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

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

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.

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Table 1.
General and Surgery related Characteristics of Participants (N=101)
Characteristics Categories n (%) or M± SD
Gender Male 49 (48.5)
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)
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)
Colorectal cancer 43 (42.6)
Type of surgery Laparoscopic surgery 80 (79.2)
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
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)
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)
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)
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)
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)
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)
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)
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)
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)
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
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
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.

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