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Postoperative recovery after different orthopedic day surgical procedures
Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
Faculty of Health and Society, Malmö University.
Örebro University Hospital.
Linköping University, Department of Social and Welfare Studies, Health, Activity, Care. Linköping University, Faculty of Health Sciences.
2011 (English)In: International Journal of Orthopaedic and Trauma Nursing, ISSN 1878-1241, Vol. 15, no 4, 165-175 p.Article in journal (Refereed) Published
Abstract [en]

Orthopedic day surgery is common. Postoperative recovery may differ according to surgical procedures and personal factors. We studied postoperative recovery up to 2 weeks after different orthopedic day surgical procedures and tried to identify possible predictors associated with recovery. Three-hundred and fifty eight patients who had undergone knee arthroscopy or surgery to the hand/arm, foot/leg or shoulder were included. Data were collected on postoperative days 1, 7 and 14 using the Swedish Post-discharge Surgery Recovery scale, the emotional state, physical comfort and physical independence dimensions in the Quality of Recovery-23 and a general health question. Multiple linear regression was used to explore predictors of recovery. The shoulder patients experienced significantly lower postoperative recovery and general health 1 and 2 weeks after surgery compared to the other patient groups (p < 0.001). Significant predictors of recovery were age, perceived health and emotional status on the first postoperative day and type of surgery. Postoperative recovery after common orthopedic day surgical procedures varies and factors influencing it need to be further explored. The impact of a patient’s emotional state on recovery after day surgery can be of particular interest in this work. Post-discharge planning needs to be tailored to the surgical procedure.

Place, publisher, year, edition, pages
Amsterdam: Elsevier , 2011. Vol. 15, no 4, 165-175 p.
Keyword [en]
Day surgery; Postoperative recovery; Orthopedic nursing
National Category
Medical and Health Sciences
URN: urn:nbn:se:liu:diva-71363DOI: 10.1016/j.ijotn.2011.02.003OAI: diva2:447770
Available from: 2011-10-13 Created: 2011-10-13 Last updated: 2012-10-31
In thesis
1. Patients’ perspectives on recovery from day surgery
Open this publication in new window or tab >>Patients’ perspectives on recovery from day surgery
2012 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

A large number of elective surgical patients in Sweden and elsewhere have their surgical procedure performed in a day surgery context. The surgical care event, with its postoperative surveillance, is brief at the surgery unit and patients are discharged home with the intention that they should manage postoperative recovery mainly themselves. However, several patients attest to being in an exposed situation when assuming responsibility for recovery at home. The overall aim of this thesis was to attain comprehensive knowledge of postoperative recovery following day surgery from a patient perspective.

A questionnaire, the Post-discharge Surgical Recovery scale, was translated into Swedish and evaluated regarding its psychometric properties in a Swedish context. A sample of 607 day surgery patients who had undergone orthopaedic, general or gynaecological surgery self-rated their recovery at postoperative Days 1, 7 and 14 using the Post-discharge Surgical Recovery scale and the Quality of Recovery-23. Health-related quality of life was assessed before and 30 days after the surgical procedure, using the EQ-5D. In a second sample, 31 patients were interviewed in their homes regarding their recovery after day surgery. The interviews were conducted on postoperative Days 11-37, and focused on the meaning of recovery, self-care and perceptions of recovery. Data were explored by means of a phenomenographic analysis.

The Post-discharge Surgical Recovery scale showed satisfactory psychometric properties when used among Swedish day surgery patients. Following discharge, recovery included both physical and emotional perspectives. Recovery varied, and influencing factors were found to be type of surgery, age, perceived health and emotional status on the first postoperative day. Orthopaedic patients had a more protracted recovery process compared to general surgery and gynaecological patients, along with more postoperative pain and lower health-related quality of life. Patients perceived that postoperative recovery comprised different internal and external factors and a large amount of responsibility regarding their recovery and surgical outcome. To be prepared for recovery at home, patients wanted knowledge and understanding about the normal range of recovery following their specific surgical procedure, and needed support from different sources in their surroundings.

This thesis provides insight into day surgery patients’ postoperative situation. Based on the studies, individualized and well thought-out support appears favourable in order to have confident and well prepared patients at home. In contrast to smooth and easy patient care at the surgery unit, the postoperative phase seems to be a weak link in the day surgical continuity of patient care. Postoperative care needs to be further improved to increase quality and patients’ overall satisfaction with the day surgical experience. Attention should be paid to patients’ physical and emotional resources and needs.

Place, publisher, year, edition, pages
Linköping: Linköping University Electronic Press, 2012. 80 p.
Linköping University Medical Dissertations, ISSN 0345-0082 ; 1330
Ambulatory surgical procedures, continuity of patient care, recovery of function, self care, qualitative research, quality of life, questionnaires, validation studies
National Category
Medical and Health Sciences
urn:nbn:se:liu:diva-85027 (URN)978-91-7519-793-7 (ISBN)
Public defence
2012-11-30, Berzeliussalen, Universitetssjukhuset, Campus US, Linköpings universitet, Linköping, 13:00 (Swedish)
Available from: 2012-10-31 Created: 2012-10-31 Last updated: 2016-09-26Bibliographically approved

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Berg, KatarinaUnosson, Mitra
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