Katarina Berg

Assessment of recovery after day surgery using a modified version of quality of recovery-40

Assessment of recovery after day surgery using a modified version of quality of recovery-40

Postoperative recovery and its association with health-related quality of life among day surgery patients

BackgroundDay surgery holds advantages for both the patient and the health care organization. However, recovery beyond the first postoperative week and following different types of surgery has not been explored to any greater degree. The current aims were to prospectively describe postoperative recovery and health-related quality of life among different groups of day surgery patients and to explore the association between postoperative recovery and health-related quality of life 30 days after discharge.MethodsA consecutive sample of 607 adult day surgery patients undergoing orthopaedic, gynaecological or general surgery was included. Postoperative recovery was assessed on days 1, 7 and 14 using the Swedish Post-discharge Surgery Recovery scale and the Quality of Recovery-23 scale. The EQ-5D was used to assess health-related quality of life preoperatively and 30 days following discharge. A repeated measure ANOVA was conducted to evaluate postoperative recovery from day 1 to day 14 and between different surgical groups. Hierarchical multiple linear regression models were used to explore the association between postoperative recovery and health-related quality of life.ResultsPostoperative recovery improved from day 1 to 14 in all surgical groups (p<0.001). The orthopaedic patients had lower postoperative recovery on day 14 compared to the general and the gynaecological patients (p<0.001). Health-related quality of life was lower among orthopaedic patients (p<0.001), even if significant improvements over time were seen in all groups. Recovery on day 7 was associated with health-related quality of life 30 days after the day surgery (p<0.05).ConclusionParticularly orthopaedic day surgical patients seem to favour a closer follow-up in order to support recovery and thereby also positively influence health-related quality of life.

Relation between personality and quality of postoperative recovery in day surgery patients.

Background and objective Personality factors have been found to influence long-term postoperative depressive symptoms, health and distress in inpatients. To our knowledge, no studies have analysed whether the personality traits of day surgery patients relate to postoperative recovery. Hence, this study aims to explore possible relationships between personality traits and the quality of postoperative recovery in patients undergoing day surgery. Methods Our study used a consecutive sample of 260 day surgery patients to explore possible relationships between personal traits, measured by a short Big Five scale, and postoperative recovery, measured by modified Quality of Recovery-40, on postoperative days 1, 7 and 14. Results We found a positive correlation in changes of ‘physical independence’ and ‘extroversion’ (r = 0.20; P = 0.010) and ‘intellect’ (r = 0.18; P = 0.021) on postoperative days 1 and 7. These correlations were not observed on postoperative day 14. With regard to the change between days 7 and 14, correlations were found between ‘physical interdependence’ and ‘agreeableness’ and between ‘physical interdependence’ and ‘conscientiousness’ (r = −0.17; P = 0.028–0.030 for both). Conclusion Day surgery patients appear to be a homogenous group with stable personalities, demonstrating some minor correlations between personality traits and the quality of postoperative recovery on days 1, 7 and 14. However, further studies are needed.

The Interaction Between the Patient and Nurse Anesthetist Immediately Before Elective Coronary Artery Bypass Surgery

PURPOSE Establishing a purposive interaction with a patient who is in a vulnerable situation before coronary artery bypass graft (CABG) surgery poses a challenge for the nurse anesthetist. The aim of this study was to identify and describe the interaction between the patient and the nurse anesthetist immediately before elective CABG surgery. DESIGN An observational study using a grounded theory design was used. METHODS A theoretical selection of patients and nurse anesthetists was made. A total of 11 situations of patient/nurse anesthetist interaction were observed. The data were analyzed using the constant comparative method. FINDINGS A core category of reassurance emerged from other categories of continuity, confirmation, and control. Continuity was characterized by expedient anesthesia nursing of high quality, confirmation was related to communication in a trusting atmosphere, and control was associated with skilled nursing interventions in the thoracic operating theatre. CONCLUSIONS Reassurance can be achieved through a well-structured anesthesia nursing performance in the thoracic operating theatre, and by focusing on the patient and continuously giving him/her information during the preoperative preparation phase.

Provision of preoperative and postoperative information increases the likelihood a person will be fully prepared for home recovery

Commentary on : Mitchell M. Home recovery following day surgery: a patient perspective. J Clin Nurs 2015;24:415–27.[OpenUrl][1][PubMed][2] Day surgery is widely applied in many countries. The organisation of care at the surgery unit is effective and most patients feel safe and well taken care of.1 The surgical care event, including postoperative surveillance, is brief and patients are discharged with the intention that they should manage postoperative recovery mainly by themselves … [1]: {openurl}?query=rft.jtitle%253DJ%2BClin%2BNurs%26rft.volume%253D24%26rft.spage%253D415%26rft_id%253Dinfo%253Apmid%252F24811058%26rft.genre%253Darticle%26rft_val_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Ajournal%26ctx_ver%253DZ39.88-2004%26url_ver%253DZ39.88-2004%26url_ctx_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Actx [2]: /lookup/external-ref?access_num=24811058&link_type=MED&atom=%2Febnurs%2F19%2F2%2F60.atom