Effects of Noise Reduction Protocol-Based Integrated Nursing Care on Perceived Comfort Level and Physiological and Psychological Stress Responses in Patients with Gastrointestinal Tumors.
Noise reduction protocol-based integrated nursing care effectively reduces environmental noise exposure in patients with gastrointestinal tumors and is associated with decreased psychological stress, improved sleep quality, and enhanced perceived comfort and quality of life.
Key Findings
Results
Noise reduction protocol-based integrated nursing care significantly improved comfort levels compared to conventional care in gastrointestinal tumor surgical patients.
Comfort was measured using the Kolcaba General Comfort Questionnaire (GCQ)
The integrated noise reduction group showed significantly greater improvements in GCQ scores than the conventional care group (P < 0.05)
The study included 54 patients in the integrated noise reduction group and 56 patients in the conventional care group
Patients were monitored from surgery until discharge
Results
The integrated noise reduction group showed significantly greater improvements across all domains of quality of life compared to the conventional care group.
Quality of life was measured using the Generic Quality of Life Inventory-74 (GQOLI-74)
Improvements were observed in all domains of the GQOLI-74 (P < 0.05)
The retrospective analysis covered clinical data from January 2023 to January 2024
Both groups received postoperative nursing care until discharge
Results
The integrated noise reduction group demonstrated significantly greater reductions in psychological stress indicators, including both depression and anxiety scores.
Psychological stress was assessed using the Hospital Anxiety and Depression Scale-Depression (HADS-D) and -Anxiety (HADS-A) subscales
Reductions in both HADS-D and HADS-A scores were significantly greater in the integrated noise reduction group (P < 0.05)
These reductions were measured preoperatively, suggesting the intervention may have also addressed pre-surgical psychological stress
Results
Sleep quality improved significantly more in the integrated noise reduction group than in the conventional care group.
Sleep quality was measured using the Pittsburgh Sleep Quality Index (PSQI), where lower scores indicate better sleep
Reductions in preoperative PSQI scores were significantly greater in the integrated noise reduction group (P < 0.05)
The PSQI improvements coincided with reductions in measured environmental noise levels
Results
Environmental noise levels were significantly reduced in the integrated noise reduction group compared to the conventional care group.
Noise was measured using equivalent continuous sound levels and maximum sound levels
Both equivalent continuous sound levels and maximum sound levels were significantly lower in the integrated noise reduction group (P < 0.05)
Noise reduction was achieved through a structured noise reduction protocol integrated into nursing care
Results
Noise reduction protocol-based integrated nursing care did not significantly affect core postoperative physical recovery parameters compared to conventional care.
Outcome measures included time to first ambulation, length of hospital stay, and Visual Analog Scale (VAS) pain scores on postoperative day 7
No significant differences were found between the two groups for any of these parameters (P > 0.05)
This suggests the intervention's benefits were primarily in psychological and comfort-related domains rather than physical recovery speed
Methods
The study population consisted of 110 surgical patients with gastrointestinal tumors treated at a single institution over a one-year period.
Patients were treated between January 2023 and January 2024
Assignment to groups was based on the postoperative nursing care received, in a retrospective study design
56 patients received conventional care and 54 patients received noise reduction protocol-based integrated nursing care
What This Means
This research suggests that adding a structured noise reduction protocol to standard nursing care for patients recovering from gastrointestinal tumor surgery can meaningfully improve their psychological wellbeing and overall hospital experience. The study compared 54 patients who received noise-reduction-focused integrated nursing care with 56 patients who received conventional care. Patients in the noise reduction group experienced lower levels of anxiety and depression, better sleep quality, greater comfort, and improved quality of life across multiple dimensions — all statistically significant differences. Actual measured noise levels in the environment (both average and peak sound levels) were also significantly lower for the noise reduction group.
Importantly, the noise reduction approach did not appear to speed up physical recovery — both groups had similar times before patients could walk, similar lengths of hospital stay, and similar pain scores one week after surgery. This suggests the intervention's main benefits were in reducing psychological and environmental stress rather than accelerating physical healing. The study was retrospective, meaning researchers looked back at existing patient records rather than conducting a prospective controlled trial, which is a limitation to consider when interpreting the strength of the evidence.
This research suggests that hospital environments that actively manage noise — through nursing protocols specifically designed to minimize sound disruption — may provide a more comfortable and less stressful recovery experience for cancer surgery patients. Given that noise is a common but often overlooked feature of hospital wards, these findings point to a potentially low-cost, practical way to improve patient wellbeing during a vulnerable period of recovery.
Huang X, Wu B. (2026). Effects of Noise Reduction Protocol-Based Integrated Nursing Care on Perceived Comfort Level and Physiological and Psychological Stress Responses in Patients with Gastrointestinal Tumors.. Noise & health. https://doi.org/10.4103/nah.nah_143_25