High-quality nursing intervention improves negative emotions and quality of life in gynecological patients after laparoscopy

In recent years, minimally invasive surgery, represented by laparoscopy, has developed rapidly and is widely used in clinical practice, showing good efficacy [1-4]. At present, lap - aroscopic surgery for gynecological diseases primarily includes hysterectomy, myomectomy, ovarian cystectomy, surgery for ectopic preg - nancy, tubal surgery, infertility exploration, and pelvic dissection [5-7]. Although laparoscopic surgery for gynecological diseases offers high High-quality nursing intervention improves negative emotions and quality of life in gynecological pa - tients after laparoscopy Yixuan Tian 1 , Chen Zhao 2 , Wenxiu Yang 1 , Rong Zhang 2 1 Department of Scientific Research Management, The First Affiliated Hospital of Baotou Medical College, Baotou 014010, Inner Mongolia Autonomous Region, China. 2 Department of Nursing, The First Affiliated Hospital of Baotou Medical College, Baotou 014010, Inner Mongolia Autonomous Region, China. Corresponding author: Rong Zhang. Declaration of conflict of interest: None. Received September 14, 2024; Accepted January 10, 2025; Published January 31, 2025 Highlights ● High-quality nursing intervention significantly reduced anxiety and depression levels in gynecological patients after laparoscopy, with the observation group showing lower self-rating anxiety scale and self-rating depression scale scores compared to the control group. ● The observation group reported significantly lower pain scores at 6, 24, 48, and 72 hours post-surgery com- pared to the control group, indicating effective postoperative pain management. ● The observation group exhibited better quality of life, enhanced self-care abilities, and higher nursing satisfac tion compared to the control group, with significant improvements in physical function, mental health, and self- care skills.

Objective: To explore the effects of high-quality nursing intervention on negative emotions and quality of life in gynecological patients after laparoscopy. Methods: A total of 132 gynecological patients after laparoscopy were randomly divided into an observation group (n=66) and a control group (n=66) in a prospective study. The con - trol group received routine nursing care, while the observation group received high-quality nursing intervention. Anxiety, depression, qual ity of life, postoperative pain, self-care ability, and patient satisfaction were compared between the two groups. Results: The Self-Rating Anxiety Scale and Self-Rating Depression Scale scores were sig- nificantly lower in the observation group compared to the control group (both P<0.001). Pain scores at 6, 24, 48, and 72 hours post-surgery were also lower in the observation group (all P<0.001). The observation group showed significantly higher scores in physical function, general health, social function, emotional role, and mental health (all P<0.001). Furthermore, th e observation group demonstrated better self-care skills, self-concept, self-care responsibility, and health knowledge (all P<0.001). Nursing satisfaction during hospitalization was significantly higher in the observation group than in the control group (P<0.05). Conclusion: High-quality nursing intervention is effective in improving depression, anxiety, postoperative pain, and quality of life in gynecological patients after laparoscopy. It also enhances self-care ability and patient satisfaction, making it worthy of clinical promotion and application.

High-quality nursing intervention, laparoscopy, quality of life, anxiety, depression 19 Precision Nursing 2025; 1 (1): 18-24. PN24090346 Precision Nursing clinical value and is considered relatively safe, it remains an invasive procedure. Postoperative complications such as bleeding, nausea, and other symptoms may occur, negatively affecting patient prognosis and quality of life, and caus - ing psychological distress [8, 9]. Therefore, im - plementing appropriate nursing interventions to alleviate these negative emotions and improve quality of life is essential for promoting patient recovery. It has been reported that high-quality nursing interventions can reduce perioperative depression and anxiety in patients with thyroid cancer and those with liver metastases after laparoscopic colorectal cancer resection [10, 11]. Comfort nursing for gynecological patients undergoing laparoscopic surgery for ovarian cysts has also been shown to improve comfort and reduce anxiety [12]. However, there is no research on the impact of high-quality nursing on the self-care abilities of gynecological pa - tients after laparoscopy. Therefore, this study aimed to evaluate the effects of high-quality nursing interventions on anxiety, depression, quality of life, postoperative pain, self-care ability, and patient satisfaction in gynecological patients after laparoscopy, providing theoretical guidance for clinical nursing practice.

General data This prospective study included 132 gyneco - logical patients who underwent laparoscopy at the First Affiliated Hospital of Baotou Medical College between June 21, 2022, and June 25, 2023. The patients were randomly assigned to either the observation group (n=66) or the con - trol group (n=66). The control group received routine nursing care, while the observation group received high-quality nursing. This study was approved by the medical ethics committee of the First Affiliated Hospital of Baotou Medical College, and all participants provided informed consent. Inclusion criteria: Gynecological patients requir- ing laparoscopic surgery; Patients with normal cognitive function; Patients aged over 18 years old. Exclusion criteria: Patients with severe heart, liver, or kidney disorders; Patients with a history of psychosis; Patients who did not cooperate; Patients with allergic reactions to therapeutic drugs; Patients with incomplete data.

