Combined effects of nurse-patient communication and psychological nursing on physical and mental stress responses after gastrointestinal surgery

Abstract

BACKGROUND

The integration of patient-nurse communication language and focused psychological nursing can provide a reference for nursing interventions in patients undergoing gastrointestinal surgery.

AIM

To analyze the impact of patient-nurse communicative language combined with focused psychological nursing on psychological and physiological stress responses, coping styles, health behaviors, and complications in patients undergoing gastrointestinal surgery.

METHODS

Eighty patients who underwent gastrointestinal surgery at Northern Jiangsu People's Hospital between October 2021 and August 2024 were selected and randomly divided into two groups, with 40 patients in each group. The control group received routine nursing care, while the observation group was provided with patient-nurse communicative language combined with focused psychological nursing care. Psychological stress responses, physiological stress responses, coping styles, health behaviors, incidence of complications, and nursing satisfaction were compared between the two groups.

RESULTS

After nursing, the observation group showed a significant improvement in psychological stress responses, with the average score on the Connor-Davidson Resilience Scale increasing from 23.22 ± 1.08 to 30.14 ± 2.78 (P < 0.05). On postoperative awakening, the heart rate of the observation group was 78.36 ± 2.98 times/min, significantly lower than the control group's 81.14 ± 2.44 times/min (P < 0.05), and the mean arterial blood pressure was 12.06 ± 1.26 kPa, compared to the control group's 13.45 ± 1.17 kPa (P < 0.05). The coping style scale scores of the observation group improved from 17.25 ± 1.40 to 23.64 ± 1.52 for confrontation, 16.94 ± 1.24 to 12.11 ± 1.02 for avoidance, and 21.69 ± 2.63 to 15.32 ± 1.41 for submission (P < 0.05). The health promotion lifestyle profile scores of the observation group increased from 104.25 ± 6.77 to 133.61 ± 10.25 (P < 0.05). The incidence of complications, such as wound infection and abdominal distension, in the observation group was 2.50%, significantly lower than that in the control group (20.00%; P < 0.05). Nursing satisfaction in the observation group was 95.00%, significantly higher than that in the control group (80.00%; P < 0.05).

CONCLUSION

The integration of patient-nurse communicative language and focused psychological nursing can alleviate psychological and physiological stress responses in patients undergoing gastrointestinal surgery, improve their coping styles and health behaviors, reduce the risk of complications, and enhance nursing satisfaction, yielding ideal clinical outcomes.

Key Words: Gastrointestinal surgery; Patient-nurse communicative language; Focused psychological nursing; Stress response; Complications

Core Tip: Reasonable and effective nursing interventions can significantly improve psychological and physiological stress responses in surgical patients and reduce the incidence of complications, which is particularly important for patients undergoing gastrointestinal surgery.

INTRODUCTION

Gastrointestinal surgery involves surgical treatment of the stomach and intestines; it includes procedures such as partial gastrectomy, intestinal resection, and gastrointestinal anastomosis. These procedures are used to treat a range of digestive system diseases including gastric ulcers, gastric cancer, and intestinal inflammation, thereby reducing the adverse effects of these diseases on patients and saving their lives[1]. However, gastrointestinal surgery is an invasive procedure that can significantly damage a patient's body. During the perioperative period, patients may experience fear due to concerns about their disease and surgery, leading to stress responses that can affect the smooth progress of surgery. Additionally, patients undergoing perioperative gastrointestinal surgery often exhibit varying degrees of psychological and physiological stress responses. If nurses communicate improperly with patients during this period, it may lead to a lack of understanding of medical staff procedures, distrust of healthcare professionals, and poor cooperation with the medical team. This can affect the success of surgery and increase the risk of complications[2]. Therefore, to ensure smooth progress and outcomes of surgery, it is essential to implement scientific and rational nursing measures for patients undergoing gastrointestinal surgery. Currently, routine nursing measures focus more on providing basic nursing care and verbal education on disease knowledge. While these improve patients' understanding of their disease and surgery to some extent, they are not very effective in improving patients' psychological and physiological stress responses and the risk of complications[3,4].

