Meta-analysis of the effects of Roy Adaptation Model-based interventions in postoperative patients with gastrointestinal cancer

BACKGROUNDThe Roy Adaptation Model (RAM) has been increasingly applied to patients with gastrointestinal (GI) cancer undergoing surgery, yet its overall effectiveness remains unclear. AIMTo systematically evaluate the efficacy of Roy interventions for postoperative patients with GI cancer. METHODSWe conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) comparing RAM with conventional routine care in postoperative patients with GI cancer.Literature searches were performed across databases from inception to May 2026.Risk of bias was assessed using RoB 2.0, and the certainty of evidence was evaluated with GRADE.RESULTS Eleven RCTs involving 1435 patients were included.RAM significantly shortened postoperative first flatus time [standardized mean difference (SMD): -5.15, 95% confidence interval (CI): -7.89 to -2.41], first defecation time (SMD: -3.90, 95%CI: -5.48 to -2.31), and bowel sound recovery time (SMD: -4.68, 95%CI: -5.64 to -3.73); and improved quality of life (QoL) in the physical (SMD: 1.33, 95%CI: 0.75-1.92)and social (SMD: 1.74, 95%CI: 0.58-2.89)domains; reduced anxiety (SMD: -1.12, 95%CI: -1.72 to -0.52); increased satisfaction (relative risk: 1.13, 95%CI: 1.05-1.21);and improved exercise of self-care agency scale (ESCA) scores in health knowledge (SMD: 1.04, 95%CI: 0.53-1.55),selfconcept (SMD: 1.09, 95%CI: 0.15-2.02),self-care (SMD: 1.46, 95%CI: 0.62-2.31),and self-4 / 34 responsibility (SMD: 2.50, 95%CI: 0.35-4.64)(all P < 0.05).However, GRADE assessment indicated very low to low certainty of evidence for most outcomes. CONCLUSIONFindings from this meta-analysis suggest that RAM may be associated with improved postoperative GI function, QoL, psychological status, satisfaction, and ESCA in patients with GI cancer undergoing surgery.However, the certainty of evidence was low to very low for all outcomes.Firm conclusions cannot be drawn at present, and further well-designed high-quality RCTs are urgently required to verify these potential effects.