Effect of multidisciplinary team collaborative nursing on wound healing and psychological symptoms in postoperative patients with gastrointestinal tumors

Abstract

BACKGROUND

Postoperative patients with gastrointestinal tumors are at high risk for poor wound healing and psychological distress, such as anxiety and depression, which can negatively impact recovery and quality of life. Multidisciplinary team (MDT) collaborative nursing has emerged as a comprehensive care approach that may address both physical and psychological needs.

AIM

To explored the impact of MDT collaborative nursing on wound healing and anxiety/depression symptoms in postoperative patients with gastrointestinal tumors.

METHODS

A retrospective analysis was conducted on 364 patients with gastrointestinal tumours admitted to our hospital between January 2022 and December 2024. Based on differing postoperative nursing approaches, two groups were established: the MDT group (n = 196) and the control group (n = 168). The control group received conventional nursing interventions, while the MDT group received MDT collaborative nursing. The study compared wound healing outcomes, pre-intervention and one-month post-intervention Hospital Anxiety and Depression Scale (HADS) scores, Functional Assessment of Cancer Therapy-General (FACT-G) quality of life scores, and complication rates between the two groups.

RESULTS

The MDT group demonstrated a Grade A wound healing rate of 88.27% and total treatment compliance of 99.49%, both significantly higher than the control group (75.00% and 95.83%, respectively). The complication incidence rate was 3.06% in the MDT group, lower than the control group (8.93%), with all differences statistically significant (P < 0.05). After one month of intervention, patients in the MDT group demonstrated lower Anxiety Self-Rating Scale and Depression Self-Rating Scale scores on the HADS scale compared to the control group. Conversely, their scores on the FACT-G scale for physical, social/family, emotional, and functional domains were higher than those in the control group, with all differences being statistically significant (P < 0.05).

CONCLUSION

MDT collaborative care promotes wound healing in patients undergoing gastrointestinal tumour surgery, alleviates anxiety and depressive symptoms, enhances treatment adherence and quality of life, and reduces the incidence of complications.

Key Words: Gastrointestinal tumor; Multidisciplinary team; Collaborative nursing; Wound healing; Anxiety and depression symptoms

Core Tip: Multidisciplinary team collaborative nursing benefits patients with postoperative gastrointestinal tumors. It improves wound healing, reduces anxiety/depression, enhances quality of life, and reduces complication rates, outperforming routine nursing.

INTRODUCTION

Gastrointestinal tumors is the general term for tumors that occur in the gastrointestinal tract. In recent years, with the aggravation of population aging and changes in lifestyle, eating habits, and other factors, its incidence has increased, becoming a major public health security issue[1,2]. Radical resection is the primary treatment for gastrointestinal tumors, and its efficacy and safety have been widely confirmed in clinical practice[3,4]. However, with the advancement of clinical practice, relevant studies have shown that most postoperative patients with gastrointestinal tumors cannot return to normal physiological function owing to traumatic stress, malnutrition, and other factors. Once postoperative complications occur, they often cause a secondary blow to patients' physical and mental health, easily leading to adverse psychological symptoms such as anxiety and depression, and may even affect wound healing and prognosis[5]. Therefore, it is important to develop effective protective strategies.

Traditional clinical nursing formulates plans based only on patient characteristics. Although it can alleviate patients' disease symptoms and promote recovery to a certain extent, it is relatively simple, lacks scientific and professional nursing guidance, and cannot meet patients' health management needs due to certain limitations[6]. The multidisciplinary team (MDT), proposed by the American Society of Clinical Oncology, is a nursing model that integrates the advantages of different disciplines, transforming the traditional individual- and experience-based nursing model into a modern team collaboration and joint decision-making model for medical staff[7]. The "Action Framework for Interprofessional Education and Collaborative Practice" released by the World Health Organization in 2010 pointed out[8] that implementing multi-dimensional cooperation and introducing interprofessional and collaborative practice into the medical management field can promote the integrated allocation of medical resources, improve the efficiency of medical MDT work, and be more conducive to meeting patients' health needs. In addition, many foreign studies have actively applied the MDT collaborative model to chronic disease nursing management, which has been confirmed to reduce the burden of chronic diseases, reduce medical security costs, and promote innovation and breakthroughs in clinical disease management[9-11].