Patient-nurse communicative language is the medium through which nurses and patients exchange information and emotions in various ways[5]. Attention to the language communication skills of nursing staff is relatively high, as it can affect not only the patients’ psychological state, but also the effectiveness of nursing care and patient satisfaction[6-10]. Therefore, hospitals are gradually applying this in clinical nursing. Focused psychological nursing is a new nursing model with a strong specificity that aims to improve the psychological state of patients and implement effective nursing measures. At present, the role of patient-nurse communicative language combined with focused psychological nursing in patients undergoing gastrointestinal surgery is unclear and has a certain research value. This study aimed to explore the impact of patient-nurse communicative language combined with focused psychological nursing on psychological and physiological stress responses and complications in patients undergoing gastrointestinal surgery. The study selected 80 patients undergoing gastrointestinal surgery for analysis, with the specific content detailed in the following text.

MATERIALS AND METHODS

General information

Patient selection and randomization: A total of 80 patients scheduled to undergo gastrointestinal surgery at the Northern Jiangsu People's Hospital from October 2021 to August 2024 were randomly selected for the study. The randomization process was performed using a computer-generated random number sequence to ensure an unbiased allocation of patients to either the observation or control group, with 40 patients in each group. Allocation concealment was maintained using sequentially numbered opaque sealed envelopes. Additionally, to minimize bias, the outcome assessors were blinded to the group assignments throughout the study. The study period was chosen to ensure a sufficient sample size and account for potential seasonal variations in surgical outcomes. All the included patients met the following inclusion criteria: (1) Undergoing gastrointestinal surgery; (2) Having normal language expression ability, normal hearing function, and the ability to communicate normally with others; (3) Having relatively stable conditions that did not require emergency surgery; and (4) Providing informed consent along with their families. Patients were excluded from the study if they met any of the following criteria: (1) Having combined heart, liver, kidney, or other organ dysfunctions; (2) Having cognitive function abnormalities that would prevent them from cooperating with the study; (3) Having received other psychological nursing interventions in the recent past; or (4) Being pregnant or breastfeeding women. In the control group, there were 21 male and 19 female patients; the age range was 29-61 years, with a mean age of 45.27 ± 5.63 years; the disease types included colorectal cancer in 21 cases, gastric cancer in 14 cases, and other types in 5 cases. In the observation group, the ratio of male to female patients was 22: 18; the age range was 28-62 years, with a mean age of 45.36 ± 5.40 years; the disease types included colorectal cancer, gastric cancer, and other types in 20, 15, and 5 cases, respectively. There were no significant differences in the clinical data between the two groups (P > 0.05).

Methods

Control group: The control group received routine nursing care, which included the following measures: (1) Health education. Before surgery, patients were educated one-on-one and face-to-face about knowledge related to their disease and gastrointestinal surgery, such as the causes, risks of the disease, and the role of gastrointestinal surgery. The patients were also briefly informed about the surgical procedures; and (2) Indicator monitoring. The nursing staff guided and assisted patients in completing various preoperative checks and explained the significance of each test.

Observation group: The observation group received patient-nurse communicative language combined with focused psychological nursing as follows.

Effective preoperative communication: (1) Clarifying communication points. Nursing staff needed to comprehensively understand the patient's medical condition, personal background, and personality traits. They communicated with patients using gentle language to understand their concerns such as lack of disease knowledge, worries about the effectiveness of gastrointestinal surgery, and postoperative complications; and (2) Preoperative Rounds. The nursing staff adhered to the principles of courtesy and respect toward patients. They provided full accompaniment to the patients, introduced the operating room environment to the patients and their families, understood the patients' needs, and tried to meet them as much as possible. When conducting health education, different communication methods were selected based on the patient's educational level and understanding: For patients with relatively high educational levels, professional terminology can be used to explain the necessity, advantages, and disadvantages of surgery. For patients with lower educational levels, simple and understandable language was used to inform them about the gastrointestinal surgery process, postoperative precautions, common complications, and coping methods, as well as how to cooperate.

For older patients, the nursing staff needed to be patient and gentle, speak slowly, and repeat gastrointestinal surgery-related information as needed.

Preoperative focused psychological nursing: (1) Open-ended psychological nursing. The nursing staff introduced the hospital and ward environment to the patients, informed them about the relevant rules and regulations, and provided information about the medical staff. They inquired about any unhealthy habits that patients may have, such as irregular eating, and explained the importance of active cooperation in gastrointestinal surgery. They also shared success stories of patients who underwent gastrointestinal surgery to build confidence in fighting the disease; (2) Heuristic psychological nursing. Nurses encouraged patients to ask questions such as why they developed gastrointestinal diseases, how to alleviate them, and the role of gastrointestinal surgery. They strengthened their communication with the patients, patiently answered their questions, and provided encouragement; (3) Discussion-based psychological nursing. Nursing staff actively communicated with patients, assessed their psychological state, and discussed potential issues that may arise during gastrointestinal surgery, such as complications, based on the patient's psychological state and behavioral habits. They conducted in-depth discussions on topics of mutual interest and facilitate interactions among patients with similar conditions, thereby encouraging mutual support and learning; and (4) Coordinated nursing. Nursing staff accompanied patients along with their family and friends and guided them to participate in recreational activities, such as watching videos, playing chess, and taking walks.

