Effects of an operating room waiting management program based on just-in-time adaptive intervention theory on patients undergoing laparoscopic hepatectomy

Abstract

Abstract: Objective:To evaluate the effects of an operating room waiting management program based on the just-in-time adaptive intervention (JITAI) theory on the preoperative waiting experience in patients undergoing laparoscopic hepatectomy.
Methods:Using convenience sampling method, a total of 70 patients who underwent laparoscopic hepatectomy at Affiliated Hospital of Jiangsu University between November 2022 and June 2026 were enrolled and divided into two groups according to admission time: a control group (between November 2022 and December 2024, n=35) and an observation group (between January 2025 and June 2026, n=35). The control group received routine operating room waiting management procedures, while the observation group received the JITAI-based operating room waiting management program in addition to routine care. The two groups were compared in terms of actual waiting time and perceived waiting time. Mean arterial pressure (MAP) and heart rate (HR) were measured. Anxiety levels were assessed using the self-rating anxiety scale (SAS), and patient satisfaction was evaluated using a self-designed satisfaction questionnaire.
Results:The observation group had significantly shorter actual waiting time and perceived waiting time than the control group (both P<0.05). SAS scores, as well as MAP and HR measured at the time of leaving the operating room waiting area, were significantly lower in the observation group than in the control group (all P<0.05). Patient satisfaction scores were significantly higher in the observation group than in the control group (P<0.05).
Conclusions:The JITAI-based operating room waiting management program can effectively shorten both actual and perceived waiting time, reduce preoperative anxiety levels, improve physiological stress responses, and enhance patient satisfaction in patients undergoing laparoscopic hepatectomy.

Key words: Just-in-time adaptive intervention, Operating room waiting, Hepatocellular carcinoma, Laparoscopic hepatectomy, Intervention

Shao Jingyi, Ai Xiaoming, Tang Weiding. Effects of an operating room waiting management program based on just-in-time adaptive intervention theory on patients undergoing laparoscopic hepatectomy[J]. Electronic Journal of Liver Tumor, 2026, 13(3): 66-72.

