The psychological ability to adopt recommended coping responses reduced infections during the COVID-19 pandemic.

Esophageal cancer is a highly aggressive malignancy with a substantial global disease burden. The latest epidemiological data show that China accounts for a particularly large proportion of new cases and deaths worldwide. At present, surgery combined with radiotherapy and chemotherapy remains the main treatment strategy for esophageal cancer. However, because of digestive tract reconstruction, tumor-related consumption, and immune alterations, patients commonly experience a range of postoperative symptoms, including pain, abdominal distension, dysphagia, reflux, and nutritional impairment. In addition, the high malignancy of esophageal cancer, together with the risks of postoperative complications and mortality, often leads to considerable psychological distress, such as anxiety and depression, and significantly compromises long-term quality of life. Older adults are a particularly vulnerable group, as they are more likely to have reduced physiological reserve, multimorbidity, cognitive decline, and poorer psychological resilience. These age-related characteristics increase the risk of postoperative complications, recurrence, functional decline, and difficulties in self-management after discharge. Therefore, improving postoperative outcomes and quality of life in elderly patients with esophageal cancer remains an urgent clinical challenge. Importantly, the care needs of elderly patients after radical esophagectomy are not confined to the perioperative period, but extend across the entire disease trajectory, including diagnosis, hospitalization, and home rehabilitation. In this context, full-course management refers to continuous and coordinated care delivered throughout these three stages, with health education serving as a key component in supporting symptom management, treatment understanding, rehabilitation participation, and long-term self-care. Nevertheless, conventional needs assessment approaches often provide only cross-sectional or problem-oriented information and are limited in their ability to capture dynamic changes in patients’ experiences, emotions, and service needs over time. Patient journey mapping (PJM) is a patient-centered visualization tool that presents patients’ behaviors, experiences, emotional responses, and needs across the care process in chronological order, thereby identifying service barriers and opportunities for improvement. It has been widely used in nursing practice. Compared with traditional methods, PJM better captures stage-specific transitions and the interaction between patients and healthcare services, making it particularly suitable for elderly patients with esophageal cancer, whose needs are complex, evolving, and highly individualized. However, to date, no study has applied PJM to elderly patients undergoing radical esophagectomy for esophageal cancer to systematically identify their service barriers and care priorities across the full course of management. Therefore, this study used PJM to map the full-course management journey of elderly patients undergoing radical esophagectomy, in order to explore their tasks, experiences, needs, and key pain points at different stages and to provide evidence for optimizing age-appropriate, individualized, and continuous care. Importantly, the burden of care after radical esophagectomy extends well beyond the perioperative period, as dysphagia, reflux, malnutrition, and impaired quality of life may persist long after discharge, particularly in older adults with frailty, multimorbidity, and reduced functional reserve., In this context, patient journey mapping provides a patient-centred framework for characterizing needs, emotional responses, and service gaps across diagnosis, hospitalization, and home recovery, thereby informing the development of age-adapted, individualized, and continuous care pathways.