Patients’ experiences of enhanced recovery after surgery: a systematic review of qualitative studies

Sibbern, Tonje; Sellevold, Vibeke Bull; Steindal, Simen Alexander; Dale, Craig; Watt‐Watson, Judy; Dihle, Alfhild

doi:10.1111/jocn.13456

Cited by 120 publications

(121 citation statements)

References 43 publications

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“…This aligns with previous work on the introduction of evidence‐based treatments in which clinicians were concerned with reduced opportunities to exercise clinical judgment and protocols not being flexible enough for complex cases (rather than having negative attitudes toward the innovation itself) . Furthermore, patients’ perceive ERAS protocols as being inflexible and would prefer less rigid guidelines . Therefore, introducing a feeding protocol that allows flexibility for clinicians to exercise their clinical judgment and factor in patients’ preferences and needs may facilitate a consistent and positive culture toward postoperative nutrition practices.…”

Section: Discussionsupporting

confidence: 75%

“…[28][29][30] Furthermore, patients' perceive ERAS protocols as being inflexible and would prefer less rigid guidelines. 31,32 Therefore, introducing a feeding protocol that allows flexibility for clinicians to exercise their clinical judgment and factor in patients' preferences and needs may facilitate a consistent and positive culture toward postoperative nutrition practices.…”

Section: Discussionmentioning

confidence: 99%

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Hospital Staffs’ Perceptions of Postoperative Nutrition Among Colorectal Patients: A Qualitative Study

et al. 2019

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Background After lower gastrointestinal surgery, few patients start eating within timeframes outlined by evidence‐based guidelines or meet their nutrition requirements in hospital. The present study explored hospital staffs’ perceptions of factors influencing timely and adequate feeding after colorectal surgery to inform future interventions for improving postoperative nutrition practices and intakes. Methods This qualitative exploratory study was conducted at an Australian hospital where Enhanced Recovery After Surgery guidelines had not been formally implemented. One‐on‐one semistructured interviews were conducted with hospital staff who provided care to patients undergoing colorectal surgery. Interviews lasted from 21 to 47 minutes and were audio recorded and transcribed verbatim. Data were analyzed using inductive thematic analysis. Emergent themes and subthemes were discussed by all investigators to ensure consensus of interpretation. Results Eighteen staff participated in interviews, including 9 doctors, 5 nurses, 2 dietitians, and 2 foodservice staff. Staffs’ responses formed 3 themes: (1) variability in perceived acceptability of postoperative feeding; (2) improving dynamics and communication within the treating team; and (3) optimizing dietary intakes with available resources. Conclusion Staff and organizational factors need to be considered when attempting to improve postoperative nutrition among patients who undergo colorectal surgery. Introducing a feeding protocol, enhancing intraprofessional and interdisciplinary communication, and ensuring the availability of appropriate, nutrient‐dense foods are pivotal to improve nutrition practices and intakes.

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Section: Discussionsupporting

confidence: 75%

Section: Discussionmentioning

confidence: 99%

Hospital Staffs’ Perceptions of Postoperative Nutrition Among Colorectal Patients: A Qualitative Study

et al. 2019

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“…After cancer surgery, patients are in an intensive and vulnerable phase of their cancer trajectory [117]. Especially patients experiencing postoperative complications feel vulnerable at home and prefer to have ready access to expert clinical advice [118]. For the patient's sense of security and health self-efficacy after (early) discharge, it is important to give patients clear and concise oral and written information on nutritional intake and symptom management at home [119].…”

Section: Enhanced Recovery After Surgery Programmentioning

confidence: 99%

Nutrition in peri-operative esophageal cancer management

Steenhagen

Vulpen

Hillegersberg

et al. 2017

Expert Review of Gastroenterology & Hepatology

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Introduction: Nutritional status and dietary intake are increasingly recognized as essential areas in esophageal cancer management. Nutritional management of esophageal cancer is a continuously evolving field and comprises an interesting area for scientific research. Areas covered: This review encompasses the current literature on nutrition in the pre-operative, perioperative, and post-operative phases of esophageal cancer. Both established interventions and potential novel targets for nutritional management are discussed. Expert commentary: To ensure an optimal pre-operative status and to reduce peri-operative complications, it is key to assess nutritional status in all pre-operative esophageal cancer patients and to apply nutritional interventions accordingly. Since esophagectomy results in a permanent anatomical change, a special focus on nutritional strategies is needed in the post-operative phase, including early initiation of enteral feeding, nutritional interventions for post-operative complications, and attention to longterm nutritional intake and status. Nutritional aspects of pre-optimization and peri-operative management should be incorporated in novel Enhanced Recovery After Surgery programs for esophageal cancer.ARTICLE HISTORY

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“…The Enhanced Recovery After Surgery ® (ERAS ® ) program is allusive to perioperative care and includes a set of evidencebased guidelines with a multimodal approach (1) associated with the areas of Surgery, Anesthesia, Nursing, and Nutrition. In this way, its introduction process presupposes a coordinated multidisciplinary approach, which also has as novelty a more active participation of clients in their recovery process, moving from the sick patient concept to the empowered patient concept (2) .…”

Section: Introductionmentioning

confidence: 99%

Nursing Interventions in the Enhanced Recovery After Surgery®: Scoping Review

2018

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Objective: To identify the Nursing interventions, described in literature, in the ERAS® program. Method: We defined a scoping review based on the recommendations of The Institute Joanna Brigs (JBI) and on research in electronic databases. We chose the studies through flow diagrams "Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)" and presented them in a chart. Results: We found 306 articles published between 2010 and 2018 and included 14 of them. The main results were: the crucial role nurses play throughout the surgical process, which begins at the preoperative nursing consultation; goes to post-operative care, such as early giving food to patients, effective management of pain or early mobilization; and ends in telephone follow-up. Conclusion: The introduction of the surgical program ERAS® may be an opportunity for nurses to play a more influential role in the surgical path, directly involving with their clients' results.

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Patients’ experiences of enhanced recovery after surgery: a systematic review of qualitative studies

Cited by 120 publications

References 43 publications

Hospital Staffs’ Perceptions of Postoperative Nutrition Among Colorectal Patients: A Qualitative Study

Hospital Staffs’ Perceptions of Postoperative Nutrition Among Colorectal Patients: A Qualitative Study

Nutrition in peri-operative esophageal cancer management

Nursing Interventions in the Enhanced Recovery After Surgery®: Scoping Review

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