Keywords

Bowel symptoms, Intervention, Low anterior resection syndrome, Rectal neoplasms, Self-management, Sphincter-preserving surgery

 

Authors

  1. Li, Cong BSN, RN
  2. Li, Zhao-Yu MSN, RN
  3. Lu, Qian PhD, RN
  4. Zhou, Yu-Jie BSN, RN
  5. Qin, Xue-Ying PhD
  6. Wu, Ai-Wen PhD, MD
  7. Pang, Dong PhD, RN

Abstract

Background: Most patients with mid and low rectal cancer passively react to bowel symptoms after sphincter-preserving surgery (SPS), and their self-management behaviors are scarce in the Chinese patient population.

 

Objective: The aim of this study was to evaluate the effect of a self-management program for bowel symptoms in patients with mid and low rectal cancer after SPS.

 

Methods: A convenient sampling method was used to recruit patients with mid and low rectal cancer after SPS in gastric wards from 2 tertiary hospitals in Beijing, China. Ninety-five patients (intervention, n = 47; control, n = 48) were recruited. The intervention group received a predetermined self-management program plus routine postoperative care; the control group received only routine care in the ward. Data on patients' bowel symptoms, quality of life, and bowel symptom self-management behaviors were collected at baseline and at 3 and 6 months postoperatively using questionnaires. A generalized estimating equation was adopted to examine group effect and time effect.

 

Results: Bowel symptoms and quality of life in both the intervention and control groups of patients improved significantly 6 months after SPS compared with baseline (time effect, P < .001). The total score of patients' bowel symptom self-management behaviors and the score of the therapeutic domain increased significantly in the intervention group compared with those in the control group (group effect, P = .009).

 

Conclusions: Self-management programs could help prompt patients' self-management behaviors, but the extent to which they impact patients' bowel symptoms requires further investigation.

 

Implications for Practice: The bowel dysfunction self-management program could alter the behavior of patients. It also effectively improves self-management strategies for bowel symptoms.