Abstract:

Objective: To explore the current status and influencing factors of early ambulation in patients with lung cancer after thoracoscopic surgery with enhanced recovery after surgery (ERAS) concept nursing, and to provide evidence for optimizing the ERAS rehabilitation program after lung cancer surgery. Methods: This observational study enrolled patients who underwent thoracoscopic lung cancer surgery at Shanxi Hospital Cancer Hospital of Chinese Academy of Sciences and Taiyuan Fourth People’s Hospital between June 1, 2023, and May 31, 2024, according to the inclusion criteria. Data were collected using a general information questionnaire (including age, gender, marital status, education level, smoking status, surgical methods, frequency of medical guidance, exercise time, postoperative pain score, etc.) and scales (including early ambulation log and self-efficacy expectation scale (SEES), digital rating scale (NRS), social support rating scale (SSRS)). Univariate and multivariate logistic regression analysis were performed to examine early ambulation status and its influencing factors. Results: A total of 189 patients met the inclusion criteria, and 189 questionnaires and scales were distributed. Of these, 164 were validly returned, with an effective response rate of 86.77% (164/189). Therefore, 164 patients were finally included in the analysis. Among them, 60 cases (36.59%) achieved early ambulation within 24 h after surgery. Multivariate logistic regression analysis showed that older age and severe postoperative pain scores were significantly associated with reduced likelihood of early ambulation (OR (95%CI): 1.046 (1.009-1.084), 1.979 (1.512-2.598), respectively). Conversely, a frequency of medical guidance 3 times per week and ≥4 times per week, high SSRS scores were significantly associated with an increased likelihood of early ambulation rate ((OR (95%CI): 0.213 (0.152-0.343), 0.160 (0.123-0.253), and 0.611 (0.474-0.789), respectively). Conclusion: The completion rate of early ambulation within 24 hours after surgery in patients with lung cancer requires improvement. Nursing management and health education should be strengthened for patients with severe postoperative pain, older age, low social support and infrequent medical guidance. Targeted measures should be formulated to optimize the ERAS rehabilitation program.

Key words: Lung cancer, Enhanced recovery after surgery, Perioperative nursing, Rehabilitation, Influencing factors