A modified Delphi method toward multidisciplinary consensus on functional convalescence recommendations after abdominal surgery

Abstract

BackgroundEvidence-based information on the resumption of daily activities following uncomplicated abdominal surgery is scarce and not yet standardized in medical guidelines. As a consequence, convalescence recommendations are generally not provided after surgery, leading to patients’ insecurity, needlessly delayed recovery and prolonged sick leave. The aim of this study was to generate consensus-based multidisciplinary convalescence recommendations, including advice on return to work, applicable for both patients and physicians.MethodUsing a modified Delphi method among a multidisciplinary panel of 13 experts consisting of surgeons, occupational physicians and general practitioners, detailed recommendations were developed for graded resumption of 34 activities after uncomplicated laparoscopic cholecystectomy, laparoscopic and open appendectomy, laparoscopic and open colectomy and laparoscopic and open inguinal hernia repair. A sample of occupational physicians, general practitioners and surgeons assessed the recommendations on feasibility in daily practice. The response of this group of care providers was discussed with the experts in the final Delphi questionnaire round.Results Out of initially 56 activities, the expert panel selected 34 relevant activities for which convalescence recommendations were developed. After four Delphi rounds, consensus was reached for all of the 34 activities for all the surgical procedures. A sample of occupational physicians, general practitioners and surgeons regarded the recommendations as feasible in daily practice.ConclusionMultidisciplinary convalescence recommendations regarding uncomplicated laparoscopic cholecystectomy, appendectomy (laparoscopic, open), colectomy (laparoscopic, open) and inguinal hernia repair (laparoscopic, open) were developed by a modified Delphi procedure. Further research is required to evaluate whether these recommendations are realistic and effective in daily practice.

Substitution of Usual Perioperative Care by eHealth to Enhance Postoperative Recovery in Patients Undergoing General Surgical or Gynecological Procedures: Study Protocol of a Randomized Controlled Trial

“…A limitation of the study is the heterogeneity of surgical procedures. However, the Delphi study that we performed to compose the convalescence recommendations used in this study showed more or less the same convalescence recommendations for all surgical procedures, which suggests that the recovery periods of these surgical procedures are comparable [24,25]. In addition, the heterogeneity can be considered an advantage, because the results will be applicable to a broader population.…”

“…Using a modified Delphi method, specific convalescence recommendations were developed for several types of abdominal surgical procedures [24,25]. The recommendations given are tailored to the patient and are based on the input of patients’ normal preoperative activities and the surgical technique (using algorithms).…”

Using the modified Delphi method to research the influencing factors of long-term health-related quality of life in patients with unruptured intracranial aneurysms after endovascular treatment

“…The modified Delphi method can help to fill the knowledge gap by reaching consensus using the knowledge and personal opinions of experts [7,8]. The modified Delphi method typically presents participants with 2-4 rounds of a fixed set of questions.…”

Management of patients after laparoscopic procedures

“…It is usually an individual decision, and depends on their occupation and the procedure performed. Patients may only require two weeks away from work after smaller procedures (such as cholecystectomy or appendicectomy) 16 . Following cancer surgery, a longer break, or gradual return to work may be advised, such as light duties or reduced hours 16 .…”

“…Patients may only require two weeks away from work after smaller procedures (such as cholecystectomy or appendicectomy) 16 . Following cancer surgery, a longer break, or gradual return to work may be advised, such as light duties or reduced hours 16 . "Sick notes" are provided by the hospital team to cover the anticipated period of absence.…”