Effect of the explain-simulate-practice-communication-support nursing mode on perioperative stress and postoperative rehabilitation of patients undergoing laparoscopic radical gastrectomy for gastric cancer

Si XIE; Mengshan CUI

ABSTRACT

Objective:

To investigate the effect of the explain-simulate-practice-communication-support (ESPCS) nursing model on perioperative stress and postoperative rehabilitation in patients undergoing laparoscopic radical gastrectomy for gastric cancer. Provide a basis for the application of ESPCS nursing model in patients undergoing radical gastrectomy for gastric cancer.

Methods:

This was a quasi-experimental study. A total of 212 patients who underwent laparoscopic radical gastrectomy for gastric cancer in the First Affiliated Hospital of China Medical University from May 2019 to May 2023 were selected by convenience sampling and divided into the observation group and the control group by random digital table method, with 106 patients in each group. The control group received routine nursing intervention, while the observation group received ESPCS nursing intervention for 3 months. The perioperative stress hormones (serum cortisol and epinephrine), Self-rating Depression Scale (SDS) score, Self-rating Anxiety Scale (SAS) score, gastrointestinal function indicators, and the 36-item Short Form Health Survey Questionnaire (SF-36) score were compared between the two groups.

Results:

Two groups of patients were lost to follow-up, with a total of 104 patients in each group. The control group consisted of 65 males and 39 females, aged (61.59 ± 3.42) years old, while the observation group consisted of 61 males and 43 females, aged (60.78 ± 3.63) years old. Six days after operation, serum cortisol and epinephrine levels in the observation group were (221.46 ± 24.15) nmol/L and (28.11 ± 3.47) pmol/L, respectively, which were lower than those in the control group (261.84 ± 27.91) nmol/L and (31.49 ± 3.86) pmol/L, respectively, and the differences were statistically significant ( t=11.16, 6.64, both P<0.05). After 1 week of operation, the SDS and SAS scores in the observation group were (41.39 ± 2.21), (39.62 ± 2.31) points, respectively, which were lower than those in the control group (45.27 ± 2.34), (44.35 ± 2.37) points, and the differences were statistically significant ( t=12.29, 14.58, both P<0.05). The time of first exhaust, first defecation, intestinal ringing and first solid eating in the observation group were (55.38 ± 6.23), (68.84 ± 7.92), (38.73 ± 4.31), (62.31 ± 7.67) h, respectively, which were lower than those in the control group (67.51 ± 8.39), (84.17 ± 9.25), (48.43 ± 5.79), (75.65 ± 8.52) h, the differences were statistically significant ( t values were 11.84-13.71, all P<0.05). After intervention, the scores of physiological function, role physical, general health, mental health, social function and the total score of SF-36 in the observation group were (82.17 ± 4.12), (83.21 ± 3.67), (75.27 ± 3.64), (80.63 ± 4.31), (77.58 ± 4.13), (73.89 ± 4.86) points, respectively, which were higher than those in the control group (75.61 ± 4.39), (74.24 ± 3.88), (69.45 ± 4.38), (71.28 ± 4.05), (72.35 ± 3.84), (68.81 ± 5.14) points, the differences were statistically significant ( t values were 7.32-17.13, all P<0.05).

Conclusions:

The ESPCS nursing model can effectively alleviate the perioperative stress reaction of gastric cancer patients undergoing laparoscopic radical gastrectomy, promote the recovery of gastrointestinal function and improve the quality of life.