Study on interactive journey map of perioperative medical experience of patients undergoing pulmonary nodule day surgery under enhanced recovery after surgery mode_West China Medical Journal

Authors：

WU Mei ¹ ,  XIA Lu ¹ , ZHANG Li ¹ , GU Fen ² , SHEN Xiaoyong ³ , CHEN Long ⁴

1. Day Surgery Ward, Huadong Hospital, Fudan University, Shanghai 200040, P. R. China;
2. Department of Nursing, Huadong Hospital, Fudan University, Shanghai 200040, P. R. China;
3. Department of Thoracic Surgery, Huadong Hospital, Fudan University, Shanghai 200040, P. R. China;
4. Medical Affair Department, Huadong Hospital, Fudan University, Shanghai 200040, P. R. China;

Corresponding?author：

XIA Lu, Email: yihaibeilu@hotmail.com

Keywords：

Patient journey map; pulmonary nodule; day surgery; patient experience; enhanced recovery after surgery

DOI：

10.7507/1002-0179.202411203

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Objective To identify the needs of patients undergoing pulmonary nodule day surgery during the perioperative medical interaction experience under the enhanced recovery after surgery mode based on the patient journey map, and to provide references for optimizing the diagnosis and treatment experience of these patients and the patient-centered medical support. Methods Using the descriptive qualitative research method, 15 patients who underwent thoracoscopic pulmonary nodule resection or pulmonary wedge resection in the day surgery ward of Huadong Hospital, Fudan University between January and June 2024 were selected for semi-structured interviews. The data were analyzed using the content analysis method, and the interactive map of the patient’s medical seeking experience was drawn. Results According to the medical seeking process and perioperative stages, the interactive journey map of the patient’s medical seeking experience was formed. The medical seeking experience and health support needs of patients undergoing pulmonary nodule day surgery were classified and summarized into themes such as medical consultation cues, screening of medical information, multidisciplinary assessment, medical-patient cognitive differences, rehabilitation exercises and sports, nutritional management, doctor-patient communication, social adaptation, and emotional expression from four links: interaction touchpoints, information flow, communication methods, and feedback mechanisms. Conclusions Patients undergoing pulmonary nodule day surgery experience the perioperative medical seeking process under the enhanced recovery after surgery mode, with a shortened hospitalization period but complex postoperative health management needs. The interaction touchpoints generated during the experience are intertwined and changeable, and the health support needs required vary at different stages of intervention points. Optimizing the touchpoints can ensure that patients receive efficient medical support when needed, thereby enhancing the patient experience, improving the medical seeking feeling, and ensuring that high-quality nursing services are implemented throughout all stages.

Citation： WU Mei, XIA Lu, ZHANG Li, GU Fen, SHEN Xiaoyong, CHEN Long. Study on interactive journey map of perioperative medical experience of patients undergoing pulmonary nodule day surgery under enhanced recovery after surgery mode. West China Medical Journal, 2025, 40(2): 276-281. doi: 10.7507/1002-0179.202411203 Copy