However, at present, there is no report on the application of MDT collaborative nursing in postoperative patients with gastrointestinal tumors, and there is a lack of effective reference. Therefore, this study aims to explore the intervention effect of MDT collaborative nursing on wound healing and anxiety/depression symptoms in postoperative patients with gastrointestinal tumors, so as to provide a reference for optimizing the clinical nursing management of gastrointestinal tumors after surgery.

MATERIALS AND METHODS

General data

A retrospective analysis of 364 patients undergoing surgery for gastrointestinal tumours admitted to our hospital between January 2022 and December 2024.

Inclusion criteria: (1) Diagnosis of gastrointestinal tumors by pathological examination; (2) Indications for surgical treatment with smooth operation; and (3) Clear consciousness, normal communication ability, and voluntary participation in this study.

Exclusion criteria: (1) Extremely unstable vital signs; (2) Metastatic tumors; (3) Severe organic lesions of the liver, kidneys, and other organs; (4) Severe infectious diseases or complications; and (5) Mental or cognitive dysfunction with poor compliance.

The patients were divided into an MDT group (n = 196) and a control group (n = 168). There were no statistically significant differences in the general data between the two groups (P > 0.05), as shown in Table 1. This study was approved by the ethics committee of our hospital. All study participants and their legal guardians provided written informed consent before recruitment.

Table 1 Comparison of general data between the two groups.

General information	MDT (n = 196)	Control (n = 168)	χ2/t	P value
Gender, n (%)
Male	112 (57.14)	91 (54.17)	0.325	0.569
Female	84 (42.86)	77 (45.83)
Tumor site, n (%)
Breadbasket	82 (41.84)	70 (41.67)	0.528	0.768
Small intestine	63 (32.14)	59 (35.12)
Large intestine	51 (26.02)	39 (23.21)
ASA classification, n (%)
II	116 (59.18)	95 (56.55)	0.258	0.612
III	80 (40.82)	73 (43.45)
Age (mean ± SD, year)	63.88 ± 6.35	63.03 ± 6.52	1.258	0.209
BMI (mean ± SD, kg/m2)	23.06 ± 1.82	22.95 ± 1.73	0.588	0.557
Surgery time (mean ± SD, min)	127.27 ± 23.55	126.70 ± 22.82	0.234	0.815

MDT: Multidisciplinary team; BMI: Body mass index.

Patients were randomly allocated to the MDT (n = 196) or control (n = 168) group using a computer-generated random number table. The randomization process was conducted by a research coordinator who was not involved in the intervention or outcome assessment.

Methods

Control group: Routine nursing interventions were adopted, including instructing patients to ensure adequate rest after surgery; closely monitoring vital signs; conducting health education on disease knowledge by distributing health education manuals and oral education; guiding patients on healthy diets; providing analgesic drug care; assisting in independent rehabilitation exercises; and notifying patients to return for regular outpatient follow-up after discharge.

MDT group: MDT collaborative nursing was applied.

Establishment of MDT collaborative nursing team

An integrated medical nursing and clinical nursing model was adopted to establish a professional medical nursing unit for postoperative gastrointestinal tumors. Constructed in the form of a MDT, it mainly included a professional team (head nurse of general surgery, one associate chief physician, and five charge nurses) and a sub-professional team (one nutritionist, one psychological expert, one international wound therapist, one pain department nurse, and one rehabilitation therapist). All team members had good communication and coordination abilities, and a WeChat group was created to facilitate timely communication and exchanges among members.

