP was found to effectively reduce psychological distress, improve sleep quality, and enhance cognitive function among patients with lymphoma undergoing chemotherapy.