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

BMC Nursing

Kristofer Årestedt²  Mitra Unosson¹  Karin Kjellgren³  Katarina Berg³ 

[1] Department of Social and Welfare Studies, Faculty of Health Sciences, Linköping University, Norrköping, Sweden;School of Health and Caring Sciences, Linnaeus University, Kalmar, Sweden;Division of Nursing Science/Department of Medical and Health Sciences, Faculty of Health Sciences, SE-581 85, Linköping, Sweden

关键词: Recovery of function;    Quality of life;    Nursing;    Ambulatory surgical procedures;   

Others  :  1092202
DOI  :  10.1186/1472-6955-11-24

 received in 2012-03-24, accepted in 2012-11-05,  发布年份 2012

【 摘 要 】

Background

Day 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.

Methods

A 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.

Results

Postoperative 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).

Conclusion

Particularly 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.

【 授权许可】

   
2012 Berg et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

【 参考文献 】

• [1]Toftgaard C: Day surgery development. Ambulatory Surgery 2009, 15(1):4-9.
• [2]Boughton M, Halliday L: Home alone: patient and carer uncertainty surrounding discharge with continuing clinical care needs. Contemp Nurse 2009, 33(1):30-40.
• [3]Young J, O’Connell B, McGregor S: Day surgery patients’ convalescence at home? Does enhanced discharge education make a difference? Nurs Health Sci 2000, 2:29-39.
• [4]Lemos P, Pinto A, Morais G, Pereira J, Loureiro R, Teixeira S, Nunes C: Patient satisfaction following day surgery. J Clin Anesth 2009, 21(3):200-205.
• [5]Rhodes L, Miles G, Pearson A: Patient subjective experience and satisfaction during the perioperative period in the day surgery setting: a systematic review. Int J Nurs Pract 2006, 12:178-192.
• [6]Mottram A: “Like a trip to McDonalds”: a grounded theory study of patient experiences of day surgery. Int J Nurs Stud 2010, 48(2):165-174.
• [7]Mattila K, Toivonen J, Janhunen L, Rosenberg P, Hynynen L: Postdischarge symptoms after ambulatory surgery: first week incidence, intensity, and risk factors. Anesth Analg 2005, 101:1643-1650.
• [8]Brattwall M, Warrén Stomberg M, Rawal N, Segerdahl M, Jakobsson J, Houltz E: Patients’ assessment of 4-week recovery after ambulatory surgery. Acta Anaesthesiol Scand 2011, 55(1):92-98.
• [9]McGrath B, Chung F: Postoperative recovery and discharge. Anesthesiol Clin North America 2003, 21:367-386.
• [10]Warrén Stomberg M, Segerdahl M, Rawal N, Jakobsson J, Brattwall M: Clinical practice and routines for day surgery in Sweden: implications for improvement in nursing interventions. J Perianesth Nurs 2008, 23(5):311-320.
• [11]Daabiss M: American Society of Anesthesiologists physical status classification. Indian Journal of Anaesthesia 2011, 55(2):111-115.
• [12]Kleinbeck S: Self-reported at-home postoperative recovery. Res Nurs Health 2000, 23:461-472.
• [13]Zalon M: Correlates of recovery among older adults after major abdominal surgery. Nurs Res 2004, 53(2):99-106.
• [14]Allvin R, Berg K, Idvall E, Nilsson U: Postoperative recovery: a concept analysis. J Adv Nurs 2007, 57(5):552-558.
• [15]Kluivers K, Riphagen I, Vierhout M, Brölmann H, de Vet H: Systematic review on recovery specific quality-of-life instruments. Surgery 2008, 143:206-215.
• [16]Palfreyman S: Patient-reported outcome measures and how they are used. Nurs Older People 2011, 23(1):31-36.
• [17]Warner M, Shields S, Chute C: Major morbidity and mortality within 1 month of ambulatory surgery and anesthesia. J Am Med Assoc 1993, 270(12):1437-1441.
• [18]Wilson I, Cleary P: Linking clinical variables with health-related quality of life. A conceptual model of patient outcomes. J Am Med Assoc 1995, 273(1):59-65.
• [19]Brattwall M, Warrén Stomberg M, Rawal N, Segerdahl M, Houltz E, Jakobsson J: Patient assessed health profile: A six-month quality of life questionnaire survey after day surgery. Scand J Public Health 2010, 38:574-579.
• [20]Suhonen R, Iivonen M, Välimäki M: Day-case surgery patients’ health-related quality of life. Int J Nurs Pract 2007, 13:121-129.
• [21]Bettelli G: High risk patients in day surgery. Minerva Anestesiol 2009, 75(5):259-268.
• [22]Berg K, Idvall E, Nilsson U, Franzén Årestedt K, Unosson M: Psychometric evaluation of the Post-discharge Surgical Recovery scale. J Eval Clin Pract 2010, 16:794-801.
• [23]Idvall E, Berg K, Unosson M, Brudin L, Nilsson U: Assessment of recovery after day surgery using a modified version of quality of recovery - 40. Acta Anaesthesiol Scand 2009, 53:673-677.
• [24]Brooks R: EuroQol: the current state of play. Health Policy 1996, 37:53-72.
• [25]Aldrete JA: Modifications to the postanesthesia score for use in ambulatory surgery. J Perianesth Nurs 1998, 13(3):148-155.
• [26]Myles P, Weitkamp K, Jones K, Melick J, Hensen S: Validity and reliability of a postoperative quality of recovery score: the QoR-40. Br J Anaesth 2000, 84(1):11-15.
• [27]Dolan P, Gudex C, Kind P, Williams A: The time-trade-off method: Results from a general population study. Health Economy 1996, 5(2):141-154.
• [28]Aggarwal R, Wilke C, Pickard S, Vats V, Mikolaitis R, Fogg L, Block J, Jolly M: Psychometric properties of the EuroQol-5D and Short Form-6D in patients with systemic lupus erythematosus. J Rheumatol 2009, 36(6):1209-1216.
• [29]Coons S, Rao S, Keininger D, Hays R: A comparative review of generic quality-of-life instruments. Pharmacoeconomics 2000, 17(1):13-35.
• [30]Miles J, Shevlin M: Applying regression & correlation. London: Sage Publication Ltd; 2001.
• [31]Suhonen R, Virtanen H, Heikkinen K, Johansson K, Kaljonen A, Leppänen T, Salanterä S, Leino-Kilpi H: Health-related quality of life of day-case surgery patients: a pre/posttest survey using the EuroQol-5D. Qual Life Res 2008, 17:169-177.
• [32]Rosén H, Clabo Lauzon L, Mårtensson L: Symptoms following day surgery: a review of the literature. Journal of Advanced Perioperative Care 2009, 4(1):7-18.
• [33]Berg K, Idvall E, Nilsson U, Unosson M: Postoperative recovery after different orthopedic day surgical procedures. International Journal of Orthopaedic and Trauma Nursing 2011, 15:165-175.
• [34]Fleisher L, Pasternak L, Lyles A: A novel index of elevated risk of inpatient hospital admission immediately following outpatient surgery. Arch Surg 2007, 142:263-268.
• [35]Gilmartin J, Wright K: The nurse’s role in day surgery: a literature review. Int Nurs Rev 2007, 54:183-190.
• [36]Hunt S, McEwen J, McKenna S: Measuring health status. London: Croom Helm; 1986.
• [37]Faul F, Erdfeller E, Buchner A, Lang AG: Statistical power analysis using G* Power 3.1: Tests for correlation and regression analyses. Behav Res Methods 2009, 41(4):1149-1160.
• [38]IAAS recommendations http://www.iaas-med-com/ webcite