Routine care was provided to the control group, which included health education, electrocardio- gram monitoring, and close observation of vital signs such as heart rate and blood pressure. Intravenous access was established to provide nutritional support as needed. The observation group received high-quality nursing, with the following specific measures [12]: Establishment of nursing team: A high-quality nursing team was established, consisting of one attending physician, one head nurse, two nursing group leaders, and one charge nurse. The team developed a scientific and rational nursing plan, which was used as the basis for unified training for the nursing staff. All team members were required to implement the mea- sures according to the training plan to ensure consistent nursing care. Preoperative nursing: Preoperative education was provided to inform patients about the sur - gical process and precautions. Patients were encouraged to ensure adequate sleep and closely monitored for vital signs. Psychological status was assessed, and if anxiety or depres - sive tendencies were detected, the nursing staff communicated with the patients and their families, sharing successful case examples to boost confidence and ensure a positive attitude toward surgery. Intraoperative care: During surgery, attention was paid to ensuring the integrity of the perium- bilical skin. Heat preservation was maintained, and the nursing staff assisted the surgical team in monitoring the operation time. Postoperative care: The incision was cleaned promptly, and the staff monitored for any signs of exudation. For patients with severe incision pain, analgesics and oxygen therapy were ad - ministered. Patients were instructed in pain relief techniques such as deep nasal breathing. The drainage tube was kept unobstructed, and the color, quantity, and shape of the drainage fluid were observed; any abnormalities were promptly reported to the physician. Early mobi - lization was encouraged, and family members were instructed to perform clockwise abdom - inal massage to alleviate abdominal disten - sion. Patients were advised to eat light foods after gastrointestinal function recovery, with increased intake of vegetables and fruits. The nursing staff assisted patients with turning and encouraged them to cough to clear respiratory secretions and prevent pulmonary infections. Postoperatively, patient communication fo - cused on surgical complications, with close at - 20 Precision Nursing 2025; 1 (1): 18-24. PN24090346 Precision Nursing tention paid to emotional changes. If anxiety or depressive tendencies were observed, targeted psychological interventions were provided im - mediately. Aseptic Technique: Strict aseptic procedures were followed, including hand hygiene and adherence to aseptic protocols during invasive procedures. Outcome measures Primary outcome measures The self-rating anxiety scale (SAS) was used to assess the anxiety status of patients. A SAS score≥50 indicates anxiety symptoms; the high- er the score, the more severe the anxiety [13]. The self-rating depression scale (SDS) was used to assess the depression status of pa - tients. Mild depression: 53–62 points; moder - ate depression: 63–72 points; severe depres - sion: ≥72 points. The higher the SDS score, the more severe the depression [14]. The medical outcomes study 36 - item short - form health survey scale was used to eval - uate the quality of life of patients. This scale includes five dimensions: physical function, general health, social function, emotional role, and mental health. The maximum score for each dimension is 100, with higher scores indi - cating better quality of life in the corresponding dimension [15]. Secondary outcome measures The visual analogue scale was used to assess pain levels. A higher score indicates more se - vere pain. Patients were asked to mark a point on a 10-point scale, with 0 indicating no pain and 10 indicating the worst pain [16]. The exercise of self-care agency scale was used to assess patients’ self-care abilities, including four dimensions: self-care