A planned but vulnerable pathway towards self‐management following day surgery. Orthopaedic patients’ experiences

Abstract

Introduction An increasing share of surgical activity is organised as day surgery, thus giving more responsibility for care to patients and their next of kin. Purpose To obtain increased understanding of orthopaedic day surgery patients’ experiences with self‐management. Methods A descriptive interview study. Eleven men and five women aged 18–78 years, who had undergone arthroscopic knee surgery in rural Norway participated in qualitative individual interviews during autumn 2018. Systematic text condensation was used as analysis strategy. Results The main theme a planned but vulnerable pathway towards self‐management and five subthemes were highlighted. The interviewees were satisfied with most aspects of the day surgery. However, challenges in adapting oral and written information to self‐management postdischarge, a need for further self‐management support at home, and strenuous travel increased the strain. Conclusion The written and oral information and support that was planned and provided by the hospital did not meet the patients’ needs for self‐management support postdischarge. The day surgery care pathway seemed to lack effective educational interventions for strengthening the patients’ self‐efficacy and control and to have potential for improvements.

Patients' experiences of day surgery and recovery: A meta‐ethnography

“…Over half of the included articles highlighted that participants undergoing day surgery treatment felt dependant on health care professionals' emotional and practical support. During their stay at the day surgery unit, many participants were pleased with the care provided if the staff showed genuine concern (Berg et al., 2013; Halding et al., 2021; Hersht et al., 2007; Renholm et al., 2009). As one participant expressed; ‘I was really nervous before the operation but coming in and everybody explaining stuff to me the day of the surgery… as they were wheeling me in, I was totally comfortable’ (Hersht et al., 2007).…”

“…He reassured me that the operation went well.’ (Gilmartin & Wright, 2008). On the contrary, some participants felt upset as their emotional needs were ignored (Gilmartin, 2007; Halding et al., 2021) or not taken seriously (Larsson et al., 2022). One participant stated, ‘… They do not seem to tell you what is happening.…”

“…For instance, several participants wanted adaption of the timing and level of information provided, care interventions, sick leave and involvement of community nursing care (Gilmartin, 2007; Greenslade et al., 2010; Halding et al., 2021; Larsson et al., 2022; Renholm et al., 2009). Many participants viewed scheduled phone calls, visits from nurses and follow‐up appointments as helpful individualised postoperative care (Berg et al., 2013; Dahlberg et al., 2018; Flanagan, 2009; Greenslade et al., 2010; Halding et al., 2021; Larsson et al., 2022; Renholm et al., 2009). As one participant said: ‘They called that evening after I got home, and the next morning they were here to check in … Home care was really good to me’ (Greenslade et al., 2010).…”

“…Unsurprisingly, several studies noted that participants believed that well‐planned and continued support from health care professionals was important for their recovery (Berg et al., 2013; Flanagan, 2009; Greenslade et al., 2010; Renholm et al., 2009). To improve day surgery practice, participants requested certain strategies to ensure provision of individualised care and support at home (Dahlberg et al., 2018; Greenslade et al., 2010; Halding et al., 2021; Renholm et al., 2009). For instance, several participants wanted adaption of the timing and level of information provided, care interventions, sick leave and involvement of community nursing care (Gilmartin, 2007; Greenslade et al., 2010; Halding et al., 2021; Larsson et al., 2022; Renholm et al., 2009).…”

difficulties faced by patients following orthopedic day surgery

“…Fifth, the article identified that patients' feelings of loneliness receives limited support from others. The second article (Halding et al 2021) used a combination of qualitative interview sub-studies and a survey. The authors applied individual interviews to 16 patients, 3-5 days post-surgery between the ages of 18 and 78.…”