Development of a Continuity of Care Program for Postoperative Enterostomy Patients With Colorectal Cancer Guided by...

Patients with colorectal cancer undergoing enterostomy often encounter complex physical, psychological, and social challenges after discharge. Effective continuity of care is essential to support postoperative recovery and long-term adaptation. However, existing care programs frequently lack a comprehensive and theoretically grounded framework. Guided by Heider's balance theory, this study developed a continuity of care program for postoperative enterostomy patients with colorectal cancer, thereby providing a reference for clinical nursing practice.

A comprehensive search of domestic and international databases, guideline networks, and professional association websites was conducted to identify publicly available clinical practice guidelines, evidence summaries, and systematic reviews related to postoperative enterostomy care in patients with colorectal cancer. Two reviewers independently performed literature screening, quality appraisal, and data extraction, followed by cross-verification to develop a preliminary program draft. Using Heider's balance theory as the conceptual framework, a preliminary continuity of care program was formulated through evidence synthesis and qualitative analysis, and subsequently refined through a two-round Delphi expert consultation process.

A total of 512 records were initially identified, and seven high-quality articles were ultimately included after screening and quality appraisal. A preliminary continuity of care program was developed through evidence synthesis and refined using a two-round Delphi expert consultation. In each round, 20 questionnaires were distributed and all were returned, yielding response rates of 100.0%. Fourteen experts provided comments in the first round, and six provided additional feedback in the second round. The expert authority coefficients were 0.805 and 0.809, respectively, while Kendall's W coefficients were 0.162 and 0.163, both statistically significant. After iterative revision, the final program consisted of 4 first-level indicators, 10 second-level indicators, and 24 third-level indicators.

This study developed a theoretically grounded and expert consensus-based continuity of care program for postoperative enterostomy patients with colorectal cancer. The program may serve as a reference for clinical nursing practice, as well as for feasibility studies and intervention research.