Construction and application effect of perioperative period nursing pathway for lung cancer based on active health concept: a quasi-randomized controlled trial_West China Medical Journal

Authors：

HU Min ¹ , WANG Jia ² , LIN Pei ² , Zerongtaji ² ,  LAI Xiaoqin ^2,3

1. Anesthesia and Surgery Center, West China Tianfu Hospital, Sichuan University, Chengdu, Sichuan 610213, P. R. China;
2. Department of Thoracic Surgery, West China Tianfu Hospital, Sichuan University, Chengdu, Sichuan 610213, P. R. China;
3. Day Surgery Center, General Practice Medical Center, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding?author：

LAI Xiaoqin, Email: laixiaoqin@wchscu.cn

Keywords：

Active health; lung cancer; selfcare; anxiety and depression; enhanced recovery after surgery

DOI：

10.7507/1002-0179.202510052

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To evaluate the effect of nursing intervention based on active health concept on self-care ability, anxiety, and depression of patients with lung cancer during perioperative period. Methods Using a quasi-randomized controlled trial design, patients with lung cancer surgery in Department of Thoracic Surgery, West China Tianfu Hospital of Sichuan University from April to July 2025 were selected and divided into an intervention group and a control group according to the time of admission. The control group received routine enhanced recovery after surgery (ERAS) nursing, while the intervention group received multi-stage active health intervention based on ERAS. Exercise of Self-care Agency Scale (ESCA) and Hospital Anxiety and Depression Scale (HADS) were used to evaluate the nursing effects before intervention (T0), at the end of intervention (T1) and 1 month after discharge (T2). Linear mixed models were used for statistical analysis. Results A total of 132 patients were enrolled, including 69 in the intervention group and 63 in the control group. At T0, demographic and clinical characteristics were comparable between the two groups (P>0.05), except for depression scores (6.39±1.38 vs. 6.85±1.46, P<0.05). At T1 and T2, the ESCA scores in the intervention group were significantly higher than those in the control group (T1: 24.50±6.07 vs. 19.04±13.76, P<0.05; T2: 25.32±9.45 vs. 20.03±8.47, P<0.05). Furthermore, both anxiety scores (T1: 15.80±1.24 vs. 17.70±0.82; T2: 17.34±0.83 vs. 17.90±0.41) and depression scores (T1: 5.49±0.92 vs. 6.35±0.60; T2: 5.35±0.56 vs. 6.06±0.35) were significantly lower in the intervention group compared to the control group (P<0.05). Conclusions Perioperative nursing based on the concept of active health can effectively improve the self-care ability of patients with lung cancer and relieve anxiety and depression. This approach provides empirical evidence for deepening patient-centered care within ERAS and is worthy of further clinical promotion and optimization.

Citation： HU Min, WANG Jia, LIN Pei, Zerongtaji, LAI Xiaoqin. Construction and application effect of perioperative period nursing pathway for lung cancer based on active health concept: a quasi-randomized controlled trial. West China Medical Journal, 2026, 41(5): 760-764. doi: 10.7507/1002-0179.202510052 Copy

