The effects of a surgical rehabilitation program on functional recovery and gastrointestinal quality of life in patients with colorectal cancer undergoing abdominal surgery

This study used an explanatory sequential mixed-methods research design to examine the effects of a surgical rehabilitation program on functional recovery and gastrointestinal quality of life in colorectal cancer surgery patients. Sixty-four colorectal cancer patients undergoing surgery were randomly assigned to the experimental and control group. Thirty-two participants of the experimental group received a surgical rehabilitation program (SRP) together with standard care whereas the other 32 participants of the control group received standard care. The SRP was designed based on Dodd symptom management model and the self-regulation theory by Johnson. The instruments used to measure the outcomes were a data demographic record, the pain numeric rating scale, an abdominal distension scale, the gastrointestinal function and eating record, the 6-minute walk test, a portable spirometer, and the Gastrointestinal Quality of life Index (GIQLI). Semi-structured interviews in qualitative approach were conducted in parallel to the final assessment. Data were analysed by using descriptive statistics, chi-squared test, independent t-test, and repeated measures ANOVA. Content analysis was conducted on qualitative data. Results revealed that the SRP could significantly improve post-operative pain (p<.01), functional walking capacity (p<.001, p<.05), gastrointestinal function regarding the time to returning of oral fluid intake (p<.05) and oral food intake (p<.05). The given SRP also promoted gastrointestinal quality of life in terms of symptom and physical function dimensions (p<.05). However, the designed SRP could not significantly promote pulmonary function (p>.05) and gastrointestinal function concerning time to returning of bowel movement (p>.05), flatulence (p>.05), and fecal excretion (p>.05). Data also showed that the SRP could not significantly improve abdominal distention (p>.05) and gastrointestinal quality of life regarding the following three dimensions: emotions, social function, and medical treatment (p>.05). In-depth interviews were also concurrently conducted to assess experiences of the SRP participation and the gathered data could be synthesized into nine main themes namely regaining good health, encountering distress, valuing awareness, intrinsic motivation, extrinsic motivation, self-care techniques, suffering impeding progress, obstructive behavior, unfavorable conditions.The finding from this study indicated that the provided surgical rehabilitation program successfully promoted a functional recovery and gastrointestinal quality of life among colorectal cancer patients having an abdominal surgery. It is advised that this rehabilitation program be applied by healthcare personnel when providing nursing care. The program effectively promoted a rapid post-operative recovery and shortened the length of hospital stay.