{"paper_id":"e69a6b70-c85b-4e65-9074-591e164732cf","body_text":"Precision Nursing\nISSN: 2957-5532\nAddress correspondence to: Rong Zhang,  Department of Nursing, The First Affiliated Hospital of \nBaotou Medical College, No.41 Shady Road, Kundulun District, Baotou 014010, Inner Mongolia Au-\ntonomous Region, China. Tel: +86-15848848666. E-mail: 121522271@qq.com.\nResearch Article https://doi.org/10.61189/848035dodpre\nIntroduction\nIn recent years, minimally invasive surgery, \nrepresented by laparoscopy, has developed \nrapidly and is widely used in clinical practice, \nshowing good efficacy [1-4]. At present, lap -\naroscopic surgery for gynecological diseases \nprimarily includes hysterectomy, myomectomy, \novarian cystectomy, surgery for ectopic preg -\nnancy, tubal surgery, infertility exploration, and \npelvic dissection [5-7]. Although laparoscopic \nsurgery for gynecological diseases offers high \nHigh-quality nursing intervention improves negative \nemotions and quality of life in gynecological pa -\ntients after laparoscopy\nYixuan Tian\n1\n, Chen Zhao\n2\n, Wenxiu Yang\n1\n, Rong Zhang\n2\n1\nDepartment of Scientific Research Management, The First Affiliated Hospital of Baotou Medical College, Baotou \n014010, Inner Mongolia Autonomous Region, China. \n2\nDepartment of Nursing, The First Affiliated Hospital of \nBaotou Medical College, Baotou 014010, Inner Mongolia Autonomous Region, China.\nCorresponding author: Rong Zhang.\nDeclaration of conflict of interest: None.\nReceived September 14, 2024; Accepted January 10, 2025; Published January 31, 2025\nHighlights\n● High-quality nursing intervention significantly reduced anxiety and depression levels in gynecological patients\nafter laparoscopy, with the observation group showing lower self-rating anxiety scale and self-rating depression\nscale scores compared to the control group.\n● The observation group reported significantly lower pain scores at 6, 24, 48, and 72 hours post-surgery com-\n   pared to the control group, indicating effective postoperative pain management.\n● The observation group exhibited better quality of life, enhanced self-care abilities, and higher nursing satisfac\ntion compared to the control group, with significant improvements in physical function, mental health, and self-\n   care skills.\nAbstract\nObjective: To explore the effects of high-quality nursing intervention on negative emotions and quality of life in \ngynecological patients after laparoscopy. Methods: A total of 132 gynecological patients after laparoscopy were \nrandomly divided into an observation group (n=66) and a control group (n=66) in a prospective study. The con -\ntrol group received routine nursing care, while the observation group received high-quality nursing intervention. \nAnxiety, depression, qual ity of life, postoperative pain, self-care ability, and patient satisfaction were compared \nbetween the two groups. Results: The Self-Rating Anxiety Scale and Self-Rating Depression Scale scores were sig-\nnificantly lower in the observation group compared to the control group (both P<0.001). Pain scores at 6, 24, 48, \nand 72 hours post-surgery were also lower in the observation group (all P<0.001). The observation group showed \nsignificantly higher scores in physical function, general health, social function, emotional role, and mental health \n(all P<0.001). Furthermore, th\ne observation group demonstrated better self-care skills, self-concept, self-care \nresponsibility, and health knowledge (all P<0.001). Nursing satisfaction during hospitalization was significantly \nhigher in the observation group than in the control group (P<0.05). Conclusion: High-quality nursing intervention \nis effective in improving depression, anxiety, postoperative pain, and quality of life in gynecological patients after \nlaparoscopy. It also enhances self-care ability and patient satisfaction, making it worthy of clinical promotion and \napplication.