Effect of Intensive Nursing Care in Elderly Patients undergoing Video-assisted Thoracoscopic Lung Cancer Surgery: A Randomised Control Study

Abstract

Introduction: Lung Cancer (LC) is a prominent cause of death worldwide, with both non small cell and small cell types increasing in prevalence. Multiple therapeutic options such as chemotherapy, radiation, and surgery, including Video-assisted Thoracoscopic Surgery (VATS), have been developed, although postoperative complications remain a concern. Nursing care has been advocated as a means to mitigate these adverse effects. However, the actual association between nursing care and LC postoperative complications and outcomes remains unknown. Aim: To assess the effects of Intensive Nursing Care (INC) on LC patients treated with VATS. Materials and Methods: The present study was a randomised control study in which a total of 256 Non Small Cell Lung Cancer (NSCLC) patients over the age of 60 years who underwent VATS in the Division 1 of Thoracic Surgery at Handan Central Hospital between January 2021 and January 2023 were included. The participants were randomly allocated to different groups: an INC group (n=126) and a control group receiving normal care (n=130). Lung function, reported symptoms, hospitalisation duration, psychological wellbeing (anxiety and depression scores), and occurrence of postsurgery symptoms (pain, fatigue, insomnia, dyspnea, nausea/vomiting) were assessed. T-tests or Fisher’s-Exact tests were used to compare baseline and postsurgical variables between the INC and Normal Nursing Care (NNC) groups using IBM Statistical Package for Social Sciences (SPSS) version 26.0 software. Results: The study population consisted of 53.1% females with an average age of 73.51±7.61 years, ranging from 60 to 85 years. INC significantly improved hospitalisation duration {Mean Difference (MD)= -1.9; 95% Confidence Interval (CI), -2.6 to -1.2; p-value<0.001}, the occurrence of postsurgery symptoms (p-value<0.001), and psychological states assessed by both the Self-rating Anxiety Scale (SRAS) (MD=-17.99; 95% CI, -18.63 to -17.35; p-value=0.001) and the Self-rating Depression Scale (SRDS) (MD= -9.04; 95% CI, -9.95 to -8.13; p-value=0.008) in comparison to NNC patients. Conclusion: Given the global burden of LC, it is crucial to emphasise not only the development of treatments for this illness but also care regimens that alleviate complications associated with these therapies. In this study, INC as an alternative to routine nursing care in postsurgery recovery has proven to be more beneficial to patients by decreasing their hospitalisation stay, the occurrence of postsurgery symptoms, and by enhancing their mental state.

Keywords

• mental state
• non small cell lung cancer
• self-rating anxiety scale
• self-rating depression scale