Predicting recovery at home after Ambulatory Surgery

Viñoles, J; Ibáñez, M. Victoria; Ayala, Guillermo

doi:10.1186/1472-6963-11-269

Cited by 11 publications

(9 citation statements)

References 18 publications

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“…High levels of pain 4 days after surgery were associated with a worse quality of life at 6 months [5]. Viñoles et al [10] reported that between 40 and 56% of hemorrhoidectomy, inguinal hernioplasty and valgus toe surgery patients had a high level of ambulatory surgical incapacity and required more accurate multimodal analgesic strategies.…”

Section: Discussionmentioning

confidence: 99%

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Postoperative Pain, an Unmet Problem in Day or Overnight Italian Surgery Patients: A Prospective Study

Campagna

D’Oulx

Paradiso

et al. 2016

Pain Research and Management

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Background. Because of economic reasons, day surgery rates have steadily increased in many countries and the trend is to perform around 70% of all surgical procedures as day surgery. Literature shows that postoperative pain treatment remains unfulfilled in several fields such as orthopedic and general surgery patients. In Italy, the day surgery program is not yet under governmental authority and is managed regionally by local practices. Aim. To investigate the trends in pain intensity and its relation to type of surgeries and pain therapy protocols, in postoperative patients, discharged from three different Ambulatory Surgeries located in North West Italy (Piedmont region). Method. The present study enrolled 276 patients who undergone different surgical procedures in ambulatory regimen. Patients recorded postoperative pain score twice a day, compliance with prescribed drugs, and pain related reasons for contacting the hospital. Monitoring lasted for 7 days. Results. At discharge, 72% of patients were under weak opioids, 12% interrupted the treatment due to side effects, 17% of patients required extra drugs, and 15% contacted the hospital reporting pain problems. About 50% of patients experienced moderate pain during the first day after surgery. Results from our study show that most of the patients experienced avoidable pain after discharge.

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Section: Discussionmentioning

confidence: 99%

“…Before the year 2010, studies reported moderate-to-severe pain scores in more than 30% of day hospital patients 24 hours after surgery [7, 10], and the overall incidence of pain after discharge was approximately 57% [11, 12]. …”

Section: Introductionmentioning

confidence: 99%

Postoperative Pain, an Unmet Problem in Day or Overnight Italian Surgery Patients: A Prospective Study

Campagna

D’Oulx

Paradiso

et al. 2016

Pain Research and Management

View full text Add to dashboard Cite

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“…Healthcare providers may also need to provide realistic expectations of recovery to both the patients and their caregivers. A recent study demonstrated the potential for predicting what recovery at home from ambulatory surgery may be like, thus allowing physicians to set patient and caregiver expectations before discharge [26]. Considering that an increasing number of surgical procedures, particularly in the field of orthopaedics, are being performed on an outpatient basis, especially on older patients with an increasing number of comorbidities, additional studies are needed to create a validated survey to assess caregiver burden, confirm our findings, and examine the extent of caregiver burden for different procedures and settings.…”

Section: Discussionmentioning

confidence: 99%

Burden Incurred by Patients and Their Caregivers After Outpatient Surgery: A Prospective Observational Study

Manohar

Cheung

et al. 2014

Clinical Orthopaedics &Amp; Related Research

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Introduction The burden of patients and their caregivers after outpatient surgery has not been fully examined. The number of outpatient surgeries has dramatically increased in the last several years, particularly in the orthopaedic sector. Patients undergoing outpatient orthopaedic procedures may be expected to have more postdischarge pain than those undergoing nonorthopaedic outpatient procedures. In light of this, assessment of patient and caregiver expectations and actual burden after discharge is of importance. Questions/purposes We assessed the impact of outpatient surgery on recovery of patients and their caregivers in the postoperative period by determining (1) expected versus actual time to resume daily activities, including work; (2) expected versus actual recovery at 7 and 30 days postoperatively; and (3) the number of caregivers that felt emotional or physical disturbances from caring for outpatients. Methods Forty-four adult patients undergoing outpatient surgical procedures and their primary caregivers were enrolled in this prospective survey study, of which 30% were orthopaedic patients. Surveys assessing postoperative recovery were given to patients at six time points, on Postoperative Days 0 to 3, 7, and 30. Surveys assessing the burden of informal caregiving were given to each patient's primary caregiver at four time points, on Postoperative Days 1 to 3 and 7. The enrollment rate was 79% (44 enrolled of 56 approached) and the survey response rate was 100% for patients and 93% (41 of 44) for caregivers. Results We found that 16 of 44 patients (36%) needed more time than originally anticipated to resume their daily activities and three of 29 patients (10%) needed more time off from work than originally anticipated. Patients were approximately 66% and 88% fully recovered 7 and 30 days after surgery, respectively. The primary caregivers noted disturbances in emotional (nine of 43, 21%) and physical (17 of 43, 40%) aspects of their daily lives while providing care for patients. Our surveyed patients were from multiple surgical services; however, our results may be generalized to an orthopaedic population, although they may underestimate actual results for this population given their generally higher pain scores. Conclusions Patients may take longer to recover from outpatient surgery than previously recognized. As increased pain and prolonged recovery may be associated with increased caregiver burden, these data are of particular significance to the outpatient orthopaedic surgical population. Informal caregiving after outpatient surgery may be an unrecognized physical and psychologic burden and may have a significant societal impact.One or more of the authors (CLW) certifies that he or she received, during the study period, funding from the

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“…Flanagan 47 suggested that nurses have the ethical responsibility to care for patients over time. Studies have advocated home care nurses as a resource and recommended, as another important resource, detailed patient phone conversations with opportunities for patients to ask questions 47‐49 . Because most phone calls from nurses to patients occur within 24 hours of discharge, it is possible that this is too soon to know the long‐term symptoms that may be experienced by patients.…”

Section: Perioperative Nursing Implicationsmentioning

confidence: 99%

Postoperative Distress of Orthopedic Ambulatory Surgery Patients

Odom-Forren¹,

Reed²,

Rush³

2017

AORN Journal

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Patients who undergo orthopedic ambulatory surgery have reported high levels of symptom distress during recovery at home. Content analysis of this qualitative descriptive study identified techniques of symptom management that effectively reduce postoperative symptom distress after orthopedic ambulatory surgery and provided insight into facilitators and barriers to postsurgery self-management. Focus groups consisted of 19 patients and caregivers recruited from a university orthopedic surgery office. The authors identified the common themes as distressing symptoms and consequences of surgery, management of symptoms, and self-management facilitators and barriers. Participants in our study noted the lack of continuity of care after discharge and wanted to know the realities of symptoms and receive more detailed information from care providers on how to self-manage symptoms. Nurses involved in the care of these patients should focus not only on short-term recovery, but on preparing patients to manage sustained recovery issues at home.

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Predicting recovery at home after Ambulatory Surgery

Cited by 11 publications

References 18 publications

Postoperative Pain, an Unmet Problem in Day or Overnight Italian Surgery Patients: A Prospective Study

Postoperative Pain, an Unmet Problem in Day or Overnight Italian Surgery Patients: A Prospective Study

Burden Incurred by Patients and Their Caregivers After Outpatient Surgery: A Prospective Observational Study

Postoperative Distress of Orthopedic Ambulatory Surgery Patients

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