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Mei CY, Zou F, Deng JM, Gong H. Impact of problem management-guided health education with positive incentive nursing after rectal cancer surgery. World J Gastrointest Surg 2025; 17:103998. [DOI: 10.4240/wjgs.v17.i6.103998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2025] [Revised: 04/06/2025] [Accepted: 05/06/2025] [Indexed: 05/30/2025] Open
Abstract
BACKGROUND Patients undergoing rectal cancer surgery frequently encounter challenges in their self-care abilities, disease knowledge, and emotional well-being postoperatively. Effective nursing interventions are critical for improving the quality of life and minimizing complications. This study explored the clinical implications of integrating health education guided by problem management with positive incentive nursing to address these challenges.
AIM To evaluate the effect of this combined nursing model on postoperative self-care ability, disease knowledge, mood state, and complication rates in patients undergoing rectal cancer surgery.
METHODS Eighty patients who underwent rectal cancer surgery between October 2021 and August 2024 were allocated into reference (routine care) and experimental (problem management-guided health education combined with positive incentive nursing) groups. The outcomes included exercise of self-care agency scale, disease knowledge (hospital-specific questionnaire), mood state (profile of mood states), and complication rates.
RESULTS The experimental group demonstrated significant improvements in self-care ability (P < 0.05), with higher scores for health knowledge, self-concept, self-care skills, and self-care responsibility than the reference group. Disease knowledge scores also improved markedly in the experimental group (P < 0.05). Mood state scores showed a significant decrease in the negative dimensions (e.g., anxiety and depression) and an increase in energy vitality (P < 0.05). Additionally, the experimental group exhibited a lower complication rate than the reference group (7.5% vs 27.5%, P < 0.05).
CONCLUSION The integration of problem management-guided health education with positive incentive nursing significantly enhanced postoperative self-care abilities, disease knowledge, and emotional well-being while reducing complication rates. This model demonstrated potential for widespread adoption in clinical practice by offering a structured approach to improve patient outcomes and quality of life.
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Affiliation(s)
- Cheng-Yan Mei
- Department of Cadre Health Care, The First Hospital of Nanchang, Nanchang 330008, Jiangxi Province, China
| | - Fei Zou
- Department of Gastrointestinal Surgery, The First Hospital of Nanchang, Nanchang 330008, Jiangxi Province, China
| | - Jun-Min Deng
- Department of Gastrointestinal Surgery, The First Hospital of Nanchang, Nanchang 330008, Jiangxi Province, China
| | - Huan Gong
- Department of Cadre Health Care, The First Hospital of Nanchang, Nanchang 330008, Jiangxi Province, China
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Tang P, Tovel R, Ong H, Proud D, Burgess A, Watson E, Chen WY, Lam D, Mohan H. The Role of Patient Education in Low Anterior Resection Syndrome: A Systematic Review. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2025:10.1007/s13187-025-02593-3. [PMID: 40014272 DOI: 10.1007/s13187-025-02593-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Accepted: 02/12/2025] [Indexed: 02/28/2025]
Abstract
Low anterior resection syndrome (LARS) is a significant complication after sphincter-preserving rectal cancer surgery and negatively impacts a patient's quality of life. Treatment of LARS is multimodal, and many treatments require engagement from the patient. Understanding the complex array of treatment options and the potential additive effects of different therapies can be difficult. This systematic review aims to assess the role of patient education in treatment of LARS in colorectal cancer patients. A systematic literature search was conducted on PubMed, EMBASE and Ovid Medline according to the PRISMA guidelines for articles published from 1946 to October 2023 and registered with PROSPERO: 42,023,434,601. Studies that reported on clinical outcomes of patients with LARS that underwent any educational intervention were included for this review. Results from five publications including 368 patients with LARS were reviewed for analysis. Three interventions were delivered to symptomatic patients postoperatively and two to all patients who underwent low anterior resection preoperatively. Five trial protocols were also included for analysis, including three preoperative and two postoperative interventions Education interventions were often delivered alongside co-interventions such as medications and pelvic floor physiotherapy. Four studies reported improvement of mean LARS scores and quality of life measures related to the education intervention and associated co-interventions. Patient education has a positive impact towards improving functional outcomes in patients with LARS following resection for rectal cancer. In practice, it is often used in conjunction with other interventions. Determining optimal content and delivery methods is a target for future research.
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Affiliation(s)
- P Tang
- Department of Colorectal Surgery, Austin Health, 145 Studley Road, Heidelberg, Melbourne, VIC, 3084, Australia
| | - R Tovel
- Department of Colorectal Surgery, Austin Health, 145 Studley Road, Heidelberg, Melbourne, VIC, 3084, Australia
| | - H Ong
- Department of Colorectal Surgery, Austin Health, 145 Studley Road, Heidelberg, Melbourne, VIC, 3084, Australia.
