Development of an expert patient program for improving self-efficacy in surgical patients with advanced gastric...

Advanced gastric cancer (AGC) poses substantial postoperative challenges that require effective self-management. Although expert patient programs (EPPs) and peer-support approaches have been used in other conditions, an operational program tailored to Chinese surgical patients with AGC has not been established. This study aimed to develop an evidence-informed, disease-adapted EPP focused on postoperative self-efficacy and self-management in this population.

A Consolidated Criteria for Reporting Qualitative Research (COREQ)-guided qualitative expert panel discussion study was conducted in April 2024 at a tertiary hospital in Guangzhou, China. Six purposively recruited experts in gastrointestinal oncology and oncology nursing participated. A preliminary EPP was drafted from a structured scoping literature review, evidence-to-mapping, and self-efficacy theory. The experts participated in two preplanned semi-structured focus-group rounds. Round 1 elicited item-by-item critique of program relevance, clarity, clinical accuracy, feasibility, safety, and cultural appropriateness. Feedback was analyzed using inductive thematic analysis and documented in a revision matrix. Round 2 reviewed the revised program and confirmed consensus.

The scoping review identified 19 relevant studies. Evidence mapping showed that existing peer-support and self-management interventions commonly addressed medical, role, and emotional management and used skills such as problem-solving, decision-making, resource use, patient-provider communication, action planning, and self-regulation. These elements were translated into a six-module preliminary EPP and a logic model linking AGC-specific postoperative challenges, program components, self-efficacy mechanisms, and intended proximal self-management capacities. Thematic analysis of expert feedback generated five refinement themes: simplifying theoretical and medical content, increasing experiential sharing by expert patients, strengthening practical guidance on red-flag symptoms, wound care, nutrition, and rehabilitation, incorporating family support, and improving flexible digital follow-up. In Round 2, all six experts endorsed the revised program.

This study produced an evidence-informed, disease-adapted EPP through a transparent qualitative expert-panel process. The contribution lies not in proposing entirely new peer-support components, but in configuring established self-management and self-efficacy elements for the postoperative AGC context in China and documenting the consensus-based refinement process. The program requires patient acceptability, feasibility, and effectiveness evaluation before routine implementation.