The Effects of a Standardized Preoperative Education Program on Stomach Cancer Patients undergoing Gastrectomy

Min Ah Yun; So Sun Kim; SangHee Kim; Sung Hoon Noh

doi:10.5388/aon.2016.16.2.85

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Yun, Kim, Kim, and Noh: The Effects of a Standardized Preoperative Education Program on Stomach Cancer Patients undergoing Gastrectomy

Original Article

Asian Oncology Nursing 2016; 16(2): 85-93.

Published online: 30 June 2016

DOI: https://doi.org/10.5388/aon.2016.16.2.85

The Effects of a Standardized Preoperative Education Program on Stomach Cancer Patients undergoing Gastrectomy

Min Ah Yun¹, So Sun Kim², SangHee Kim², Sung Hoon Noh³

¹Severance Hospital, Yonsei University Health System, Seoul, Korea.

²Yonsei University College of Nursing & Mo-Im Kim Nursing Research Institute, Seoul, Korea.

³Department of Surgery, Yonsei University College of Medicine, Seoul, Korea.

Address reprint requests to: Yun, Min Ah. Severance Hospital, Yonsei University Health System, 50-1, Yonsei-ro, Seodaemun-gu, Seoul 03722, Korea. Tel: +82-2-2227-3620, Fax: +82-2-313-8289, lirlu@naver.com

Received 22 May 2016 Revised 26 June 2016 Accepted 27 June 2016

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

The purpose of this study was to identify the effects of a standardized preoperative education program on self-care knowledge, performance, satisfaction, and physical recovery in the stomach cancer patients undergoing gastrectomy.

Methods

A nonequivalent control group non-synchronized design was utilized and 63 participants who underwent gastrectomy (31 for experimental group, 32 for control group) were recruited at a university hospital from May to August 2015.

Results

There were significant differences between the groups in self-care knowledge (F=17.63, p<.001), performance (F=-9.25, p<.001) and satisfaction (F=-6.91, p<.001). Although the pain levels (F=974.57, p<.001) showed significant differences in each group and 3 time intervals (F=18.26, p<.001), there was no interaction of group and time (F=0.09, p=.917). The highest body temperature at 48 hours after surgery (F=1.32, p=.192), as well as presence of atelectasis (F=2.23, p=.213) indicating a chance of pulmonary complications, and the time of first gas pass (F=-1.05, p=.299), presence of paralytic ileus (F=0.13, p=.719) were not significantly differ.

Conclusion

The preoperative education program developed in this study can be utilized as a part of nursing interventions and be beneficial to patients who undergo stomach cancer surgery for their thorough understanding.

Keywords: Stomach Neoplasms, Patient Education, Self-Care, Recovery

Figures and Tables

Table 1

Demographic and Disease-related Characteristics (N=63)

Characteristics	Categories	Cont. (n=32)	Exp. (n=31)	χ² or t	p
Characteristics	Categories	n (%) or M±SD	n (%) or M±SD	χ² or t	p
Age (year)		56.4±11.4	59.3±9.9	0.75	.390
Gender	Male	23 (71.9)	20 (64.5)	0.39	.595^*
Gender	Female	9 (28.1)	11 (35.5)	0.39	.595^*
Education level	≤High school	21 (65.6)	19 (61.3)	0.13	.721^*
Education level	≥College	11 (34.4)	12 (38.7)	0.13	.721^*
ASA score		1.97±0.47	1.77±0.56	5.01	.029
History of abdominal surgery	Yes	11 (34.4)	6 (19.4)	1.80	.257^*
History of abdominal surgery	No	21 (65.6)	25 (80.6)	1.80	.257^*
Name of operation	RSTG Bl	10 (31.3)	11 (35.5)	3.40	.603^*
	RSTG Bll	0 (0.0)	1 (3.2)
	RSTG RY	7 (21.9)	5 (16.1)
	RTG	13 (40.6)	14 (45.2)
	Palliative GJ	2 (6.2)	0 (0.0)
Self-care knowledge	Pretest	8.56±2.71	9.48±2.23	2.77	.101

^*Chi-square test; Cont.= Control group; Exp.= Experimental group; ASA score= American Society of Anesthesiologist Physical status classification score; RSTG Bl= Radical subtotal gastrectomy with billoth l; RSTG Bll= Radical subtotal gastrectomy with billoth ll; RSTG RY= Radical subtotal gastrectomy with roux-en Y Gastrojejunostomy; RTG= Radical total gastrectomy with Roux-en-Y esophagojejunostomy; Palliative GJ= Palliative gastrojejunostomy.

