Concept clarification of «delayed surgical recovery» for clinical practice implementation

Abstract

Context: While the concept of "delayed surgical recovery" has a high estimated occurrence in surgical nursing practice, the lack of specificity of critical attributes has interfered with diagnostic accuracy and consequent application in clinical practice. There is thus a need for concept clarification. Objectives: To analyse of the concept of the nursing diagnosis «delayed surgical recovery», using the method of Walker and Avant, 2011. Main topics under analysis: Critical attributes were identified and antecedents and consequences were pointed out. Model, contrary, and illegitimate cases are presented. Suture dehiscence, hyperaemia, presence of secretion in the surgical wound, prolonged postoperative time, and reporting that more time is needed for recovery were the key critical attributes for diagnosis. Conclusion: The concept analysis made it possible to establish the boundaries of the defining attributes and provide the basis to develop the cases that explain the circumstances surrounding the diagnosis of «delayed surgical recovery».

The effect of discharge training developed based on nursing interventions classification (NIC) on surgical recovery in oncology patients: Randomized controlled trial ‐ A pilot study1

“…Problems that are often experienced by patients who undergo gastric and colorectal cancer surgery, such as nausea, pain, fatigue and loss of appetite, may cause slower recovery and delays in their return to daily routines and work (Delphino et al, 2015; Kahokehr et al, 2010; McGrath et al, 2017; Santana et al, 2018). Some studies have reported that postponing activities at home or work indicate the interruption of surgical recovery (Norlyk & Harder, 2011; Santana et al, 2018).…”

“…Preconceptions of the recovery process based on the surgical procedure might be affected negatively among patients who had undergone gastric or colorectal cancer surgery (Norlyk & Harder, 2011). Patients might think that they are not fully recovered or that they need more time to recover after their discharge (Delphino et al, 2015). This study showed that the intervention and control groups reported mild distress about the problem described as perceiving that more time is needed to recover and that there was a statistically significant difference between the groups at the times T2, T3 and T4.…”

“…Patients who had undergone gastric or colorectal cancer surgery may experience losses in their self‐care abilities to the common post‐discharge problems such as pain, fatigue and the existence of incision, and they might need help to maintain their daily life activities such as maintaining personal hygiene, dressing and undressing (Açıksöz & Uzun, 2007; Delphino et al, 2015; Williams, 2008). Studies have reported that there is a statistically significant correlation between the patients' self‐care levels and general health outcomes and that insufficient self‐care management after discharge might cause delay in recovery (Güçlü & Kurşun, 2017; Santos et al, 2018).…”

“…Symptomatic findings such as disconnection of sutures in the surgical area, hyperaemia, oedema and infection in the surgical area indicate deteriorated recovery in that area; the emergence of surgical site infections occurs between the 13th and 30th days post‐surgery (Delphino et al, 2015; Santana, Delphino, et al, 2014). Patients discharged after surgery should be followed up in terms of these symptoms and findings for the full extent of the recovery period (Santana & de Oliveira Lopes, 2015).…”

Analysis of the concept of powerlessness in individuals with stroke

“…(10) It is also seen that in this taxonomic classification system all diagnostic categories are derived from concepts and present theoretical models or formulations (11) to give meaning to the observations of physiological, psychic, social, religious and spiritual phenomena, going through continuous analyzes according to studies found in the literature. (12)(13)(14)(15)(16)(17)(18)(19) As already mentioned, the conceptual definition of powerlessness (00125) standardized by NANDA-I is "lived experience of lack of control over a situation, including a perception that one's actions do not significantly affect a result." (2) .…”