\nKeywords: High-quality nursing intervention, laparoscopy, quality of life, anxiety, depression\n\n\n19\nPrecision Nursing 2025; 1 (1): 18-24. PN24090346\nPrecision Nursing\nclinical value and is considered relatively safe, \nit remains an invasive procedure. Postoperative \ncomplications such as bleeding, nausea, and \nother symptoms may occur, negatively affecting \npatient prognosis and quality of life, and caus -\ning psychological distress [8, 9]. Therefore, im -\nplementing appropriate nursing interventions to \nalleviate these negative emotions and improve \nquality of life is essential for promoting patient \nrecovery. It has been reported that high-quality \nnursing interventions can reduce perioperative \ndepression and anxiety in patients with thyroid \ncancer and those with liver metastases after \nlaparoscopic colorectal cancer resection [10, \n11]. Comfort nursing for gynecological patients \nundergoing laparoscopic surgery for ovarian \ncysts has also been shown to improve comfort \nand reduce anxiety [12]. However, there is no \nresearch on the impact of high-quality nursing \non the self-care abilities of gynecological pa -\ntients after laparoscopy. Therefore, this study \naimed to evaluate the effects of high-quality \nnursing interventions on anxiety, depression, \nquality of life, postoperative pain, self-care \nability, and patient satisfaction in gynecological \npatients after laparoscopy, providing theoretical \nguidance for clinical nursing practice.\nMaterials and methods\nGeneral data\nThis prospective study included 132 gyneco -\nlogical patients who underwent laparoscopy at \nthe First Affiliated Hospital of Baotou Medical \nCollege between June 21, 2022, and June 25, \n2023. The patients were randomly assigned to \neither the observation group (n=66) or the con -\ntrol group (n=66). The control group received \nroutine nursing care, while the observation \ngroup received high-quality nursing. This study \nwas approved by the medical ethics committee \nof the First Affiliated Hospital of Baotou Medical \nCollege, and all participants provided informed \nconsent.\nInclusion criteria: Gynecological patients requir-\ning laparoscopic surgery; Patients with normal \ncognitive function; Patients aged over 18 years \nold.\nExclusion criteria: Patients with severe heart, \nliver, or kidney disorders; Patients with a history \nof psychosis; Patients who did not cooperate; \nPatients with allergic reactions to therapeutic \ndrugs; Patients with incomplete data.\nMethods\nRoutine care was provided to the control group, \nwhich included health education, electrocardio-\ngram monitoring, and close observation of vital \nsigns such as heart rate and blood pressure. \nIntravenous access was established to provide \nnutritional support as needed.\nThe observation group received high-quality \nnursing, with the following specific measures \n[12]:\nEstablishment of nursing team: A high-quality \nnursing team was established, consisting of \none attending physician, one head nurse, two \nnursing group leaders, and one charge nurse. \nThe team developed a scientific and rational \nnursing plan, which was used as the basis for \nunified training for the nursing staff. All team \nmembers were required to implement the mea-\nsures according to the training plan to ensure \nconsistent nursing care.\nPreoperative nursing: Preoperative education \nwas provided to inform patients about the sur -\ngical process and precautions. Patients were \nencouraged to ensure adequate sleep and \nclosely monitored for vital signs. Psychological \nstatus was assessed, and if anxiety or depres -\nsive tendencies were detected, the nursing \nstaff communicated with the patients and their \nfamilies, sharing successful case examples to \nboost confidence and ensure a positive attitude \ntoward surgery.\nIntraoperative care: During surgery, attention \nwas paid to ensuring the integrity of the perium-\nbilical skin. Heat preservation was maintained, \nand the nursing staff assisted the surgical team \nin monitoring the operation time.