References

[1] Bray F, Laversanne M, Sung H, et al.Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries[J]. CA Cancer J Clin, 2024, 74(3): 229-263.
[2] Tsai KY, Chen HA, Wang WY, et al.Long-term and short-term surgical outcomes of laparoscopic versus open liver resection for hepatocellular carcinoma: might laparoscopic approach be better in early HCC?[J]. Surg Endosc, 2019, 33(4): 1131-1139.
[3] Zhang X, Zhang H, Zhang Z, et al.The mediating effect of resilience on the relationship between symptom burden and anxiety/depression among Chinese patients with primary liver cancer after liver resection[J]. Patient Prefer Adherence, 2023, 17: 3033-3043.
[4] Koyuncu A, Yakit E.The effect of waiting time on the surgical stretcher in the operating room for urological surgery on anxiety and surgical fear: a comparative cross-sectional study[J]. J Perianesth Nurs, 2025, 40(6): 1535-1540.
[5] Bayram E, Dolğun İ.Does preoperative waiting time influence anxiety and analgesic demand? A prospective observational study. Ir J Med Sci, 2025, 194(6):2383-2389.
[6] Mashkani O, Ernst AT, Thiruvady D, et al.Minimizing patients total clinical condition deterioration in operating theatre departments[J]. Ann Oper Res, 2022: 1-37.
[7] Spruijt-metz D, Marlin BM, Pavel M, et al. Advancing behavioral intervention and theory development for mobile health: the HeartSteps Ⅱ protocol[J]. Int J Environ Res Public Health, 2022, 19(4): 2267.
[8] 代玉, 罗月, 杨会琼, 等. 基于即时适配干预理论的智慧护理方案在介入手术患者中的应用研究[J]. 中华护理杂志, 2025, 60(20): 2437-2443.
[9] Von Lützow U, Neuendorf NL, Scherr S.Effectiveness of just-in-time adaptive interventions for improving mental health and psychological well-being: a systematic review and meta-analysis[J]. BMJ Ment Health, 2025, 28(1): e301641.
[10] 田思颖, 常红. 即时适配干预在慢性病患者久坐与身体活动中应用的研究进展[J]. 中华护理杂志, 2025, 60(5): 619-623.
[11] 潘美琪, 胡凯利, 徐咏连, 等. 基于即时适配干预理念的多联预康复管理策略在腰椎退行性疾病病人中的应用[J]. 骨科, 2025, 16(3): 243-249.
[12] Li L, Zhang HZ, Ge Y, et al.The perioperative experience and needs of hepatocellular carcinoma patients in interventional therapy: a phenomenological qualitative study[J]. Eur J Gastroenterol Hepatol, 2024, 36(4): 423-429.
[13] Lee HH, Chiu CC, Lin JJ, et al.Impact of preoperative anxiety and depression on quality of life before and after resection of hepatocellular carcinoma[J]. J Affect Disord, 2019, 246: 361-367.
[14] Kondo HM, Gheorghiu E, Pinheiro AP.Malleability and fluidity of time perception[J]. Sci Rep, 2024, 14(1): 12244.
[15] Fabbri M, Pizzini B, Beracci A, et al.Time consciousness: silence, mindfulness, and subjective time perception[J]. Prog Brain Res, 2024, 287: 191-215.
[16] 米星宇, 卢诗琪, 满一凡, 等. 术前焦虑与抑郁状态对肝细胞癌根治术后长期预后影响的前瞻性队列研究[J]. 中国普通外科杂志, 2026(2): 306-322.
[17] Ossai EN, Nwosu ADG, Onwuasoigwe O, et al.Prevalence and predictors of anxiety among surgical patients in the preoperative holding area of national orthopaedic hospital, enugu, nigeria: a cross-sectional study[J]. J West Afr Coll Surg, 2023, 13(2): 105-112.
[18] Zhi LJ, Yang W, He B. Current status and optimization of patients' waiting time in preoperative waiting room[J]. J Perianesth Nurs, 2026, 27: S1089-9472(25)00546-5.
[19] Dziadzko M, Mazard T, Bonhomme M, et al.Preoperative anxiety in the surgical transfer and waiting area: a cross-sectional mixed method study[J]. J Clin Med, 2022, 11(9): 2668.
[20] Gao L, Chen W, Qin S, et al.The impact of preoperative interview and prospective nursing on perioperative psychological stress and postoperative complications in patients undergoing TACE intervention for hepatocellular carcinoma[J]. Medicine (Baltimore), 2024, 103(2): e35929.
[21] Koç Apaydin Z, Kina H.Lumbar disk herniation surgeries: the impact of preoperative holding area duration on anxiety and postoperative pain[J]. Turk J Med Sci, 2025, 55(5): 1256-1264.
[22] Wu B, Wang HJ, Yang XP, et al.The influence of preoperative waiting time on anxiety and pain levels in outpatient surgery for breast diseases[J]. J Patient Saf, 2024, 20(2): 105-109.
[23] 吴蓓, 江会. 学龄前儿童术前等待时间对焦虑水平影响的研究[J]. 中国护理管理, 2020, 20(5): 792-796.
[24] Bidgoli ZA, Sadat Z, Zarei M, et al.Does a 30-minute introductory visit to the operating room reduce patients' anxiety before elective surgery? A prospective controlled observational study[J]. Patient Saf Surg, 2023, 17(1): 31.
[25] Dai WS, Huang ST, Xu N, et al.The effect of music therapy on pain, anxiety and depression in patients after coronary artery bypass grafting[J]. J Cardiothorac Surg, 2020, 15(1): 81.
[26] Pathan FKM, Pandian JS, Shaikh AI, et al.Effect of slow breathing exercise and progressive muscle relaxation technique in the individual with essential hypertension: a randomized controlled trial[J]. Medicine (Baltimore), 2023, 102(47): e35792.
[27] Wang Y, Liu C, Wang P.Patient satisfaction impact indicators from a psychosocial perspective[J]. Front Public Health, 2023, 11: 1103819.