Classification Into Different Patient Groups—A Step Toward Tailoring Care After Major Oncological Surgery?

Abstract

Objective: To evaluate how the distribution of patients in groups (based on subjective health experience) changes over time and to investigate differences in physical functioning and mental health between these patient groups. Design: An observational cohort study. Setting: University medical center. Participants: Patients who underwent gastrointestinal or bladder oncological surgery (N=98). Interventions: Not applicable. Main Outcome Measures: The classification of patients into different groups based on the subjective health experience model (acceptance and perceived control), preoperatively and 1 and 3 months after discharge. Results: In total, 98 patients were included. Preoperatively, 31% of the patients were classified as having low acceptance and perceived control (group 4), and this proportion increased to 47% and 45% 1 and 3 months after discharge, respectively. These patients had significantly lower levels of physical functioning (preoperatively, 55 vs 61; P=.030; 1 month, 47 vs 57; P=.002; 3 months, 52 vs 62; P=.006) and higher levels of anxiety and depression (preoperatively, 14 vs 9; P<.001; 1 month, 11 vs 3; P=.001; 3 months, 10 vs 3; P=.009) than patients with high acceptance and perceived control (group 1). Conclusions: The classification of patients to different groups provides insight in different levels of physical and mental health. However, frequent evaluation is important because of changes in patient groups over time.

Keywords

• Classification
• Oncological surgery
• Postoperative recovery
• Rehabilitation
• Subjective health experience
• Tailored care