A qualitative evaluation of patients’ experiences of an enhanced recovery programme for colorectal cancer

Blazeby, Jane M; Soulsby, M; Winstone, K; King, PM; Bulley, S. H.; Kennedy, R. H.

doi:10.1111/j.1463-1318.2009.02104.x

Cited by 62 publications

(148 citation statements)

References 27 publications

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“…Patients generally faced the prospect of surgery with optimism and a sense of renewed hope, which provided a powerful context to the way they approached participating in an ERP. This finding resonates with the findings of previous studies of patients undergoing ERP following surgery for colorectal and gynaecological cancer respectively: patients' acknowledged the challenges and complexities of early discharge from hospital [16,21].…”

Section: Discussionsupporting

confidence: 88%

“…Health-related quality of life may not always be sensitive enough to detect subtle differences in recovery in complex interventions [16]. Qualitative methods have a role to play in uncovering responses to the recovery process particularly for complex interventions [17].…”

Section: Introductionmentioning

confidence: 99%

“…A qualitative study evaluating the experiences of patients enrolled in an ERP for colorectal cancer and found that many patients were pleased to be discharged quickly and considered recovery from home preferable as it allowed them to have more control over their own recovery [16]. A recent qualitative study of women undergoing surgery for gynaecological cancer within an ERP found positive responses to the experience, despite the fact that the focus on activity rather than rest and recuperation was experienced as counter-intuitive [21] The qualitative literature on the patient experience has primarily focused on the acceptability of preoperative information integral to the "fast track" ethos [8,18].…”

Section: Introductionmentioning

confidence: 99%

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‘Am I really ready to go home?’: a qualitative study of patients’ experience of early discharge following an enhanced recovery programme for liver resection surgery

Vandrevala

Senior

Spring

et al. 2016

Support Care Cancer

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2 AbstractPurpose: Fast-track surgery or Enhanced Recovery Programmes (ERP) have been shown to improve patient outcomes with shorter post-operative recovery times, fewer complications and more cost-effective care amongst the reported benefits. Traditionally the effectiveness of ERPs have been assessed by measuring clinical outcomes, with the patient experience often being neglected. The aim of this qualitative study was to ascertain patients' expectations and experiences of fast track surgery and recovery at home within the setting of an Enhanced Recovery Programme (ERP).Method: 20 patients enrolled in the treatment group of the randomised controlled trial 'Enhanced recovery in liver resection surgery' were interviewed pre-operatively and 6 weeks post-surgery. Transcripts were analysed using Thematic Analysis.Results: Patients approached the surgery with a sense of renewed hope. Involvement with the ERP was viewed positively and having milestones to aim for gave patients a sense of purpose. Many felt that real recovery from surgery began at home and so felt positive about having an early discharge. Patients did report some concerns about being discharged early and those who failed to meet milestones or were readmitted to hospital experienced this as failure.Conclusions: This qualitative data demonstrates some of the complexities of patients' expectations and experiences of the ERP. Whilst patients generally experience the ERP positively, they also have concerns about the process. The study highlights areas where additional support may be needed for patients enrolled in ERPs and discharged early.Keywords: qualitative research, enhanced recovery programmes, liver cancer, discharge from hospital The final publication is available at Springer via http://dx

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Section: Discussionsupporting

confidence: 88%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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‘Am I really ready to go home?’: a qualitative study of patients’ experience of early discharge following an enhanced recovery programme for liver resection surgery

Vandrevala

Senior

Spring

et al. 2016

Support Care Cancer

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“…1 Yet patients equate recovery with return to their normal activities, 5 a process that occurs usually after discharge and requires a time frame of weeks to months. 6,7 It is not clear if interventions impacting shortterm biological changes will also have a downstream effect on longer-term recovery. 8 Our intention in this review is to provide a framework for measuring outcomes of ERAS programs.…”

Section: Résumémentioning

confidence: 99%

What outcomes are important in the assessment of Enhanced Recovery After Surgery (ERAS) pathways?

Feldman

Lee

Fiore

2014

Can J Anesth/J Can Anesth

104

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“…On the other hand, early discharge after colorectal surgery has also been experienced as positive as patients felt their recovery enhanced by their being at home because they had the opportunity to eat, drink, and rest without the disturbance of hospital routines. However, some patients with minor complications expressed difficulties gaining access to specialist care and expert advice after discharge, leading to a feeling of vulnerability [15].…”

Section: Introductionmentioning

confidence: 99%

Patient-reported recovery after enhanced colorectal cancer surgery: a longitudinal six-month follow-up study

Jakobsson

Idvall

Wann-Hansson

2014

Int J Colorectal Dis

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1 AbstractPurpose. The concept of enhanced recovery after surgery (ERAS) is a modern regime of care, and numerous studies have proved its beneficial impact on recovery after colorectal surgery. However, little is known about patients' continuing recovery after discharge. Therefore, the purpose of this study was to describe patientreported recovery after colorectal cancer surgery in the context of ERAS from the day of discharge until one month and six months after surgery.Method. Assessments were made at discharge, at one month, and at six months after surgery using the questionnaire Postoperative Recovery Profile (PRP). In all, 119 patients recovering from abdominoperineal resection, rectal resection, or colonic resection completed all three assessments.Results. The global score of recovery showed that no patient experienced being fully recovered at discharge. After rectal resection, patients frequently reported being not at all recovered. One month after surgery, patients recovering from colonic resection reported significant improvements regarding 11 of 17 questionnaire items, whereas abdominoperineal resection patients reported no significant improvements regarding any item. Instead, significantly higher levels of problems were reported in the items fatigue, muscle weakness, and feeling down. Rectal resection patients reported significant improvements between one and six months after surgery regarding 7 of 19 items. However, the item gastrointestinal function distinguished, as patients reported significant deterioration towards higher levels of problems six months after surgery.Conclusion. This study elucidates the difference between groups of colorectal patients and the diverse patterns of their recovery, implying different needs in terms of prolonged support after discharge.

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A qualitative evaluation of patients’ experiences of an enhanced recovery programme for colorectal cancer

Abstract: Although many participants reported benefits from an ERP, the study highlighted areas for improvement. In particular participants reported the need for better access to information and specialist advice in the early days after hospital discharge.

Cited by 62 publications

References 27 publications

‘Am I really ready to go home?’: a qualitative study of patients’ experience of early discharge following an enhanced recovery programme for liver resection surgery

‘Am I really ready to go home?’: a qualitative study of patients’ experience of early discharge following an enhanced recovery programme for liver resection surgery

What outcomes are important in the assessment of Enhanced Recovery After Surgery (ERAS) pathways?

Patient-reported recovery after enhanced colorectal cancer surgery: a longitudinal six-month follow-up study

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