Table 2

Comparison of Self-care Knowledge, Self-care Performance, Patient Satisfaction between Control Group and Experi-mental Group (N=63)

Variables	Categories	Cont. (n=32)	Exp. (n=31)		F or t	p
Variables	Categories	M±SD	M±SD		F or t	p
Self-care knowledge	Pretest	8.56±2.71	9.48±2.23	Group	24.15^*	<.001
	Posttest	11.25±1.97	14.68±0.54	Time	16.12^*	<.001
	Posttest	11.25±1.97	14.68±0.54	Group^*Time	17.63^*	<.001
Self-care performance	Posttest	3.18±0.48	3.95±0.07		-9.25	<.001
Patient satisfaction	Posttest	3.28±0.52	3.96±0.18		-6.91	<.001

^*ANCOVA with ASA score as a covariate; Cont.= Control group; Exp.= Experimental group.

Table 3

Comparison of Postoperative Physical Recovery between Control Group and Experimental Group (N=63)

Variables		Cont. (n=32)	Exp. (n=31)		χ² or t or F	p
Variables		n (%) or M±SD	n (%) or M±SD		χ² or t or F	p
Pain levels (VAS sore)	24 hr	4.63±1.58	4.42±1.43	Group	974.57^*	<.001
	48 hr	4.06±1.68	3.74±1.32	Time	18.26^*	<.001
	72 hr	3.16±1.44	3.03±1.25	Group^*Time	0.09^*	.917
Temperature (℃)		38.14±0.41	38±0.42		1.32^†	.192
Atelectasis	Yes	9 (28.1)	4 (12.9)		2.23^‡	.213
	No	23 (71.9)	27 (87.1)		1.32^†	.192
		38.14±0.41	38±0.42		2.23^‡	.213
		9 (28.1)	4 (12.9)
		23 (71.9)	27 (87.1)
Expelling of gas (hr)		86.28±14.4	91.06±21.27		-1.05^†	.299
Ileus	Yes	12 (48.0)	13 (47.4)		0.13^‡	.719
	No	20 (52.0)	18 (52.6)		-1.05^†	.299
		86.28±14.4	91.06±21.27		0.13^‡	.719
		12 (48.0)	13 (47.4)
		20 (52.0)	18 (52.6)

^*RepeatedmeasureANOVA;^†Two sample t-test; ^‡Chi-square test; Cont.= Control group; Exp.= Experimental group.

Notes

This article is a condensed form of the first author's master's thesis from Yonsei University.

References

1. National Cancer Center. Annual report of cancer statistics in Korea in 2012. Annual report. Seoul, Korea: National Cancer Center;2014.

2. Kim JE. A study of nutrition assessment and the analysis of the factors affecting malnutrition after subtotal gastrectomy of gastric cancer patients [master's thesis]. Seoul: Catholic Univ;2002.

3. Lee SS, Han SW, Jeong HY, Song JW, Chung HY, Yu W. Quality of life of long-term survivors after a subtotal or a total gastrectomy for gastric cancer. J Korean Gastric Cancer Assoc. 2010; 10(1):34–39.

4. Kim MS, Park JM, Choi YS, Cha SJ, Kim BG, Chi KC. Risk factors for complications following resection of gastric cancer. J Gastric Cancer. 2010; 10(3):118–125.

5. On~ate-Ocan~a LF, Corte´s-Ca´rdenas SA, Aiello-Crocifoglio V, Mondrago´n-Sa´nchez R, Ruiz-Molina JM. Preoperative multivariate prediction of morbidity after gastrectomy for adenocarcinoma. Ann Surg Oncol. 2000; 7(4):281–288.

6. Kim CJ, Park JW, Yun JS, Kim ON, Kwon YS, Lee HS. A study comparing the perception of patients, nurses, and doctors about the educational needs of cancer patients. Korean Nurse. 1989; 28(1):53–66.

