Effect of the advanced-practice-nurse-led postoperative self-management enhancement programme on self-efficacy, self-management, and pain after lung cancer resection: A randomised controlled trial.

PURPOSE: To evaluate the effectiveness of the advanced-practice-nurse-led postoperative self-management enhancement programme (N-PSMEP) on self-efficacy, self-management ability, and postoperative recovery outcomes after lung cancer surgery. METHODS: In this randomised controlled trial, 78 patients with a clinical diagnosis of lung cancer were randomised to the intervention or control group (n = 39 each). Two participants (one per group) whose postoperative histopathological examination did not confirm lung cancer were excluded from the eligible analysis population in accordance with the prespecified exclusion criterion, leaving an eligible analysis population of 76 participants with pathologically confirmed lung cancer. The intervention group received the eight-week N-PSMEP in addition to standard care. Outcomes were assessed at baseline (T1), post-intervention (eight weeks after surgery; T2), and follow-up (16 weeks after surgery; T3). The primary outcomes were self-efficacy and self-management ability; secondary outcomes included pain, pulmonary function, postoperative pulmonary complications, readmission, 6-min walk test (6MWT), and quality of life (QoL). Data were analysed using linear mixed-effects models. RESULTS: The intervention group demonstrated significantly greater improvements in self-efficacy and self-management ability over time. A smaller postoperative increase in pain was also observed; however, this secondary finding should be interpreted cautiously. No significant group × time interactions were observed for pulmonary function, the 6MWT, or QoL. Postoperative pulmonary complications and readmission rates did not differ significantly between groups. CONCLUSIONS: The N-PSMEP significantly improved self-efficacy and self-management ability and was associated with a smaller postoperative increase in pain after lung cancer surgery. TRIAL REGISTRATION: Korean Clinical Research Information Service (CRIS), KCT0009125.