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Effectiveness of digital personalized nursing pathway on postoperative rehabilitation in patients with non-small cell
Yue Wang1, Yanjun Shang1, Ling Xu1
1Department of Pulmonary and Critical Care Medicine, Shanghai Changzheng Hospital, Naval Medical University, Shanghai, China.
Objectives:
To evaluate the effectiveness of a digital personalized nursing pathway (D-PNP) compared with conventional nursing pathway (CNP) on postoperative rehabilitation in patients with non-small cell lung cancer (NSCLC).
Methods:
This quasi-experimental study was conducted at a tertiary hospital in China from January 2022 to June 2024. A total of 184 NSCLC patients undergoing surgical resection were enrolled (D-PNP: n = 92; CNP: n = 92). The D-PNP intervention included a mobile health application for risk stratification, personalized rehabilitation protocols, symptom monitoring, and remote follow-up. Primary outcomes were postoperative pulmonary complications (PPCs) and pulmonary function recovery.
Results:
A total of 172 patients completed the study (D-PNP: n = 87; CNP: n = 85). The D-PNP group had lower PPC rates (10.3% vs. 24.7%; risk difference: -14.4%, 95% CI: -25.2% to -3.6%; P = 0.013; NNT = 7). At 3 months, FEV1 recovery was superior in the D-PNP group (94.4% vs. 88.2% of baseline; between-group P = 0.018). The D-PNP group also showed better quality of life (P < 0.001 for selected 3-month domains), lower anxiety and depression scores (both P < 0.001 at 3 months), higher rehabilitation compliance (86.2% vs. 68.2%; P = 0.005), and a non-significant trend toward lower 30-day readmission (3.4% vs. 10.6%; Fisher's exact P = 0.079).
Conclusion:
D-PNP was associated with reduced complications, improved functional recovery, and better rehabilitation adherence in NSCLC patients. Confirmation through randomized controlled trials is warranted.
