Development and Monitoring Evaluation of the Clinical Pathway for post-operative care in patients with thyroid cancer in integrative medical center

Hong, Sung-eun; Hyun, Myung Han; Lee, Sang Hyung; Kim, Bup-Woo; Kim, Hee Jun; Ko, Eun Ju; Lee, Jee Young; Hong, Sung-eun; Hyun, Myung Han; Lee, Sang Hyung; Kim, Bup-Woo; Kim, Hee Jun; Ko, Eun Ju; Lee, Jee Young

doi:2025.46.1.15

JKM > Volume 46(1); 2025 > Article

ORIGINAL ARTICLE

J Korean Med. 2025;46(1): 15-28. doi: https://doi.org/10.13048/jkm.25002

갑상선암 수술 후 환자의 협진병원용 한의표준임상경로 개발 및 모니터링 평가

홍성은¹

¹차의과학대학교, 일산차병원 암통합진료센터
²차의과학대학교 일산차병원 외과

Development and Monitoring Evaluation of the Clinical Pathway for post-operative care in patients with thyroid cancer in integrative medical center

¹Integrative Cancer Center, CHA Ilsan Medical Center, CHA university
²Department of Surgery, CHA Ilsan Medical Center, CHA University School of Medicine

Corresponding Author: Jee Young Lee ,Tel: +82-31-782-3113, Fax: +82-31-782-3105, Email: happiade@chamc.co.kr

Received: September 19, 2024; Revised: November 8, 2024. Accepted: February 11, 2025.

ABSTRACT

Objectives: This study aimed to develop a clinical pathway (CP) for post-operative care in patients with thyroid cancer in integrative medical center setting, specifically targeting the improvement of quality of life (QoL) and clinical management standardization. The CP was refined through a modified Delphi method and subsequently monitored in a clinical setting.
Methods: The CP model was based on an analysis of medical records of thyroid cancer patients from July 2022 to February 2024. A time-task matrix was established, categorizing tasks by timeline (pre-operative, operation day, post-operative) and clinical activities (KM (Korean Medicine) evaluation, treatment, activity, diet, education). The draft CP model was validated using the modified Delphi method. Finally, the CP was pilot-tested in a clinical environment monitoring indicators such as CP application rate, completion rate, QoL, and satisfaction levels. To evaluate the CP, THYCA-QoL questionnaire was used, and pain levels were assessed using the Numeric Rating Scale (NRS).
Results: The final CP model showed 81.8% application rate and 100% completion rate during the monitoring period. Results of THYCA-QoL questionnaire showed significant improvement in various aspects, including neuromuscula, oral and throat, and psychological issues. The NRS indicated a 48.1% reduction in neck pain intensity after post-CP application. Both patient and medical staff satisfaction increased following the CP's application
Conclusions: The integrative CP model for post-operative care in thyroid cancer patients improved QoL and reduced pain, demonstrating its potential as a standardized tool of integrative cancer healthcare settings. Future studies should refine the model and expand its use to validate efficacy and optimize quality of care.

Keywords: Thyroid cancer | clinical pathway | integrative medicine | modified Delphi | post –operative care