1.	Bray F, Laversanne M, Sung H, et al. Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin, 2024, 74(3): 229-263.
2.	鄭榮壽, 陳茹, 韓冰峰, 等. 2022 年中國惡性腫瘤流行情況分析. 中華腫瘤雜志, 2024, 46(3): 221-231.
3.	徐瑜, 李夢俠. 《CSCO 非小細胞肺癌診療指南 2024》更新解讀. 現代醫藥衛生, 2024, 40(11): 1801-1808.
4.	Merlo A, Carlson R, Espey J 3rd, et al. Postoperative symptom burden in patients undergoing lung cancer surgery. J Pain Symptom Manage, 2022, 64(3): 254-267.
5.	Wang M, Sun Y, Zhang M, et al. Effects of high-quality nursing care on quality of life, survival, and recurrence in patients with advanced nonsmall cell lung cancer. Medicine (Baltimore), 2022, 101(37): e30569.
6.	Liu YY, Zhao Y, Yin YY, et al. Effects of transitional care interventions on quality of life in people with lung cancer: a systematic review and meta-analysis. J Clin Nurs, 2024, 33(5): 1976-1994.
7.	World Health Organization, Health and Welfare Canada, Canadian Public Health Association. Ottawa charter for health promotion. Can J Public Health, 1986, 77(6): 425-430.
8.	新華社. 中共中央國務院印發《“健康中國 2030”規劃綱要》. (2016-10-25)[2025-04-16].
9.	史紀元, 劉倩, 韋帥芳, 等. 護理臨床實踐指南面臨的機遇與挑戰. 協和醫學雜志. (2025-08-05)[2025-10-10].
10.	車國衛. 加速康復外科: 肺癌手術日間化現狀與策略. 中國肺癌雜志, 2020, 23(1): 1-4.
11.	蔣秋鑫, 馮玲, 李慧, 等. 加速康復外科聯合主動健康理念在肺癌患者護理中的應用效果分析. 華西醫學, 2026, 41(4): 575-580.
12.	Li X, Zhang K, Xu D, et al. The effect of Orem’s nursing theory on the pain levels, self-care abilities, psychological statuses, and quality of life of bone cancer patients. Am J Transl Res, 2023, 15(2): 1438-1445.
13.	Rowntree RA, Hosseinzadeh H. Lung cancer and self-management interventions: a systematic review of randomised controlled trials. Int J Environ Res Public Health, 2022, 19(1): 536.
14.	郭麗娜, 高涵, 郭啟云, 等. 修正版自我護理能力評估量表漢化后的信效度評價. 中國實用護理雜志, 2014, 30(30): 64-66.
15.	孫振曉, 劉化學, 焦林瑛, 等. 醫院焦慮抑郁量表的信度及效度研究. 中華臨床醫師雜志(電子版), 2017, 11(2): 198-201.
16.	Faul F, Erdfelder E, Buchner A, et al. Statistical power analyses using G*Power 3.1: tests for correlation and regression analyses. Behav Res Methods, 2009, 41(4): 1149-1160.
17.	劉理, 安勝利. 醫學統計學. 蘇州: 蘇州大學出版社, 2021: 247.
18.	Luke SG. Evaluating significance in linear mixed-effects models in R. Behav Res Methods, 2017, 49(4): 1494-1502.
19.	Bayly J, Wakefield D, Hepgul N, et al. Changing health behaviour with rehabilitation in thoracic cancer: a systematic review and synthesis. Psychooncology, 2018, 27(7): 1675-1694.
20.	Huang B, Lv L, Zhang Q. Impact of empowerment education concept plus humanistic care on moods and quality of life in lung cancer patients undergoing chemotherapy. Psychiatry Clin Psychopharmacol, 2025, 35(3): 275-284.
21.	孫曉敏, 桑瑩瑩, 單傳琳, 等. 基于 LEARNS 賦能教育對胸腔鏡肺癌手術患者早期康復效果分析. 安徽醫學, 2025, 46(11): 1438-1442.
22.	王嬌燕, 陳晨. 健康信念護理結合持續性呼吸練習指導對肺癌術后病人呼吸功能及自我護理意識的影響. 全科護理, 2023, 21(16): 2240-2242.
23.	Li T, Wu Y, Yang Q, et al. Cross-lag analysis of prognostic nutritional index and psychosomatic symptom clusters in patients with lung cancer: a longitudinal study. Cancer Manag Res, 2025, 17: 3349-3358.
24.	劉盼. 健康信念模式的分階段健康教育對肺癌患者疾病不確定感及負性情緒的影響. 慢性病學雜志, 2025, 26(10): 1565-1568.
25.	Budhwani S, Wodchis WP, Zimmermann C, et al. Self-management, self-management support needs and interventions in advanced cancer: a scoping review. BMJ Support Palliat Care, 2019, 9(1): 12-25.
26.	Liu YY, Lu HB, Li YJ, et al. Effects of mindful breathing training combined with diary-based rehabilitation guidance in lung cancer patients undergoing surgery: a randomized controlled trial. Complement Ther Clin Pract, 2024, 55: 101849.
27.	Chayadi E, Baes N, Kiropoulos L. The effects of mindfulness-based interventions on symptoms of depression, anxiety, and cancer-related fatigue in oncology patients: a systematic review and meta-analysis. PLoS One, 2022, 17(7): e0269519.
28.	Xing Y, Zhao W, Duan C, et al. Developing a visual model for predicting depression in patients with lung cancer. J Clin Nurs, 2023, 32(15/16): 4614-4625.
29.	Sun M, Liu C, Lu Y, et al. Effects of physical activity on quality of life, anxiety and depression in breast cancer survivors: a systematic review and meta-analysis. Asian Nurs Res (Korean Soc Nurs Sci), 2023, 17(5): 276-285.

