Analysis of the application value and prognostic impact of comfort-oriented nursing in the operating room for gastric cancer patients with cancer-related insomnia
Abstract
Background: Cancer-related insomnia (CRI) is a prevalent and clinically significant comorbidity among patients with cancer, particularly among patients diagnosed with gastric cancer (GC). This condition not only causes erratic fluctuations in physiological parameters but also induces a series of symptoms, including fatigue, neurasthenia, and exacerbation of negative emotional states, thus disrupting the normal trajectory of treatment and hindering the recovery of patients. Objective: To evaluate the impact of comfort-oriented nursing in the operating room on the recovery outcomes of GC patients with concomitant CRI, thereby providing evidence-based insights for clinical decision-making. Methods: A total of 137 GC patients with CRI who were admitted to our institution between October 2022 and October 2023 were selected for this study. Of these patients, 72 patients who received routine nursing in the operating room composed the control group. The remaining 65 patients received comfort-oriented nursing in the operating room and composed the observation group. The postoperative gastrointestinal function recovery time was recorded in both groups. Additionally, the Pittsburgh Sleep Quality Index (PSQI) and the Self-rating Anxiety/Depression Scale (SAS/SDS) were utilized to assess sleep quality and the presence of negative emotional states, respectively. Moreover, patient postoperative pain and satisfaction with nursing care were surveyed. All the patients were followed up for 1 year, during which survival rates and quality of life metrics were documented. Results: Compared with the control group, the observation group demonstrated significantly shorter postoperative gastrointestinal function recovery times (P < 0.05). Additionally, patients in the observation group had lower PSQI, SAS, and SDS scores after the intervention (P < 0.05). Moreover, patients in the observation group reported milder postoperative pain and higher satisfaction with nursing care (P < 0.05). Finally, although no significant intergroup differences were observed in overall survival rates during the 1-year follow-up period (P > 0.05), patients in the observation group reported better quality of life. Conclusion: comfort-oriented nursing in the operating room can effectively ameliorate sleep disturbances and mitigate negative emotions in GC patients with CRI, thereby facilitating the postoperative recovery of these patients.
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References
1. López MJ, Carbajal J, Alfaro AL, et al. Characteristics of gastric cancer around the world. Critical Reviews in Oncology/Hematology. 2023; 181: 103841. doi: 10.1016/j.critrevonc.2022.103841
2. Xia JY, Aadam AA. Advances in screening and detection of gastric cancer. Journal of Surgical Oncology. 2022; 125(7): 1104-1109. doi: 10.1002/jso.26844
3. Rao X, Zhang C, Luo H, et al. Targeting Gastric Cancer Stem Cells to Enhance Treatment Response. Cells. 2022; 11(18): 2828. doi: 10.3390/cells11182828
4. Song N, Zhang X, Su J, et al. Nature and Determinants of Fear of Cancer Recurrence After Endoscopic Submucosal Dissection for Early Gastric Cancer. Gastroenterology Nursing. 2024; 47(5): 358-367. doi: 10.1097/sga.0000000000000812
5. Zhu G hui, Li J, Li J, et al. The characteristics and related factors of insomnia among postoperative patients with gastric cancer: a cross-sectional survey. Supportive Care in Cancer. 2021; 29(12): 7315-7322. doi: 10.1007/s00520-021-06295-6
6. Fleming L, Randell K, Stewart E, et al. Insomnia in breast cancer: a prospective observational study. Sleep. 2018; 42(3). doi: 10.1093/sleep/zsy245
7. Ma Y, He B, Jiang M, et al. Prevalence and risk factors of cancer-related fatigue: A systematic review and meta-analysis. International Journal of Nursing Studies. 2020; 111: 103707. doi: 10.1016/j.ijnurstu.2020.103707
