The effect of nursing intervention guided by rehabilitation needs on the quality of postoperative self‐care agency and social relationships in esophageal cancer patients

To explore the effect of rehabilitation‐oriented nursing intervention on self‐care ability and social relationship quality of patients with esophageal cancer after operation. 124 esophageal cancer patients from February 2019 to January 2020 were selected and divided into study group and control group. The control group was given routine nursing, and the study group was given rehabilitation‐oriented nursing intervention on the basis of the control group. The self‐care ability score (ESCA), social relationship quality score (SQRS), mood state score, hope level score (HHI), and nursing job satisfaction were statistically analyzed. Before intervention, there was no significant difference between two groups. After intervention, the scores of health knowledge, self‐concept, self‐responsibility, and self‐care skills were higher in the study group. The scores of friend relationship, family commitment, and family intimacy were significantly higher in the study group, also the SAS (Self‐Rating Anxiety Scale) and SDS (Self‐Rating Depression Scale) scores in the study group were lower than those in the control group, and the scores of attitudes to maintain close relationship with others, attitude to take positive action and attitude towards reality and future in the study group were higher than those in the control group. In addition, the satisfaction of nursing work in the study group was higher than that in the control group. The rehabilitation needs oriented nursing intervention for esophageal cancer patients can effectively regulate patients' depression and anxiety, improve their self‐care ability and hope level, improve the quality of social relations, and patients have high recognition of nursing work.

complications, which in turn have an adverse impact on patients' rehabilitation. [3][4] Therefore, timely and effective nursing intervention is of great significance. The traditional nursing mode mainly focused on the physical level of related intervention and failed to combine the specific pathophysiological needs of patients to give targeted care. 5 As being part of the care providers group, nursing staffs should carry out intervention, taking into consideration the psychological, physiological needs of patients, in order to meet their relevant needs to the greatest extent. 6 The rehabilitation care-oriented nursing intervention is mainly based on the subjective needs of patients and the existing and potential problems. Therefore, it is important to develop targeted nursing programs, in order to provide patients with high-quality nursing services, and promote a good prognosis of the disease. In view of this, our study screened 124 patients with esophageal cancer in our hospital to explore the application value of rehabilitation needsoriented nursing intervention, and has been elaborated hereunder.

| General information
Methodology: 124 patients with esophageal cancer in our hospital from February 2019 to January 2020 were selected and divided into: Study group (n = 62) and Control group (n = 62), according to the filing order. There were 36 males and 26 females in the study group; The average age was (56.04 ± 6.90) years (range, 43-69 years

| Methodology
The control group was given routine nursing, including close monitor- After passing the training, the patients were evaluated to understand their rehabilitation needs and agreed on the nursing plan: (1) In order to increase awareness for patients with esophageal cancer undergoing postoperative rehabilitation and their relatives, health education manual was prepared and health education given to them for a duration of 30 min per session. The main contents were knowledge of esophageal cancer disease and surgical treatment, how to carry out early activities, how to prevent pulmonary infection, how to improve nutrition and how to deal with pain, etc. The main aim of educating patients and their relatives was to ensure that patients can fully realize that self-care is the best way to maintain health and comfort, guide family members to supervise patients' self-care and to assist them in their activities.

| Observation indexes
(1) The scores of self-care ability before and after the intervention in the two groups were counted and evaluated according to the self-care ability scale (ESCA), including self-care responsibility, health knowledge level, self-care skills, and self-concept, with a total of 172 points.
The higher the score, the better is considered. 8 (2) The scores of social relationship quality before and after the intervention in the two groups were statistically evaluated according to the social relationship quality scale (SQRS), including friend relationship (five items), family commitment (five items), and family intimacy (seven items). Each item was divided into 1-4 points according to very disagree to very agree, and the higher the score, the better the result. 9

| ESCA score
Before the intervention, there was no significant difference in the scores of health knowledge, self-concept, self-responsibility, and selfcare skills between the two groups (p > .05). After the intervention, the scores of health knowledge, self-concept, self-responsibility, and self-care skills in the study group were higher than those in the control group (p < .05; see Table 1).

