A journey to a new stable state—further development of the postoperative recovery concept from day surgical perspective: a qualitative study

Abstract

ObjectiveThis study aims to further develop the concept analysis by Allvin et al in 2007 and Lundmark et al in 2016 from the perspective of day-surgery patients. Also, to describe how patients experience postoperative recovery in relation to the identified dimensions and subdimensions and to interpret the findings in order to get a deeper understanding of the concept postoperative recovery.DesignDescriptive qualitative design with a theoretical thematic analysis.SettingSix day-surgery departments in Sweden.ParticipantsThirty-eight adult participants who had undergone day surgery in Sweden. Participants were purposively selected.ResultsFour dimensions—physical, psychological, social and habitual—were confirmed. A total of eight subdimensions were also confirmed, two from Allvin et al’s study and six from Lundmark et al’s study. Recovery included physical symptoms and challenges coping with and regaining control over symptoms and bodily functions. Both positive and negative emotions were present, and strategies on how to handle emotions and achieve well-being were established. Patients became dependent on others. They coped with and adapted to the recovery process and gradually stabilised, reaching a new stable state.ConclusionPostoperative recovery was described as a process with a clear starting point, and as a dynamic and individual process leading to an experience of a new stable state. The recovery process included physical symptoms, emotions and social and habitual consequences that challenges them. To follow-up and measure all four dimensions of postoperative recovery in order to support and understand the process of postoperative recovery is, therefore, recommended.

Swedish Web Version of the Quality of Recovery Scale Adapted for Patients Undergoing Local Anesthesia and Peripheral Nerve Blockade (SwQoR-LA): Prospective Psychometric Evaluation Study

“…Furthermore, the SwQoR-LA is a real-time recovery, electronic assessment, which is important to identify specific deficits in patient recovery [ 12 , 13 ]. As postoperative recovery is a dynamic and individual process that includes physical, psychological, social, and habitual aspects [ 1 - 3 ], recovery assessments should be multidimensional, be patient focused, and occur in real time at multiple clinically relevant postoperative time points [ 14 ]. The ability to identify symptom-specific recovery failure and implement targeted therapies to improve recovery is an important goal for perioperative care [ 12 , 14 ].…”

“…However, a symptom that that seems to be missing in SwQoR-LA is postoperative fatigue. Postoperative fatigue has been reported as a common symptom after day surgery [30] and occurs in patients, irrespective of whether general or local anesthesia is used [1,30,31]. Postoperative fatigue has a large impact on patients' daily life [31,32].…”

“…Postoperative recovery is an individual process and a transformative journey to a new stable state [1]. It has a clear starting point [1], followed by a dynamic and individual process including physical, psychological, social, and habitual dimensions [1][2][3] that affect each other [1]. Due to advances in surgery, anesthesia, nursing care, and early mobilization, postoperative outcome and recovery have improved [4,5].…”

Swedish Web Version of the Quality of Recovery Scale Adapted for Patients Undergoing Local Anesthesia and Peripheral Nerve Blockade (SwQoR-LA): Prospective Psychometric Evaluation Study (Preprint)

“…Furthermore, the SwQoR-LA is a real-time recovery, electronic assessment, which is important to identify specific deficits in patient recovery [12,13]. As postoperative recovery is a dynamic and individual process that includes physical, psychological, social, and habitual aspects [1][2][3], recovery assessments should be multidimensional, be patient focused, and occur in real time at multiple clinically relevant postoperative time points [14]. The ability to identify symptom-specific recovery failure and implement targeted therapies to improve recovery is an important goal for perioperative care [12,14].…”

Postoperative Recovery: Experiences of Patients Who Have Undergone Orthopedic Day Surgery

“…7 Therefore, to promote recovery in patients who have undergone day surgery, all information provided as part of the perioperative process must be thorough as well as understandable to the patient and their immediate family. 11 Postoperative recovery is a commonly used concept, but it lacks a clear definition. It is seen as a process and as a subjective experience.…”