Effective communication during surgery: Before surgery, the nursing staff reiterated the surgical process to the patient using a gentle and consultative tone to gain the patient's approval and cooperation. They explained the potential adverse effects of anesthesia and used body language to encourage patients, such as providing affirming looks and physical reassurance.

Effective communication after surgery: After the patient awakened from the surgery, if a body part or organ could not be preserved, the nursing staff maintained a natural demeanor and avoided any language or actions that might have affected the patient's emotions. They encouraged the patient to face reality positively and explained how to identify and deal with complications such as wound infection, abdominal distension, and adhesive intestinal obstruction. They also closely monitored the patient's postoperative conditions.

Observational indicators

(1) Psychological stress response: The Connor-Davidson Resilience Scale (CD-RISC) was used to assess psychological resilience before and after the completion of nursing care. The scale includes three dimensions: Tenacity, strength, and optimism, with 25 items, each scored from 0 to 4, for a total score range of 0 to 100. Higher scores indicated better psychological resilience and stronger stress capabilities; (2) Physiological Stress Response: Heart rate and mean arterial pressure levels were recorded 24 hours before surgery and when the patient was awake after surgery; (3) Coping styles: The Medical Coping Modes Questionnaire (MCMQ) was used to assess coping styles before and after the completion of nursing care. The content includes three subscales: Confrontative (7 items), avoidant (5 items), and submissive (8 items), with total scores ranging from 0 to 80. Higher confrontative scores and lower avoidant and submissive scores indicated better coping styles; (4) Health behaviors: The health promotion lifestyle profile II (HPLP-II) was used to evaluate health behaviors before and after the completion of nursing care. The content included six dimensions: Stress management, nutrition, etc., with 52 items, each scored from 1 to 4 for a total score range of 52 to 208. Higher scores indicated better health behaviors; (5) Complications: Complications, such as wound infection, abdominal distension, and adhesive intestinal obstruction, were recorded; and (6) Nursing satisfaction: After completion of nursing care, a hospital-developed patient nursing satisfaction survey was used to assess satisfaction. The survey included four dimensions: Rationality of the nursing plan application, nursing skill proficiency, nursing service attitude, and degree of responsibility. Each item is scored from 0 to 3, with 0 being dissatisfied, 1 being average, 2 being fairly satisfied, and 3 being very satisfied. The Cronbach’s α coefficient of the scale is 0.846.

Statistical analysis

Statistical analysis was performed using SPSS version 22.0. The specific statistical test methods and selection rationale were as follows: Categorical data were expressed as n (%), and the χ² test was used for intergroup comparisons. A corrected χ² test was applied when n > 30 or < 5. The χ² test is a commonly used method for analyzing categorical data and is suitable for comparing differences in proportions or rates between groups, particularly when the sample size is sufficiently large. In this study, the χ² test was used to compare the incidence of complications between the two groups. However, when the sample size was small or the expected frequencies in the contingency table were low, Fisher's exact test was used. Fisher's exact test calculates the exact probability of data distribution based on the contingency table, making it more suitable for small sample sizes or cases with cell counts less than 5, providing more accurate results. In this study, Fisher's exact test was used to analyze the incidence of complications such as wound infection and abdominal distension.

For quantitative data (mean ± SD) with normal distribution, t-tests were used for both intergroup and intragroup comparisons. The t-test is one of the most widely used statistical methods for comparing the means of two groups. It assumes that the data follow a normal distribution and have equal variance. In this study, a t-test was used to compare psychological and physiological stress responses, coping styles, and health behaviors between the two groups. The rationale for choosing the t-test was that it could effectively detect differences in the means of quantitative data between the groups, thus providing a reliable basis for determining whether the differences in outcomes between the two groups were statistically significant.

The CD-RISC was used to assess psychological resilience. This scale has been widely recognized and applied in psychological research. It includes three dimensions: Tenacity, strength, and optimism, with a total score ranging from 0 to 100. Higher scores indicated better psychological resilience and stronger stress-coping abilities. The CD-RISC has been validated for reliability and validity in multiple studies and is suitable for evaluating psychological stress responses in patients undergoing gastrointestinal surgery, thereby providing a quantitative basis for assessing psychological states.

