Chen LY. Impact of Neuman model-guided stepped care on elderly gastric cancer patients’ postop recovery. World J Gastrointest Surg 2025; 17(10): 107935 [DOI: 10.4240/wjgs.v17.i10.107935]
Corresponding Author of This Article
Ling-Yu Chen, Doctorate Student, Department of Nephrology and Geriatrics, Fenyang Hospital, Shanxi Province, No. 186 Shengli Road, Fenyang 032200, Shanxi Province, China. chenkai74159@163.com
Research Domain of This Article
Gastroenterology & Hepatology
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Clinical Trials Study
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This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Oct 27, 2025 (publication date) through Oct 24, 2025
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Publication Name
World Journal of Gastrointestinal Surgery
ISSN
1948-9366
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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
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Chen LY. Impact of Neuman model-guided stepped care on elderly gastric cancer patients’ postop recovery. World J Gastrointest Surg 2025; 17(10): 107935 [DOI: 10.4240/wjgs.v17.i10.107935]
World J Gastrointest Surg. Oct 27, 2025; 17(10): 107935 Published online Oct 27, 2025. doi: 10.4240/wjgs.v17.i10.107935
Impact of Neuman model-guided stepped care on elderly gastric cancer patients’ postop recovery
Ling-Yu Chen
Ling-Yu Chen, Department of Nephrology and Geriatrics, Fenyang Hospital, Shanxi Province, Fenyang 032200, Shanxi Province, China
Author contributions: Chen LY designed the research study, performed the research, contributed new reagents and analytical tools; Chen LY analyzed the data and wrote the manuscript.
Institutional review board statement: This study was approved by the Medical Ethics Committee of Fenyang Hospital, Shanxi Province, approval No. 2025006.
Clinical trial registration statement: The study was registered at the Clinical Trial Center (www.researchregistry.com) with registration number: Researchregistry11330.
Informed consent statement: All study participants and their legal guardians provided written informed consent before recruitment into the study.
Conflict-of-interest statement: The author reports no relevant conflicts of interest for this article.
CONSORT 2010 statement: The authors have read the CONSORT 2010 Statement, and the manuscript was prepared and revised according to the CONSORT 2010 Statement.
Data sharing statement: No additional data are available.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ling-Yu Chen, Doctorate Student, Department of Nephrology and Geriatrics, Fenyang Hospital, Shanxi Province, No. 186 Shengli Road, Fenyang 032200, Shanxi Province, China. chenkai74159@163.com
Received: May 23, 2025 Revised: June 29, 2025 Accepted: August 8, 2025 Published online: October 27, 2025 Processing time: 153 Days and 16.5 Hours
Abstract
BACKGROUND
Owing to age-related physiological declines, elderly patients undergoing radical gastrectomy (RG) often experience physical and psychological challenges. Hence, appropriate nursing strategies need to be identified for optimizing patient outcomes.
AIM
To evaluate the effects of the Neuman Systems Model-guided stepped care intervention (NGSC) model on postoperative physical and psychological recovery in elderly patients with gastric cancer who underwent RG.
METHODS
In total, 80 elderly patients (≥ 65 years old) who underwent RG at the Shanxi Fenyang Hospital between January 2023 and June 2024 were included and randomly divided as follows: Control group (n = 40, those receiving conventional stepped care intervention); observation group (n = 40, those receiving NGSC). Postoperative recovery indices, anxiety/depression scores (Self-Rating Anxiety Scale/Self-Rating Depression Scale), quality of life (36-item short form health survey), and adverse event rates were compared between the groups.
RESULTS
Compared with the control group, the observation group presented significantly shorter recovery times for first bowel sounds, ambulation, flatus, oral intake, catheter removal, and hospitalization (all P < 0.05). Notably, in the observation group, Self-Rating Anxiety Scale/Self-Rating Depression Scale scores and the adverse event rate were significantly lower (all P < 0.05), whereas 36-item short form health survey scores were higher (P < 0.05), compared with those in the control group.
CONCLUSION
Overall, the findings of this study show that the proposed NGSC model accelerates postoperative recovery, alleviates psychological distress, improves quality of life, and reduces complications in elderly patients with gastric cancer who underwent RG, presenting potential for clinical application.
Core Tip: This study innovatively applied the Neuman Systems Model to stepped care interventions during postoperative recovery for elderly gastric cancer patients. By systematically assessing patients’ stressors and hierarchically activating the physiological-psychological defense mechanisms, the Neuman Systems Model-guided approach could significantly accelerate functional recovery (32% reduction in bowel sound recovery time, 24% shorter hospitalization) and reduce anxiety/depression rates by 41%. Concurrently, it showed improvement in the quality of life scores (36-item short form health survey increased by 18.6 points), thereby establishing a theoretically driven practical paradigm for perioperative management in cases of geriatric oncology.
