Objective To examine the effectiveness of narrative nursing based on diary writing on perceived stress and chemotherapy-related cognitive impairment in patients receiving chemotherapy for cancer.Methods A total of 70 cancer patients receiving first chemotherapy were assigned to a control group or an intervention group chronologically, with 35 in each group.The control group was given conventional nursing care, while the intervention group additionally received narrative nursing based on diary writing once a week for eight weeks.Before and after the intervention, the Self-rating Anxiety Scale,Self-rating Depression Scale, Chinese version of the Perceived Stress Scale, Pittsburgh Sleep Quality Index, Functional Assessment of Cancer Therapy-Cognitive Function were utilized to evaluate the effect.Results A total of 31 in the control group and 32 in the intervention group completed the study.The scores of anxiety, depression, perceived stress, sleep quality and cognitive function in the intervention group were significantly lower than those in the control group （all P＜0.05）.Conclusion Narrative nursing based on diary writing can alleviate patients′ anxiety, depression, and perceived stress, whilst improve sleep quality and cognitive function.