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Postoperative recovery from the perspective of day surgery patients: A phenomenographic study
Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Health Sciences.
Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.ORCID iD: 0000-0002-2764-3095
2013 (English)In: International Journal of Nursing Studies, ISSN 0020-7489, E-ISSN 1873-491X, Vol. 50, no 12, 1630-1638 p.Article in journal (Refereed) Published
Abstract [en]

Background: Today, many patients undergo surgical procedures in a day surgery setting. The shift from inpatient care to care at the patient’s own home following discharge places various demands on patients and their families during the recovery process. There is a need for knowledge of how the postoperative recovery process is perceived, as research indicates a lack of support for patients managing recovery at home.

Objectives: To explore day surgery patients’ perceptions of postoperative recovery.

Design: A qualitative design with a phenomenographic approach was used.

Methods and settings: Semi-structured interviews with 31 patients undergoing an orthopaedic, general or urologic day surgical procedure were carried out face-to-face at the patients’ homes, 11-37 days post-discharge. Patients were recruited from two day surgery settings: one private unit and one unit associated with a local county hospital.

Results: The patients perceived postoperative recovery as comprising internal and external prerequisites and implied changes in ordinary life with varying levels of support. The organization at the day surgery unit, with its advantages and disadvantages, was perceived as having an impact on the subsequent recovery trajectory. The results are demonstrated in three descriptive categories: ‘Conditions for recovery at home’, The rollback to ordinary life’ and ‘Being a cog in a flow of care’.

Conclusions: Postoperative recovery following day surgery implies, from the patients’ perspective, a migration from being a recipient of care at the day surgery unit to playing an active role, with extensive responsibility at home. To manage self-care confidently, postdischarge patients require knowledge and understanding of what constitutes the normal range in recovery following their specific surgical procedure.

Place, publisher, year, edition, pages
Elsevier, 2013. Vol. 50, no 12, 1630-1638 p.
Keyword [en]
Ambulatory surgical procedures, nursing, qualitative research, recovery of function, self care
National Category
Medical and Health Sciences
URN: urn:nbn:se:liu:diva-85026DOI: 10.1016/j.ijnurstu.2013.05.002ISI: 000327225300007OAI: diva2:563656

Funding agencies|ALF||County Council of Ostergotland, Sweden||Linkoping University||

Available from: 2012-10-31 Created: 2012-10-31 Last updated: 2016-09-26Bibliographically approved
In thesis
1. Patients’ perspectives on recovery from day surgery
Open this publication in new window or tab >>Patients’ perspectives on recovery from day surgery
2012 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

A large number of elective surgical patients in Sweden and elsewhere have their surgical procedure performed in a day surgery context. The surgical care event, with its postoperative surveillance, is brief at the surgery unit and patients are discharged home with the intention that they should manage postoperative recovery mainly themselves. However, several patients attest to being in an exposed situation when assuming responsibility for recovery at home. The overall aim of this thesis was to attain comprehensive knowledge of postoperative recovery following day surgery from a patient perspective.

A questionnaire, the Post-discharge Surgical Recovery scale, was translated into Swedish and evaluated regarding its psychometric properties in a Swedish context. A sample of 607 day surgery patients who had undergone orthopaedic, general or gynaecological surgery self-rated their recovery at postoperative Days 1, 7 and 14 using the Post-discharge Surgical Recovery scale and the Quality of Recovery-23. Health-related quality of life was assessed before and 30 days after the surgical procedure, using the EQ-5D. In a second sample, 31 patients were interviewed in their homes regarding their recovery after day surgery. The interviews were conducted on postoperative Days 11-37, and focused on the meaning of recovery, self-care and perceptions of recovery. Data were explored by means of a phenomenographic analysis.

The Post-discharge Surgical Recovery scale showed satisfactory psychometric properties when used among Swedish day surgery patients. Following discharge, recovery included both physical and emotional perspectives. Recovery varied, and influencing factors were found to be type of surgery, age, perceived health and emotional status on the first postoperative day. Orthopaedic patients had a more protracted recovery process compared to general surgery and gynaecological patients, along with more postoperative pain and lower health-related quality of life. Patients perceived that postoperative recovery comprised different internal and external factors and a large amount of responsibility regarding their recovery and surgical outcome. To be prepared for recovery at home, patients wanted knowledge and understanding about the normal range of recovery following their specific surgical procedure, and needed support from different sources in their surroundings.

This thesis provides insight into day surgery patients’ postoperative situation. Based on the studies, individualized and well thought-out support appears favourable in order to have confident and well prepared patients at home. In contrast to smooth and easy patient care at the surgery unit, the postoperative phase seems to be a weak link in the day surgical continuity of patient care. Postoperative care needs to be further improved to increase quality and patients’ overall satisfaction with the day surgical experience. Attention should be paid to patients’ physical and emotional resources and needs.

Place, publisher, year, edition, pages
Linköping: Linköping University Electronic Press, 2012. 80 p.
Linköping University Medical Dissertations, ISSN 0345-0082 ; 1330
Ambulatory surgical procedures, continuity of patient care, recovery of function, self care, qualitative research, quality of life, questionnaires, validation studies
National Category
Medical and Health Sciences
urn:nbn:se:liu:diva-85027 (URN)978-91-7519-793-7 (ISBN)
Public defence
2012-11-30, Berzeliussalen, Universitetssjukhuset, Campus US, Linköpings universitet, Linköping, 13:00 (Swedish)
Available from: 2012-10-31 Created: 2012-10-31 Last updated: 2016-09-26Bibliographically approved

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