Division of responsibilities

The head nurse of general surgery served as the team leader, responsible for carrying out systematic work training, supervising the nursing process, and evaluating nursing effects; the associate chief physician was responsible for condition assessment and formulation of diagnosis and treatment plans; the charge nurse was responsible for collecting patients' general data (physical status, psychological status, nutritional status, pain level, and occurrence of complications, etc.), implementing and recording nursing plans; among the sub-professional team, the nutritionist was responsible for evaluating patients' nutritional status and formulating nutritional intervention plans, the psychological expert was responsible for evaluating patients' psychological status and providing psychological counseling services; the international wound therapist was responsible for comprehensive assessment of wounds (depth, infection status, and patients' overall health status, etc.) and related treatment work; the pain department nurse was responsible for evaluating patients' postoperative pain symptoms and formulating pain intervention plans; the rehabilitation therapist was responsible for evaluating patients' physical status and formulating exercise plans. If nonprofessional nursing problems occurred during the nursing process, the relevant members of the sub-professional team provided consultations or nursing assistance.

Implementation of MDT collaborative nursing MDT collaborative nursing was conducted based on individualized patient assessments and regular team coordination. Weekly MDT meetings (approximately 45-60 minutes) were held to discuss patient progress, adjust care plans, and address clinical challenges. A WeChat communication group was established to allow real-time information exchange and ensure timely intervention updates.

Cognitive intervention: The nurse in charge understood patients' cognitive level of disease knowledge through knowledge quizzes, selected appropriate health education plans according to patients' educational background and cognitive level, provided targeted explanations for doubts and key links, and introduced past successful cases to further improve patients' disease cognition and enhance treatment confidence.

Psychological intervention: The nurse in charge conducted one-on-one communication with patients to fully understand their emotional expression methods. Based on respecting patients' feelings and emotions, the nurse fully evaluated patients' negative emotions and potential influencing factors and provided targeted psychological counseling, including using micro-expressions such as eye contact and smiling or adopting music therapy, peer education, family emotional support, etc., to help patients improve their mood. For patients with obvious anxiety and depression symptoms, psychological experts assisted in the intervention using multiple methods, such as mindfulness-based stress reduction training, cognitive behavioral therapy, and narrative therapy, to establish a good doctor-patient relationship. For patients with prominent symptoms of anxiety and depression, psychological experts participated in interventions using methods such as mindfulness-based stress reduction, cognitive behavioral therapy, and narrative therapy.

Wound intervention: The responsible nurse strictly adheres to aseptic technique principles, performing timely wound dressing changes to maintain local cleanliness and dryness, whilst maintaining comprehensive wound care documentation. Should localised symptoms such as redness, swelling, exudate, or elevated skin temperature arise, an international certified wound therapist shall conduct a thorough assessment of the wound. This assessment shall be discussed with the Associate Chief Physician to jointly formulate a targeted wound management plan.

Pain intervention: The pain department nurse evaluated the degree of postoperative pain in the patients using a visual analog scale (VAS). Targeted nursing care was provided based on scoring results. For example, if the VAS score was < 6 points, methods such as deep breathing, self-massage, and listening to music were used for pain self-management. If the VAS score is ≥ 6 points, analgesic drugs were reasonably selected for intervention according to the degree of pain.

Nutritional intervention: On the first day after surgery, the charge nurse and nutritionist collaborated to evaluate the patients' nutritional status using the nutritional risk screening 2002 (NRS2002)[12]. Patients with < 3 points had no nutritional risk, and those with ≥ 3 points had nutritional risk. For patients with NRS2002 score < 3 points, the recommended total intake was 25-30 kJ/(kg·d), and the protein intake was 1-1.5 kJ/(kg·d). The principle of small and frequent meals (about six meals/day) was followed, and the intake of vitamins, proteins, etc., was gradually increased to meet the body's supply needs. For patients with an NRS2002 score ≥ 3 points, oral/enteral nutrition was preferred. The general recommended energy requirement was 84-105 kJ/(kg·d) for bedridden patients and 105-125 kJ/(kg·d) for active patients. For patients with good gastrointestinal function and tolerance, it was recommended to reach the full amount within 2-3 days, whereas for patients with poor gastrointestinal tolerance, it was delayed to 5-7 days. For patients who cannot eat orally for various reasons, an indwelling enteral nutrition tube should be used[13,14]. During the nutritional intervention, the charge nurse measured and recorded the patients' weights weekly and used the NR2002 scale for nutritional risk screening. The nutritionist checked the changes in the patients' nutritional indicators (total protein, albumin, prealbumin, etc.) weekly, evaluated the effect of the nutritional intervention in combination with the nursing records, and adjusted the nutritional intervention plan.