\nPostoperative care: The incision was cleaned \npromptly, and the staff monitored for any signs \nof exudation. For patients with severe incision \npain, analgesics and oxygen therapy were ad -\nministered. Patients were instructed in pain \nrelief techniques such as deep nasal breathing. \nThe drainage tube was kept unobstructed, and \nthe color, quantity, and shape of the drainage \nfluid were observed; any abnormalities were \npromptly reported to the physician. Early mobi -\nlization was encouraged, and family members \nwere instructed to perform clockwise abdom -\ninal massage to alleviate abdominal disten -\nsion. Patients were advised to eat light foods \nafter gastrointestinal function recovery, with \nincreased intake of vegetables and fruits. The \nnursing staff assisted patients with turning and \nencouraged them to cough to clear respiratory \nsecretions and prevent pulmonary infections. \nPostoperatively, patient communication fo -\ncused on surgical complications, with close at -\n\n20\nPrecision Nursing 2025; 1 (1): 18-24. PN24090346\nPrecision Nursing\ntention paid to emotional changes. If anxiety or \ndepressive tendencies were observed, targeted \npsychological interventions were provided im -\nmediately.\nAseptic Technique: Strict aseptic procedures \nwere followed, including hand hygiene and \nadherence to aseptic protocols during invasive \nprocedures.\nOutcome measures\nPrimary outcome measures\nThe self-rating anxiety scale (SAS) was used \nto assess the anxiety status of patients. A SAS \nscore≥50 indicates anxiety symptoms; the high-\ner the score, the more severe the anxiety [13].\nThe self-rating depression scale (SDS) was \nused to assess the depression status of pa -\ntients. Mild depression: 53–62 points; moder -\nate depression: 63–72 points; severe depres -\nsion: ≥72 points. The higher the SDS score, the \nmore severe the depression [14].\nThe medical outcomes study 36 - item short \n- form health survey scale was used to eval -\nuate the quality of life of patients. This scale \nincludes five dimensions: physical function, \ngeneral health, social function, emotional role, \nand mental health. The maximum score for \neach dimension is 100, with higher scores indi -\ncating better quality of life in the corresponding \ndimension [15].\nSecondary outcome measures\nThe visual analogue scale was used to assess \npain levels. A higher score indicates more se -\nvere pain. Patients were asked to mark a point \non a 10-point scale, with 0 indicating no pain \nand 10 indicating the worst pain [16].\nThe exercise of self-care agency scale was used \nto assess patients’ self-care abilities, including \nfour dimensions: self-care skills, self-concept, \nself-care responsibility, and health knowledge \nlevel. A higher score indicates stronger self-care \nability [17].\nPatients completed a self-developed satisfac -\ntion survey from our hospital to assess nursing \nsatisfaction. Satisfaction scores were catego -\nTable 1. Comparison of general baseline data between the two groups (n,x±s)\nIndicators Observation group (n=66) Control group (n=66) Χ²/t P\nAge (years old) 45.50±10.1 47.60±11.9 1.061 1.978\nBMI (Kg. m\n-2\n) 22.73±2.04 22.50±3.02 0.527 0.603\nReason for surgery (case) 1.987 0.575\n      Ovarian cyst 23 28\n      Uterine leiomyoma 20 15\n      Ectopic pregnancy 13 10\n      Cervical cancer 10 13\nEducation level (case) 3.873 0.144\n       Illiteracy 10 15\n       Less than high school 31 36\n       High school or above 25 15\nComplications (case)\n     Hypertension 13 18 1.054 0.304\n     Surgical history 18 25 1.690 0.193\n     Diabetes 3 4 0.150 0.697\n     Other internal medical diseases 5 7 0.366 0.544\nNote: BMI, Body mass index.\nTable 2. Comparison of visual analogue scale scores between the two groups (points, x±s)\nPostoperative pain Observation group (n=66) Control group (n=66) t P\n6h 2.32±0.21 2.89±0.13 18.749 <0.001\n24h 1.54±0.15 2.61±0.23 31.657 <0.001\n48h 1.25±0.20 2.56±0.21 36.698 <0.001\n72h 0.78±0.26 1.98±0.20 29.720 <0.001\n\n21\nPrecision Nursing 2025; 1 (1): 18-24. PN24090346\nComparison of general \nbaseline data between \nthe two groups\nThere were no significant differences in age, \ncause of surgery, education level, or complica -\ntions between the two groups (all P>0.05), in-\ndicating comparability between the groups. As \nshown in Table 1.