- University of Melbourne, Melbourne, Australia.
| | - David Proud
- Department of Colorectal Surgery, Austin Health, 145 Studley Road, Heidelberg, Melbourne, VIC, 3084, Australia
- University of Melbourne, Melbourne, Australia
| | - Adele Burgess
- Department of Colorectal Surgery, Austin Health, 145 Studley Road, Heidelberg, Melbourne, VIC, 3084, Australia
- University of Melbourne, Melbourne, Australia
| | - Eleanor Watson
- Department of Colorectal Surgery, Austin Health, 145 Studley Road, Heidelberg, Melbourne, VIC, 3084, Australia
- University of Melbourne, Melbourne, Australia
| | - Wui Yeat Chen
- Department of Colorectal Surgery, Austin Health, 145 Studley Road, Heidelberg, Melbourne, VIC, 3084, Australia
- University of Melbourne, Melbourne, Australia
| | - David Lam
- Department of Colorectal Surgery, Austin Health, 145 Studley Road, Heidelberg, Melbourne, VIC, 3084, Australia
| | - Helen Mohan
- Department of Colorectal Surgery, Austin Health, 145 Studley Road, Heidelberg, Melbourne, VIC, 3084, Australia
- University of Melbourne, Melbourne, Australia
- Peter MacCallum Cancer Centre, Melbourne, Australia
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Brock H, Lambrineas L, Ong HI, Chen WY, Das A, Edsell A, Proud D, Carrington E, Smart P, Mohan H, Burgess A. Preventative strategies for low anterior resection syndrome. Tech Coloproctol 2023; 28:10. [PMID: 38091118 DOI: 10.1007/s10151-023-02872-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 11/11/2023] [Indexed: 12/18/2023]
Abstract
BACKGROUND A common and debilitating complication of low anterior resection for rectal cancer is low anterior resection syndrome (LARS). As a multifactorial entity, LARS is poorly understood and challenging to treat. Despite this, prevention strategies are commonly overlooked. Our aim was to review the pathophysiology of LARS and explore current evidence on the efficacy and feasibility of prophylactic techniques. METHODS A literature review was performed between [1st January 2000 to 1st October 2023] for studies which investigated preventative interventions for LARS. Mechanisms by which LARS develop are described, followed by a review of prophylactic strategies to prevent LARS. Medline, Cochrane, and PubMed databases were searched, 189 articles screened, 8 duplicates removed and 18 studies reviewed. RESULTS Colonic dysmotility, anal sphincter dysfunction and neorectal dysfunction all contribute to the development of LARS, with the complex mechanism of defecation interrupted by surgery. Transanal irrigation (TAI) and pelvic floor rehabilitation (PFR) have shown benefits in preventing LARS, but may be limited by patient compliance. Intraoperative nerve monitoring (IONM) and robotic-assisted surgery have shown some promise in surgically preventing LARS. Nerve stimulation and other novel strategies currently used in treatment of LARS have yet to be investigated in their roles prophylactically. CONCLUSIONS To date, there is a limited evidence base for all preventative strategies including IONM, RAS, PFP and TAI. These strategies are limited by either access (IONM, RAS and PFP) or acceptability (PFP and TAI), which are both key to the success of any intervention. The results of ongoing trials will serve to assess acceptability, while technological advancement may improve access to some of the aforementioned strategies.
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Affiliation(s)
- H Brock
- Austin Health, Department of Surgery, University of Melbourne, Melbourne, Australia
- Department of Colorectal Surgery, Austin Health, Melbourne, Australia
- Western General, Melbourne, Australia
| | - L Lambrineas
- Austin Health, Department of Surgery, University of Melbourne, Melbourne, Australia
| | - H I Ong
- Austin Health, Department of Surgery, University of Melbourne, Melbourne, Australia.
- Department of Colorectal Surgery, Austin Health, Melbourne, Australia.
| | - W Y Chen
- Austin Health, Department of Surgery, University of Melbourne, Melbourne, Australia
| | - A Das
- Department of Colorectal Surgery, Austin Health, Melbourne, Australia
| | - A Edsell
- Austin Health, Department of Surgery, University of Melbourne, Melbourne, Australia
| | - D Proud
- Austin Health, Department of Surgery, University of Melbourne, Melbourne, Australia
- Department of Colorectal Surgery, Austin Health, Melbourne, Australia
| | | | - P Smart
- Austin Health, Department of Surgery, University of Melbourne, Melbourne, Australia
- Department of Colorectal Surgery, Austin Health, Melbourne, Australia
| | - H Mohan
- Austin Health, Department of Surgery, University of Melbourne, Melbourne, Australia
- Department of Colorectal Surgery, Austin Health, Melbourne, Australia
| | - A Burgess
- Austin Health, Department of Surgery, University of Melbourne, Melbourne, Australia
- Department of Colorectal Surgery, Austin Health, Melbourne, Australia
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