This study aimed to develop and validate a personalized postoperative care pathway for gynecological oncology patients based on precision medicine principles, exploring effective strategies to improve patient engagement, self-management capacity, and long-term recovery outcomes. A prospective controlled trial was conducted, randomizing 80 postoperative gynecological cancer patients into an intervention group (n = 40) and a control group (n = 40). The control group received standard postoperative care, while the intervention group underwent a multi-module personalized care pathway incorporating the Transtheoretical Model (TTM), Patient Activation Measure (PAM), Shared Decision-Making (SDM) framework, and assessment of digital engagement and adaptability. Intervention components included collaborative rehabilitation goal-setting, digital platform tracking, stage-matched behavioral interventions, SDM support, health empowerment training, and remote psychological counseling. Scale-based outcomes were assessed over 6 months (PAM, SDM, and Health Empowerment Scale HES), while survival analysis (disease-free survival DFS and event-free survival EFS) was conducted over a 12-month follow-up period. The intervention group demonstrated significantly superior outcomes in self-management capacity (PAM score: 71.77 ± 6.9 vs. 63.01 ± 7.2, P < 0.05), shared decision-making ability (SDM score: 72.73 ± 6.8 vs. 61.54 ± 7.1, P < 0.001), and health empowerment (HES score: 35.7 ± 3.2 vs. 29.6 ± 4.1, P < 0.001). Notably, 67.5% of intervention patients reached the “action” or “maintenance” stage of health behavior change, compared to only 35% in the control group. Kaplan-Meier analysis revealed significantly prolonged 12-month disease-free survival (DFS) in the intervention group (10.37 vs. 7.32 months, P < 0.05), with Cox regression identifying personalized care as an independent protective factor (HR = 0.57, 95% CI: 0.34–0.94, P = 0.028). The precision nursing-based postoperative intervention pathway significantly enhanced gynecological oncology patients’ self-management capacity, treatment engagement, and long-term survival outcomes, demonstrating strong feasibility and scalability. This study provides empirical support for transforming postoperative care into an integrated system of behavioral empowerment, digital support, and collaborative participation.
Hu et al. (Mon,) studied this question.