A number of patients experienced significant pain postoperatively. Although multi-modal analgesics were available, analgesic administration practices did not consistently reflect management responsive to patient needs. Despite this, patients were largely satisfied with the care received suggesting the need for further research to understand how patients perceive the efficacy of pain management.

Our review demonstrates that a focus on the documentation traditions of perioperative nurses combined with training, structure and improved technical tools may facilitate the documentation and thereby improve patient safety.

The family's interactions and its handling of lifestyle changes were important to the adolescent's maintained weight loss. It is fundamental that the entire family is supportive, regardless of family structure and these issues ought to be addressed in future interventions.

On the basis of the study, it was hypothesised that a prejudice-free, individually accepting and supporting intervention must be provided for each family over time to ensure successful weight loss.