The Effect of Preoperative Education on Recovery of Thoracic Surgery Patients

Detailed Description

Thoracic surgery for lung cancer is associated with significant postoperative pain, reduced pulmonary function, limited shoulder mobility, and delayed functional recovery. These factors may negatively affect patient outcomes, prolong hospitalization, and increase the risk of postoperative complications. Preoperative education is considered a key nursing intervention that may enhance patients' physical and psychological preparedness for surgery and improve postoperative recovery.

This randomized controlled experimental study was conducted in the thoracic surgery units of a tertiary public hospital in Istanbul. A total of 100 patients scheduled for elective thoracic surgery due to lung cancer were enrolled and randomly assigned to either the intervention group (n=50) or the control group (n=50). Randomization was performed using a computer-generated randomization method.

Patients in the control group received standard preoperative and postoperative care routinely provided by the hospital. Patients in the intervention group received structured preoperative education delivered by a nurse, supported by a standardized patient education booklet. The education included information on the surgical procedure, breathing and coughing exercises, use of incentive spirometry, early ambulation, shoulder and upper extremity exercises, and pain management strategies.

Data were collected at three time points: preoperatively, on postoperative day 1, and on postoperative day 4. Outcome measures included pulmonary function tests (FEV1 and FVC), shoulder joint range of motion assessed by goniometry, pain intensity measured using the Visual Analog Scale (VAS), and recovery quality evaluated using the Quality of Recovery-40 (QoR-40) questionnaire. Vital signs and oxygen saturation levels were also recorded.

The primary objective of the study was to determine whether structured preoperative education improves postoperative recovery outcomes compared to routine care. Secondary objectives included evaluating the effects of education on pain levels, pulmonary function, shoulder mobility, and quality of recovery.

The results of this study are expected to provide evidence supporting the integration of structured preoperative nursing education into clinical care protocols for patients undergoing thoracic surgery, with the goal of improving functional recovery and patient-centered outcomes.

Inclusion criteria

• Patients diagnosed with lung cancer who are hospitalized for elective thoracic surgery
• Aged 18 years and older
• Able to read, write, and speak Turkish
• Able to understand the information provided and without any condition that interferes with verbal communication
• Eastern Cooperative Oncology Group (ECOG) performance status of 0, 1, or 2
• Patients scheduled for lung resection via thoracotomy
• Patients undergoing surgery under general anesthesia

Exclusion criteria

• Patients with chronic pain in the preoperative period who are using analgesic medications for pain management
• Patients receiving antineoplastic treatment
• Patients undergoing reoperation due to lung cancer
• Patients with an ECOG performance status greater than 2
• Patients diagnosed with metastatic lung cancer
• Patients with limited mobility in the preoperative period