Lung Cancer, Nursing Care, Patient Education, Thoracic Surgery
Conditions
Keywords
Preoperative Education, Quality of recovery, Thoracic surgery, Pulmonary function test, Shoulder joint range of motion
Brief summary
Brief Summary This randomized controlled study evaluated the effect of structured preoperative education on postoperative recovery outcomes in patients undergoing thoracic surgery for lung cancer. The study was conducted in a tertiary public hospital in Istanbul between June 2022 and December 2023 and included 100 adult patients who met the inclusion criteria. Participants were randomly assigned to an intervention group or a control group. Patients in the intervention group received structured, nurse-led preoperative education supported by a standardized patient education booklet, while the control group received routine hospital care. Recovery outcomes were assessed using physiological parameters, pulmonary function tests, shoulder joint range of motion measurements, pain intensity scores, and the Quality of Recovery-40 (QoR-40) questionnaire during the early postoperative period. The findings of this study aim to contribute evidence on the role of preoperative nursing education in improving functional recovery, reducing postoperative pain, and supporting respiratory function in patients undergoing thoracic surgery.
Detailed description
Detailed Description Thoracic surgery for lung cancer is associated with significant postoperative pain, reduced pulmonary function, limited shoulder mobility, and delayed functional recovery. These factors may negatively affect patient outcomes, prolong hospitalization, and increase the risk of postoperative complications. Preoperative education is considered a key nursing intervention that may enhance patients' physical and psychological preparedness for surgery and improve postoperative recovery. This randomized controlled experimental study was conducted in the thoracic surgery units of a tertiary public hospital in Istanbul. A total of 100 patients scheduled for elective thoracic surgery due to lung cancer were enrolled and randomly assigned to either the intervention group (n=50) or the control group (n=50). Randomization was performed using a computer-generated randomization method. Patients in the control group received standard preoperative and postoperative care routinely provided by the hospital. Patients in the intervention group received structured preoperative education delivered by a nurse, supported by a standardized patient education booklet. The education included information on the surgical procedure, breathing and coughing exercises, use of incentive spirometry, early ambulation, shoulder and upper extremity exercises, and pain management strategies. Data were collected at three time points: preoperatively, on postoperative day 1, and on postoperative day 4. Outcome measures included pulmonary function tests (FEV1 and FVC), shoulder joint range of motion assessed by goniometry, pain intensity measured using the Visual Analog Scale (VAS), and recovery quality evaluated using the Quality of Recovery-40 (QoR-40) questionnaire. Vital signs and oxygen saturation levels were also recorded. The primary objective of the study was to determine whether structured preoperative education improves postoperative recovery outcomes compared to routine care. Secondary objectives included evaluating the effects of education on pain levels, pulmonary function, shoulder mobility, and quality of recovery. The results of this study are expected to provide evidence supporting the integration of structured preoperative nursing education into clinical care protocols for patients undergoing thoracic surgery, with the goal of improving functional recovery and patient-centered outcomes.
Interventions
BEHAVIORALStructured Preoperative Education
A structured, nurse-led preoperative education program delivered prior to thoracic surgery.
OTHERroutine care
Standard care routinely provided by the hospital
Sponsors
Başakşehir Çam & Sakura City Hospital
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Intervention model description
Participants are randomly assigned to either an intervention group receiving structured preoperative education or a control group receiving routine care, and outcomes are assessed in parallel.
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Patients diagnosed with lung cancer who are hospitalized for elective thoracic surgery * Aged 18 years and older * Able to read, write, and speak Turkish * Able to understand the information provided and without any condition that interferes with verbal communication * Eastern Cooperative Oncology Group (ECOG) performance status of 0, 1, or 2 * Patients scheduled for lung resection via thoracotomy * Patients undergoing surgery under general anesthesia
Exclusion criteria
* Patients with chronic pain in the preoperative period who are using analgesic medications for pain management * Patients receiving antineoplastic treatment * Patients undergoing reoperation due to lung cancer * Patients with an ECOG performance status greater than 2 * Patients diagnosed with metastatic lung cancer * Patients with limited mobility in the preoperative period
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Postoperative Recovery Quality | Postoperative day 1 and postoperative day 4 | Postoperative recovery quality assessed using the Quality of Recovery-40 (QoR-40) questionnaire. The total score ranges from 40 to 200, with higher scores indicating better recovery quality. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Postoperative Pain Intensity | Preoperative period, postoperative day 1, and postoperative day 4 | Pain intensity assessed using the Visual Analog Scale (VAS), ranging from 0 to 10, where higher scores indicate worse pain. |
| Pulmonary Function | Preoperative period, postoperative day 1, and postoperative day 4 | Pulmonary function assessed using forced expiratory volume in one second (FEV1) and forced vital capacity (FVC), measured in liters. |
| Shoulder Joint Range of Motion | Preoperative period, postoperative day 1, and postoperative day 4 | Shoulder joint range of motion measured using a goniometer and expressed in degrees. Higher values indicate better functional outcome. |
| Postoperative Heart Rate | Preoperative period, postoperative day 1, and postoperative day 4 | Heart rate measured in beats per minute (bpm). Higher values indicate a worse outcome. |
| Postoperative Blood Pressure | Preoperative period, postoperative day 1, and postoperative day 4 | Systolic and diastolic blood pressure measured in millimeters of mercury (mmHg). Higher values indicate a worse outcome. |
| Postoperative Respiratory Rate | Preoperative period, postoperative day 1, and postoperative day 4 | Respiratory rate measured as breaths per minute. Higher values indicate a worse outcome. |
| Postoperative Oxygen Saturation | Preoperative period, postoperative day 1, and postoperative day 4 | Peripheral oxygen saturation measured by pulse oximetry and expressed as percentage (%). Higher values indicate a better outcome. |
Countries
Turkey (Türkiye)
Outcome results
None listed