Effect of Nutritional-Psychological Dual-Wheel-Driven Enhanced Recovery after Surgery Nursing on the Prognosis of Patients with Bladder Cancer: A Retrospective Cohort Study.

BACKGROUND

Bladder cancer has a high recurrence rate and presents postoperative challenges that impact patient recovery. Enhanced recovery after surgery (ERAS) programs, which incorporate nutritional and psychological strategies, have demonstrated benefits in perioperative care. This study evaluates the effect of a novel nutritional-psychological dual-wheel-driven ERAS protocol on postoperative outcomes in patients undergoing bladder cancer surgery.

METHODS

A retrospective cohort study was conducted on patients with bladder cancer treated between January 2021 and June 2024. Participants were divided into a routine ERAS group and an enhanced support group receiving enhanced nutritional and psychological support. Perioperative outcomes, including postoperative recovery time, anxiety, nutritional status, complications and patient satisfaction were assessed between groups.

RESULTS

The enhanced support group (n = 121) demonstrated significant improvements in postoperative recovery metrics compared with the routine group (n = 124), that is, they had reduced intensive care unit stay, faster nasogastric tube removal and earlier time to flatus, defecation and full oral diet (p < 0.05). Repeated-measures analysis of variance (ANOVA) revealed a significant interaction effect of time and group on Nutritional Risk Screening (NRS) 2002 scores (p = 0.010). The main effects of time and group were significant for NRS 2002, Self-Rating Anxiety Scale (SAS) and visual analogue scale (VAS) scores (all p < 0.05). Simple effects analysis showed lower NRS 2002 and SAS scores in the enhanced support group than in the routine group at 24 hours before surgery and 1 day after surgery (p < 0.05) but higher VAS scores (p < 0.05). Fewer wound leakage complications occurred in the enhanced support group (p = 0.031), and patient satisfaction rates were significantly higher (p = 0.003).

CONCLUSIONS

The nutritional-psychological dual-wheel-driven ERAS protocol is associated with improved postoperative recovery, reduced complications and increased patient satisfaction in patients with bladder cancer.