Department of Cardiothoracic Surgery, University Hospital Augsburg, Stenglinstr. 2, 86156, Augsburg, Germany.
BMC Health Serv Res. 2024 Oct 30;24(1):1309. doi: 10.1186/s12913-024-11791-6.
The implementation of ERAS represents a promising solution to improve treatment efficiency and facilitate patient involvement. This innovative care model aims to optimize recovery processes following surgeries by adopting a holistic, interprofessional approach. At our hospital, ERAS was implemented in minimally invasive heart valve surgery, offering two distinct ERAS models. Additionally, there is also the standard of care without ERAS. The objective of the study is to gain insight into patient satisfaction and perceived differences across these various care models.
Patients were interviewed using semi-structured interviews approximately two to three months after undergoing surgery. The data were analysed using qualitative content analysis in accordance with the methodology proposed by Kuckartz. Four main categories were established: Preoperative care, postoperative care and communication, patient participation and involvement, and rehabilitation and post-clinical course.
Comprehensive preoperative education and seamless communication throughout the perioperative care journey were identified as fundamental to patient satisfaction and optimal care processes. Patients in the ERAS + model reported higher overall satisfaction with their care compared to patients in the standard of care and ERAS groups.
Preoperative education establishes the foundation for patients' subsequent behaviours and expectations regarding their treatment. Physical activity, nutrition, and mental health are significant aspects. The active involvement and participation of patients and their families in the treatment process facilitated superior postoperative care, intensive physiotherapy, mental support, and faster recovery. A functional flow of information throughout the entire care process is vital. Moreover, having a dedicated point of contact had a beneficial impact on patients´ well-being. The integration of innovative ERAS concepts, which encompass interprofessional preoperative patient education and psychosomatic support, represents a promising approach from a patient perspective, offering benefits to a broad spectrum of cardiac surgical patients.
加速康复外科（ERAS）的实施代表了一种有前途的解决方案，可以提高治疗效率并促进患者参与。这种创新的护理模式旨在通过采用整体、跨专业的方法来优化手术后的恢复过程。在我们医院，ERAS 已应用于微创心脏瓣膜手术中，提供了两种不同的 ERAS 模式。此外，还有没有 ERAS 的标准护理。本研究的目的是深入了解患者对这些不同护理模式的满意度和感知差异。
大约在手术后两到三个月，使用半结构化访谈对患者进行访谈。使用 Kuckartz 提出的方法，对数据进行了定性内容分析。建立了四个主要类别：术前护理、术后护理和沟通、患者参与和参与、康复和临床后阶段。
全面的术前教育和围手术期护理过程中的无缝沟通被认为是患者满意度和最佳护理过程的基础。与标准护理和 ERAS 组相比，ERAS + 组的患者对其护理的总体满意度更高。
术前教育为患者对其治疗的后续行为和期望奠定了基础。体育活动、营养和心理健康是重要方面。患者及其家属积极参与治疗过程，促进了更好的术后护理、强化物理治疗、心理支持和更快的康复。整个护理过程中信息的流畅流动至关重要。此外，有专门的联系人对患者的幸福感产生了有益的影响。从患者的角度来看，整合创新的 ERAS 概念，包括跨专业的术前患者教育和身心支持，代表了一种很有前途的方法，为广泛的心脏外科患者带来了益处。