Rehabilitation exercise intervention: On the day after surgery, the charge nurse and rehabilitation therapist collaborated to evaluate the patients' physical tolerance and exercise status and guided the patients to perform simple limb movement training in bed (e.g., ankle pump exercises, intermittent double lower limb massage, and knee flexion exercises) and respiratory muscle training (e.g., pursed-lip breathing, effective coughing, and balloon blowing). After patients got out of bed for independent activities, following the step-by-step principle, they were gradually recommended and guided to perform combined rehabilitation exercises in various ways, including aerobic, stretching, and resistance exercises. The exercise intensity was generally 50% of the maximum heart rate. Exercise frequency: Respiratory muscle training: 10-20 minutes/time, 2-3 times/day; aerobic exercise: 30 minutes/time, 5 times/week; resistance exercise was generally 20-30 minutes/time, 2-3 times/week[15]. Exercise intensity and frequency were adjusted by the rehabilitation therapist according to the patients’ conditions, with an adjustment range of 5%-10%. After discharge, the WeChat online platform was used to continuously follow up on the patients' rehabilitation exercise situations and provide targeted professional guidance. The intervention time for both groups was 1 month.

Each team member had a clearly defined role: The head nurse coordinated team activities and supervised nursing quality; the associate chief physician managed clinical evaluation; charge nurses executed care plans and maintained records; and the nutritionist, psychologist, wound therapist, pain nurse, and rehabilitation therapist provided specialized support within their respective domains. All interventions were tailored and dynamically adjusted based on the MDT’s regular evaluations.

Blinding

Due to the nature of the intervention, complete blinding of the patients and care providers was not feasible. However, to minimize detection and performance bias, outcome assessors who evaluated the wound-healing status, anxiety/depression scores, quality of life, and complications were blinded to the group assignments. Data analysts were blinded during the statistical analysis.

Observation indicators

Wound-healing status: Assessment One month after intervention, wound healing was assessed by two physicians with ≥ 5 years' clinical experience who had undergone systematic training. These assessors were completely unaware of the study's content and details. Grade A healing: The wound appeared flat, with the same color as the surrounding skin, and no redness, swelling, pain, or exudate. Grade B healing: The wound scar was reduced, palpation caused self-perceived pain, and effusion and hematoma were visible but without suppuration. Grade C healing: The wound scar was obvious, with obvious pain, suppuration, and the need for incision and drainage. Grade A healing rates of the two groups were recorded.

Anxiety and depression symptoms: Before the intervention and 1 month after the intervention, the Hospital Anxiety and Depression Scale (HADS) compiled by Zigmond AG and other scholars[16] was used to evaluate two sub-scales: The Anxiety Self-Rating Scale (HADS-A) and the Depression Self-Rating Scale (HADS-D), which includes seven items. According to the Likert 4-point scoring method (0-3 points), the higher the score, the more severe the anxiety and depression symptoms. The Cronbach's α coefficient of this scale was 0.890, and the Cronbach's α coefficients of the HADS-A and HADS-D sub-scales were 0.820 and 0.807, respectively.

Treatment adherence: Assessed using a self-developed adherence scale, comprising: Full adherence (strictly following medical instructions for medication, rehabilitation exercises, and nutritional management); partial adherence (exhibiting non-compliant behaviour initially, but adhering after explanation); non-adherence (failure to follow instructions, resulting in treatment or rehabilitation interruption). Overall treatment adherence rate = Full adherence rate + Partial adherence rate.