\nComparison of anxiety status between the two \ngroups\nThe SAS score in the observation group was \nlower than that in the control group with statis -\ntically significant difference (all P<0.001). As \nshown in Figure 1.\nComparison of depression status between the \ntwo groups\nThe SDS score in the observation group was \nlower than that in the control group with statis -\ntically significant difference (all P<0.001). As \nshown in Figure 2.\nComparison of postoperative pain between the \ntwo groups\nThe pain scores at 6, 24, 48, and 72 hours af -\nter surgery were lower in the observation group \ncompared to the control group, with statistically \nsignificant differences (all P<0.001). As shown \nin Table 2.\nComparison of quality of life between the two \ngroups\nThe observation group scored higher in phys -\nical function, general health, social function, \nemotional role, and mental health dimensions \ncompared to the control group, with statistically \nsignificant differences (all P<0.001). As shown \nin Table 3.\nComparison of self-care ability between the \ntwo groups\nThe observation group scored higher in all \ndimensions of self-care skills, self-concept, \nself-care responsibility, and health knowledge \ncompared to the control group, with statistically \nsignificant differences (all P<0.001). As shown \nin Table 4.\nComparison of nursing satisfaction between \nthe two groups\nThe nursing satisfaction rate during hospitaliza-\ntion was significantly higher in the observation \ngroup than in the control group (P<0.05). As \nshown in Table 5.\nFigure 1. Comparison of SAS scores between \nthe two groups.  Compared with control group, \n###\nP<0.001. SAS, self-rating anxiety scale.\nFigure 2. Comparison of SDS scores between \nthe two groups . Compared with control group, \n###\nP<0.001. SDS, self-rating depression scale.\nrized as: satisfactory (90–100 points), basically \nsatisfactory (60–89 points), and unsatisfactory \n(<60 points).  Nursing  satisfaction= (satisfac -\ntory + basically  satisfactory)  cases/total  cas-\nes*100%.\nStatistical analysis\nData were analyzed using SPSS  20.0. Enumer-\nation data are presented as n\n (%), and the χ² \ntest was used for comparisons. M easurement \ndata with a normal distribution are expressed \nas mean ± standard deviation (  ± s), with the \nindependent t-test used for group comparisons. \nRank sum tests were used for comparisons of \nordinal data. For comparisons among multiple \ntime points, one-way analysis of variance (ANO-\nVA) was applied, followed by post-hoc tests for \npairwise comparisons. P<0.05 was considered \nstatistically significant.\nResults\nPrecision Nursing\nx\n\n22\nPrecision Nursing 2025; 1 (1): 18-24. PN24090346\nPrecision Nursing\nDiscussion\nHigh-quality nursing intervention is based on \na patient-centered approach, fully implements \nthe nursing responsibility system, enhances \nthe quality of care, and consequently improves \npatient and societal satisfaction [18]. Since its \nintroduction into clinical practice, high-quality \nnursing intervention has been widely applied in \nthe management of severe diseases, postoper -\native recovery, and chronic conditions, yielding \npositive outcomes and improving patient prog -\nnosis and nursing quality [19-21].\nAnxiety and depression can result in symptoms \nsuch as increased heart rate, rapid breathing, \nsleep disturbances, depressed mood, and gas -\ntrointestinal issues. In severe cases, they may \nlead to hallucinations, delusions, and other \npsychotic symptoms. Studies have shown that \ngynecological patients undergoing laparoscopic \nsurgery often experience anxiety and depres -\nsion due to pain and the fear of postoperative \ncomplications [22]. Another study suggested \nthat anxiety and depression can exacerbate \npostoperative pain in patients undergoing gy -\nnecological laparoscopic surgery [23]. Li et al. \nstudied 90 patients with ovarian cysts, where \nthe control group received routine care and \nthe observation group received the high-quality \ncare model. The results revealed significantly \nlower General Comfort Questionnaire and Hos -\npital anxiety and depression scale scores in \nthe observation group compared to the control \ngroup after intervention, concluding that the \nhigh-quality care model reduced the likelihood \nof anxiety [24].