Nurse Counseling for Physical Activity in Patients Undergoing Esophagectomy

Abstract

Strong evidence exists regarding multiple benefits of physical activity among cancer patients. Patients undergoing esophagectomy received counseling for physical activity by a nurse and instructions to keep a diary of physical activities before surgery, followed by 2 counseling sessions after surgery. Physical activity, body mass index, psychological distress, and quality of life were measured at baseline, 2–4 weeks, and 3 and 6 months after discharge. Of 29 participants (mean age = 65.9 years), 72.5% underwent thoracoscopic esophagectomy in the prone position with 3-field lymphadectomy. The results of the International Physical Activity Questionnaire indicated that postoperative physical activity returned to nearly preoperative level, and the number of inactive patients gradually decreased by half at 6 months after discharge. Quality of life scores, except those for role function and social function, tended to return to the baseline at 6 months after discharge. Psychological distress measured by the Kessler 6 remained lower than the baseline, whereas the mean score of body mass index gradually declined after discharge. Patients undergoing esophagectomy and receiving nurse counseling can return to preoperative physical activity level in their daily lives after surgery. Nurses should integrate physical activity promotion into cancer care.

Changes in psychological distress and quality of life after esophageal cancer surgery: A prospective study

“…A previous study of 49 patients who underwent esophageal cancer surgery showed similar results (8). Research indicates that esophageal cancer symptoms worsen two to four weeks after surgery compared with the preoperative period (11). In the rst year after esophageal cancer surgery, the most severe symptoms tend to occur two months postoperatively (7).…”

“…Anxiety and depression were higher one-month postoperatively than they were preoperatively, and they recovered to preoperative levels three months postoperatively. The results showed that the highest psychological stress was observed two to four weeks after surgery for esophageal cancer (11), and more than 40% of patients experienced anxiety and depression during their rst outpatient visit after esophageal cancer surgery (16). Patients with esophageal cancer experience severe anxiety and depression one month after surgery.…”

“…A study of the changes in anxiety and depression levels before and six and 12 months after esophageal cancer surgery demonstrated that anxiety levels remained stable over time, while levels of depression increased until 12 months post-surgery (10). Another study examining changes in psychological stress showed the highest psychological stress levels occurred two to four weeks after surgery (11).…”

Impact of curative treatment on the physical fitness of patients with esophageal cancer: A systematic review and meta-analysis

“…Muscle strength was measured in terms of hand grip strength (HGS) [9,30,31,33,35,41e46], knee extensor muscle strength [9,30,32,33,38,41], chair stand test [42,47], heel raising test [47], maximal inspiratory pressure (MIP) [30,42] or maximal expiratory pressure (MEP) [30]. Physical activity was measured using accelerometry [31,35], the international physical activity questionnaire (IPAQ) [32,48], the LASA physical activity questionnaire (LAPAQ) [42] or the physical activity level (PAL) score [49]. Activities of daily living (ADL) were assessed with the modified Katz scale [50], the modified Lawton and Brody Scale [50] or the Amsterdam linear disability score [51].…”

Effectiveness of the Tailored, Early Comprehensive Rehabilitation Program (t-ECRP) Based on ERAS in Improving the Physical Function Recovery for Patients Following Minimally Invasive Esophagectomy: A Prospective Randomized Controlled Trial

“…[19] However, results from longitudinal studies showed that patients after esophagectomy tended to have lower levels of physical activity compared with their preoperative levels. [14] It had been shown that activity capacity was associated with postoperative complications intently. [32] Long-term bed rest after surgery wound increases the risk of complications, such as venous thromboembolism, muscle loss, insulin resistance, and pulmonary complications.…”