skills, self-concept, self-care responsibility, and health knowledge level. A higher score indicates stronger self-care ability [17]. Patients completed a self-developed satisfac - tion survey from our hospital to assess nursing satisfaction. Satisfaction scores were catego - Table 1. Comparison of general baseline data between the two groups (n,x±s) Indicators Observation group (n=66) Control group (n=66) Χ²/t P Age (years old) 45.50±10.1 47.60±11.9 1.061 1.978 BMI (Kg. m -2 ) 22.73±2.04 22.50±3.02 0.527 0.603 Reason for surgery (case) 1.987 0.575 Ovarian cyst 23 28 Uterine leiomyoma 20 15 Ectopic pregnancy 13 10 Cervical cancer 10 13 Education level (case) 3.873 0.144 Illiteracy 10 15 Less than high school 31 36 High school or above 25 15 Complications (case) Hypertension 13 18 1.054 0.304 Surgical history 18 25 1.690 0.193 Diabetes 3 4 0.150 0.697 Other internal medical diseases 5 7 0.366 0.544 Note: BMI, Body mass index. Table 2. Comparison of visual analogue scale scores between the two groups (points, x±s) Postoperative pain Observation group (n=66) Control group (n=66) t P 6h 2.32±0.21 2.89±0.13 18.749 <0.001 24h 1.54±0.15 2.61±0.23 31.657 <0.001 48h 1.25±0.20 2.56±0.21 36.698 <0.001 72h 0.78±0.26 1.98±0.20 29.720 <0.001 21 Precision Nursing 2025; 1 (1): 18-24. PN24090346 Comparison of general baseline data between the two groups There were no significant differences in age, cause of surgery, education level, or complica - tions between the two groups (all P>0.05), in- dicating comparability between the groups. As shown in Table 1. Comparison of anxiety status between the two groups The SAS score in the observation group was lower than that in the control group with statis - tically significant difference (all P<0.001). As shown in Figure 1. Comparison of depression status between the two groups The SDS score in the observation group was lower than that in the control group with statis - tically significant difference (all P<0.001). As shown in Figure 2. Comparison of postoperative pain between the two groups The pain scores at 6, 24, 48, and 72 hours af - ter surgery were lower in the observation group compared to the control group, with statistically significant differences (all P<0.001). As shown in Table 2. Comparison of quality of life between the two groups The observation group scored higher in phys - ical function, general health, social function, emotional role, and mental health dimensions compared to the control group, with statistically significant differences (all P<0.001). As shown in Table 3. Comparison of self-care ability between the two groups The observation group scored higher in all dimensions of self-care skills, self-concept, self-care responsibility, and health knowledge compared to the control group, with statistically significant differences (all P<0.001). As shown in Table 4. Comparison of nursing satisfaction between the two groups The nursing satisfaction rate during hospitaliza- tion was significantly higher in the observation group than in the control group (P<0.05). As shown in Table 5. Figure 1. Comparison of SAS scores between the two groups. Compared with control group, ### P<0.001. SAS, self-rating anxiety scale. Figure 2. Comparison of SDS scores between the two groups . Compared with control group, ### P<0.001. SDS, self-rating depression scale. rized as: satisfactory (90–100 points), basically satisfactory (60–89 points), and unsatisfactory (<60 points). Nursing satisfaction= (satisfac - tory + basically satisfactory) cases/total cas- es*100%. Statistical analysis Data were analyzed using SPSS 20.0. Enumer- ation data are presented as n (%), and the χ² test was used for comparisons. M easurement data with a normal distribution are expressed as mean ± standard deviation ( ± s), with the independent t-test used for group comparisons. Rank sum tests were used for comparisons of ordinal data. For comparisons among multiple time points, one-way analysis of variance (ANO- VA) was applied, followed by post-hoc tests for pairwise comparisons. P<0.05 was considered statistically significant.