\nLiu et al. conducted a study on 110 patients \nwith uterine fibroids who underwent laparo -\nscopic myomectomy [25]. The study found that \nthe observation group had better outcomes, \nincluding shorter medication time, reduced bed \nrest, and shorter postoperative hospital stay, \nwhile nursing satisfaction and General Comfort \nQuestionnaire scores were higher. The study \nconcluded that high-quality nursing significantly \nreduced postoperative stress, improved patient \nsatisfaction, and promoted rehabilitation [25]. \nIn the present study, the observation group \nreceived the high-quality nursing model. Com -\npared with the control group receiving routine \nnursing, the SAS and SDS scores of patients \nin the observation group were lower, indicating \nthat the high-quality nursing model alleviated \nanxiety and depression. This effect may be at -\ntributed to health education on disease knowl -\nedge, the necessity of laparoscopic surgery, \nand postoperative complications, which helped \npatients actively cooperate with treatment and \nbuild confidence. Additionally, attention was \npaid to patients’ emotional well-being postoper-\natively, with targeted psychological counseling \nto address anxiety and depression, helping to \neliminate negative post-surgery emotions.\nPain is a complex physiological and psycholog -\nical experience. Prolonged pain can become \nan unbearable affliction, amplifying negative \nTable 3. Comparison of quality of life scores between the two groups (points, x±s)\nQuality of life scores Observation group (n=66) Control group (n=66) t P \nPhysical function 79.65±9.43 64.54±8.32 9.761 <0.001\nGeneral health 92.65±11.21 84.09±12.56 4.131 <0.001\nSocial function 73.86±10.34 64.29±9.56 5.521 <0.001\nRole emotional 63.09±8.98 54.97±6.90 5.825 <0.001\nMental health 68.87±9.43 56.09±6.98 8.850 <0.001\nTable 4. Comparison of self-care agency ability scores between the two groups (points, x±s)\nSelf-care ability scores Observation group (n=66) Control group (n=66) t P\nSelf-care skills 39.20±1.89 29.76±2.91 22.102 <0.001\nSelf-concept 26.76±1.32 22.16±2.23 14.421 <0.001\nSelf-care responsibility 21.65±2.34 18.65±1.45 8.853 <0.001\nHealth knowledge level 71.78±2.38 54.58±1.97 45.228 <0.001\nTable 5. Comparison of satisfaction with nursing care between the two groups [n (%)]\nGroup Satisfactory Basically satisfactory Unsatisfactory Satisfaction\nObservation group (n=66) 30 (45.45) 29 (43.94) 7 (10.61) 59 (89.39)\nControl group (n=66) 24 (36.36) 24 (36.36) 18 (27.28) 48 (72.73)\nU/χ² 5.978 5.970\nP 0.050 0.014\n\n23\nPrecision Nursing 2025; 1 (1): 18-24. PN24090346\nPrecision Nursing\nemotions and increasing pain perception. Stud-\nies, such as that by Zhong et al., have shown \nthat high-quality nursing can effectively alle -\nviate pain in patients with severe intrauterine \nadhesions after hysteroscopic resection [26]. \nIn this study, the observation group, receiving \nthe high-quality nursing model, had significant -\nly lower pain scores compared to the control \ngroup. These results suggest that the high-qual-\nity nursing model effectively relieved patient \npain, likely due to the reduction of negative \nemotions, which in turn decreased the per -\nceived pain.\nSelf-care refers to activities performed by an \nindividual to sustain life, health, and comfort. \nStudies have shown that high-quality care im -\nproves the self-care abilities of patients with \nchronic diseases and those recovering from \nsurgery [10]. In this study, the observation \ngroup received the high-quality nursing model. \nCompared with the routine nursing model in the \ncontrol group, the results demonstrated that \nthe self-care ability of the observation group \nwas superior. This suggests that the high-qual -\nity nursing model can enhance the self-care \nabilities of gynecological patients undergoing \nlaparoscopic surgery. The improvement may be \nattributed to health education, psychological \ncounseling, and other interventions that reduce \npatients’ adverse emotions. These strategies \nhelp patients better understand the surgery \nand prognosis, maintain optimal psychological \nstates, alleviate pain, and ultimately improve \ntheir physical well-being and self-care abilities.