1.	馬天文, 謝晨, 曹勁松, 等. 低劑量 CT 在肺結節篩查中的應用及預測模型的建立. 中國 CT 和 MRI 雜志, 2024, 22(9): 53-56.
2.	梁文華, 黎才琛, 何建行. 肺癌早篩早診的精準化探索. 中國腫瘤臨床, 2021, 48(10): 506-510.
3.	呂亞軍, 黃艷紅, 張久榮. 合并癥負擔對早期非小細胞肺癌患者胸腔鏡肺葉切除術后并發癥的影響:一項傾向性評分匹配分析. 中國全科醫學, 2020, 23(20): 2498-2502, 2519.
4.	車國衛. 加速康復外科: 肺癌手術日間化現狀與策略. 中國肺癌雜志, 2020, 23(1): 1-4.
5.	俞德梁, 寧鵬濤, 王娟, 等. 關于日間手術定義與首批推薦適宜手術的思考. 醫學與哲學, 2015, 36(24): 5-7, 14.
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7.	中國人民共和國國家衛生健康委員會. 國家衛健委印發《關于開展改善就醫感受提升患者體驗主題活動的通知》. 食品與健康, 2023, 35(8): 4.
8.	Davies EL, Bulto LN, Walsh A, et al. Reporting and conducting patient journey mapping research in healthcare: a scoping review. J Adv Nurs, 2023, 79(1): 83-100.
9.	戴夢嶠, 廖曉琴. 患者旅程地圖在慢性病照護中的研究進展. 護理學雜志, 2024, 39(13): 121-125.
10.	Mrklas KJ, Barber T, Campbell-Scherer D, et al. Co-design in the development of a mobile health app for the management of knee osteoarthritis by patients and physicians: qualitative study. JMIR Mhealth Uhealth, 2020, 8(7): e17893.
11.	中華醫學會呼吸病學分會, 中國肺癌防治聯盟專家組. 肺結節診治中國專家共識(2024 年版). 中華結核和呼吸雜志, 2024, 47(8): 716-729.
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14.	Ly S, Runacres F, Poon P. Journey mapping as a novel approach to healthcare: a qualitative mixed methods study in palliative care. BMC Health Serv Res, 2021, 21(1): 915.
15.	Elo S, Kyng?s H. The qualitative content analysis process. J Adv Nurs, 2008, 62(1): 107-115.
16.	史校銘, 焦子宸, 張子睿, 等. 集中管理日間手術模式下胸腔鏡手術與普通住院手術模式治療肺結節的療效及安全性比較. 川北醫學院學報, 2023, 38(6): 806-809.
17.	張黎, 劉洋, 黃明君, 等. 胸腔鏡肺結節日間手術患者精細化管理效果研究. 華西醫學, 2021, 36(2): 183-189.
18.	Van Schalkwijk DL, Widdershoven JWMG, Elias-Smale S, et al. ShareHeart: a patient journey map of patients with ischemia and non-obstructive coronary artery disease based on qualitative research. J Clin Nurs, 2023, 32(13/14): 3434-3444.
19.	Saragosa M, Nizzer S, McKay S, et al. The hospital-to-home care transition experience of home care clients: an exploratory study using patient journey mapping. BMC Health Serv Res, 2023, 23(1): 934.
20.	Farmer J, Bigby C, Davis H, et al. The state of health services partnering with consumers: evidence from an online survey of Australian health services. BMC Health Serv Res, 2018, 18(1): 628.
21.	張育琳, 金曉鳳, 黃文婷, 等. 改善患者就醫體驗提升滿意度實踐探索. 中國醫院, 2024, 28(6): 88-90.
22.	張霄艷, 王靜, 王雨璇. 武漢市基層醫療機構就診患者的感知服務質量和滿意度對忠誠度的影響機制分析. 醫學與社會, 2023, 36(6): 59-63, 99.
23.	張蕊, 趙麗亭, 吳美, 等. 加速康復外科多學科團隊協作模式在日間手術中應用的范圍綜述(英文). 中西醫結合護理(中英文), 2023, 9(7): 180-185.
24.	王淼, 楊麗, 黃一敏, 等. 上海市級醫院兒童日間手術進展與思考. 中國衛生質量管理, 2021, 28(3): 1-2, 8.