7. Kim MO, Kim UK, Cho EY. The effects of Multimedia diet education on nutritional status in stomach neoplasms patient with gastrectomy. J Korean Clin Nurs Res. 2008; 14(1):45–59.

8. Cho EH, Hwang SY. Effects of the nurse-led discharge education on symptom experience and self-care compliance in patients with chronic obstructive pulmonary disease. Korean J Adult Nurs. 2011; 23(6):595–604.

9. Lee JA, Lee SH, Park JH, Park JH, Kim SG, Seo JH. Analysis of the factors related to the needs of patients with cancer. J Prev Med Public Health. 2010; 43(3):222–234.

10. Hur HK. Information needs of women with breast cancer. J Korean Acad Adult Nurs. 2000; 12(2):286–295.

11. Noh SH, Ryu CH. Can I live without the stomach. Seoul: Cultural History of Medicine;2003.

12. Ahn SH. The effects of individualized cardiac rehabilitation education on knowledge, self-efficacy and health behavior of patients with percutaneous coronary intervention(PCI) [master's thesis]. Seoul: Kyung-hee Univ;2013.

13. Garretson S. Benefits of pre-operative information programmes. Nurs Stand. 2004; 18(47):33–37.

14. Kim HS, Suh EY, Lee HJ, Yang HK. The effects of patient participationbased dietary intervention on nutritional and functional status for patients with gastrectomy: a randomized controlled trial. Cancer Nurs. 2014; 37(2):E10–E20.

16. Hong YL. Effect of preoperative educational DVD on postoperative self care knowledge and performance in lung cancer patient [master's thesis]. Seoul: Han-yang Univ;2007.

17. Jeon MK. Development of self-care performance scale for patients with stomach cancer after gastrectomy [dissertation]. Busan: Ko-sin Univ;2014.

18. Hur HK. Nurses' attitudes toward postoperative pain control. Korean J Adult Nurs. 1994; 6(2):236–250.

19. Haines KJ, Skinner EH, Berney S. The Austin Health POST Study Investigators. Association of postoperative pulmonary complications with delayed mobilization following major abdominal surgery: an observational cohort study. Physiotherapy. 2013; 99:119–125.

20. Mattei P, Rombeau JL. Review of the pathophysiology and management of postoperative ileus. World J Surg. 2006; 30(8):1382–1391.

21. Choi HJ. Comparative study between the patients' satisfaction level of nursing service and revisit intention of the inpatients according to the ward type [master's thesis]. Seoul: Sahm-yook Univ;2014.

22. Kim MS, Park KH. Effects of preoperative nursing education for patient with general anesthetic surgery. J Korean Data Anal Soc. 2012; 14(4):1975–1986.

23. White J, Dixon S. Nurse led patient education programme for patients undergoing a lung resection for primary cancer. J Thorac Dis. 2015; 7(S2):S131–S137.

24. Holman H, Lorig K. Patient self-management: a key to effectiveness and efficiency in care of chronic disease. Public Health Rep. 2004; 119(3):239–243.

25. Kim MY. Development and effects of a web-based self-efficacy promoting program on stomach cancer patients with gastrectomy [dissertation]. Seoul: Kosin Univ;2009.

26. Hermann F, Gunter FK, Andrea R, Paul P, Hubert A. Effectiveness of education for gastric cancer patients, a controlled prospective trial comparing interactive vs. lecture-based programs. Patient Educ Couns. 2009; 76(2009):91–98.

27. Na IJ, Lee BS. The effect of a telephone follow-up on the self-care and the satisfaction on nursing care in G-I surgical patients. J Korean Acad Nurs Adm. 1999; 5(2):355–368.

28. Park JS, Lee MH, Lee HR. Effects of preoperative pain management education on the control of postoperative pain, focused on the PCA used surgical patients with uterine tumor. J Korean Oncol Nurs. 2011; 11(2):108–115.

29. Kim SS, Sin JH. The effects of systemic pre-operative deep breathing & coughing education to post operative respiratory infection. J Korean Clin Nurs Res. 1997; 3(1):165–185.

30. Kim I, Lee HJ. Effects of a progressive walking program on physical activity, exercise tolerance, recovery, and post-operative complications in patients with a lung resection. J Korean Acad Nurs. 2014; 44(4):381–390.

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