Influences of Resilience and Social Support on Postoperative Recovery among Patients with Gastrointestinal Cancer

Young Man Kim; Hye Jeong Jung; Eui Geum Oh

doi:10.7475/kjan.2017.29.4.432

Journal List > Korean J Adult Nurs > v.29(4) > 1096353

Go to TopGo to Top Go to BottomGo to Bottom

TOOLS

Kim, Jung, and Oh: Influences of Resilience and Social Support on Postoperative Recovery among Patients with Gastrointestinal Cancer

Original Article

Korean J Adult Nurs 2017;29(4):432-440.

Published online: 9 August 2017

DOI: https://doi.org/10.7475/kjan.2017.29.4.432

Influences of Resilience and Social Support on Postoperative Recovery among Patients with Gastrointestinal Cancer

Young Man Kim, MSN, RN¹, Hye Jeong Jung, MSN, RN¹, Eui Geum Oh, Ph.D., RN, FAAN^2,

¹College of Nursing, Yonsei University, Seoul, Korea

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

Corresponding author: Oh, Eui Geum College of Nursing, Yonsei University, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Korea. Tel: +82-2-2228-3256, Fax: +82-2-392-5440, E-mail: euigeum@yuhs.ac

Received 26 June 201717 August 2017 Accepted 26 August 2017

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 investigate patients’ perceived postoperative recovery over time and to identify the influences of resilience and social support on postoperative recovery among patients with gastrointestinal cancer.

Methods

101 patients with GI cancer who underwent surgery at S tertiary hospital were recruited from October 29th, 2015 to January 19th, 2016. Data was collected 3 times at postoperative day (POD)3, and POD5 in the hospital and at POD14 at home. Statistical analyses used were descriptive statistics, t-test, ANOVA, ANCOVA, correlation, and linear mixed model.

Results

The patients’ perceived postoperative recovery(reverse cording) decreased at home rather than time during hospital stay (POD3: 16.70, POD5: 15.74, POD14: 17.08). Postoperative recovery at POD5 showed negative correlation with resilience (r=-.36, p=.002). Postoperative recovery scores at POD14 were negatively correlated with resilience (r=-.60, p<.001) and social support (r=-.34, p=.019). There was a positive correlation (r=-.36, p=.002) between resilience and social support. Resilience was a significant associated factor with postoperative recovery over time (β=-0.29, p=.001).

Conclusion

Since the degree of postoperative recovery after hospital discharge was perceived lower than that of during hospital stay, nursing interventions such as nurse-led telephone follow-up programs should be applied during the transition period.

Keywords: Gastrointestinal neoplasms, Postoperative period, Recovery of function, Resilience, Psychological, Social support

REFERENCES

1. Statistics Korea. Cancer registration statistics [Internet]. Seoul: Statistics Korea;2014. [cited 2017 June 26]. Available from:. https://kosis.kr/eng/statisticsList/statisticsList_01List.jsp?vwcd=MT_ETITLE&parentId=D.

2. Aloia TA, Zimmitti G, Conrad C, Gottumukalla V, Kopetz S, Vauthey JN. Return to intended oncologic treatment (RIOT): a novel metric for evaluating the quality of oncosurgical therapy for malignancy. Journal of Surgical Oncology. 2014; 110(2):107–14. https://doi.org/10.1002/jso.23626.

3. Allvin R, Berg K, Idvall E, Nilsson U. Postoperative recovery: a concept analysis. Journal of Advanced Nursing. 2007; 57(5):552–8. https://doi.org/10.1111/j.1365-2648.2006.04156.x.

4. Myles PS, Weitkamp B, Jones K, Melick J, Hensen S. Validity and reliability of a postoperative quality of recovery score: the QoR-40. British Journal of Anaesthesia. 2000; 84(1):11–5. https://doi.org/10.1093/oxfordjournals.bja.a013366.

5. Pöpping DM, Zahn PK, Van Aken HK, Dasch B, Boche R, Pogatzki-Zahn EM. Effectiveness and safety of postoperative pain management: a survey of 18 925 consecutive patients between 1998 and 2006 (2nd revision): a database analysis of pro-spectively raised data. British Journal of Anaesthesia. 2008; 101(6):832–40. https://doi.org/10.1093/bja/aen300.

