Commentary: Impact of improving educational nursing interventions in perioperative nursing interventions on outcomes of prostate cancer patients with laparoscopic radical prostatectomy

In their study, the authors investigated the extent to which enhanced educational nursing interventions contribute to positive outcomes for prostate cancer patients. The research employed a randomised experimental design, utilising a personalised perioperative nursing intervention (PNI) to assess its effectiveness. The findings have significant policy implications, underscoring the importance of personalised nursing care in improving the quality of life and both physical and psychological well-being of prostate cancer patients who have undergone laparoscopic radical prostatectomy. Although the research design is solid and the findings are robust, there are some places that future studies in this area could address.

Implications of the research findings

The findings indicate that providing PNI to individual patients can reduce blood loss, accelerate the recovery of intestinal function, shorten the duration of postoperative hospital stays, decrease the incidence of postoperative complications and enhance patient satisfaction scores. All these positive outcomes contain two significant implications for related stakeholders.

It is essential to prioritise the enhancement of patients’ health literacy. Health literacy encompasses individuals’ ability to access, understand, evaluate and apply health information, knowledge and services (Sørensen et al., 2012). Given that personalised PNI represents a novel form of healthcare service, enhancing the health literacy of both patients and their family members is essential. This can be achieved by educating them on the importance of utilising PNI for postoperative recovery.

Another essential aspect is to improve nurses’ proficiency in patient education and communication if PNI for individuals is implemented. This necessitates that nurses enhance their literacy by developing their capacities for comprehensive communication with patients. From the perspective of medical sociology, a power dynamic exists between the authoritative knowledge held by healthcare professionals, such as doctors and nurses, and the patients. However, patients can also build their own power and influence interactions with nurses through counselling, questioning and extensive disclosure (Kettunen et al., 2002). Therefore, communication between nurses and patients can be bidirectional. How should nurses manage such comprehensive communication? Is establishing personal connections an effective strategy in this context? Addressing these questions necessitates additional training for nurses. This raises a critical concern regarding the financial implications of providing specialised training for nurses, which could potentially increase the operational costs for hospitals. It is essential to consider whether all hospitals have the financial capacity to bear these additional training expenses.

Furthermore, although personalised PNI demonstrates positive medical effectiveness, its utilisation may exacerbate health disparities among patients. According to fundamental cause theory, individuals with higher socioeconomic status are more likely to access superior medical care (Phelan and Link, 2013), the disparity of which would perpetuate health inequalities between hierarchical social groups. According to the authors, PNI provided to individual patients encompass personalised education, nurse–patient communication, additional oral nutritional intake, haemodynamic planning, the use of sterile instruments and dressings and the monitoring of deflation or defecation. The comprehensive nature of these services can significantly elevate the cost of postoperative care. Consequently, this increased cost may result in only patients with higher socioeconomic status being able to afford personalised PNI, thereby exacerbating health inequalities. To address this issue, it is imperative to reduce the cost of personalised PNI services by integrating them into medical insurance. This strategy would make personalised PNI more accessible and inclusive for all patients.

What future studies could address

Methodologically, future studies can improve the research design in two key areas. Firstly, regarding variable measurement, the current study employs a single item, a 100-point scale, to measure life satisfaction. Although a single-item measure has certain validity (Jovanović and Lazić, 2020), future research could enhance this by using a set of survey questions to assess patients’ well-being and life satisfaction postoperation. For example, employing relevant scales to assess positive or negative affect after operation could serve as an avenue to evaluate the reliability of personalised PNI.

Secondly, the research design itself could be more complex. For instance, future studies could consider educational level to determine whether personalised PNI are more effective for patients with higher or lower educational status. If patients with lower education levels benefit less from these services than their higher-educated counterparts, it is imperative to develop more targeted policies that address education and communication needs specific to these patients. Age may serve as another significant predictor in this context. The participants in this study were aged between 61 and 75 years. Typically, older adults under the age of 70 are classified as the young-old, whereas those aged 70 and above are categorised as the old–old (or the middle-to-oldest old; Gouveia et al., 2017; Koo et al., 2017). It remains to be explored whether personalised PNI operates differently for young-old versus middle-to-oldest old patients. Additionally, it is worth investigating whether middle-to-oldest old patients require more specialised care within the framework of PNI. Future research should address these questions.

In addition to enhancing the research design, as the authors have noted, it is necessary to explore other potential interventions to improve postoperative quality of life. The effectiveness of involving patients’ family members in nurse–patient communication warrants further investigation, particularly given that many patients are older adults who require additional assistance in communicating with healthcare providers. Additionally, the role of social workers in related interventions remains an area ripe for exploration. These topics present valuable opportunities for future scholarly research.

Lastly, we are particularly interested in the generalisability of the authors’ findings concerning the implementation of personalised nursing care. This study specifically examines prostate cancer patients who have undergone laparoscopic radical prostatectomy, making the research objective group quite specific. Future studies could explore whether personalised PNI would be effective for other postoperative cancer patients and whether it would aid in the recovery of patients undergoing surgeries for other diseases. Furthermore, the applicability of these findings to hospitals and patients in developing societies warrants consideration. For instance, hospitals in developing countries often face challenges such as limited medical resources, making it difficult to provide personalised care services. In such contexts, exploring alternative strategies to enhance patients’ postoperative quality of life is essential.

Conclusion

The study examines the effectiveness of personalised PNI on recovery outcomes for prostate cancer patients who have undergone laparoscopic radical prostatectomy, utilising a randomised experimental design. The findings demonstrate the efficacy of personalised PNI. These results indicate the critical importance of enhancing patients’ health literacy and the ability of nurses to communicate comprehensively with patients. Nevertheless, this study is deficient in its integration of essential analyses from a medical sociology perspective. Future research should investigate whether more tailored interventions are necessary for patients from diverse backgrounds, such as those with lower educational attainment, individuals belonging to middle-to-oldest age groups and those from relatively lower socioeconomic statuses. Finally, the generalisability of personalised PNI across diverse societies with stratified economic development levels and various types of hospitals with different financial budgets should be meticulously evaluated, and further exploration of other potential interventions is warranted.

Biography

Xiangnan Chai serves as an Assistant Professor in the Sociology Department at the School of Social and Behavioral Sciences, Nanjing University. He earned his doctorate from the Sociology Department at the University of Western Ontario. His research interests encompass health and health inequalities, aging and the life course and medical sociology. His recent scholarly endeavours have concentrated on health literacy, digital health and the health of the older population.

Cong Chen is an undergraduate student in the Department of Sociology at the School of Social and Behavioral Sciences, Nanjing University. Her research interests include health inequalities and population aging.