Roy adaptation model-based patient education for elderly patients undergoing laparoscopic radical gastrectomy

The study aimed to evaluate the effect of the Roy adaptation model (RAM)-based patient education on adaptation levels to the disease, mental health, and life satisfaction of elderly patients undergoing laparoscopic radical gastrectomy.

The study adapted a pretest-posttest randomized clinical trial design with a comparison between the RAM group (giving RAM-based patient education plus usual care; n = 80) and the usual care group (giving usual care pathways; n = 80). The primary outcome measure was physiologic-physical, self-concept, role function, and interdependence adaption levels measured by the subscales of the Functional Assessment of Cancer Therapy-Gastric Module (FACT-Ga). Secondary outcome measures were mental health measured by the Hospital Anxiety and Depression Scale (HADS) and life satisfaction by the Life Satisfaction Index A (LSI-A).

The RAM group showed shortened time to flatus and first oral intake, and reduced postoperative hospitalization compared to the usual care group (p < 0.05). The analysis of covariance controlling for baseline scores suggested that a significantly main effect of treatment in patient's scores in each FACT-G subscale, FACT-G total, gastric cancer subscale, and FACT-Ga total, HADS-A, HADS-D, and LSI-A. The RAM group had higher scores of physical well-being (η² = 0.10), emotional well-being (η² = 0.12), functional well-being (η² = 0.11), and social well-being (η² = 0.06) subscales of FACT-Ga, FACT-G total (η² = 0.30), gastric cancer subscale (η² = 0.10), and FACT-Ga total (η² = 0.28), lower scores of HADS-A (η² = 0.12) and HADS-D (η² = 0.11), and a higher score of LSI-A (η² = 0.12) than the usual care group at 1 month post intervention.

These results demonstrate that RAM-based patient education could effectively increase adaptation levels to the disease, improve mental health, and life satisfaction of elderly patients undergoing laparoscopic radical gastrectomy.