Table 2.

Characteristics of the included studies on gastric cancer.

Study/Reference	Study design	Sample size	Cancer type	Assessment for anxiety	Nursing methods and protocols	Main findings
(18) China	Retrospective study	128 patients	Gastric cancer	HADS	Video-based nursing education. Protocol: A 20-min video which showed the information of this surgery and hospitalization, including benefits of minimally invasive gastrectomy, team members, anesthesia, environment of waiting room, operating room and recovery room, fluid intake and postoperative care.	The prevalence of anxiety was significantly lower in the intervention group than the control group (59.4% vs 76.6%, P = 0.037). The anxiety level dropped dramatically at 24h after surgery in both groups. Consistently, the anxiety score and prevalence of patients with anxiety were lower in intervention group than the control group (all P <0.05).
(19) China	Cohort	128 patients	Gastric cancer	SAS	Multidisciplinary cooperative continuous care. Protocol: 1. Establishment of a multidisciplinary cooperative continuous nursing group; 2. Specific interventions: distribution of nursing services, scheduled plan, data collected for establishing continuous nursing files, WeChat for communication, telephone follow-up, home-visit, and health education lectures.	The SAS score in the study group was significantly lower than that in the control group (47.14 ± 5.40 vs. 51.13 ± 5.09, P<0.001). Multidisciplinary cooperative continuous nursing could also ameliorate the depression, postoperative pain, and quality of life.
(21) China	Case control	88 patients	Gastric cancer	HAMA	Accelerated rehabilitation nursing. Protocol: 1. Preoperative nursing: explanation the surgery, 6h of fasting and water deprivation, and glucose water 2 h before surgery; 2. Intraoperative nursing: kept warm and controlled infusion; 3. Postoperative nursing: pain nursing, psychological nursing, exercise rehabilitation nursing; 4. Promote bowel movement.	HAMA score in the study group after intervention were significantly lower than that of the control group (P<0.05). Accelerated rehabilitation nursing also improved postoperative recovery of intestinal function, nutritional status, the quality of life, and reduced the incidence of complications.
(24) China	RCT	103 patients	Gastric cancer	HAMA	Traditional Chinese medicine (TCM) nursing. Protocol: The study group was received TCM nursing until the patients were discharged. The methods included TCM psychological care, syndrome differentiation nursing, dietetic nursing, and nursing of auricular-plaster therapy of TCM.	After TCM nursing intervention, the scores of HAMA were significantly lower than those before intervention (7.69 ± 1.29 vs 5.90 ± 1.23, P<0.05). HAMA scores in the study group were remarkable lower than those in the control group (5.90 ± 1.23 vs 6.80 ± 1.11, P<0.05). Perioperative TCM nursing could improve postoperative gastrointestinal dysfunction, alleviate acute inflammation, reduce postoperative complications, and improve the quality of life of postoperative patients.
(31) China	Retrospective study	100 patients	Gastric cancer	SAS	Evidence-based early warning nursing. Protocol: 1. Before surgery, the patient’s disease condition and psychological state were evaluated. 2. Targeted psychological counseling to help them to adjust their psychological state. 3. One day before surgery, the patients were introduced the anesthesia purpose, method, requirements and possible discomfort of the surgery. 4. Effective intraoperative nursing to avoid the occurrence of intraoperative accidents. 5. Early warning of physiological, drug, and psychological care for patients after surgery.	Patients received evidence-based early warning nursing exerted a significantly declination of SAS scores than that in the routine group (P<0.001). Additionally, under this nursing model, nurses could improve the care plans that reduce postoperative complications and pain for the patients, which might enhance the patient satisfaction.

STAI, State-Trait Anxiety Inventory; HADS, Hospital Anxiety and Depression Scale; SAS, self-rating anxiety scale; HAMA, Hamilton anxiety scale.