Understanding the Meaning of Recovery to Patients Undergoing Abdominal Surgery

Abstract

IMPORTANCE Postoperative recovery is difficult to define or measure. Research addressing interventions aimed to improve recovery after abdominal surgery often focuses on measures such as duration of hospital stay and complication rates. Although these clinical parameters are relevant, understanding patients' perspectives regarding postoperative recovery is fundamental to guiding patient-centered care.OBJECTIVE To elucidate the meaning of recovery from the perspective of patients undergoing abdominal surgery. DESIGN, SETTING, AND PARTICIPANTSThis international qualitative study involved semistructured interviews with patients recovering from abdominal surgery from October 2016 to November 2018 in tertiary hospitals in 4 countries (Canada, Italy, Brazil, and Japan). A purposive maximal variation sampling method was used to ensure the recruitment of patients with varying demographic, clinical, and surgical characteristics. Data on race were not collected. Each interview lasted between 1 and 2 hours. Interviews were recorded and then transcribed verbatim. Transcripts were then analyzed using an inductive thematic analysis approach. Data analysis was conducted from July 2019 to September 2019. MAIN OUTCOMES AND MEASURESThe qualitative analysis revealed themes reflecting the meaning of recovery from the perspective of patients undergoing abdominal surgery.RESULTS Thirty patients recovering from abdominal surgery were interviewed (15 [50%] female; mean [SD] age, 57 [18] years; 10 [33%] underwent major surgery; 16 [53%] underwent laparoscopic surgery). The interviews revealed that for patients undergoing abdominal surgery, the meaning of recovery embodied 5 overarching themes: (1) returning to habits and routines, (2) resolution of symptoms, (3) overcoming mental strains, (4) regaining independence, and (5) enjoying life. Themes associating the meaning of recovery to traditional parameters, such as earlier hospital discharge or absence of complications, were not identified in the interviews.CONCLUSIONS AND RELEVANCE This qualitative study suggests that the meaning of recovery from the perspective of patients undergoing abdominal surgery goes beyond traditional clinical parameters. The elements of recovery identified in this study should be taken into account in patient-surgeon discussions about recovery and when developing patient-centered strategies to improve postoperative outcomes.

The health‐related quality of life changes following surgery in patients with colorectal cancer: a longitudinal study

“…18,19 Recent research has shown that recovery is both multi-phased and multi-dimensional, and can vary between individuals. 3,19 Furthermore, with an ageing population, there are more elderly patients with multiple comorbidities. Understanding what 'good' quality of life means to them will help clinicians to provide tailored treatment.…”

“…However, this may lack HRQoL information. Patient‐centeredness is an important criteria for judging healthcare quality, and PROMs provide a mechanism for better understanding the specific needs of individual patients 18,19 . Recent research has shown that recovery is both multi‐phased and multi‐dimensional, and can vary between individuals 3,19 .…”

“…Patient‐centeredness is an important criteria for judging healthcare quality, and PROMs provide a mechanism for better understanding the specific needs of individual patients 18,19 . Recent research has shown that recovery is both multi‐phased and multi‐dimensional, and can vary between individuals 3,19 . Furthermore, with an ageing population, there are more elderly patients with multiple comorbidities.…”

Methods and timing in the assessment of postoperative recovery: a scoping review

“…7,8 Patients' perceptions of recovery do not merely pertain to single symptoms, but include returning to habits, social relations, regaining independence, and psychological and mental strains. 4,121 That is why exploring how the four dimensions of recovery were represented is important. The results indicate that 13/25 instruments had items in all four dimensions and 9/ 25 had items in three dimensions, showing that the concept of recovery is quite well assessed in the instruments identified here.…”

Randomized controlled trial of the Effect of General Anesthetics on postoperative recovery after minimally Invasive Nephrectomy (REGAIN trial)

“…Therefore, it is becoming increasingly di cult to identify whether treatments exert signi cant effects on postoperative outcomes using these traditional variables (Yoon et al, 2020). Furthermore, these variables have been reported to deviate greatly from patient-perceived postoperative recovery (Rajabiyazdi et al, 2021). In contrast, the Quality of Recovery-15 (QoR-15) questionnaire can provide a meaningful and overall assessment of patient-centered postoperative recovery (P. S. Myles 2018) and has been recommended as an endpoint in clinical studies investigating postoperative recovery (Kleif, Waage, Christensen, & Gögenur 2018; P. S. Myles et al, 2018).…”