1. Bray F, Laversanne M, Sung H, et al. Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin, 2024, 74(3): 229-263.
2. 鄭榮壽, 陳茹, 韓冰峰, 等. 2022 年中國惡性腫瘤流行情況分析. 中華腫瘤雜志, 2024, 46(3): 221-231.
3. 徐瑜, 李夢俠. 《CSCO 非小細胞肺癌診療指南 2024》更新解讀. 現代醫藥衛生, 2024, 40(11): 1801-1808.
4. Merlo A, Carlson R, Espey J 3rd, et al. Postoperative symptom burden in patients undergoing lung cancer surgery. J Pain Symptom Manage, 2022, 64(3): 254-267.
5. Wang M, Sun Y, Zhang M, et al. Effects of high-quality nursing care on quality of life, survival, and recurrence in patients with advanced nonsmall cell lung cancer. Medicine (Baltimore), 2022, 101(37): e30569.
6. Liu YY, Zhao Y, Yin YY, et al. Effects of transitional care interventions on quality of life in people with lung cancer: a systematic review and meta-analysis. J Clin Nurs, 2024, 33(5): 1976-1994.
7. World Health Organization, Health and Welfare Canada, Canadian Public Health Association. Ottawa charter for health promotion. Can J Public Health, 1986, 77(6): 425-430.
8. 新華社. 中共中央國務院印發《“健康中國 2030”規劃綱要》. (2016-10-25)[2025-04-16].
9. 史紀元, 劉倩, 韋帥芳, 等. 護理臨床實踐指南面臨的機遇與挑戰. 協和醫學雜志. (2025-08-05)[2025-10-10].
10. 車國衛. 加速康復外科: 肺癌手術日間化現狀與策略. 中國肺癌雜志, 2020, 23(1): 1-4.
11. 蔣秋鑫, 馮玲, 李慧, 等. 加速康復外科聯合主動健康理念在肺癌患者護理中的應用效果分析. 華西醫學, 2026, 41(4): 575-580.
12. Li X, Zhang K, Xu D, et al. The effect of Orem’s nursing theory on the pain levels, self-care abilities, psychological statuses, and quality of life of bone cancer patients. Am J Transl Res, 2023, 15(2): 1438-1445.
13. Rowntree RA, Hosseinzadeh H. Lung cancer and self-management interventions: a systematic review of randomised controlled trials. Int J Environ Res Public Health, 2022, 19(1): 536.
14. 郭麗娜, 高涵, 郭啟云, 等. 修正版自我護理能力評估量表漢化后的信效度評價. 中國實用護理雜志, 2014, 30(30): 64-66.
15. 孫振曉, 劉化學, 焦林瑛, 等. 醫院焦慮抑郁量表的信度及效度研究. 中華臨床醫師雜志(電子版), 2017, 11(2): 198-201.
16. Faul F, Erdfelder E, Buchner A, et al. Statistical power analyses using G*Power 3.1: tests for correlation and regression analyses. Behav Res Methods, 2009, 41(4): 1149-1160.
17. 劉理, 安勝利. 醫學統計學. 蘇州: 蘇州大學出版社, 2021: 247.
18. Luke SG. Evaluating significance in linear mixed-effects models in R. Behav Res Methods, 2017, 49(4): 1494-1502.
19. Bayly J, Wakefield D, Hepgul N, et al. Changing health behaviour with rehabilitation in thoracic cancer: a systematic review and synthesis. Psychooncology, 2018, 27(7): 1675-1694.
20. Huang B, Lv L, Zhang Q. Impact of empowerment education concept plus humanistic care on moods and quality of life in lung cancer patients undergoing chemotherapy. Psychiatry Clin Psychopharmacol, 2025, 35(3): 275-284.
21. 孫曉敏, 桑瑩瑩, 單傳琳, 等. 基于 LEARNS 賦能教育對胸腔鏡肺癌手術患者早期康復效果分析. 安徽醫學, 2025, 46(11): 1438-1442.
22. 王嬌燕, 陳晨. 健康信念護理結合持續性呼吸練習指導對肺癌術后病人呼吸功能及自我護理意識的影響. 全科護理, 2023, 21(16): 2240-2242.
23. Li T, Wu Y, Yang Q, et al. Cross-lag analysis of prognostic nutritional index and psychosomatic symptom clusters in patients with lung cancer: a longitudinal study. Cancer Manag Res, 2025, 17: 3349-3358.
24. 劉盼. 健康信念模式的分階段健康教育對肺癌患者疾病不確定感及負性情緒的影響. 慢性病學雜志, 2025, 26(10): 1565-1568.
25. Budhwani S, Wodchis WP, Zimmermann C, et al. Self-management, self-management support needs and interventions in advanced cancer: a scoping review. BMJ Support Palliat Care, 2019, 9(1): 12-25.
26. Liu YY, Lu HB, Li YJ, et al. Effects of mindful breathing training combined with diary-based rehabilitation guidance in lung cancer patients undergoing surgery: a randomized controlled trial. Complement Ther Clin Pract, 2024, 55: 101849.
27. Chayadi E, Baes N, Kiropoulos L. The effects of mindfulness-based interventions on symptoms of depression, anxiety, and cancer-related fatigue in oncology patients: a systematic review and meta-analysis. PLoS One, 2022, 17(7): e0269519.
28. Xing Y, Zhao W, Duan C, et al. Developing a visual model for predicting depression in patients with lung cancer. J Clin Nurs, 2023, 32(15/16): 4614-4625.
29. Sun M, Liu C, Lu Y, et al. Effects of physical activity on quality of life, anxiety and depression in breast cancer survivors: a systematic review and meta-analysis. Asian Nurs Res (Korean Soc Nurs Sci), 2023, 17(5): 276-285.

West China Medical Journal

Construction and application effect of perioperative period nursing pathway for lung cancer based on active health concept: a quasi-randomized controlled trial

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content