Effects of early activity intervention on intestinal motility recovery in patients after colorectal cancer surgery

Table 1 Comparison of general characteristics between the two groups, n (%)/mean ± SD

Characteristic	Experimental group (n = 40)	Control group (n = 40)	Statistic	P value
Age (years)	61.5 ± 8.7	62.3 ± 9.1	t = 0.412	0.682
Gender			χ2 = 0.205	0.651
Male	22 (55.0)	24 (60.0)
Female	18 (45.0)	16 (40.0)
BMI (kg/m2)	23.4 ± 2.6	23.8 ± 2.8	t = 0.678	0.500
Tumor location			χ2 = 0.201	0.654
Colon	17 (42.5)	19 (47.5)
Rectum	23 (57.5)	21 (52.5)
Tumor diameter (cm)	3.8 ± 1.4	4.1 ± 1.6	t = 0.928	0.356
TNM stage			χ2 = 0.278	0.870
Stage I	12 (30.0)	10 (25.0)
Stage II	16 (40.0)	18 (45.0)
Stage III	12 (30.0)	12 (30.0)
Surgical approach			χ2 = 0.053	0.818
Open	15 (37.5)	16 (40.0)
Laparoscopic	25 (62.5)	24 (60.0)
Operation time (minutes)	168.4 ± 32.7	172.6 ± 35.2	t = 0.577	0.566
Intraoperative blood loss (mL)	145.7 ± 52.3	152.1 ± 56.8	t = 0.537	0.593
Intraoperative blood transfusion	4 (10.0)	5 (12.5)	χ2 = 0.125	0.723
Anesthesia method			χ2 = 0.417	0.519
General anesthesia	35 (87.5)	33 (82.5)
Combined anesthesia	5 (12.5)	7 (17.5)
ASA classification			χ2 = 0.223	0.894
Class I	8 (20.0)	9 (22.5)
Class II	24 (60.0)	22 (55.0)
Class III	8 (20.0)	9 (22.5)
Comorbidities	16 (40.0)	17 (42.5)	χ2 = 0.053	0.819

Measurement data were analyzed using t-test, and count data were analyzed using χ² test. P < 0.05 was considered statistically significant. BMI: Body mass index; TNM: Tumor-node-metastasis; ASA: American Society of Anesthesiologists.

Table 2 Comparison of postoperative pain scores and related indicators between experimental and control groups, n (%)/mean ± SD

Indicator	Experimental group (n = 40)	Control group (n = 40)	Statistic	P value
NRS pain score (points)
24 hours after surgery	4.2 ± 0.9	5.1 ± 1.2	t = 3.976	0.002
48 hours after surgery	3.0 ± 0.7	4.3 ± 1.0	t = 7.126	< 0.001
72 hours after surgery	1.8 ± 0.5	3.2 ± 0.8	t = 9.542	< 0.001
Good pain control
Proportion with good pain control at 48 hours after surgery1 (%)	33 (82.5)	18 (45.0)	χ2 = 11.882	< 0.001
Analgesic medication use
Additional requests for analgesic medication (times)	2.3 ± 1.1	4.8 ± 1.6	t = 8.475	< 0.001
Pain-related effects
Incidence of pain-related sleep disturbance (%)	6 (15.0)	15 (37.5)	χ2 = 5.227	0.022
Impact of pain on daily activities score (points)	2.6 ± 0.7	4.1 ± 1.2	t = 7.138	< 0.001
Pain control satisfaction rate (%)	36 (90.0)	27 (67.5)	χ2 = 6.465	0.011

¹Good pain control is defined as NRS score ≤ 3 points.

Measurement data were analyzed using t-test, and count data were analyzed using χ² test. P < 0.05 was considered statistically significant.

Table 3 Effects of early activity intervention on nursing workload and patient outcomes, mean ± SD

Indicator	Experimental group (n = 40)	Control group (n = 40)	Statistic	P value
Nutrition & tolerance
Good enteral nutrition tolerance (%)	90.0 (36/40)	72.5 (29/40)	χ2 = 4.021	0.045
Time to first liquid diet (hours)	62.3 ± 9.6	83.7 ± 12.4	t = 8.732	< 0.001
Time to full enteral nutrition (days)	4.3 ± 0.8	5.8 ± 1.2	t = 6.975	< 0.001
Target intake achievement within 7 days (%)	85.0 (34/40)	65.0 (26/40)	χ2 = 4.267	0.039
Serum albumin on POD 7 (g/L)	36.2 ± 3.5	32.8 ± 3.9	t = 4.183	< 0.001
Weight loss at 14 days (%)	3.2 ± 1.3	5.4 ± 1.8	t = 6.432	< 0.001
Nursing workload & efficiency
Daily nursing time POD 3-7 (minutes)	78.3 ± 15.6	96.2 ± 20.3	t = 4.530	< 0.001
Extra interventions for complications (times/patient)	1.2 ± 1.0	2.8 ± 1.5	t = 5.731	< 0.001
Discharge instruction time (minutes)	22.4 ± 5.3	31.5 ± 7.2	t = 6.620	< 0.001
Professional achievement score	87.6 ± 6.2	79.4 ± 7.8	t = 3.854	< 0.001
Psychological & sleep status
HADS-A anxiety score	5.2 ± 1.8	8.1 ± 2.4	t = 6.320	< 0.001
HADS-D depression score	4.8 ± 1.5	7.6 ± 2.2	t = 7.125	< 0.001
PSQI global score	6.3 ± 1.4	9.2 ± 2.1	t = 7.536	< 0.001
Night-time sleep duration (hours)	6.5 ± 0.8	5.2 ± 1.1	t = 6.284	< 0.001
Sleep efficiency (%)	78.2 ± 6.5	65.4 ± 8.9	t = 7.764	< 0.001
Nursing satisfaction
Overall satisfaction score	92.6 ± 5.8	85.3 ± 7.2	t = 5.119	< 0.001

Lower scores for Hospital Anxiety and Depression Scale-A, Hospital Anxiety and Depression Scale-D, and Pittsburgh Sleep Quality Index indicate better outcomes, while higher scores for professional achievement, nighttime sleep duration, and sleep efficiency indicate better outcomes. POD: Postoperative day; HADS: Hospital Anxiety and Depression Scale; PSQI: Pittsburgh Sleep Quality Index.