Effect of comprehensive nursing intervention on perioperative anxiety and sleep quality in elderly patients with digestive tract malignancies.

Objective: To analyze the effect of comprehensive nursing intervention on perioperative anxiety and sleep quality in elderly patients with digestive tract malignancies.

Methods: In this retrospective study, a total of 96 elderly patients with digestive tract malignancies treated in The First People's Hospital of Wenling from January 2020 to July 2021 were included into a comprehensive group (n=49, comprehensive nursing) and a conventional group (n=47, conventional nursing) according to different intervention methods. Anxiety was assessed using Self-rating Anxiety Scale (SAS) and Hamilton Anxiety Scale (HAMA), and sleep quality was assessed using Pittsburgh Sleep Quality Index (PSQI).

Results: The scores of SAS and HAMA of the comprehensive group on day 1 before surgery and day 7 after surgery were lower than those of the conventional group (<0.05). After intervention, PSQI score of the comprehensive group was lower than that of the conventional group (<0.05). The comprehensive group had a higher percentage of rapid eye movement sleep, sleep efficiency, and subjective sleep quality scores, and had lower arousal index on the 1st night after surgery than the conventional group (<0.05). The comprehensive group had a lower incidence of complications and mortality than the conventional group (<0.05). Univariate analysis showed that the mortality of elderly patients with digestive tract malignancies was significantly higher in patients with age over 70 years old, negative emotions, low degree of tumor differentiation, tumor stage III-IV, history of surgery, no preoperative chemoradiotherapy and conventional nursing. Poorly differentiated tumor, stage III-IV, history of surgery, and conventional nursing were independent risk factors (<0.05).

Conclusion: Comprehensive nursing intervention could effectively improve the perioperative anxiety and sleep quality as well as reduce the incidence of complications in elderly patients with digestive tract malignancies. Attention should be paid to the degree of tumor differentiation, tumor stage, and surgical history in the perioperative period.