Narrative nursing to address negative emotions, body image disturbance, and satisfaction in patients after axillary odor surgery: a sequential explanatory mixed-methods study

Background Patients commonly experience negative emotions and body image disturbance following axillary odor surgery, while conventional nursing care often fails to adequately address their psychological needs. Narrative nursing, as a humanistic care model, offers a novel perspective for this issue. Methods A sequential explanatory mixed-methods design was employed. In the quantitative phase, 120 post-operative axillary odor patients were randomly assigned to either an intervention group or a control group. Assessments were conducted using the SAS, SDS, BIRS and a satisfaction questionnaire. In the qualitative phase, 15 participants from the intervention group were purposively selected for semi-structured interviews, and the data were analyzed using Colaizzi’s phenomenological analysis method to extract themes. Results Quantitative results showed that the intervention group had significantly lower scores on the SAS, SDS, BIRS, and significantly higher satisfaction scores compared to the control group ( p < 0.001). Qualitative analysis yielded four themes: Emotional Catharsis and Psychological Liberation, Restructuring a Positive Illness Narrative and Self-Identity, Enhanced Sense of Control and Therapeutic Alliance, and Promotion of Mind-Body Integration and Quality of Life. Conclusion Narrative nursing effectively alleviates negative emotions and body image disturbance in patients after axillary odor surgery and improves their satisfaction. The mechanism of action lies in helping patients externalize their problems and reconstruct a positive self-perception through the narrative process. It represents an effective model for transitioning from technical treatment to integrated mind-body care.