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Symptoms following day surgery: a review of the literature
University of Skövde, School of Life Sciences.
College of Nursing, University of Rhode Island, United States.
University of Skövde, School of Life Sciences.
2009 (English)In: Journal of Advanced Perioperative Care, ISSN 1470-5664, Vol. 4, no 1, 7-18 p.Article, review/survey (Refereed) Published
Abstract [en]

Aim: The purpose of this paper is to provide a broad-based overview of the current literature regarding patients’ experiences of symptoms following day surgery. Background: The advent of new anaesthetic and anti-emetic agents, advanced surgical techniques and the need for reduced costs for inpatient hospital services, has resulted in about 70% of all surgical procedures being undertaken as day surgery (Mattila et al 2005, Qureshi et al 2006) in many countries such as the United Kingdom (UK) (Aylin et al 2005) and Europe, Australia and North America (Jarrett 2001). As more and more types of surgery, including increasingly complex procedures, are undertaken as day surgery and with the expansion of day surgery for patients who are older, frail or who have multiple co-morbidities, there is a need to expand the knowledge base regarding patients’ symptom experience at home following day surgery. In particular, there is a need to examine the patients’ experience of symptoms longitudinally and to examine the impact of these on the return to activities of daily living (Gudex et al 2006). Method: Nursing and health care papers published in English between 1992 and April 2008 were sought, using the Cumulative Index of Nursing and Allied Health Literature (CINAHL) database. Thirty six papers were selected and critiqued. A checklist was used to review the included studies for their type of method and the way they were designed and implemented (Goodman 1993). Findings: The wide range of studies reviewed provided further understanding of incidence, intensity and duration of symptoms experienced by patients after day surgery. Patients almost invariably report that pain and other symptoms were at their peak up to 24 hours after discharge and frequently persisted for six days or more. However, a clear picture of the symptom experience following day surgery failed to emerge because methodological differences make comparison across studies difficult. While there has been little exploration of the symptom experience longitudinally, those studies that have examined symptoms over time suggest that the patient's experience of them does have a significant impact on their ability to function in their normal social and work roles for a prolonged period of time following day surgery. In the studies reviewed when day surgery patients´ activity levels were reduced postoperatively, return to usual activity was delayed and activities of daily living were reported as difficult to manage. Conclusion: This review demonstrates that patients' experience of symptoms in the recovery period at home following day surgery is more profound than clinicians expect, lasts for a longer period and interferes with the ability to return to normal activities. However there are still gaps in knowledge particularly concerning the extent to which patients continue to experience symptoms after six days and beyond. Further research needs to explore multidimensional perspectives on symptoms together with an additional and more thorough evaluation of the impact of symptoms on daily living. Recommendations: Further research regarding these gaps in knowledge is necessary in order to develop a deeper understanding of patients’ symptom experience following day surgery and to develop appropriate assessment and intervention strategies for this population. The perioperative nurse with his or her specialised knowledge is well suited to face these challenges.

 

Place, publisher, year, edition, pages
Association for Perioperative Practice , 2009. Vol. 4, no 1, 7-18 p.
Keyword [en]
Day surgery, Recovery, Postoperative symptoms, Experience, Home and activities of daily living
National Category
Medical and Health Sciences
Research subject
Medical sciences
Identifiers
URN: urn:nbn:se:his:diva-3451Scopus ID: 2-s2.0-78649443510OAI: oai:DiVA.org:his-3451DiVA: diva2:273180
Available from: 2009-10-20 Created: 2009-10-20 Last updated: 2013-04-15Bibliographically approved

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