Process-based nursing using explanation-simulation-practice-communication-support model for pain management after liver cancer intervention

Abstract

BACKGROUND

Liver cancer is highly prevalent and fatal; transcatheter arterial chemoembolization is its main interventional therapy. Post-transcatheter arterial chemoembolization pain is common and affects recovery, demanding optimized nursing strategies.

AIM

To explore the application of process-based nursing using the Explain-Simulate-Practice-Communication-Support (ESPCS) model for pain management after interventional therapy for liver cancer.

METHODS

A total of 500 patients who underwent interventional therapy for liver cancer and were admitted to Ganzhou Fifth People’s Hospital between January 2022 and January 2025 were selected and divided into a control group (n = 250, treated with routine nursing intervention) and an observation group (n = 250, treated with process-based nursing intervention using the ESPCS model) using a random number table method. Both groups received the intervention until discharge. The Visual Analog Scale scores at 2 hours, 6 hours, 12 hours, and 24 hours after surgery, the scores of the Hospital Anxiety and Depression Scale (HADS), and the Functional Assessment of Cancer Therapy-General before and after intervention, and the incidence of complications were compared between the two groups.

RESULTS

At 2 hours, 6 hours, 12 hours, and 24 hours postoperatively, the Visual Analog Scale scores in the observation group were significantly lower than those in the control group (2 hours: 4.18 ± 0.85 vs 4.36 ± 1.03, P = 0.034; 6 hours: 3.31 ± 0.67 vs 3.69 ± 0.82, P < 0.001; 12 hours: 2.89 ± 0.58 vs 3.13 ± 0.65, P < 0.001; 24 hours: 1.82 ± 0.69 vs 2.51 ± 0.82, P < 0.001). After intervention, HADS-Anxiety and HADS-Depression scores were significantly lower in the observation group than in the control group (HADS-Anxiety: 7.15 ± 1.57 vs 8.43 ± 1.82; HADS-Depression: 6.72 ± 1.49 vs 7.26 ± 1.76; both P < 0.001). Functional Assessment of Cancer Therapy-General domain scores in the observation group were significantly higher than those in the control group, including physical well-being (26.25 ± 3.01 vs 24.40 ± 2.77), social/family well-being (18.33 ± 2.65 vs 16.06 ± 2.12), emotional well-being (28.35 ± 3.43 vs 25.70 ± 3.12), and functional well-being (18.45 ± 3.03 vs 16.84 ± 2.86) (all P < 0.001). The incidence of complications was significantly lower in the observation group than in the control group (3.20% vs 7.20%, P = 0.044).

CONCLUSION

Process-based nursing interventions based on the ESPCS model can effectively alleviate the degree of pain in patients after interventional therapy for liver cancer, improve their psychological state and quality of life, and reduce the incidence of complications.

Keywords: Liver cancer; Interventional therapy; Explain-Simulate-Practice-Communication-Support model; Process-based nursing; Pain management

Core Tip: Process-based nursing based on the Explain-Simulate-Practice-Communication-Support model significantly reduced postoperative pain scores, alleviated anxiety and depression, improved quality of life, and lowered complication rates in patients undergoing transcatheter arterial chemoembolization for liver cancer. This model provides an evidence-based and structured nursing framework for postoperative pain management.