United Kingdom telephone follow up nursing service model for colorectal cancer patients after enhanced recovery after surgery program in Hong Kong: Feasibility study

Abstract

Introduction: Colorectal cancer is most common cancer in Hong Kong. The advancement in laparoscopic surgery or enhanced recovery after surgery (ERAS) program reduced pain, postoperative ileus and hospital stay. However, no nurse-led postoperative care was designed for early discharged. Nurse telephone follow up after ERAS is widely used in United Kingdom but benefits is unknown in Hong Kong. Objectives: This study aims to assess the feasibility and acceptability of using United Kingdom telephone follow up nursing service on ERAS patients. Also to explore the psychological wellbeing of patient with early discharged. Methodology: This was a prospective four week intervention study conducted in four hospitals (QMH, UCH, CMC and QEH). A structured UK telephone follow up was given to ERAS patients after discharged. Study participants were recruited by using convenience sampling. Three structured telephone calls were given to patients within 2-3 days, 2 weeks and 4 weeks after discharged. The main outcome measures were feasibility and acceptability of using telephone follow up. Additional, psychological wellbeing of ERAS patients will be assessed by Chinese version of the Depression, Anxiety and Stress Scale21 at three time points: pre-telephone, 2 weeks and 4 weeks after start of telephone follow up. Result & Outcome: From Aug 2018 to Jan 2019, 73 patients (38 male, 35 female) with mean age of 67.01 (S.D. 9.74, 29-89) were recruited. The telephone follow up was found to be feasible, with a total of 215 out of 219 telephone calls (98.17%) made successfully. The mean time of each telephone is 9.84 (S.D. 4.016; 3-20) minutes. The telephone call was well accepted by patients, as 70 patients (95.89%) retained in the study. During telephone conversation, patients reported different home care problems and nursing advice could provide immediately. Unnecessary readmissions are avoided. The mean score for stress, anxiety and depression (7.61, 5.47 and 4.97) measured at baseline decreased over time after telephone intervention. The telephone follow up is found feasible and acceptable model in Hong Kong. It provides valuable information for further applicability study.