Quality of life: Before and 1 month after the intervention, the Functional Assessment of Cancer Therapy-General (FACT-G) compiled by Tatiane and Silva[17] was used to evaluate four dimensions: Physical condition, social/family condition, emotional condition, and functional condition, with seven, seven, six, and seven items, respectively. According to the Likert 5-point scoring method (0-4 points), the higher the score, the better the quality of life. The Cronbach's α coefficients of this scale were 0.884, 0.821, 0.867, and 0.835, respectively.

Incidence of complications: Infection, incision bleeding, and anastomotic fistula were recorded during the intervention period of the two groups.

Statistical analysis

SPSS 26.0 statistical software was used for the analysis. Enumeration data were expressed as [n (%)], and the χ² test was used. Measurement data conforming to normal distribution were expressed as mean ± SD. The independent samples t-test was used for intergroup comparisons, and the paired t-test was used for intragroup comparisons. Statistical significance was set at P < 0.05.

RESULTS

Comparison of wound-healing status between the two groups

The Grade A wound-healing rate in the MDT group was 88.27%, which was significantly higher than the 75.00% rate in the control group (P < 0.05) (Table 2).

Table 2 Comparison of wound healing between the two group, n (%).

Groups	Case	Grade A healing	Grade B healing	Grade C healing
MDT	196	173 (88.27)	22 (11.22)	1 (0.51)
Control	168	126 (75.00)	36 (21.43)	6 (3.57)
		12.257
P value		0.002

MDT: Multidisciplinary team.

Comparison of anxiety and depression symptom scores between the two groups

One month after the intervention, the HADS-A and HADS-D scores in the HADS scale of both groups showed a downward trend compared with those before the intervention. Moreover, 1 month after the intervention, each score on the HADS scale of the MDT group was lower than that of the control group, and the difference was statistically significant (P < 0.05) (Table 3).

Table 3 Comparison of anxiety and depression symptom scores between the two groups (mean ± SD, score).

Groups	Case	HADS-A score		HADS-D score
		Before intervention	After 1 month of intervention	Before intervention	After 1 month of intervention
MDT	196	14.95 ± 2.51	7.13 ± 1.52a	14.01 ± 2.40	6.26 ± 1.36a
Control	168	15.09 ± 2.55	9.15 ± 1.87a	13.98 ± 2.32	8.05 ± 1.69a
t		0.527	11.365	0.121	11.192
P value		0.599	< 0.001	0.904	< 0.001

^aP < 0.05 vs same group before intervention.

MDT: Multidisciplinary team; HADS-A: Anxiety Self-Rating Scale; HADS-D: Depression Self-Rating Scale.

Treatment adherence

The overall treatment compliance rate in the MDT group was 99.49%, which was higher than that in the control group (95.83%). This difference was statistically significant (P < 0.05) (Table 4).

Table 4 Comparison of treatment compliance between the two groups, n (%).

Group	Cases	Full compliance	Partial compliance	Non-compliance	Total compliance
MDT group	196	150 (76.53)	45 (22.96)	1 (0.51)	195 (99.49)
Control group	168	112 (66.67)	49 (29.16)	7 (4.17)	161 (95.83)
χ²					4.054
P value					0.044

MDT: Multidisciplinary team.

Comparison of quality-of-life scores between the two groups

One month after the intervention, the scores of physical condition, social/family condition, emotional condition, and functional condition on the FACT-G scale of both groups showed an upward trend compared to those before the intervention. Moreover, 1 month after the intervention, each score on the FACT-G scale of the MDT group was higher than that of the control group, and the difference was statistically significant (P < 0.05) (Table 5).

Table 5 Comparison of quality-of-life scores between the two groups (mean ± SD, score).

Groups	Case	Physiological status		Social/family situation		Emotional status		Function status
		Before intervention	After 1 month of intervention	Before intervention	After 1 month of intervention	Before intervention	After 1 month of intervention	Before intervention	After 1 month of intervention
MDT	196	13.76 ± 3.33	26.69 ± 4.62	11.43 ± 2.65	18.51 ± 3.22	12.01 ± 2.77	21.19 ± 3.72	12.61 ± 2.45	18.39 ± 3.03
Control	168	13.15 ± 3.26	23.51 ± 4.37	11.19 ± 2.78	15.82 ± 3.09	11.92 ± 2.54	19.05 ± 3.51	12.74 ± 2.53	16.08 ± 2.75
t		1.759	6.712	0.824	8.095	0.321	5.615	0.497	7.565
P value		0.079	< 0.001	0.400	< 0.001	0.748	< 0.001	0.619	< 0.001

MDT: Multidisciplinary team.