6. Allvin R, Ehnfors M, Rawal N, Idvall E. Experiences of the postoperative recovery process: an interview study. The Open Nursing Journal. 2008; 2:1–7. https://doi.org/10.2174/1874434600802010001.

7. Allvin R, Svensson E, Rawal N, Ehnfors M, Kling AM, Idvall E. The Postoperative Recovery Profile (PRP) - a multidimensional questionnaire for evaluation of recovery profiles. Journal of Evaluation in Clinical Practice. 2011; 17(2):236–43. https://doi.org/10.1111/j.1365-2753.2010.01428.x.

8. Wagnild GM, Young HM. Development and psychometric evaluation of the Resilience Scale. Journal of Nursing Measurement. 1993; 1(2):165–78.

9. Eicher M, Matzka M, Dubey C, White K. Resilience in adult cancer care: an integrative literature review. Oncology Nursing Forum. 2015; 42(1):E3–16. https://doi.org/10.1188/15.ONF.E3-E16.

10. Choi KS, Park JA, Lee JH. The effect of symptom experience and resilience on quality of life in patients with colorectal cancers. Asian Oncology Nursing. 2012; 12(1):61–8. https://doi.org/10.5388/aon.2012.12.1.61.

11. Lee EK. A study on factors affecting cancer patients. The Journal of Korean Academic Society of Nursing Education. 2007; 13(1):52–8.

12. Chan CW, Hon HC, Chien WT, Lopez V. Social support and coping in Chinese patients undergoing cancer surgery. Cancer Nursing. 2004; 27(3):230–6.

13. Lee EJ, Yoon JH, Park DH, Park DL. Performance status and resilience in patients with colorectal cancer. Asian Oncology Nursing. 2013; 13(4):273–9. https://doi.org/10.5388/aon.2013.13.4.273.

14. Jo HS, Kim BG, Lee HJ, Lee BY. Perceived social support as influencing factors on quality of life among cancer patients. Korean Journal of Health Education and Promotion. 2010; 27(4):51–9.

15. Forsberg A, Vikman I, Wälivaara BM, Engström Å. Patients' perceptions of their postoperative recovery for one month. Journal of Clinical Nursing. 2015; 24(13-14):1825–36. https://doi.org/10.1111/jocn.12793.

16. Ljungqvist O, Scott M, Fearon KC. Enhanced recovery after surgery: a review. JAMA Surgery. 2017; 152(3):292–8. https://doi.org/10.1001/jamasurg.2016.4952.

17. Oh HK, Ihn MH, Son IT, Park JT, Lee J, Kim DW, et al. Factors associated with failure of enhanced recovery programs after laparoscopic colon cancer surgery: a single-center retrospective study. Surgical Endoscopy. 2016; 30(3):1086–93.

18. Allvin R, Ehnfors M, Rawal N, Svensson E, Idvall E. Development of a questionnaire to measure patient-reported postoperative recovery: content validity and intra-patient reliability. Journal of Evaluation in Clinical Practice. 2009; 15(3):411–9. https://doi.org/10.1111/j.1365-2753.2008.01027.x.

19. Zimet GD, Dahlem NW, Zimet SG, Farley GK. The multidimensional scale of perceived social support. Journal of Personality Assessment. 1988; 52(1):30–41. https://doi.org/10.1207/s15327752jpa5201_2.

20. Twisk JW. Applied longitudinal data analysis for epidemiol-ogy-a practical guide. 2nd ed.Cambridge: Cambridge University Press;2003. p. 57–9.

21. Allvin R, Kling AM, Idvall E, Svensson E. Patient Reported Outcome Measures (PROMs) after total hip- and knee replacement surgery evaluated by the Postoperative Recovery Profile questionnaire (PRP) - improving clinical quality and person- centeredness. International Journal of Person Centered Medicine. 2012; 2(3):368–76.

22. Weiss ME, Piacentine LB, Lokken L, Ancona J, Archer J, Gres-ser S, et al. Perceived readiness for hospital discharge in adult medical-surgical patients. Clinical Nurse Specialist. 2007; 21(1):31–42.