The MCMQ was used to evaluate coping styles. The MCMQ comprises three subscales: Confrontational, avoidant, and submissive, with total scores ranging from 0 to 80. Higher confrontational scores and lower avoidant and submissive scores indicated better coping styles. This scale is widely used in medical research to assess how individuals cope with stressors. This study aimed to explore the impact of nursing interventions on patients' coping styles and offer insights into psychological adjustment following gastrointestinal surgery.

The HPLP-II scale was used to evaluate health behaviors. The HPLP-II includes six dimensions, such as stress management and nutrition, with 52 items. Each item is scored from 1 to 4, resulting in a total score ranging from 52 to 208. Higher scores reflect better health behaviors. This scale is a commonly used tool for assessing health-related lifestyle behaviors, with high reliability and validity. This study aimed to examine the effects of nursing interventions on patient health behaviors to provide a basis for promoting healthy lifestyles among postoperative patients. A P-value less than 0.05 was considered statistically significant.

RESULTS

Comparison of psychological stress reactions between groups

Before nursing care, there was no significant difference in psychological stress reaction scores between the two groups (P > 0.05). After nursing care, the CD-RISC scale scores of the observation group were significantly higher (P < 0.05), as shown in Table 1.

Table 1 Comparison of psychological stress responses between the two groups (mean ± SD, score).

Group	Cases	Diligence			Self-improvement		Optimistic
		Before		After	Before	After	Before	After
Observation	40	23.22 ± 1.08	30.14 ± 2.78		17.59 ± 1.11	23.42 ± 1.29	7.66 ± 0.74	12.78 ± 1.11
Control	40	23.57 ± 1.43	27.04 ± 2.15		17.36 ± 1.20	21.05 ± 1.34	7.59 ± 0.68	11.16 ± 1.04
t		1.235	5.579		0.890	8.059	0.441	6.736
P value		0.220	< 0.001		0.376	< 0.001	0.661	< 0.001

Comparison of the physiological stress response between the two groups

At 24 hours before surgery, there was no significant difference in heart rate and mean arterial pressure level between the two groups (P > 0.05); however, when awake, the observation group was low (P < 0.05), as shown in Table 2.

Table 2 Comparison of physiological stress responses between both groups (mean ± SD).

Group	Case	Heart rate (times/min)		MABP (kPa)
		24 hours before surgery	When awake after surgery	24 hours before surgery	When awake after surgery
Observation	40	77.01 ± 3.56	78.36 ± 2.98	11.14 ± 1.02	12.06 ± 1.26
Control	40	77.78 ± 3.50	81.14 ± 2.44	11.29 ± 1.14	13.45 ± 1.17
t		0.975	4.565	0.620	5.113
P value		0.332	< 0.001	0.537	< 0.001

MABP: Mean arterial blood pressure.

Compare the two groups

Before nursing, there was no significant difference in the scores of all study subjects (P > 0.05); however, after nursing, the MCMQ scores of the two groups were significantly different (P < 0.05) (Table 3).

Table 3 Comparison of coping methods between the two groups (mean ± SD, score).

Group	Case	Face		Escape		Surrender
		Before	After	Before	After	Before	After
Observation	40	17.25 ± 1.40	23.64 ± 1.52	16.94 ± 1.24	12.11 ± 1.02	21.69 ± 2.63	15.32 ± 1.41
Control	40	17.36 ± 1.29	20.06 ± 1.44	16.79 ± 1.30	13.59 ± 1.14	21.54 ± 2.44	17.05 ± 1.29
t		0.365	10.814	0.528	6.119	0.264	5.725
P value		0.716	< 0.001	0.599	< 0.001	0.792	< 0.001

Comparison of health behaviors between the two groups

Before care, the health behavior scores of the different groups were not significantly different (P > 0.05); however, after care, the HPLP scores in the observation group were relatively high (P < 0.05), as shown in Table 4.

Table 4 Comparison of two groups (mean ± SD, score).

Group	Case	HPLP-II
		Before	After
Observation	40	104.25 ± 6.77	133.61 ± 10.25
Control	40	104.39 ± 6.45	121.12 ± 10.16
t		0.095	5.473
P value		0.925	< 0.001

HPLP-II: Health promotion lifestyle profile II.

Comparison of complications between the two groups

The incidence of the incision infection and abdominal distension varied significantly between the two groups (P < 0.05), as shown in Table 5 comparison of care satisfaction between both groups.