Comparison of complication incidence between the two groups

The incidence of complications in the MDT group was 3.06%, which was lower than 8.93% in the control group (P < 0.05) (Table 6).

Table 6 Comparison of the incidence of complications between the two groups, n (%).

Groups	Case	Infect	Surgical incision bleeding	Anastomotic fistula	Ileac passion	Total
MDT	196	4 (2.04)	1 (0.51)	1 (0.51)	0	6 (3.06)
Control	168	9 (5.36)	2 (1.19)	1 (0.60)	3 (1.78)	15 (8.93)
t						5.728
P value						0.017

P < 0.05 vs the same group before intervention.

MDT: Multidisciplinary team.

DISCUSSION

At present, surgery is the main method for the clinical treatment of gastrointestinal tumors, which can maximally resect tumor lesions to achieve the goal of radical cure, reduce tumor load, and improve patient prognosis[18,19]. However, the gastrointestinal functional status of postoperative patients with gastrointestinal tumors has not yet recovered, and factors such as surgical trauma stress may affect wound healing and increase the risk of complications[20]. Therefore, scientific and standardized nursing interventions are important to guarantee surgical outcomes. The results of this study showed that the Grade A wound-healing rate in the MDT group was higher than that in the control group (88.27% vs 75.00%), whereas the incidence of complications was lower in the MDT group than in the control group (3.06% vs 8.93%). This indicates that MDT collaborative nursing can promote wound healing and reduce the incidence of complications in postoperative patients with gastrointestinal tumors. Traditional clinical nursing focuses on disease management and lacks professional guidance from multiple disciplines, such as nutrition and rehabilitation medicine. Under collaborative MDT nursing interventions, resources from various medical and nursing perspectives can be integrated to serve patients according to their actual conditions. For example, the international wound therapist is responsible for comprehensive assessment and related treatment of wounds, which can accelerate wound-healing speed and reduce the risk of infection and other related complications; pain intervention can reduce patients' postoperative stress response, greatly improve physical comfort, and thus better cooperate with the implementation of various treatment and nursing measures; nutritional intervention can help patients effectively supplement the nutrients needed by the body, promote the recovery of gastrointestinal function and various body functions, and accelerate wound healing; rehabilitation exercise intervention can improve blood circulation and promote metabolism. The collaborative intervention of the above nursing measures helps meet patients' multilevel nursing needs, provides a foundation for postoperative rehabilitation, promotes wound healing, and reduces the incidence of complications.

Related studies have reported that psychological symptoms are common in patients with tumors, with an average prevalence of depression of 21.2%, and a similar prevalence of anxiety[21]. In particular, postoperative patients with gastrointestinal tumors may have their psychological status significantly affected by various factors, such as the traumatic stress response and fear of cancer recurrence, making them more prone to anxiety and depression symptoms[22,23]. Therefore, clinical medical workers should not only strengthen patients' disease management but also actively pay attention to their anxiety and depression symptoms. MDT collaborative nursing fully embodies the holistic “patient-centered” nursing concept and can provide patients with comprehensive nursing services in physiology and psychology. In this study, based on traditional nursing, MDT collaborative nursing intervention combined with psychological nursing, by fully understanding the dynamic changes in patients' psychological status, provided timely psychological support and counseling methods, such as music therapy, family emotional support, mindfulness-based stress reduction training, cognitive behavioral therapy, and narrative therapy, which helped alleviate patients' negative psychological emotions. “Management of Anxiety and Depression in Adult Cancer Survivors: The ASCO Updated Guidelines”[24] and the “Integrative Oncology Nursing Guidelines for Anxiety and Depression Symptoms in Adult Cancer Patients”[25], released in 2023, strongly recommend that mindfulness-based stress reduction, music therapy, and cognitive behavioral therapy should be used as the main intervention methods for anxiety and depression symptoms in cancer patients. The results of this study showed that 1 month after the intervention, the HADS-A and HADS-D scores in the HADS scale of both groups showed a downward trend compared with those before the intervention. Moreover, 1 month after the intervention, each HADS score of the MDT group was lower than that of the control group. This further indicates that MDT collaborative nursing can improve anxiety and depressive symptoms in postoperative patients with gastrointestinal tumors.

