Steinberg-Bernstein Centre for Minimally Invasive Surgery and Innovation, McGill University Health Centre, Montreal, Québec, Canada.
Department of Surgery, McGill University Health Centre, Montreal, Québec, Canada.
JAMA Surg. 2021 Aug 1;156(8):758-765. doi: 10.1001/jamasurg.2021.1557.
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.
To elucidate the meaning of recovery from the perspective of patients undergoing abdominal surgery.
DESIGN, SETTING, AND PARTICIPANTS: This 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.
The qualitative analysis revealed themes reflecting the meaning of recovery from the perspective of patients undergoing abdominal surgery.
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.
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.
术后恢复难以定义或衡量。针对旨在改善腹部手术后恢复的干预措施的研究通常侧重于住院时间和并发症发生率等措施。尽管这些临床参数很重要，但了解患者对术后恢复的看法对于指导以患者为中心的护理至关重要。
从接受腹部手术的患者的角度阐明恢复的含义。
设计、地点和参与者：这是一项国际定性研究，涉及 2016 年 10 月至 2018 年 11 月在 4 个国家（加拿大、意大利、巴西和日本）的三级医院接受腹部手术的患者的半结构化访谈。采用有目的的最大变异抽样方法，以确保招募具有不同人口统计学、临床和手术特征的患者。未收集种族数据。每次访谈持续 1 至 2 小时。访谈内容进行了记录，然后逐字转录。使用归纳主题分析方法对转录本进行分析。数据分析于 2019 年 7 月至 2019 年 9 月进行。
定性分析揭示了反映接受腹部手术患者对恢复的看法的主题。
对 30 名接受腹部手术的患者进行了采访（女性 15 名[50%]；平均[标准差]年龄 57[18]岁；10 名[33%]接受了大手术；16 名[53%]接受了腹腔镜手术）。访谈结果表明，对于接受腹部手术的患者，恢复的意义体现了 5 个总体主题：（1）恢复习惯和日常生活；（2）消除症状；（3）克服心理压力；（4）恢复独立性；（5）享受生活。访谈中未确定与传统参数（如提前出院或无并发症）相关的恢复意义主题。
这项定性研究表明，从接受腹部手术的患者的角度来看，恢复的意义超出了传统的临床参数。本研究确定的恢复要素应纳入医患关于恢复的讨论中，并在制定以患者为中心的策略以改善术后结果时加以考虑。