\nStudies have indicated that gynecological pa -\ntients undergoing laparoscopic surgery are \noften at risk for complications such as pain, \ninfection, bleeding, bladder and ureteral injury, \nintestinal obstruction, subcutaneous emphyse -\nma, and lower extremity deep venous thrombo -\nsis, all of which negatively impact their quality \nof life [12]. In this study, the observation group, \nreceiving high-quality nursing, exhibited sig -\nnificantly higher quality of life scores across all \ndimensions compared to the control group. This \nsuggests that the high-quality nursing model \ncan improve the quality of life for gynecological \npatients undergoing laparoscopic surgery, likely \ndue to the enhancement of patients’ self-care \nabilities.\nFinally, this study assessed nursing satisfaction \nin both groups. The results revealed significant-\nly higher nursing satisfaction in the observa -\ntion group compared to the control group. This \ncould be attributed to the fact that high-quality \nnursing interventions reduced pain, anxiety, \nand depression, improved self-care abilities \nand quality of life, enhanced clinical outcomes, \nand provided a better subjective experience for \npatients seeking medical care. However, the \nstudy had limitations, including a small sam -\nple size, a single-center design, and a short \nfollow-up period. Additionally, the study did \nnot evaluate anxiety and depression after dis -\ncharge or assess the negative emotions of core \ncaregivers. Future studies with larger sample \nsizes and longer follow-up periods are needed \nto confirm the feasibility and significance of the \nhigh-quality nursing model for gynecological pa-\ntients following laparoscopy. Further research is \nalso needed to explore the broader application \nvalue of high-quality care.\nConclusion\nIn conclusion, the application of high-quality \nnursing for gynecological patients after lapa -\nroscopy shows positive effects. It can alleviate \ndepression, anxiety, and postoperative pain, \nimprove quality of life, enhance self-care abil -\nities, and increase patient satisfaction. These \nfindings suggest that the high-quality nursing \nmodel is worthy of clinical promotion and appli -\ncation.\nAuthor Contributions: Yixuan Tian designed the \nstudy, conducted the data analysis, and drafted \nthe manuscript. Chen Zhao contributed to the \nstudy design, data collection, and interpreta -\ntion of the results. Wenxiu Yang assisted with \nthe data collection, statistical analysis, and pro-\nvided critical revisions to the manuscript. Rong \nZhang supervised the study, contributed to the \ninterpretation of the data, and reviewed and \nedited the manuscript. All authors have read \nand approved the final manuscript.\nReferences\n[1] Khandpur RS. Laparoscope. Compendium of \nBiomedical Instrumentation, 2019.\n[2] Chen J, Yu S, Xu L. Laparoscopic Partial Sple -\nnectomy: A Safe and Feasible Treatment for \nSplenic Benign Lesions. Surg Laparosc En -\ndosc Percutan Tech 2018;28(5):287-290.\n[3] Liao KX, Cao L, Wang YZ, et al. Laparoscopic \npartial splenectomy in the treatment of splen -\nic ectopic pregnancy. Hepatobiliary Surg Nutr \n2024;13(3):569-572.\n[4] Romboli A, Annicchiarico A, Morini A, et al. \nLaparoscopic Partial Splenectomy: A Critical \nAppraisal of an Emerging Technique. A Review \nof the First 457 Published Cases. 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Altern Ther \nHealth Med 2023;29(6):311-315.\n[25] Liu Z, Gao Z, Li F, et al. Application Effect of \nLaparoscopic Myomectomy and Comprehen -\nsive Rehabilitation Nursing on Patients with \nUterine Fibroids. Comput Math Methods Med \n2022;2022:4018803.\n[26] Zhong CX, Liu HY, Gu LH, et al. Effect of high \nquality nursing on quality of life and pain of \npatients with severe intrauterine adhesions \nafter hysteroscopic resection. J Mod Integr \nChin West Med 2018;27(23):105-108.","source_license":"CC0","license_restricted":false}