Table 5 Comparison of complication occurrence between the two groups, n (%).

Group	Case	Infection of incisional wound	Ventosity	Adhesive ileus	Total incidence
Observation	40	1 (2.50)	0 (0.00)	0 (0.00)	1 (2.50)
Control	40	4 (10.00)	4 (10.00)	0 (0.00)	8 (20.00)
Correction χ2					4.507
P value					0.034

The satisfaction with care in the observation group was 95.00%, which was higher than the 80.00% in the control group (P < 0.05), as shown in Table 6.

Table 6 Comparison of nursing satisfaction between the two groups, n (%).

Group	Case	Very satisfied	More satisfied	Commonly	Unsatisfied	Degree of satisfaction
Observation	40	19 (47.50)	16 (40.00)	3 (7.50)	2 (5.00)	38 (95.00)
Control	40	12 (30.00)	14 (35.00)	6 (15.00)	8 (20.00)	32 (80.00)
χ2						4.114
P value						0.043

DISCUSSION

Gastrointestinal surgery is a vital procedure for treating various gastrointestinal diseases such as colorectal and gastric cancers; it has become a common surgical procedure in clinical practice[11,12]. However, owing to the invasiveness of surgery and the stress it places on the body, patients are prone to psychological and physiological stress responses that can impact surgical outcomes and recovery. Therefore, effective nursing interventions are crucial to improve patient outcomes and enhance the overall quality of care[13-15].

In recent years, the focus of nursing care has shifted from being "disease-centered" to "patient-centered," emphasizing the importance of communication skills and psychological support in nursing practice[16]. The integration of patient-nurse communicative language and focused psychological nursing represents a response to this paradigm shift that aims to address both the physical and psychological needs of patients and improve their recovery outcomes[17-20].

The results of this study demonstrated that the combination of patient-nurse communicative language and focused psychological nursing can significantly enhance the psychological resilience of patients undergoing gastrointestinal surgery[21]. This approach not only helps patients better understand their condition and the surgical process, but also provides them with the necessary psychological support to cope with the stress associated with surgery[22]. Thus, it can potentially improve overall surgical outcomes and patient satisfaction[23].

The study found that after nursing care, the observation group had significantly higher CD-RISC scale scores (P < 0.05), and upon postoperative awakening, the observation group had lower heart rate and mean arterial pressure levels (P < 0.05). These results indicate that a combination of patient-nurse communication and focused psychological nursing can help improve psychological and physiological stress responses in patients undergoing gastrointestinal surgery[24]. Patient-nurse communicative language can clarify the key points of communication, allowing nursing staff to use the art of language to implement effective nursing measures, respect and understand patients, meet their needs as much as possible, and enhance patients' trust in nursing staff, thereby increasing their cooperation[25].

Focused psychological nursing is a patient-centered psychological nursing model that focuses on the inner experiences and emotional needs of patients and improves their psychological state through various interventions. The combination of patient-nurse communicative language and focused psychological nursing used in this study divided nursing into preoperative, intraoperative, and postoperative stages[26]. Preoperative nursing includes effective communication and focused psychological nursing, with the former establishing a good relationship with patients by clarifying communication points and preoperative visits and enhancing patients' trust in the nursing staff, which can alleviate patients' negative emotions to a considerable extent. In focused psychological nursing before surgery, open-ended, heuristic, discussion-based, and coordinated psychological nursing are used to explain various factors, including the hospital and ward environment, and the hospital rules and regulations, further alleviating patients' negative emotions and reducing stress responses. During effective intraoperative communication, stress responses can be alleviated by explaining possible intraoperative situations and using body language to encourage patients. Finally, in effective postoperative communication, using a gentle and natural tone to communicate with patients can help reduce their sense of burden and, combined with preoperative and intraoperative nursing, can further improve the psychological and physiological stress responses of patients undergoing gastrointestinal surgery[27].

Gastrointestinal surgery is mainly used to treat diseases, such as colorectal and gastric cancers. Patients with this condition are prone to panic and helplessness. At the same time, owing to factors such as cultural level and living environment, patients have a relatively low cognition of gastrointestinal surgery-related knowledge, which affects their coping methods. The data from this study show that there was a significant difference in the MCMQ scale scores between the two groups after nursing care (P < 0.05), indicating that the combined nursing care in this study helped improve the coping methods of patients undergoing gastrointestinal surgery. In effective communication before surgery, combined with patient-nurse communicative language, nursing staff should fully understand the patients' conditions and accompany them throughout the process[28]. For patients with different cultural levels, different communication methods were used to explain gastrointestinal surgery-related knowledge, enhance their cognition of surgery, and improve their coping methods. In focused psychological nursing before surgery, various psychological nursing methods, such as introducing the hospital and medical staff; encouraging patients to think and ask questions; guiding patients to communicate with peers; enhancing patients' understanding of the hospital, disease, and surgery; alleviating their panic; and encouraging them to face the disease and gastrointestinal surgery with the correct attitude, can also improve their coping methods[29].

