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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

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Abstract

Purpose

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

Twenty 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.

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Author information

Authors and Affiliations

  1. Faculty of Arts & Social Sciences, Kingston University, Kingston, UK

    T. Vandrevala

  2. Department of Psychology, BPP University, London, UK

    V. Senior

  3. Department of Hepatopancreaticobiliary Surgery, Royal Surrey County Hospital NHS Foundation Trust, Guildford, UK

    L. Spring

  4. Department of Anaesthesia, Royal Surrey County Hospital NHS Foundation Trust, Guildford, UK

    L. Kelliher & C. Jones

Authors
  1. T. Vandrevala
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  2. V. Senior
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  3. L. Spring
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  4. L. Kelliher
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  5. C. Jones
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Corresponding author

Correspondence to T. Vandrevala.

Ethics declarations

Ethical approval for the main trail and this qualitative study was received from National Health Service Research Ethics Committee and monitored by the Trust Research and Development Department.

Conflict of Interest

No funding was received for this project.

We have full control of all primary data and agree to allow the journal to review their data if requested.

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Vandrevala, T., Senior, V., Spring, L. et al. ‘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. Support Care Cancer 24, 3447–3454 (2016). https://doi.org/10.1007/s00520-016-3158-6

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  • DOI: https://doi.org/10.1007/s00520-016-3158-6

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