This randomized controlled trial evaluates the clinical efficacy of a structured early rehabilitation nursing (ERN) pathway compared to routine care in patients with severe acute pancreatitis (SAP). The study aims to determine if the ERN pathway, which includes phased mobility, respiratory training, and psychological support, can improve gastrointestinal recovery, reduce hospital stay and complications, and enhance functional independence and quality of life.
Severe acute pancreatitis (SAP) is a life-threatening condition with high mortality and morbidity, often complicated by prolonged immobilization, leading to muscle atrophy, delayed gut recovery, and increased infection risk. Current nursing practices often neglect early mobilization. This study introduced and tested a structured early rehabilitation nursing pathway (SERNP) designed to address these gaps. A total of 104 eligible SAP patients were randomly assigned to either the SERNP group (n=52) or a control group receiving routine care (n=52). The SERNP intervention was initiated within 48 hours of achieving hemodynamic stability and was delivered in three phases over 14 days: Phase 1 (Days 1-3) focused on bedside passive exercises and respiratory training; Phase 2 (Days 4-7) introduced progressive mobilization like sitting and assisted standing; and Phase 3 (Days 8-14) involved supervised ambulation. The study hypothesis was that the SERNP would accelerate recovery and improve outcomes by addressing both the physiological and psychosocial consequences of SAP.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
104
A multi-component, phased nursing intervention focused on early and progressive mobilization, respiratory exercises, and psychological support.
Standard nursing care for severe acute pancreatitis patients in the ICU, including monitoring and passive limb mobilization.
Affiliated Hospital of Jianghan University, The Sixth Hospital of Wuhan
Wuhan, Hubei, China
Time to Relief of Abdominal Distension
Time in days from randomization until the resolution of abdominal distension, as assessed by clinical evaluation.
Time frame: From randomization up to hospital discharge (an average of 14 days)
Time to First Bowel Movement
Time in days from randomization until the first anal exhaust (bowel movement).
Time frame: From randomization up to hospital discharge (an average of 14 days)
Duration of Hospital Stay
Total length of stay in the hospital, measured in days.
Time frame: From hospital admission up to hospital discharge (an average of 14 days)
Incidence of Complications
Percentage of patients who developed complications, including pressure ulcers, pneumonia, and venous thrombosis.
Time frame: From randomization until hospital discharge (an average of 14 days)
Activities of Daily Living (ADL) Score
Functional independence measured using the Barthel Index (BI). The scale ranges from 0 to 100, with higher scores indicating greater independence.
Time frame: Within 24 hours prior to Intensive Care Unit (ICU) discharge
Quality of Life (QoL) Score
Quality of life assessed using the World Health Organization Quality of Life-BREF (WHOQOL-BREF) questionnaire. This measures four domains: physical health, psychological health, social relationships, and environment. Scores are transformed to a 0-100 scale, with higher scores indicating better QoL.
Time frame: At 48 hours prior to hospital discharge
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Nursing Satisfaction
Patient satisfaction with nursing care, measured using a 10-item Likert scale developed for ICU settings. The rate of patients rating care as "satisfied" or "very satisfied" was calculated.
Time frame: Within 24 hours prior to hospital discharge