1. 馬天文, 謝晨, 曹勁松, 等. 低劑量 CT 在肺結節篩查中的應用及預測模型的建立. 中國 CT 和 MRI 雜志, 2024, 22(9): 53-56.
2. 梁文華, 黎才琛, 何建行. 肺癌早篩早診的精準化探索. 中國腫瘤臨床, 2021, 48(10): 506-510.
3. 呂亞軍, 黃艷紅, 張久榮. 合并癥負擔對早期非小細胞肺癌患者胸腔鏡肺葉切除術后并發癥的影響:一項傾向性評分匹配分析. 中國全科醫學, 2020, 23(20): 2498-2502, 2519.
4. 車國衛. 加速康復外科: 肺癌手術日間化現狀與策略. 中國肺癌雜志, 2020, 23(1): 1-4.
5. 俞德梁, 寧鵬濤, 王娟, 等. 關于日間手術定義與首批推薦適宜手術的思考. 醫學與哲學, 2015, 36(24): 5-7, 14.
6. 馬正良, 黃宇光, 顧小萍, 等. 成人日間手術加速康復外科麻醉管理專家共識. 協和醫學雜志, 2019, 10(6): 562-569.
7. 中國人民共和國國家衛生健康委員會. 國家衛健委印發《關于開展改善就醫感受提升患者體驗主題活動的通知》. 食品與健康, 2023, 35(8): 4.
8. Davies EL, Bulto LN, Walsh A, et al. Reporting and conducting patient journey mapping research in healthcare: a scoping review. J Adv Nurs, 2023, 79(1): 83-100.
9. 戴夢嶠, 廖曉琴. 患者旅程地圖在慢性病照護中的研究進展. 護理學雜志, 2024, 39(13): 121-125.
10. Mrklas KJ, Barber T, Campbell-Scherer D, et al. Co-design in the development of a mobile health app for the management of knee osteoarthritis by patients and physicians: qualitative study. JMIR Mhealth Uhealth, 2020, 8(7): e17893.
11. 中華醫學會呼吸病學分會, 中國肺癌防治聯盟專家組. 肺結節診治中國專家共識(2024 年版). 中華結核和呼吸雜志, 2024, 47(8): 716-729.
12. Bharatan T, Devi R, Huang PH, et al. A methodology for mapping the patient journey for noncommunicable diseases in low- and middle-income countries. J Healthc Leadersh, 2021, 13: 35-46.
13. Harris KW, Hammack-Aviran CM, Brelsford KM, et al. Mapping parents’ journey following prenatal diagnosis of CHD: a qualitative study. Cardiol Young, 2023, 33(8): 1387-1395.
14. Ly S, Runacres F, Poon P. Journey mapping as a novel approach to healthcare: a qualitative mixed methods study in palliative care. BMC Health Serv Res, 2021, 21(1): 915.
15. Elo S, Kyng?s H. The qualitative content analysis process. J Adv Nurs, 2008, 62(1): 107-115.
16. 史校銘, 焦子宸, 張子睿, 等. 集中管理日間手術模式下胸腔鏡手術與普通住院手術模式治療肺結節的療效及安全性比較. 川北醫學院學報, 2023, 38(6): 806-809.
17. 張黎, 劉洋, 黃明君, 等. 胸腔鏡肺結節日間手術患者精細化管理效果研究. 華西醫學, 2021, 36(2): 183-189.
18. Van Schalkwijk DL, Widdershoven JWMG, Elias-Smale S, et al. ShareHeart: a patient journey map of patients with ischemia and non-obstructive coronary artery disease based on qualitative research. J Clin Nurs, 2023, 32(13/14): 3434-3444.
19. Saragosa M, Nizzer S, McKay S, et al. The hospital-to-home care transition experience of home care clients: an exploratory study using patient journey mapping. BMC Health Serv Res, 2023, 23(1): 934.
20. Farmer J, Bigby C, Davis H, et al. The state of health services partnering with consumers: evidence from an online survey of Australian health services. BMC Health Serv Res, 2018, 18(1): 628.
21. 張育琳, 金曉鳳, 黃文婷, 等. 改善患者就醫體驗提升滿意度實踐探索. 中國醫院, 2024, 28(6): 88-90.
22. 張霄艷, 王靜, 王雨璇. 武漢市基層醫療機構就診患者的感知服務質量和滿意度對忠誠度的影響機制分析. 醫學與社會, 2023, 36(6): 59-63, 99.
23. 張蕊, 趙麗亭, 吳美, 等. 加速康復外科多學科團隊協作模式在日間手術中應用的范圍綜述(英文). 中西醫結合護理(中英文), 2023, 9(7): 180-185.
24. 王淼, 楊麗, 黃一敏, 等. 上海市級醫院兒童日間手術進展與思考. 中國衛生質量管理, 2021, 28(3): 1-2, 8.

West China Medical Journal

Study on interactive journey map of perioperative medical experience of patients undergoing pulmonary nodule day surgery under enhanced recovery after surgery mode

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