| SQRS score
Before the intervention, there was no significant difference in the scores of friend relationship, family commitment and family intimacy between the two groups (p > .05). After the intervention, the scores of friend relationship, family commitment and family intimacy in the study group were higher than those in the control group (p < .05; see Table 2).

| SAS and SDS scores
Before the intervention, there was no significant difference in SAS and SDS scores between the two groups (p > .05). After the intervention, SAS and SDS scores of the study group were lower than those of the control group (p < .05; see Table 3).

| HHI score
Before the intervention, there was no significant difference in the scores of maintaining close relationship attitude, taking positive action attitude, and attitude towards reality and future between the two groups (p > .05). After the intervention, the scores of maintaining close relationship attitude, taking positive action attitude, and attitude towards reality and future in the study group were higher than those in the control group (p < .05; see Table 4).

| Nursing job satisfaction
The nursing satisfaction of the study group (95.16%) was higher than that of the control group (82.26%) (p < .05; see Table 5).

| DISCUSSION
Esophageal cancer has a high incidence rate. Nowadays, surgery plays an important role in the management and is the first choice for treatment of diseases. 12 However, the operation is an invasive and traumatizing treatment. It can cause different degrees of inflammatory stress reaction during the operation, and increase the risk of postoperative complications. 13 Therefore, how to take effective nursing measures to implement treatment on patients after esophageal cancer surgery and to ensure the overall treatment effect and prognosis of the disease, has become a research hotspot.
In the routine nursing care for patients postesophageal cancer surgery, most of the nursing staffs are based on the common diseases and follow the doctor's advice. However, the nursing care provided remained passive with lack of subjectivity, initiative, systemic and pertinence, resulting in poor benefits for patients. 14 The rehabilitation process needs oriented nursing intervention. This is a new type of nursing modality, which is to first communicate with patients before providing nursing care, to master each patient's specific characteristics, to make clear the individual pathological and physiological needs of patients are met, and formulate nursing plans accordingly, so as to ensure that the nursing content can meet the specific rehabilitation needs of patients and provide high-qality nursing services. In so doing, it can promote early recovery of patients. 15 Jing et al. 16  In this study, the rehabilitation needs oriented nursing measures were adopted and provided to patients with esophageal cancer in our hospital. It was found that the SDS and SAS scores of the patients were lower than those of the control group, the scores of social relationship quality were improved more significantly than those of the control group, and the score of hope level was higher than that of the control group. Therefore, it can be concluded that this approach can more effectively regulate the depression and anxiety of patients with esophageal cancer, improve their hope level, and improve the quality of social relations.
In addition, from the results of this study, the self-care ability score of the study group was higher than that of the control group after the intervention, suggesting that the rehabilitation needs oriented nursing intervention can also improve the self-care ability of patients with esophageal cancer. Good self-care ability can ensure that patients maintain a good psychological state while facing the disease, have a stronger sense of responsibility for their own health, and have a better ability to obtain disease information. This approach gives full credit to self-care ability in disease and shortens the process of postoperative rehabilitation. [17][18]  strengthen their self-care awareness and ability. At the same time, the improvement of patients' self-ability can fully mobilize the potential of patients with esophageal cancer, assist them to complete the role transformation, and establish the disease rehabilitation information system, so that patients and nursing staff can jointly promote, and build a nursing mode combining active nursing and active participation. In addition, through the investigation and analysis of patients' subjective satisfaction with nursing work, it was found that the satisfaction of nursing work in the study group was higher than that in the control group, which indicated that the rehabilitation needs oriented nursing intervention was conducive to deepening patients' satisfaction with nursing work, establishing a harmonious relationship between nurses and patients, reducing nurse patient disputes, and establishing a high-quality service image of the hospital.
To sum up, nursing intervention based on rehabilitation needs can effectively regulate patients' depression and anxiety, improve their self-care ability and hope level, improve the quality of social relations, and patients have high recognition of nursing work.