Development and implementation of personalized postoperative care plans for gynecological oncology patients under the precision medicine paradigm: strategies to enhance patient participation and self-management capacity

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.