Surgical Recovery Through the Lens of Patients with Colorectal Disease: A Qualitative Study in an Enhanced Recovery after Surgery Setting.

Autor:	Li Y; From the School of Human Nutrition, McGill University, Montreal, QC, Canada (Li, Gillis)., Hajjar R; Patient Partner, McGill University Health Centre, Montreal, QC, Canada (Hajjar)., Gramlich L; Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada (Gramlich)., Nelson G; Departments of Oncology and of Obstetrics and Gynaecology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada (Nelson).; Ariadne Labs, Brigham and Women's Hospital, Harvard TH Chan School of Public Health, Boston, MA (Nelson)., Ljungqvist O; Department of Surgery, School of Medical Sciences, Örebro University, Örebro, Sweden (Ljungqvist)., Gillis C; From the School of Human Nutrition, McGill University, Montreal, QC, Canada (Li, Gillis).; Departments of Anesthesia and Surgery, McGill University, Montreal, QC, Canada (Gillis).
Jazyk:	angličtina
Zdroj:	Journal of the American College of Surgeons [J Am Coll Surg] 2025 Jan 01; Vol. 240 (1), pp. 11-23. Date of Electronic Publication: 2024 Dec 16.
DOI:	10.1097/XCS.0000000000001218
Abstrakt:	Background: As perioperative care shifts to a more patient-centered model, understanding needs and experiences of patients is vital. Gaining such insight can enhance the alignment of care with patient priorities, encouraging adherence to recovery-oriented interventions. We aimed to explore patient-defined recovery and the elements that modify the recovery process for patients with colorectal disease under enhanced recovery after surgery (ERAS) care. Study Design: A qualitative study was conducted at an ERAS-participating hospital in Alberta, Canada, between April 2018 and June 2019. A co-design focus group set the research direction, and semistructured interviews were conducted postoperatively in-hospital or within 3 months postdischarge. Diverse patient ages and colorectal conditions were targeted through purposive sampling. Interviews were transcribed verbatim and analyzed through manifest and latent content analysis. Results: Twenty patients with mean age 62 (SD 13) years and 45% with cancer (17 interview, 2 focus group + interview, and 1 focus group only) were enrolled. Recovery was defined by patients as the return to normal routines and four themes were identified. First, phases of recovery: recovery was described as multidimensional phases distinctively as early, late or long-term, and the endpoint. Second, recovery facilitators: recovery was supported through positive mindsets, conscious recovery, and taking an active role. Third, recovery barriers: recovery was hindered by negative mindsets and treatment side effects. Finally, recovery catalysts: communication, autonomy, and expectations facilitated active or passive recovery. Conclusions: Our patient-oriented recovery model may contribute a new dimension to the ERAS framework by capturing patients' recovery experiences. Further research is encouraged to explore its value in enhancing patient-centered care within ERAS. (Copyright © 2024 by the American College of Surgeons. Published by Wolters Kluwer Health, Inc. All rights reserved.)
Databáze:	MEDLINE
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