23. Kelly MA, McKinley S. Patients' recovery after critical illness at early follow-up. Journal of Clinical Nursing. 2010; 19(5-6):691–700. https://doi.org/10.1111/j.1365-2702.2009.03117.x.

24. Oh EG, Lee HJ, Kim Y, Sung JH, Park YS, Yoo JY, et al. Current status of home visit programs: activities and barriers of home care nursing services. Journal of Korean Academy of Nursing. 2015; 45(5):742–51. https://doi.org/10.4040/jkan.2015.45.5.742.

25. Kim SY. Influential factors on quality of recovery of patients undergone cardiac surgery. The Korean Journal of Rehabili-tation Nursing. 2014; 17(2):64–71.

26. Royse CF, Williams Z, Ye G, Wilkinson D, De Steiger R, Richardson M, et al. Knee surgery recovery: Post-operative Quality of Recovery Scale comparison of age and complexity of surgery. Acta Anaesthesiologica Scandinavica. 2014; 58(6):660–7. https://doi.org/10.1111/aas.12273.

27. Kan EZ. Perceptions of recovery, physical health, personal meaning, role function, and social support after first-time cor-onary artery bypass graft surgery. Dimensions of Critical Care Nursing. 2009; 28(4):189–95. https://doi.org/10.1097/DCC.0b013e3181a471eb.

28. Everhart JS, Best TM, Flanigan DC. Psychological predictors of anterior cruciate ligament reconstruction outcomes: a systematic review. Knee Surgery, Sports Traumatology, Arthro-scopy. 2015; 23(3):752–62. https://doi.org/10.1007/s00167-013-2699-1.

29. Molina Y, Yi JC, Martinez-Gutierrez J, Reding KW, Yi-Frazier JP, Rosenberg AR. Resilience among patients across the cancer continuum: diverse perspectives. Clinical Journal of Oncology Nursing. 2014; 18(1):93–101. https://doi.org/10.1188/14.CJON.93-101.

30. Shih TH, Fan X. Comparing response rates in e-mail and paper surveys: a meta-analysis. Educational Research Review. 2009; 4(1):26–40. https://doi.org/10.1016/j.edurev.2008.01.003.

Table 1.

General and Surgery related Characteristics of Participants (N=101)

Characteristics	Categories	n (%) or M± SD
Gender	Male	49 (48.5)
Gender	Female	52 (51.5)
Age (year)	≤54	57.16±12.3131 (30.7)
	55~64	40 (39.6)
	≥65	30 (29.7)
Marital status	Single	5 (5.0)
	Married	90 (89.1)
	Widowed	6 (5.9)
Occupation	Yes	46 (45.5)
Occupation	No	55 (54.5)
Education completed	≤ Junior high school	23 (22.8)
	High school	38 (37.6)
	≥ College	40 (39.6)
Diagnosis	Stomach cancer	58 (57.4)
Diagnosis	Colorectal cancer	43 (42.6)
Type of surgery	Laparoscopic surgery	80 (79.2)
Type of surgery	Open surgery	21 (20.8)
ASA classification	I	17 (16.8)
	II	60 (59.4)
	III	24 (23.8)

ASA classification=American Society of Anesthesiologists physical status classification.

Table 2.

Resilience and Social Support according to Participants' Characteristics (N=82)

Variables	Categories	Resilience		Social support
Variables	Categories	M± SD	t or F (p)	M± SD	t or F (p)
Age (year)	≤54 ^a	96.13±10.55	1.15 (.321)	73.82±8.86	4.29 (.017)
	55~64 ^b	92.06±8.73		69.44±9.46	a＞ c
	≥65 ^c	93.22±11.34		65.44±10.95
Gender	Male	95.16±10.71	1.29 (.200)	69.75±10.54	-0.29 (.773)
Gender	Female	92.16±9.19		70.40±9.56
Occupation	Yes	97.03±10.42	2.87 (.005)	71.30±9.39	1.10 (.276)
Occupation	No	90.64±8.73		68.85±10.55
Diagnosis	Stomach cancer	94.80±10.95	1.09 (.278)	70.30±9.58	0.22 (.829)
Diagnosis	Colorectal cancer	92.24±8.70		69.81±10.63
Type of surgery	Laparoscopic	93.93±10.30	0.44 (.664)	69.79±10.18	-0.48 (.631)
Type of surgery	Open	92.68±9.23		71.12±9.53
ASA classification	I	97.36±13.13	0.88 (.420)	70.15±8.73	0.33 (.721)
	II	93.00±8.74		70.69±10.64
	III	93.05±10.94		68.47±9.44

ASA classification=American Society of Anesthesiologists physical status classification.