The data in Table 4 show that the observation group had higher HPLP-II scores after nursing care (P < 0.05), indicating that the combination of patient-nurse communicative language and focused psychological nursing can improve the health behaviors of patients undergoing gastrointestinal surgery. During preoperative visits for effective communication before surgery, communicating with patients in a gentle manner, understanding their needs and satisfying them, and using different communication methods to explain the process of gastrointestinal surgery and postoperative precautions can enhance patients' cognition of gastrointestinal surgery and help improve their health behaviors.

Patients undergoing gastrointestinal surgery are prone to complications such as abdominal distension and wound infection due to the surgery, which affect their prognosis. This study found that the incidence of complications such as wound infection and abdominal distension in the observation group was relatively low (P < 0.05), indicating that the combination of patient-nurse communicative language and focused psychological nursing can help reduce the risk of complications in patients undergoing gastrointestinal surgery[30]. In the nursing methods used in the observation group, explaining possible complications, coping, and cooperation methods in effective communication before surgery could enhance patient cooperation, allowing medical staff to maximize the effectiveness of their work, thereby reducing the risk of complications. In this study, the observation group had higher nursing satisfaction than the control group (P < 0.05). This is because the combination of patient-nurse communicative language and focused psychological nursing is centered on the patient, implementing various nursing measures and focusing on establishing a good nurse-patient relationship through gentle communication, allowing patients to feel the care and love of the nursing staff. Combined with various psychological nursing measures, it can alleviate negative emotions, maintain the stability of patients' psychological states, reduce the impact of negative emotions on surgery and postoperative recovery, and improve patient satisfaction with nursing care.

This study has some limitations. First, it included only 80 patients from a single hospital, which may have limited the generalizability of the findings to a broader population. Second, the study focused on immediate postoperative outcomes and nursing satisfaction but did not assess long-term health outcomes or patient quality of life. Long-term follow-up studies are required to evaluate the sustained effects of combined nursing interventions. Third, while the study controlled for several variables, it is unclear how other factors, such as socioeconomic status, education level, and pre-existing psychological conditions, were managed. Future studies should consider these factors to provide a more comprehensive understanding of their potential impacts on outcomes. Fourth, we excluded patients with cognitive impairment or other psychological conditions that may not reflect the typical patient population undergoing gastrointestinal surgery. Research including a more diverse patient population would enhance the applicability of these findings. Lastly, although the study mentions "focused psychological nursing," it does not provide detailed descriptions of the specific techniques or interventions used. Future research should focus on the specific components of nursing interventions to allow for better replication and application in clinical practice.

Compared to similar studies, this study stands out in its integrated approach to nursing intervention, combining patient-nurse communicative language with focused psychological nursing. While previous studies have explored various nursing strategies for patients undergoing gastrointestinal surgery, the combination used in this study offers a more holistic approach to address both the psychological and physiological aspects of patient care. The significant improvements in stress responses, coping styles, health behaviors, and nursing satisfaction observed in this study highlight the potential benefits of this integrated approach. However, further research is required to confirm the universality and applicability of these findings to different healthcare settings and patient populations.

In conclusion, this study demonstrated that the combination of patient-nurse communicative language and focused psychological nursing significantly improved psychological and physiological stress responses, health behaviors, and coping strategies of patients undergoing gastrointestinal surgery. It also enhanced nursing satisfaction and reduced the risk of complications, thus confirming the effectiveness and ideal outcomes of the nursing model in clinical practice. Future research should address the limitations identified in this study, such as expanding the sample size, including diverse patient populations, and assessing long-term outcomes to further strengthen the evidence base for this nursing intervention.

CONCLUSION

In summary, this study demonstrated that the combination of patient-nurse communicative language and focused psychological nursing significantly improved psychological and physiological stress responses, health behaviors, and coping strategies of patients undergoing gastrointestinal surgery. It also enhanced nursing satisfaction and reduced the risk of complications, confirming the effectiveness and ideal outcomes of this nursing model in clinical practice.