Psychosocial Outcomes in Patients Who Participated in a Hospital-Based Family Involvement Program After Major Abdominal Oncological Surgery: A Preplanned Secondary Analysis of a Prospective Cohort Study

参与医院家庭参与计划的腹部重大肿瘤手术患者的心理社会结局:一项前瞻性队列研究的预先计划的二次分析

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Abstract

BACKGROUND: Major abdominal cancer surgery can significantly affect patients' psychosocial wellbeing, including anxiety, depression, sleep quality, and self-perceived health. Support from family caregivers during hospitalization may influence these outcomes. AIM: This study evaluates the psychosocial outcomes of a Family Involvement Program (FIP) for patients undergoing major abdominal cancer surgery. METHODS: A secondary analysis was conducted using data from a patient-preferred prospective cohort study. Patients who participated in the FIP alongside a family caregiver were compared to those who received usual care. The following psychosocial outcomes were assessed and analyzed using linear mixed-effects models with stepwise backward selection: sleep quality, anxiety and depression (HADS), self-perceived health (EQ-VAS) and health related quality of life (EQ-5D-5L) index score. Satisfaction with care was analyzed using linear regression. Fidelity metrics included completion rates of fundamental and optional care activities and the number of caregivers staying overnight. RESULTS: Patients in the FIP group reported significant higher sleep quality and significantly higher satisfaction with healthcare than those receiving usual care. No significant differences were found in anxiety, depression, or self-perceived health between groups. Engagement in fundamental and optional care activities by family caregivers varied across activities and postoperative days, with 80%-90% of caregivers staying overnight. CONCLUSION: Family caregiver involvement during hospital admission for major abdominal cancer surgery improved sleep quality and satisfaction with care. Participation in the FIP did not significantly affect patients' anxiety, depression, or self-perceived health. These findings suggest that family involvement programs may enhance the patients' psychosocial wellbeing during cancer recovery.

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