Table 3.

Postoperative Recovery according to Participants' Characteristics and over Time (N=101)

Variables	Categories	POD 3 (n=101)		POD 5 (n=81)		POD 14 (n=52)
Variables	Categories	M± SD	t or F (p)	M± SD	t or F (p)	M± SD	t or F (p)
Age (year)	≤54 ^a	20.67±9.76	4.74 (.011)	17.93±10.16	0.87 (.425)	14.14±8.96	1.73 (.189)
	55~64 ^b	15.66±7.08	a＞ c	15.32±9.41		17.78±6.29
	≥65 ^c	14.34±8.58		14.24±10.83		20.10±12.74
Gender	Male	16.87±9.78	0.06 (.950)	15.83±9.93	-0.17 (.866)	16.67±11.37	0.02 (.982)
Gender	Female	16.76±7.75		16.21±10.14		16.61±5.80
Occupation	Yes	15.60±9.20	1.28 (.205)	14.46±9.37	1.37 (.174)	13.04±7.41	3.31 (.002^∗)
Occupation	No	17.87±8.29		17.53±10.42		20.87±9.32
Diagnosis	Stomach cancer	15.39±7.71	-1.95 (.054)	15.81±8.45	-0.19 (.852)	14.10±8.19	-2.42 (.020)
Diagnosis	Colorectal cancer	18.85±9.79		16.25±11.65		20.14±9.43
Type of surgery	Laparoscopic	17.40±9.30	1.80 (.078)	15.87±9.85	-0.24 (.815)	16.85±9.50	0.32 (.749)
Type of surgery	Open	14.42±5.54		16.50±10.65		15.80±7.96
ASA classification	I	16.29±6.56	0.93 (.400)	15.92±4.94	0.00 (.999)	12.45±3.72	2.31 (.111)
	II	17.75±9.82		16.00±11.04		16.79±10.38
	III	14.87±7.14		16.11±9.87		20.80±8.02
Postoperative recovery		16.81±8.75		16.01±9.97		16.64±9.15
Estimated postoperative recovery		16.70		15.74		17.08
a, b, c= Scheffé test; POD=postoperative day; ASA classification=American Society of Anesthesiologists physical status classification;

^∗ Postoperative recovery at POD14 was not statistically significant after adjusted for age of participants (F=0.00, p=.883).

Table 4.

Correlations among Resilience, Social Support, and Postoperative Recovery in Patients with GI Cancer (N=101)

Variables	POD 5	POD 14	Social support	Resilience
Variables	r (p)	r (p)	r (p)	r (p)
POD 3	.53 (＜.001)	.35 (.017)	.08 (.522)	-.10 (.397)
POD 5	1	.33 (.022)	-.16 (.172)	-.36 (.002)
POD 14		1	-.34 (.019)	-.60 (＜.001)
Social support			1	.31 (.008)

GI=gastrointenstinal; POD=postoperative day.

Table 5.

Factors affecting Postoperative Recovery over Time (N=101)

Variables	Categories	Model 1			Model 2
Variables	Categories	β	SE	t (p)	β	SE	t (p)
(Intercept)		48.49	9.05	5.36 (＜.001)	44.28	8.18	5.41 (＜.001)
Resilience		-0.28	0.92	-3.10 (.001)	-0.29	0.87	-3.39 (.001)
POD (ref: 3)	5	-1.01	1.18	-0.86 (.790)	-0.97	1.16	-0.83 (.790)
	14	0.26	1.44	0.18 (.406)	0.37	1.40	0.27 (.406)
Age (ref: ≥65)	≤54	4.80	2.38	2.02 (.048)
	55~64	1.12	2.25	0.50 (.619)
Diagnosis (ref: colorectal cancer)	Stomach cancer	-2.61	1.74	-1.50 (.139)
Social support		-0.08	0.09	-0.87 (.389)

POD=postoperative day; ref.=reference.

TOOLS

Similar articles