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High-quality nursing intervention is based on a patient-centered approach, fully implements the nursing responsibility system, enhances the quality of care, and consequently improves patient and societal satisfaction [18]. Since its

into clinical practice, high-quality nursing intervention has been widely applied in the management of severe diseases, postoper - ative recovery, and chronic conditions, yielding positive outcomes and improving patient prog - nosis and nursing quality [19-21]. Anxiety and depression can result in symptoms such as increased heart rate, rapid breathing, sleep disturbances, depressed mood, and gas - trointestinal issues. In severe cases, they may lead to hallucinations, delusions, and other psychotic symptoms. Studies have shown that gynecological patients undergoing laparoscopic surgery often experience anxiety and depres - sion due to pain and the fear of postoperative complications [22]. Another study suggested that anxiety and depression can exacerbate postoperative pain in patients undergoing gy - necological laparoscopic surgery [23]. Li et al. studied 90 patients with ovarian cysts, where the control group received routine care and the observation group received the high-quality care model. The results revealed significantly lower General Comfort Questionnaire and Hos - pital anxiety and depression scale scores in the observation group compared to the control group after intervention, concluding that the high-quality care model reduced the likelihood of anxiety [24]. Liu et al. conducted a study on 110 patients with uterine fibroids who underwent laparo - scopic myomectomy [25]. The study found that the observation group had better outcomes, including shorter medication time, reduced bed rest, and shorter postoperative hospital stay, while nursing satisfaction and General Comfort Questionnaire scores were higher. The study concluded that high-quality nursing significantly reduced postoperative stress, improved patient satisfaction, and promoted rehabilitation [25]. In the present study, the observation group received the high-quality nursing model. Com - pared with the control group receiving routine nursing, the SAS and SDS scores of patients in the observation group were lower, indicating that the high-quality nursing model alleviated anxiety and depression. This effect may be at - tributed to health education on disease knowl - edge, the necessity of laparoscopic surgery, and postoperative complications, which helped patients actively cooperate with treatment and build confidence. Additionally, attention was paid to patients’ emotional well-being postoper- atively, with targeted psychological counseling to address anxiety and depression, helping to eliminate negative post-surgery emotions. Pain is a complex physiological and psycholog - ical experience. Prolonged pain can become an unbearable affliction, amplifying negative Table 3. Comparison of quality of life scores between the two groups (points, x±s) Quality of life scores Observation group (n=66) Control group (n=66) t P Physical function 79.65±9.43 64.54±8.32 9.761 <0.001 General health 92.65±11.21 84.09±12.56 4.131 <0.001 Social function 73.86±10.34 64.29±9.56 5.521 <0.001 Role emotional 63.09±8.98 54.97±6.90 5.825 <0.001 Mental health 68.87±9.43 56.09±6.98 8.850 <0.001 Table 4. Comparison of self-care agency ability scores between the two groups (points, x±s) Self-care ability scores Observation group (n=66) Control group (n=66) t P Self-care skills 39.20±1.89 29.76±2.91 22.102 <0.001 Self-concept 26.76±1.32 22.16±2.23 14.421 <0.001 Self-care responsibility 21.65±2.34 18.65±1.45 8.853 <0.001 Health knowledge level 71.78±2.38 54.58±1.97 45.228 <0.001 Table 5. Comparison of satisfaction with nursing care between the two groups [n (%)] Group Satisfactory Basically satisfactory Unsatisfactory Satisfaction Observation group (n=66) 30 (45.45) 29 (43.94) 7 (10.61) 59 (89.39) Control group (n=66) 24 (36.36) 24 (36.36) 18 (27.28) 48 (72.73) U/χ² 5.978 5.970 P 0.050 0.014 23 Precision Nursing 2025; 1 (1): 18-24. PN24090346 Precision Nursing emotions and increasing pain perception. Stud- ies, such as that by Zhong et al., have shown that high-quality nursing can effectively alle - viate pain in patients with severe intrauterine adhesions after hysteroscopic resection [26]. In this study, the observation group, receiving the high-quality nursing model, had significant - ly lower pain scores compared to the control group. These results suggest that the high-qual- ity nursing model effectively relieved patient pain, likely due to the reduction of negative emotions, which in turn decreased the per - ceived pain. Self-care refers to activities performed by an individual to sustain life, health, and comfort. Studies have shown that high-quality care im - proves the self-care abilities of patients with chronic diseases and those recovering from surgery [10]. In this study, the observation group received the high-quality nursing model. Compared with the routine nursing model in the control group, the results demonstrated that the self-care ability of the observation group was superior. This suggests that the high-qual - ity nursing model can enhance the self-care abilities of gynecological patients undergoing laparoscopic surgery. The improvement may be attributed to health education, psychological counseling, and other interventions that reduce patients’ adverse emotions. These strategies help patients better understand the surgery and prognosis, maintain optimal psychological states, alleviate pain, and ultimately improve their physical well-being and self-care abilities. Studies have indicated that gynecological pa - tients undergoing laparoscopic surgery are often at risk for complications such as pain, infection, bleeding, bladder and ureteral injury, intestinal obstruction, subcutaneous emphyse - ma, and lower extremity deep venous thrombo - sis, all of which negatively impact their quality of life [12]. In this study, the observation group, receiving high-quality nursing, exhibited sig - nificantly higher quality of life scores across all dimensions compared to the control group. This suggests that the high-quality nursing model can improve the quality of life for gynecological patients undergoing laparoscopic surgery, likely due to the enhancement of patients’ self-care abilities. Finally, this study assessed nursing satisfaction in both groups. The results revealed significant- ly higher nursing satisfaction in the observa - tion group compared to the control group. This could be attributed to the fact that high-quality nursing interventions reduced pain, anxiety, and depression, improved self-care abilities and quality of life, enhanced clinical outcomes, and provided a better subjective experience for patients seeking medical care. However, the study had limitations, including a small sam - ple size, a single-center design, and a short follow-up period. Additionally, the study did not evaluate anxiety and depression after dis - charge or assess the negative emotions of core caregivers. Future studies with larger sample sizes and longer follow-up periods are needed to confirm the feasibility and significance of the high-quality nursing model for gynecological pa- tients following laparoscopy. Further research is also needed to explore the broader application value of high-quality care.

In conclusion, the application of high-quality nursing for gynecological patients after lapa - roscopy shows positive effects. It can alleviate depression, anxiety, and postoperative pain, improve quality of life, enhance self-care abil - ities, and increase patient satisfaction. These findings suggest that the high-quality nursing model is worthy of clinical promotion and appli - cation. Author Contributions: Yixuan Tian designed the study, conducted the data analysis, and drafted the manuscript. Chen Zhao contributed to the study design, data collection, and interpreta - tion of the results. Wenxiu Yang assisted with the data collection, statistical analysis, and pro- vided critical revisions to the manuscript. Rong Zhang supervised the study, contributed to the interpretation of the data, and reviewed and edited the manuscript. All authors have read and approved the final manuscript.

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