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Evaluation of postoperative recovery in day surgery patients using a mobile phone application: a multicentre randomized trial
Örebro universitet, Institutionen för hälsovetenskaper. (Centre for Perioperative Nursing)ORCID-id: 0000-0001-7574-6745
Örebro universitet, Institutionen för hälsovetenskaper. (Perioperativ omvårdnad)ORCID-id: 0000-0002-4170-6451
Örebro universitet, Institutionen för hälsovetenskaper. (Perioperativ omvårdnad)ORCID-id: 0000-0002-5996-2584
Örebro universitet, Institutionen för hälsovetenskaper. (Centre for Perioperative Nursing)ORCID-id: 0000-0001-5403-4183
2017 (Engelska)Ingår i: British Journal of Anaesthesia, ISSN 0007-0912, E-ISSN 1471-6771, Vol. 119, nr 5, s. 1030-1038Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

Background: Many patients undergoing anaesthesia and surgery experience postoperative complications. Our aim was to investigate whether a systematic follow-up smartphone-based assessment, using recovery assessment by phone points (RAPP) compared with standard care, had a positive effect on day surgery patients' postoperative recovery. We also investigated whether there were differences in women and men's recovery and recovery scores.

Methods: The study was a single-blind, multicentre randomized controlled trial. A total of 997 patients were randomly allocated to either RAPP or standard care. The Swedish web version of a quality of recovery (SwQoR) questionnaire was used to evaluate the patients' postoperative recovery, either on paper or using an application (RAPP) on postoperative days seven and 14.

Results: On postoperative day seven the RAPP group reported significantly better values in seven out of 24 items of the SwQoR: sleeping difficulties; not having a general feeling of wellbeing; having difficulty feeling relaxed/comfortable; and dizziness; headache; pain in the surgical wound; and a swollen surgical wound compared with the control group, implying a good postoperative recovery. Both men and women in the RAPP group reported significantly better values (and, hence good postoperative recovery) compared with the control group in the items sleeping difficulties; not having a general feeling of wellbeing and pain in the surgical wound.

Conclusions: Measurement of patient-reported outcomes using a smartphone-based application was associated with decreased discomfort from several postoperative symptoms. Systematic e-assessment can thereby increase patients' quality of recovery and identify key areas for improvement in perioperative care.

Ort, förlag, år, upplaga, sidor
Oxford University Press, 2017. Vol. 119, nr 5, s. 1030-1038
Nyckelord [en]
Mobile application, patient outcome assessment, postoperative complications, postoperative period
Nationell ämneskategori
Anestesi och intensivvård
Identifikatorer
URN: urn:nbn:se:oru:diva-61084DOI: 10.1093/bja/aex331ISI: 000413642900026PubMedID: 29077818Scopus ID: 2-s2.0-85034763250OAI: oai:DiVA.org:oru-61084DiVA, id: diva2:1142349
Forskningsfinansiär
Forte, Forskningsrådet för hälsa, arbetsliv och välfärd, 2013-4765Vetenskapsrådet, 2015-02273Tillgänglig från: 2017-09-19 Skapad: 2017-09-19 Senast uppdaterad: 2019-03-26Bibliografiskt granskad
Ingår i avhandling
1. e-Assessed follow-up of postoperative recovery: developement, evaluation and patient experiences
Öppna denna publikation i ny flik eller fönster >>e-Assessed follow-up of postoperative recovery: developement, evaluation and patient experiences
2018 (Engelska)Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
Abstract [en]

The majority of all surgeries are performed as day surgery. After discharge, patients are expected to take responsibility for their postoperative recovery themselves. Recovery Assessment by Phone Points (RAPP) is an e-assessment developed for assessing and providing follow-up on postoperative recovery, which includes the Swedish web-version of the Quality of Recovery questionnaire (SwQoR). It also enables the patient to get in contact with the day surgery unit. The overall aim of this thesis was to further develop and evaluate a systematic follow-up of postoperative recovery using a mobile app in adult persons undergoing day surgery, as well as to describe their experiences of postoperative recovery when using the mobile app. Study I: This study included three steps. Equivalence testing between the paper and app versions of the SwQoR showed agreement (n=69). The feasibility and acceptability evaluation showed that participants (n=63) were positive towards using a mobile phone application during postoperative recovery. Content validity of the SwQoR reduced the original 31 items to 24. Studies II and III: A multicentre, two-group, parallel, single-blind randomized controlled trial including 997 participants was conducted to investigate the effect of e-assessment on postoperative recovery (II) and cost-effectiveness (III) in a RAPP group compared with a control group. The RAPP group reported significantly better quality of postoperative recovery on postoperative days 7 and 14 compared with the control group. Moreover, RAPP may be cost-effective as it provides low-cost care. Study IV: Explored experience of postoperative recovery in participants using a mobile phone app during their postoperative recovery. Qualitative inductive semi-structured interviews (n=18) were performed. Findings showed that feeling safe is important during postoperative recovery. This feeling can be created by patients themselves, but sufficient support and information from health care and next of kin is needed. Overall, this thesis showed positive results for RAPP, suggesting that RAPP is a solution that may benefit patients after day surgery.

Ort, förlag, år, upplaga, sidor
Örebro: Örebro University, 2018. s. 97
Serie
Örebro Studies in Medicine, ISSN 1652-4063 ; 182
Nyckelord
Ambulatory surgery, cost-effectiveness, eHealth, mobile applications, postoperative recovery, qualitative research, randomised controlled trial
Nationell ämneskategori
Annan hälsovetenskap
Identifikatorer
urn:nbn:se:oru:diva-65776 (URN)978-91-7529-249-6 (ISBN)
Disputation
2018-06-15, Örebro universitet, Forumhuset, Hörsal F, Fakultetsgatan 1, Örebro, 09:00 (Svenska)
Opponent
Handledare
Tillgänglig från: 2018-03-14 Skapad: 2018-03-14 Senast uppdaterad: 2019-03-26Bibliografiskt granskad

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Jaensson, MariaDahlberg, KarunaEriksson, MatsNilsson, Ulrica

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