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The goal of this clinical trial is to evaluate the effectiveness of a multidisciplinary specialist nurse-led perioperative nursing management model for patients undergoing head and neck cancer surgery. The study aims to improve perioperative recovery, reduce postoperative complications, and enhance the quality of nursing care for patients with head and neck cancer.
The main questions it aims to answer are:
Does the multidisciplinary specialist nurse-led nursing management model reduce the incidence of postoperative complications in patients undergoing head and neck cancer surgery? Does the intervention improve nutritional indicators, quality of life, and nursing satisfaction compared with routine perioperative nursing care? Does the intervention reduce length of hospital stay and hospitalization costs?
Researchers will compare patients receiving the multidisciplinary specialist nurse-led perioperative nursing management model with patients receiving routine perioperative nursing care to evaluate the effectiveness of the intervention.
Participants will:
Receive either routine perioperative nursing care or the multidisciplinary specialist nurse-led nursing management intervention during hospitalization Undergo comprehensive perioperative assessments, including nutritional status, risk of pulmonary complications, swallowing function, voice function, oral health status, and psychological condition Receive individualized multidisciplinary rehabilitation and nursing interventions developed collaboratively by specialist nurses, physicians, dietitians, and psychological counselors Participate in perioperative rehabilitation, health education, and continuous follow-up management during hospitalization Complete assessments of quality of life and nursing satisfaction during the perioperative period
Patients in the control group will receive routine perioperative nursing care for head and neck cancer surgery. Routine care includes admission education, nutritional screening and intervention, disease- and examination-related education, basic nursing care, specialized nursing care, and respiratory function training. Prior to discharge, patients will receive standardized health education regarding daily life precautions, swallowing and voice rehabilitation exercises, wound care, and management of nasogastric and tracheostomy tubes.
Participants in the intervention group will receive a multidisciplinary specialist nurse-led perioperative nursing management program in addition to routine care. The intervention was developed through evidence-based literature review and expert panel discussions and is guided by collaborative care theory. The management model consists of four major components: comprehensive assessment, individualized intervention planning, dynamic follow-up and feedback, and quality assurance with interdisciplinary coordination.
Comprehensive preoperative assessment
Following admission, patients will undergo multidimensional assessment and early risk screening performed by specialist nurses from different disciplines, with corresponding interventions initiated when necessary.
Assessment components include:
â‘ Nutritional risk assessment: Registered nurses will conduct screening using the Nutritional Risk Screening 2002 (NRS-2002). Patients identified as being at nutritional risk will undergo further assessment using the Patient-Generated Subjective Global Assessment (PG-SGA) by nutrition specialist nurses and dietitians.
â‘¡Pulmonary complication risk assessment: Respiratory specialist nurses will assess risk factors for postoperative pulmonary complications using a structured screening tool developed for patients with head and neck cancer.
â‘¢Swallowing and voice function assessment: Rehabilitation specialist nurses will assess swallowing function using the Eating Assessment Tool-10 (EAT-10) and the Kubota Water Swallow Test. Voice function will be evaluated using the Voice Handicap Index-10 (VHI-10).
â‘£Oral health assessment: Oral and maxillofacial specialist nurses will evaluate oral health status using the Oral Health Assessment Tool (OHAT).
Psychological assessment: Responsible nurses will conduct psychological screening using the Patient Health Questionnaire-2 (PHQ-2) and Generalized ⑤Anxiety Disorder-2 (GAD-2). Participants with scores ≥3 on either assessment will undergo further evaluation using PHQ-9 and GAD-7 by psychological counselors.
Individualized multidisciplinary intervention
Following comprehensive assessment, the multidisciplinary core team will identify and prioritize patient problems and develop individualized management plans. Standardized management checklists will be used and adjusted according to patient condition and clinical needs.
The intervention is implemented during two phases:
Admission-to-preoperative phase:
Nutritional management â‘¡Respiratory function training
Oral health management â‘£Swallowing function training
Non-verbal communication intervention
Postoperative phase:
Nutritional management
Airway management
Oral and skin care
Dynamic tracking and multidisciplinary follow-up The multidisciplinary team will monitor intervention implementation through daily morning handovers. Team meetings will be conducted at least once weekly to review patient progress, identify key clinical issues, discuss difficult cases, and optimize intervention strategies to ensure implementation throughout the perioperative period.
