Study on the Efficacy of “Information Platform + Self-Care Model” on the Health Status of Discharged Patients Following Vaginal Natural Orifice Transluminal Endoscopic Surgery

Figures & data

Table 1 Core Intervention Content and Guidance Methods of “Information Platform + Self-Care Model”

Core Modules	Specific Module Name	Content	Initial Guidance Methods (See Remarks of the Table)	Follow-Up Guidance Methods
1. Discharge procedures	1) Preparation of objects	Important documents required for handling discharge	①	Regularly evaluate patients’ skills before and after discharge, and provide targeted guidance for patients on what they do not understand
	2) Notes for reimbursement	Reimbursement process and precautions
	3) Notes for medical record copying	Process and precautions of medical record copying
2. Health education	1) Living guidance	Diet, excretion, bathing, rest, exercise, work, clothing, menstrual cycle changes, sexual life guidance, fertility consultation, and contraindications	①
3. Learning of self-care skills	1) Canal care	Contents of catheter care, replacement of urinary bag and drainage bag, time of extubation	① ②
	2) Vulva care	Cleaning and disinfection of vulva
	3) Thrombosis prophylaxis	Methods of thrombosis prevention exercise
	4) Chronic disease guidance	Blood pressure monitoring Blood glucose monitoring
	5) Post-discharge medication guidance	Methods and cautions for using estrogen, anti-inflammatory suppository, and other drugs and precautions
4. Observation of complications	1) Observation of complications	Increased vaginal bleeding Abnormal pain, vaginal wall hematoma, etc.	① ③
5. Symptomatic guidance	1) Symptomatic guidance	Self-examination and initial treatment of general symptoms	① ③
6. Consultation and feedback	1) Consultation	Contact information of nursing staff and official account	④	Follow up patients regularly, the specialist nursing team members answer patients’ questions, and consult experts in case of difficult questions
	2) Feedback	Investigate the effect and satisfaction after each consultation
7. Other aspects	1) Gynecological health tips		①	Intermittent push notification
	2) Article appreciation
	3) Epidemic prevention and control	Daily protection, and preparation of admission for prevention and control

Notes: Remarks: ① Guide patients to read articles and review pictures on the official account ② Watch videos ③ View examples ④ Contact nursing staff by telephone or via the official account.

Table 2 General Data of Patients

Item	Type	n/M (P25, P75)	Proportion (%)
Age (year)	p<0.05	31 (27, 39)	—
Ethnicity	Han	53	96.4
	Minority	2	3.6
Occupation	Unemployed	10	18.2
	Retired/retired for illness	2	3.6
	Government/public institution	11	20
	In business	13	23.6
	Worker/waiter	13	23.6
	Farmer	1	1.8
	Other	5	9.1
Education	Primary school and below	2	3.6
	Junior high school	11	20
	Senior high school or technical secondary school	15	27.3
	Junior college or higher vocational college	16	29.1
	Bachelor’s degree or above	11	20
Marital status	Married	45	81.8
	Unmarried	7	12.7
	Divorced	3	5.5
	Widowed	0	0
Fertility	With child	30	54.5
	No child	25	45.5
Number of children	No	29	52.7
	1	21	38.2
	More than 1	5	9.1
Pregnancy desire	Strongly desire	29	52.7
	Does not affect	6	10.9
	No intention of becoming pregnant	15	27.3
	Not applicable	5	9.1
Family income and expenditure	Below RMB 1000	2	3.6
	1001–3000	6	10.9
	3001–5000	10	18.2
	5001–7000	17	30.9
	7001–10,000	9	16.4
	More than RMB 10,000	11	20
Family income and expenditure	Sufficient income	4	7.3
	Income and expenses at par	45	81.8
	Expenses more than income	6	10.9
Payment mode (multiple choices)	Self-paying	6	10.9
	Commercial insurance	7	12.7
	Social insurance	49	89.1
Place of residence	Village	11	20
	Township	5	9.1
	County	11	20
	Prefecture-level city and above	28	50.9
Hospital convenient for medical treatment	Yes	51	92.7
	No	2	3.6
	Unclear	2	3.6
Living mode	Alone	5	9.1
	With family members	49	89.1
	Other	1	1.8
Relationship with primary caregiver	Disharmonious	0	0
	Normal	2	3.6
	Harmonious	52	94.5
	Not applicable	1	1.8
Disease diagnosis	Cervical disease	1	1.8
	Uterine disease	10	18.2
	Fallopian tube disease	27	49.1
	Ovarian disease	17	30.9
Complication (multiple choices)	No	44	80
	Cardiovascular and cerebrovascular diseases	2	3.6
	Hepatic disease	5	9.1
	Other	4	7.3
Surgical duration (min)	p<0.05	78 (65, 120)	—
Type of catheter indwelled after surgery (multiple)	Drainage tube	1	1.8
	Urinary catheter	55	100
Number of postoperative catheters	1	54	98.2
	More than 1	1	1.8
Discharged with catheter	No	53	96.4
	Yes	2	3.6
Type of catheter at discharge (multiple choice)	Discharged with drainage tube	0	0
	Discharged with urinary catheter	2	3.6
Complications during hospitalization (multiple choice)	No	52	94.5
	Abnormal bleeding at vaginal incision or surrounding area	2	3.6
	Poor healing at vaginal incision or stub	1	1.8
Days of hospitalization (d)	p<0.05	4(4, 5)	—

Table 3 Comparison of Quality of Life Scores One Month After Discharge Between the Intervention Group and the Control Group

SF-36	Intervention Group (n = 28) [±S/M (P25, P75)]	Control Group (n = 27) [±S/M (P25, P75)]	Difference Median 95% CI	Z/t/t’	P
Total Score (TS)	597.76 ± 116.64	463.70 ±148.34	134 (62, 206)	3.733^a	<0.001
Dimension 1 Physical functioning (PF)	80 (62.5, 93.75)	90 (50, 95)	0 (−10, 10)	0.034^b	0.973
Dimension 2 Physical role functioning (PRF)	100 (25, 100)	25 (0, 75)	25 (0, 50)	2.679^b	0.007
Dimension 3 Bodily pain (BP)	74 (62.5, 84)	74 (62, 74)	0 (0, 10)	1.47^b	0.141
Dimension 4 General health perceptions (GHP)	69.64 ± 14.33	48.52 ± 12.92	21.12 (13.74, 28.51)	5.734^a	<0.001
Dimension 1–4 Physiological health content (PHC)	284.57± 67.18	228.44 ± 69.74	56.13 (19.10, 93.16)	3.04^a	0.004
Dimension 5 Vitality (VT)	70.54 ± 15.60	51.85 ± 20.76	18.68 (8.78, 28.59)	3.783^a	<0.001
Dimension 6 Social role functioning (SRF)	87.5 (75, 100)	75 (50, 87.5)	12.5 (0, 25)	2.034^b	0.042
Dimension 7 Emotional role functioning (ERF)	100 (66.67, 100)	66.67 (0, 100)	33.3 (0, 33.3)	3.19^b	0.001
Dimension 8 Mental health (MH)	76.29 ± 15.77	61.19 ± 18.76	15.10 (5.74, 24.46)	3.236^a	0.002
Dimension 5–8 Mental health content (MHC)	313.19 ± 59.85	235.26 ± 86.95	77.93 (37.27, 118.59)	3.858^c	<0.001

Note: Remarks: ^at-test; ^bWilcoxon rank-sum test; ^ct-test.

Data Sharing Statement

All data generated or analysed during this study are included in this article. Further enquiries can be directed to the corresponding author.