8. Yang P, Zhang L, Tian X. Application of stepped care model in cancer patients: a scoping review. Supportive Care in Cancer. 2024; 33(1). doi: 10.1007/s00520-024-09086-x
9. Zhang K, Zhao G. The Value of Refined Nursing Management for Surgical Efficiency, Postoperative Recovery, and Stress Response in Laparoscopic General Surgery. Annali Italiani di Chirurgia. 2024; 95(5): 809-815. doi: 10.62713/aic.3636
10. Deng Y, Tian Y, Guo C, et al. The Application of Concept Map Thinking Combined with Kolcaba’s Comfort Nursing in the Perioperative Care of Patients Undergoing Nasal Deformity Correction. British Journal of Hospital Medicine. 2024; 85(12): 1-17. doi: 10.12968/hmed.2024.0562
11. Okuyan YC, Bolsoy N, Cetinkaya A. Exploring birth experience of mothers, based on comfort theory. The Journal of the Pakistan Medical Association. 2024; 74(9): 1623-1629. doi: 10.47391/JPMA.10470
12. Oliveira SM de, Costa KN de FM, Santos KFO dos, et al. Comfort needs as perceived by hospitalized elders: an analysis under the light of Kolcaba’s theory. Revista Brasileira de Enfermagem. 2020; 73(suppl 3). doi: 10.1590/0034-7167-2019-0501
13. Yılmaz M, Karabulut N. How Can we Improve the Comfort Level and Sleep Quality After Surgery? Journal of PeriAnesthesia Nursing. 2022; 37(1): 100-104. doi: 10.1016/j.jopan.2021.05.008
14. Graci G. Pathogenesis and management of cancer-related insomnia. The Journal of Supportive Oncology. 2005; 3(5): 349-359.
15. Zitser J, Allen IE, Falgàs N, et al. Pittsburgh Sleep Quality Index (PSQI) responses are modulated by total sleep time and wake after sleep onset in healthy older adults. PLOS ONE. 2022; 17(6): e0270095. doi: 10.1371/journal.pone.0270095
16. Hao X, Yi Y, Lin X, et al. Personalised graded psychological intervention on negative emotion and quality of life in patients with breast cancer. Technology and Health Care. 2024; 32(4): 2815-2823. doi: 10.3233/thc-232021
17. Åström M, Thet Lwin ZM, Teni FS, et al. Use of the visual analogue scale for health state valuation: A scoping review. Quality of Life Research. 2023; 32(10): 2719-2729. doi: 10.1007/s11136-023-03411-3
18. Musoro JZ, Coens C, Sprangers MAG, et al. Minimally important differences for interpreting EORTC QLQ-C30 change scores over time: A synthesis across 21 clinical trials involving nine different cancer types. European Journal of Cancer. 2023; 188: 171-182. doi: 10.1016/j.ejca.2023.04.027
19. Büttner-Teleagă A, Kim YT, Osel T, et al. Sleep Disorders in Cancer—A Systematic Review. International Journal of Environmental Research and Public Health. 2021; 18(21): 11696. doi: 10.3390/ijerph182111696
20. Tauber NM, O’Toole MS, Dinkel A, et al. Effect of Psychological Intervention on Fear of Cancer Recurrence: A Systematic Review and Meta-Analysis. Journal of Clinical Oncology. 2019; 37(31): 2899-2915. doi: 10.1200/jco.19.00572
21. Paley CA, Boland JW, Santarelli M, et al. Non-pharmacological interventions to manage psychological distress in patients living with cancer: a systematic review. BMC Palliative Care. 2023; 22(1). doi: 10.1186/s12904-023-01202-8
22. Li M, Yao X, Chao L. Observation on the effect of intraoperative risk management combined with comfort nursing in gynecological laparoscopic surgery. Medicine. 2023; 102(29): e34394. doi: 10.1097/md.0000000000034394
23. Yeo S, Lee J, Kim K, et al. Depression, Rather Than Cancer-Related Fatigue or Insomnia, Decreased the Quality of Life of Cancer Patients. Cancer Research and Treatment. 2021; 53(3): 641-649. doi: 10.4143/crt.2020.1212
24. Gao X, Xian H. Effect of preoperative visit combined with comfort nursing in operating room nursing and postoperative hypothermia incidence and its application. Minerva Surgery. 2024. doi: 10.23736/s2724-5691.24.10519-9
25. Kılınç T, Yayla A, Karaman Özlü Z, et al. The relationship of decision regret with quality of life and comfort level in patients undergoing laparoscopic sleeve gastrectomy: A cross-sectional study. Surgery for Obesity and Related Diseases. 2025; 21(1): 41-51. doi: 10.1016/j.soard.2024.08.030
