Implementation of a clinical pathway in primary spontaneous pneumothorax patients treated by wedge resection surgery

Abstract

Purpose: This study was conducted to develop a clinical pathway for primary spontaneous pneumothorax (PSP) patients treated by wedge resection surgery. The authors also aimed to evaluate the effects of the implementation of the PSP clinical pathway on (1) complication occurrence rates, (2) self-efficacy with respect to PSP recurrence prevention, (3) patient-perceived quality of life, and (4) patient treatment satisfaction.

Design: This study was conducted using a quasi-experimental, nonequivalent study design.

Sample: The study subjects were 60 PSP patients admitted to the thoracic surgery departments at 2 university hospitals located in Seoul, South Korea.

Methods: A retrospective medical record review was conducted to develop a PSP clinical pathway, and the developed clinical pathway was then applied to the treatment group (n = 30). Complication occurrence rates, self-efficacy with respect to PSP recurrence prevention, perceived quality of life, and patient treatment satisfaction were measured.

Findings: The developed PSP clinical pathway is comprehensive and includes self-care and recurrence prevention education in addition to common protocols, such as medication and diagnostic tests. The pathway significantly improved self-efficacy with respect to preventing PSP recurrence, health-related quality of life, and patient treatment satisfaction, but did not reduce complication rates.

Implications: The present study offers a new comprehensive clinical pathway for PSP patients who have undergone wedge resection surgery. This study may be useful in the clinical nursing field by providing guiding standards for PSP-related education with respect to diet, exercise, self-supervision, complication, stress control, and recurrence prevention.