Construction And Preliminary Application Of Perioperative Exercise Program For Frail Elderly Patients With Colorectal Cancer

ObjectiveTo establish a perioperative exercise program for frail elderly patients with Colorectal Cancer and verify its safety and feasibility through preliminary application.Methods1.Based on the guidance of goal-oriented theory,systematically searched Chinese and English databases to initially construct the draft of the exercise program.The final draft of the exercise program was formed after revision and improvement through Delphi expert consultation.2.32 frail elderly inpatients with colorectal cancer in a Grade-A tertiary hospital from July to December in 2022 were selected.The patients were divided into control group and intervention group by the hospital district grouping method for quasi-experimental research,with 16 patients in each group.The control group received routine perioperative nursing,and the intervention group received exercise based on the final draft of "Perioperative exercise program for frail elderly patients with colorectal cancer".Results1.Construction of the exercise program:(1)Through the systematic literature screening,a total of 26 documents were finally included.The relevant content was summarized through the literature analysis method,and the first draft was formulated based on the goal-oriented theory.(2)A total of 15 experts participated in the Delphi expert consultation.The effective response rates of the two-round expert consultation questionnaires was 100%.The expert authority coefficient was 0.88.The variation coefficients of the two-round expert inquiries were 0～0.23 and 0～0.11,respectively.The coordination coefficients were 0.167 and 0.224,respectively.After two rounds of expert consultation,the final draft was formed,including 5 first-level indicators,20 second-level indicators and 34 third-level indicators.2.Preliminary application of the Exercise Program:On the third day after surgery,the scores of the 15-item Quality of Recovery scales in the intervention group were higher than those in the control group,and the difference was statistically significant(P<0.05).At discharge,the scores of Timed Up and Go Test,Grip strength and Barthel index of the patients in the intervention group were also better than those in the control group,which also showed great difference(P<0.05).No serious adverse events related to exercise occurred during practice.Most patients in the intervention group(71.43%)complied with the Exercise Program.ConclusionBased on the guidance of goal-oriented theory,literature review and Delphi expert consultation,"Perioperative exercise program for frail elderly patients with colorectal cancer" was proved to be reliable and practical.It provides personalized exercise programs for patients step-by-step.The exercise program can effectively improve physical function,postoperative recovery quality,and the recovery of basic activities of daily living of patients.The safety and effect of the program have been preliminarily confirmed.It has laid a theoretical foundation for further clinical intervention research.