The Effect of Preoperative Education on Recovery of Thoracic Surgery Patients

Brief Summary

This randomized controlled study evaluated the effect of structured preoperative education on postoperative recovery outcomes in patients undergoing thoracic surgery for lung cancer. The study was conducted in a tertiary public hospital in Istanbul between June 2022 and December 2023 and included 100 adult patients who met the inclusion criteria. Participants were randomly assigned to an intervention group or a control group.

Patients in the intervention group received structured, nurse-led preoperative education supported by a standardized patient education booklet, while the control group received routine hospital care. Recovery outcomes were assessed using physiological parameters, pulmonary function tests, shoulder joint range of motion measurements, pain intensity scores, and the Quality of Recovery-40 (QoR-40) questionnaire during the early postoperative period.

The findings of this study aim to contribute evidence on the role of preoperative nursing education in improving functional recovery, reducing postoperative pain, and supporting respiratory function in patients undergoing thoracic surgery.

Study Overview

• Status: Completed
• Conditions: Lung Cancer; Thoracic Surgery; Patient Education; Nursing Care
• Intervention / Treatment: Behavioral: Structured Preoperative Education; Other: routine care

Detailed Description

Detailed Description

Thoracic surgery for lung cancer is associated with significant postoperative pain, reduced pulmonary function, limited shoulder mobility, and delayed functional recovery. These factors may negatively affect patient outcomes, prolong hospitalization, and increase the risk of postoperative complications. Preoperative education is considered a key nursing intervention that may enhance patients' physical and psychological preparedness for surgery and improve postoperative recovery.

This randomized controlled experimental study was conducted in the thoracic surgery units of a tertiary public hospital in Istanbul. A total of 100 patients scheduled for elective thoracic surgery due to lung cancer were enrolled and randomly assigned to either the intervention group (n=50) or the control group (n=50). Randomization was performed using a computer-generated randomization method.

Patients in the control group received standard preoperative and postoperative care routinely provided by the hospital. Patients in the intervention group received structured preoperative education delivered by a nurse, supported by a standardized patient education booklet. The education included information on the surgical procedure, breathing and coughing exercises, use of incentive spirometry, early ambulation, shoulder and upper extremity exercises, and pain management strategies.

Data were collected at three time points: preoperatively, on postoperative day 1, and on postoperative day 4. Outcome measures included pulmonary function tests (FEV1 and FVC), shoulder joint range of motion assessed by goniometry, pain intensity measured using the Visual Analog Scale (VAS), and recovery quality evaluated using the Quality of Recovery-40 (QoR-40) questionnaire. Vital signs and oxygen saturation levels were also recorded.

The primary objective of the study was to determine whether structured preoperative education improves postoperative recovery outcomes compared to routine care. Secondary objectives included evaluating the effects of education on pain levels, pulmonary function, shoulder mobility, and quality of recovery.

The results of this study are expected to provide evidence supporting the integration of structured preoperative nursing education into clinical care protocols for patients undergoing thoracic surgery, with the goal of improving functional recovery and patient-centered outcomes.

• Study Type: Interventional
• Enrollment (Actual): 100
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Turkey (Türkiye)
  • başakşehir
    • Istanbul, başakşehir, Turkey (Türkiye), 34480
      • Basaksehir Cam and Sakura City Hospital

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Patients diagnosed with lung cancer who are hospitalized for elective thoracic surgery
• Aged 18 years and older
• Able to read, write, and speak Turkish
• Able to understand the information provided and without any condition that interferes with verbal communication
• Eastern Cooperative Oncology Group (ECOG) performance status of 0, 1, or 2
• Patients scheduled for lung resection via thoracotomy
• Patients undergoing surgery under general anesthesia

Exclusion Criteria:

• Patients with chronic pain in the preoperative period who are using analgesic medications for pain management
• Patients receiving antineoplastic treatment
• Patients undergoing reoperation due to lung cancer
• Patients with an ECOG performance status greater than 2
• Patients diagnosed with metastatic lung cancer
• Patients with limited mobility in the preoperative period

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Intervention Group: Structured Preoperative Education; Participants assigned to this arm receive structured, nurse-led preoperative education in addition to routine hospital care prior to thoracic surgery.	Behavioral: Structured Preoperative Education; A structured, nurse-led preoperative education program delivered prior to thoracic surgery.
Active Comparator: Control Group: Routine Care; Participants assigned to this arm receive standard preoperative and postoperative care routinely provided by the hospital.	Other: routine care; Standard care routinely provided by the hospital

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Postoperative Recovery Quality	Postoperative recovery quality assessed using the Quality of Recovery-40 (QoR-40) questionnaire. The total score ranges from 40 to 200, with higher scores indicating better recovery quality.	Postoperative day 1 and postoperative day 4

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Postoperative Pain Intensity	Pain intensity assessed using the Visual Analog Scale (VAS), ranging from 0 to 10, where higher scores indicate worse pain.	Preoperative period, postoperative day 1, and postoperative day 4
Pulmonary Function	Pulmonary function assessed using forced expiratory volume in one second (FEV1) and forced vital capacity (FVC), measured in liters.	Preoperative period, postoperative day 1, and postoperative day 4
Shoulder Joint Range of Motion	Shoulder joint range of motion measured using a goniometer and expressed in degrees. Higher values indicate better functional outcome.	Preoperative period, postoperative day 1, and postoperative day 4
Postoperative Heart Rate	Heart rate measured in beats per minute (bpm). Higher values indicate a worse outcome.	Preoperative period, postoperative day 1, and postoperative day 4
Postoperative Blood Pressure	Systolic and diastolic blood pressure measured in millimeters of mercury (mmHg). Higher values indicate a worse outcome.	Preoperative period, postoperative day 1, and postoperative day 4
Postoperative Respiratory Rate	Respiratory rate measured as breaths per minute. Higher values indicate a worse outcome.	Preoperative period, postoperative day 1, and postoperative day 4
Postoperative Oxygen Saturation	Peripheral oxygen saturation measured by pulse oximetry and expressed as percentage (%). Higher values indicate a better outcome.	Preoperative period, postoperative day 1, and postoperative day 4

Collaborators and Investigators

• Sponsor: Başakşehir Çam & Sakura City Hospital

Study record dates

Study Major Dates

• Study Start (Actual): June 1, 2022
• Primary Completion (Actual): December 31, 2023
• Study Completion (Actual): December 31, 2023

Study Registration Dates

• First Submitted: January 23, 2026
• First Submitted That Met QC Criteria: February 3, 2026
• First Posted (Actual): February 5, 2026

Study Record Updates

• Last Update Posted (Actual): February 5, 2026
• Last Update Submitted That Met QC Criteria: February 3, 2026
• Last Verified: February 1, 2026

More Information

Terms related to this study

• Keywords: Quality of recovery; Thoracic surgery; Pulmonary function test; Preoperative Education; Shoulder joint range of motion
• Additional Relevant MeSH Terms: Neoplasms by Site; Neoplasms; Respiratory Tract Diseases; Lung Diseases; Respiratory Tract Neoplasms; Thoracic Neoplasms; Lung Neoplasms
• Other Study ID Numbers: THORACIC-EDU-RECOVERY-01

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO
• IPD Plan Description: Individual participant data will not be shared, as this is a single-center academic thesis study and the informed consent and ethics approval do not include provisions for public data sharing.

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No