Preoperative Health Belief Model-Based Nursing Intervention on Anxiety and Pain-Related Stress in Lung Cancer Patients

Summary

This protocol details a Health Belief Model-based preoperative visit designed to alleviate anxiety and pain-related stress in lung cancer surgery patients, aiming to improve postoperative outcomes.

Abstract

To explore the intervention effect of preoperative visit nursing based on the Health Belief Model (HBM) on the perception of preoperative anxiety and pain-related stress in patients with lung cancer (LC).

This retrospective study included 110 LC patients who underwent surgery at our hospital from June 2022 to June 2024. Based on the preoperative nursing protocol received, patients were assigned to a control group (routine preoperative care, n = 55) or a study group (HBM-based preoperative visit nursing, n = 55). Primary outcomes were preoperative anxiety (Amsterdam Anxiety and Information Scale [APAIS]; higher scores indicate greater anxiety), pain sensitivity (Pain Sensitivity Questionnaire [PSQ]; higher scores indicate greater sensitivity), perceived stress (Perceived Stress Scale [PSS]; higher scores indicate greater stress), and postoperative pain (Visual Analogue Scale [VAS]; higher scores indicate greater pain). Secondary outcomes included preoperative physiological parameters (systolic/diastolic blood pressure, heart rate), sleep quality (Pittsburgh Sleep Quality Index [PSQI]; higher scores indicate poorer sleep), and postoperative complications.No significant baseline differences existed between groups (P > 0.05). Between-group comparisons used independent t-tests or chi-square tests; repeated-measures ANOVA was used for longitudinal data. After intervention, APAIS, PSQ, and PSS scores decreased in both groups, with significantly lower scores in the study group (P < 0.05). Except at 6 h postoperatively, VAS scores at 12 h, 24 h, and 48 h were significantly lower in the study group (P < 0.05). Preoperative physiological parameters increased less in the study group (P < 0.05); PSQI scores decreased more in the study group (P < 0.05). The study group had a lower postoperative complication rate (3.64% vs. 16.36%, P < 0.05). HBM-based preoperative visit nursing may alleviate preoperative anxiety, pain sensitivity, and stress perception, reduce postoperative pain and physiological stress, improve sleep quality, and lower postoperative complications in LC patients.

Introduction

Lung cancer (LC) is one of the most common malignancies and occurs when abnormal cells in the lungs grow uncontrollably to form masses or tumors¹. In recent decades, factors such as population aging, industrial pollution, widespread tobacco use, and dietary carcinogen exposure have contributed to the rising incidence of LC². Patients with LC typically present with cough, dyspnea, and shortness of breath. Without timely treatment, disease progression may lead to comorbidities including cardiovascular disease, chronic obstructive pulmonary disease, and diabetes, exacerbating the condition and imposing a substantial burden ....

Protocol

This study was conducted in accordance with the guidelines of the Ethics Committee of Affiliated Hospital of Panzhihua University (Approval No: 2020-039). Due to the retrospective nature of the study, which involved only the analysis of de-identified data from existing medical records, the requirement for informed consent was waived by the ethics committee. Patient data were anonymized prior to analysis to ensure confidentiality. This study was designed as a retrospective cohort study. Data were collected by reviewing the electronic medical records of patients who underwent lung cancer surgery at our institution between June 2022 and June 2024. During this period, two....

Results

In the study group, there were 36 males and 19 females, with an average age of 55.11 ± 9.36 years and body mass index (BMI) of 23.38 ± 1.80 kg/m². TNM stages I, II, and III were documented in 19, 26, and 10 patients, respectively. Adenocarcinoma was the dominant histology (n = 31), followed by squamous-cell carcinoma (n = 21), small-cell carcinoma (n = 2), and other subtypes (n = 1). Tumour location was right-sided in 41 cases and left-sided in 14. Twenty-six participants had completed junior high.......

Discussion

With changes in dietary habits, physical activity patterns, work-related stress, and environmental exposures among Chinese residents, the incidence of LC has shown a trend toward younger age, seriously threatening human health and life safety¹⁷. For eligible patients, surgery offers the best evidence-based chance of cure for LC¹⁸. However, before surgery, most patients have anxiety and pain-related pressure perception, and this pressure will increase with the progress of th.......

Materials

List of materials used in this article

Name	Company	Catalog Number	Comments
Electrocardiogram machine	Hubei Cardiogenic Technology Co., LTD.	CBox-0001
Electronic sphygmometer	Hunan Deda Medical Co., LTD.	DE-X10
Sample Size Calculation Software	G*Power	Version 3.1	Used for a priori power analysis
Statistical Analysis Software	IBM SPSS Statistics	Version 27.0	Used for all data analysis