MDT Collaborative Care Enhances Treatment Adherence and Quality of Life in Postoperative Gastrointestinal Cancer Patients The study findings indicate that after one month of intervention, the MDT group demonstrated higher scores across all FACT-G scale domains and a greater overall treatment adherence rate compared to the control group. This demonstrates that MDT collaborative care improves treatment adherence and quality of life in postoperative gastrointestinal cancer patients. Analysis suggests this improvement stems from two primary factors. Firstly, MDT collaborative care emphasises the coordinated involvement of all departments relevant to the patient's disease management. This approach fully leverages the advantages of multidisciplinary collaboration. By focusing on the specific characteristics of the patient's condition, it facilitates the provision of specialised advice and medical care services. This collaborative effort enables the development of targeted, personalised, and standardised treatment plans[26]. Such an approach not only ensures seamless management across every stage of care but also delivers comprehensive nursing services, thereby addressing both the patient's physical and psychological health needs. On the other hand, through cognitive and psychological interventions, MDT collaborative care enhances patients' disease awareness, bolsters their confidence in combating cancer, and alleviates fears of postoperative disease progression[27]. This maximises psychological comfort, facilitates better cooperation with treatment and care measures, and significantly improves treatment adherence. Multifaceted nursing interventions encompassing pain management, nutritional support, and rehabilitation exercises accelerate the recovery process, facilitating an earlier return to normal family and social life. Consequently, patients experience a marked improvement in quality of life[28].

There are several limitations in this study. Firstly, the follow-up period was only one month, which may not be sufficient to evaluate the long-term outcomes of MDT collaborative nursing. Whether the observed improvements in wound healing, psychological status, and quality of life can be sustained over time remains unclear. Longer follow-up periods are needed in future research. Secondly, this study did not account for potential confounding factors such as tumor stage, type and extent of surgery, or use of adjuvant treatments like chemotherapy or radiotherapy. These factors may have influenced the patients’ recovery and could have affected the comparison between groups. Thirdly, all participants were from a single hospital. This may reflect specific regional practices or patient characteristics, such as differences in nutritional status or comorbidity profiles. As a result, the generalizability of the findings to other settings may be limited. Lastly, the study did not assess patient adherence to the nursing interventions, such as completion of rehabilitation exercises or compliance with nutritional guidance. Adherence could be a key factor influencing the effectiveness of the intervention. Including relevant indicators in future studies would help to better understand the relationship between adherence and outcomes.

CONCLUSION

MDT collaborative care promotes wound healing in patients undergoing gastrointestinal tumour surgery, alleviates anxiety and depressive symptoms, enhances treatment adherence and quality of life, and reduces complication rates, demonstrating significant clinical value. Nevertheless, this study exhibits certain limitations, including: Resource constraints resulting in a relatively homogeneous sample size; an intervention period limited to one month without long-term follow-up; MDT collaborative care restricted to in-house healthcare personnel without integration of ‘internet-based healthcare services’; Potential confounding factors, including tumour severity and the nature of surgical interventions, were not considered for their impact on wound healing or the management of adjuvant therapies for symptom intensity. This may introduce bias into the findings, and the analysis of the superiority of the MDT collaborative nursing intervention was insufficient. Therefore, future studies should expand the sample size and inclusion criteria, extend the follow-up period, and further investigate the impact of MDT collaborative nursing on the rehabilitation management of patients undergoing gastrointestinal tumour surgery.