Effect of CICARE and humanistic care on resilience and pain after colon polypectomy

doi:10.4240/wjgs.120980

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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

Randomized Controlled Trial

Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.

World J Gastrointest Surg. Jul 27, 2026; 18(7): 120980
Published online Jul 27, 2026. doi: 10.4240/wjgs.120980

Effect of CICARE and humanistic care on resilience and pain after colon polypectomy

Yan-Ping Zheng, Hui-Li Pan, Hong-Fang Yu, Jun Cao, Wei-Hua Lu, Guo-Ying Ding, Cao-Xin Yan

Yan-Ping Zheng, Hui-Li Pan, Jun Cao, Wei-Hua Lu, Guo-Ying Ding, Department of Nursing, The Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou 310009, Zhejiang Province, China

Hong-Fang Yu, Endoscopy Center, The Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou 310009, Zhejiang Province, China

Cao-Xin Yan, Department of Ultrasound Medicine, The Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou 310009, Zhejiang Province, China

Co-first authors: Yan-Ping Zheng and Hui-Li Pan.

Co-corresponding authors: Guo-Ying Ding and Cao-Xin Yan.

Author contributions: Zheng YP, Pan HL, and Cao J were responsible for the research design; Zheng YP was responsible for ethical review, copyright and licensing, writing the paper, and follow-up; Yu HF and Lu WH were responsible for data collection; Ding GY was responsible for data analysis; Cao J was responsible for funding application; Yan CX was responsible for reviewing and editing, as well as communication and coordination; Zheng YP and Pan HL contributed equally to this manuscript and are co-first authors; Ding GY and Yan CX contributed equally to this manuscript and are co-corresponding authors. All authors have read and approved the final manuscript.

AI contribution statement: We used DeepL to assist in polishing the language of the manuscript. We did not use AI to write the content of the manuscript. The entire main content of this article was written by the author. The design of the study and the interpretation of the results were all completed by the author. All the pictures were created by the author and no AI was used.

Supported by 2025 General Scientific Research Project of Zhejiang Provincial Department of Education, No. Y202557945.

Institutional review board statement: This study is a randomized controlled trial that has been approved by the Ethics Committee of the Second Affiliated Hospital Zhejiang University School of Medicine.

Clinical trial registration statement: This study has not yet been registered with clinical trials. This study is a single center, prospective randomized controlled trial and belongs to non-pharmacological nursing intervention research. Due to insufficient understanding of the specific scope of application of the clinical trial registration policy by the researchers during the initial stage of the study, the clinical trial registration could not be completed within 6 months after the first subject was enrolled. This study has been reviewed by the ethics committee of the institution, and has followed medical research standards throughout the process. The data collection and analysis are authentic and complete. This is to clarify and promise that future similar studies will strictly comply with the requirements for clinical trial registration and complete registration ahead of schedule.

Informed consent statement: All research participants or their legal guardians provided written informed consent prior to study registration.

Conflict-of-interest statement: All the authors report 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 other data available.

Corresponding author: Guo-Ying Ding, Chief Nurse, Department of Nursing, The Second Affiliated Hospital Zhejiang University School of Medicine, No. 88 Jiefang Road, Shangcheng District, Hangzhou 310009, Zhejiang Province, China. 2198037@zju.edu.cn

Received: March 13, 2026
Revised: April 22, 2026
Accepted: June 2, 2026
Published online: July 27, 2026
Processing time: 136 Days and 1.3 Hours

Abstract

BACKGROUND

Colon polypectomy under endoscopic ultrasound is a common procedure, yet postoperative pain and psychological distress often impair recovery and reduce resilience. Traditional care focuses on physiological monitoring, neglecting psychosocial support. Based on positive psychology and patient-centered communication principles, we hypothesize that combining the Connect, Introduce, Communicate, Ask, Respond, Exit (CICARE) communication model with humanistic care will significantly enhance psychological resilience, alleviate pain, and improve postoperative outcomes in these patients.

AIM

To investigate the effects of CICARE combined with humanistic care on post-polypectomy resilience and pain.

METHODS

In this prospective randomized controlled trial, 98 patients undergoing ultrasound-guided colon polypectomy were randomized into observation group (CICARE plus humanistic care) and control group (routine care plus standard humanistic support), 49 each. Psychological resilience, anxiety, depression, and pain were assessed using the Connor-Davidson Resilience Scale, Hospital Anxiety and Depression Scale, and Numerical Rating Scale. The t tests or rank-sum tests were used for comparison.

RESULTS

After surgery, the observation group showed significantly higher Connor-Davidson Resilience Scale scores than the control group across resilience (42.92 ± 3.35 vs 36.37 ± 3.58), strength (26.86 ± 2.92 vs 24.61 ± 2.98), optimism (9.63 ± 1.30 vs 8.80 ± 1.15), and total score (80.31 ± 4.30 vs 73.84 ± 3.29). Anxiety and depression scores were lower (7.53 ± 1.12 vs 8.16 ± 0.87; 6.55 ± 1.16 vs 8.22 ± 1.30). Severe pain incidence was reduced (4.09% vs 10.21%). The observation group also had shorter first defecation (1.46 ± 0.34 days), first oral intake (0.53 ± 0.07 days), hospital stay (2.06 ± 0.84 days), higher self-management ability (168.18 ± 8.41), and better quality of life (5.53 ± 0.98), all P < 0.05.

CONCLUSION

Combining CICARE with humanistic care after colon polypectomy improves psychological resilience, alleviates anxiety, depression and pain, and enhances postoperative recovery, self-management and quality of life.

Keywords: Colonic polyps; Endoscopic ultrasound; Connect-introduce-communicate-ask-respond-end communication model; Humanistic care; Psychological resilience; Pain

Core Tip: The Connect, Introduce, Communicate, Ask, Respond, Exit (CICARE) communication model combined with humanistic care significantly improves postoperative outcomes in patients undergoing endoscopic ultrasound-guided colon polypectomy. This integrated approach enhances psychological resilience, alleviates anxiety and depression, reduces pain intensity, and promotes self-management ability. By systematically addressing patients’ cognitive and emotional needs through structured, empathetic communication, this nursing strategy accelerates physical recovery and improves quality of life, providing an evidence-based framework for patient-centered postoperative care.