TOPLINE

An 8-week program led by an advanced practice nurse (APN) improved self-efficacy and self-management through 16 weeks after lung cancer surgery compared with standard care, but no significant between-group differences were seen in lung function, walking distance, or quality of life.

METHODOLOGY

• Researchers randomly assigned 78 adults with lung cancer of clinical stage II or below, scheduled for thoracoscopic lobectomy or segmentectomy at a tertiary hospital in South Korea, to an intervention or control group. Two patients were excluded after final pathology showed no lung cancer, leaving 38 per group. The mean age was 62.6 years, and 51.3% were men.
• The intervention group received standard care plus an 8-week program led by an APN, with five 30-minute face-to-face sessions and three 20-minute phone calls that began before surgery. Sessions covered education, breathing exercises, symptom and pain management, coaching, and emotional support. All 38 completed every session.
• The control group received standard care, including an education booklet, a video, and an 80-minute multidisciplinary education session.
• Blinded assessors measured self-efficacy (scored 10-100) and self-management ability (0-96) as the primary outcomes before surgery and at 8 and 16 weeks afterward; secondary outcomes were pain (0-40), lung function, walking distance, postoperative lung complications, readmission, and quality of life.

TAKEAWAY

• Self-efficacy improved significantly more with the intervention than with standard care at 8 weeks (between-group difference, 17.03 points; P = .02) and 16 weeks (19.82 points; P = .02).
• Self-management ability increased from 77.8 to 90.0 in the intervention group vs 75.7 to 79.7 in the control group at 16 weeks (mean difference, 8.16; Bonferroni-adjusted P =.016).The 8-week difference was 9.63 (P = .002).
• Pain increased less after surgery in the intervention group (from 1.6 to 3.2) than in the control group (from 1.1 to 6.0) at 16 weeks Bonferroni-adjusted P = .040). This exploratory secondary finding was significant.
• No significant between-group differences were seen over time in lung function, 6-minute walk distance, quality of life, readmission rates, and pulmonary complications.

IN PRACTICE

The nurse-led postoperative self-management enhancement program "significantly improved self-efficacy and self-management ability and attenuated the postoperative increase in pain after lung cancer surgery, supporting the value of APN-led, theory-driven interventions in surgical oncology care," the authors wrote.

SOURCE

The study was led by Ji Eun Han, Seoul National University Bundang Hospital, Seongnam, South Korea. It was published online on September 9 in the European Journal of Oncology Nursing.

LIMITATIONS

The study was limited by the lack of blinding for participants and the nurse delivering the program. The absence of an attention-matched control group made it difficult to separate the program’s effects from those of additional nurse contact. This single-center trial was small, followed for only 16 weeks, and was underpowered for readmission and complications. Also, it did not evaluate analgesic use or behavioral mechanisms.

DISCLOSURES

The study was funded by the Korean Association of Advanced Practice Nurses. The authors reported no conflicts of interest. 

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.