Effect of whole-process management based on planned behavior theory on postoperative recovery of acute appendicitis patients

Abstract

BACKGROUND

The theory of planned behavior (TPB) and whole-course nursing are mainly used for patients with cancer, chronic diseases, and other conditions that require long-term rehabilitation. There are few studies on diseases, such as acute abdomen, for which patients urgently need surgery. Owing to the particularity of acute abdomen and limited preoperative preparation, patients and their families may not fully realize the significance of postoperative rehabilitation and the development of good treatment behavior. Therefore, this study used acute appendicitis as an entry point to explore the influence of TPB and the whole-process management of acute abdominal disease.

AIM

To examine the impact of TPB-based whole-process management on postoperative rehabilitation and complications in patients with acute appendicitis.

METHODS

A total of 180 patients enrolled between July 2023 and June 2024 were randomly assigned via computer-generated sequence into two groups in a 1:1 ratio, with 90 cases each. In the control group, 17 cases withdrew, leaving 73 cases that ultimately received routine care. In the experimental group, 6 cases withdrew, leaving 84 cases that ultimately received full-process TPB management. The postoperative rehabilitation and complications were compared between the two groups.

RESULTS

The first exhaust time, bowel sound recovery time, first defecation time, first postoperative ground movement time, and postoperative hospital stay were shorter in the experimental group than in the control group (P < 0.05). The Visual Analog Scale scores of the experimental group were lower than those of the control group at 6 hours, 12 hours, 24 hours, and 48 hours postoperatively (P < 0.05). The total incidence of complications was lower in the experimental group than in the control group (P < 0.05). The total satisfaction rate of the experimental group was higher than that of the control group (P < 0.05). In both groups, patients 48 hours postoperatively had lower Self-Rating Anxiety Scale scores than those preoperatively. The Self-Rating Anxiety Scale score of the experimental group at 48 hours was lower than that of the control group (P < 0.05).

CONCLUSION

Whole-process management based on the TPB can shorten the postoperative recovery time in patients with acute appendicitis and reduce the incidence of pain and complications.

Keywords: Theory of planned behavior; Whole process management; Acute appendicitis; Postoperative rehabilitation; Complications

Core Tip: The theory of planned behavior, which is widely applied in China as well as globally, is underutilized in acute surgical conditions in clinical nursing. While commonly used for long-term rehabilitation in China, there is minimal research on its application in urgent surgeries such as acute abdominal diseases. Domestic studies primarily focus on preoperative full-course nursing for cancers (e.g., cervical and breast cancers) requiring extensive preparation, thereby neglecting acute cases such as appendicitis with rapid surgical turnover. This study pioneered the theory of planned behavior-based full-process management for patients with acute appendicitis and evaluated its impact on postoperative recovery and complication rates.