Quality assurance and interdisciplinary coordination Quality assurance measures include daily supervision by nurse managers, standardized departmental training, and structured feedback mechanisms. These approaches are intended to improve consistency of care delivery, maintain nursing quality, and enhance communication efficiency among multidisciplinary team members.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Multidisciplinary Specialist Nurse-Led Perioperative Nursing Management | Experimental | Participants in this group will receive a multidisciplinary specialist nurse-led perioperative nursing management program in addition to routine care. The intervention is based on collaborative care theory and includes comprehensive assessment, individualized multidisciplinary interventions, dynamic follow-up, and quality assurance. Specialist nurses collaborate with physicians, dietitians, and psychological counselors to provide personalized perioperative management. |
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| Routine Perioperative Nursing Care | Placebo Comparator | Participants in this group will receive routine perioperative nursing care for head and neck cancer surgery. Routine care includes admission education, nutritional screening and intervention, disease-related education, basic and specialized nursing care, respiratory function training, and discharge health education. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Multidisciplinary Specialist Nurse-Led Perioperative Nursing Management | Behavioral | Participants in the intervention group will receive a multidisciplinary specialist nurse-led perioperative nursing management program based on collaborative care theory. The intervention includes comprehensive assessment, individualized multidimensional rehabilitation, follow-up feedback, and quality control coordination throughout the perioperative period. Specialist nurses collaborate with physicians, dietitians, and psychological counselors to provide personalized management plans according to patients' nutritional status, pulmonary complication risk, swallowing function, voice function, oral health condition, and psychological status. Dynamic multidisciplinary communication and continuous monitoring are implemented during hospitalization to optimize perioperative recovery and nursing outcomes. |
| Measure | Description | Time Frame |
|---|---|---|
| postoperative complication rates | Nurses will collect and record the occurrence of postoperative complications during hospitalization in both groups. Complications will be evaluated and confirmed by physicians and include pharyngocutaneous fistula, pulmonary infection, deep vein thrombosis of the lower extremities, and flap compromise. | the day of surgery until discharge (up to 30 days ), a nurse will monitor and record patients' clinical conditions daily，On the day of discharge, the nurse will summarize and finalize the total incidence of complications during the hospital stay. |
| Nutritional indicators (prealbumin, albumin) | Nutritional indicators will be assessed by serum prealbumin and albumin levels. Nurses will collect 5 mL of fasting venous blood samples in the morning at hospital admission and on postoperative day 7. Serum prealbumin and albumin levels will be measured and compared between groups. | At hospital admission and postoperative day 7 |
| Quality of life assessed by Functional Assessment of Cancer Therapy-General (FACT-G) | Quality of life will be assessed using the Functional Assessment of Cancer Therapy-General (FACT-G), which includes four domains: physical well-being, social/family well-being, emotional well-being, and functional well-being. The questionnaire contains 27 items scored on a 5-point Likert scale, with a total score ranging from 0 to 108. Higher scores indicate better quality of life. Only the general module will be used in this study because most patients remain on enteral tube feeding before discharge. | On the morning of hospital discharge |
| Nutritional indicators (BMI) | Body mass index (BMI) will be calculated using patients' height and weight measurements. Nurses will measure height and body weight at hospital admission and on the day of discharge, and BMI values will be calculated and compared between groups. | On the mornings of both hospital admission and discharge, a designated nurse will measure the patient's height and weight using standardized medical scales, and then calculate and record the BMI value. |
| Measure | Description | Time Frame |
|---|---|---|
| Postoperative length of hospital stay | Nurses will collect and record postoperative length of hospital stay in both groups. Postoperative length of hospital stay is defined as the number of days from postoperative day 1 to the day of hospital discharge, excluding the day of surgery. | From postoperative day 1 to the day of hospital discharge (Up to 30 days). |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| jiayan Cao | Contact | 86+23340123-3130 | Caojiayan_1976@126.com |
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Tianjin Medical University Cancer Institute and Hospital | Recruiting | Tianjin | China |
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| Routine Perioperative Nursing Care | Behavioral | Participants in the control group will receive routine perioperative nursing care for patients undergoing head and neck cancer surgery, including admission education, nutritional screening and intervention, education related to the disease and examinations, basic nursing care, specialized nursing care, and respiratory function training. Before discharge, patients will receive health education regarding daily life precautions, swallowing and voice training methods, wound care, and nasogastric tube and tracheostomy tube care. |
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| Hospitalization costs | Nurses will collect and record total hospitalization costs incurred during the hospital stay for participants in both groups. | On the morning of hospital discharge,Nurses will collect and record total hospitalization costs incurred during the hospital stay for participants in both groups. |
| Nursing satisfaction assessed by the Newcastle Satisfaction with Nursing Scales (NSNS) | Nursing satisfaction will be assessed using the Newcastle Satisfaction with Nursing Scales (NSNS), a patient-reported instrument designed to evaluate satisfaction with nursing services from the patient's perspective. The scale contains 19 items scored using a 5-point Likert scale. Total scores range from 19 to 95, with higher scores indicating greater satisfaction with nursing care and lower scores indicating poorer satisfaction. The NSNS has demonstrated excellent reliability, with a reported Cronbach's alpha coefficient of 0.967. | On the morning of hospital discharge.The NSNS questionnaire will be administered by nurses on the morning of hospital discharge, and participants will complete the questionnaire before completing discharge procedures. |
| ID | Term |
|---|---|
| D006258 | Head and Neck Neoplasms |
| ID | Term |
|---|---|
| D009371 | Neoplasms by Site |
| D009369 | Neoplasms |
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