The Factors Influencing Early Ambulation in Patients With Gastrointestinal Neoplasms

Background Early ambulation helps improve postoperative recovery in gastrointestinal neoplasm patients. However, compliance with early ambulation remains low. Objective This study aimed to explore the influencing factors and experiences of early ambulation in gastrointestinal neoplasm patients and to provide suggestions for subsequent intervention programs. Methods A convergent mixed-method design was used, which was based on the Health Belief Model. Gastrointestinal neoplasm patients were invited to participate in the quantitative and qualitative investigations. The demographic data, early activity awareness, self-efficacy, disease treatment data, and social psychological data of 405 gastrointestinal neoplasm patients were collected and analyzed in a nested case-control study. A semistructured interview on early ambulation was conducted for 16 patients. Finally, the results of the 2 studies were integrated. Results Quantitative analysis revealed that age, education level, exercise habits, nutritional status, pulmonary disease status, activity awareness, and social support were the influencing factors ( P < .05). Five themes were extracted from the qualitative research results: insufficient recognition of perceived threat, perceived barriers and benefits, cues to action (internal/external factors), self-efficacy (success/failure), and needs. Conclusions Patients’ perceptions of early ambulation and social support influenced early ambulation. Perceptions of benefits/barriers, age, education level, and humanized nursing may affect early postoperative movement. Self-efficacy and behavioral cues, such as pulmonary disease status, nutritional status, and pain status, still need further exploration. Implication for Practice Reinforcing perceived severity, perceived benefits, and social support; removing possible barriers; and providing individualized health education according to the age and educational level of patients are recommended.