Postoperative recovery at home after ambulatory gynecologic laparoscopic surgery.

The purposes of this descriptive, correlational study were to measure pain, fatigue, and functional limitations affecting the "at home" recovery process for ambulatory gynecologic laparoscopic surgery and to explore the relationships between these variables and the return to normal activities. Subjects (N = 91) recorded daily ratings of pain, fatigue, and function on a Home Recovery Log for 6 days postoperatively. The findings indicate that 95% of subjects resumed basic self-care activities such as dressing, bathing, and eating by postoperative day (POD) 3; however, less than 40% of subjects were able to perform other role functions such as shopping, laundry, and work outside of the home. A logistic regression model indicated that pain ratings and functional status on POD 2 were the best predictors of subjects who would need more than 5 days to resume their usual activities and routines. The findings have implications for preoperative teaching and telephone follow-up for ambulatory surgery patients. Preoperative teaching should prepare women for the additional days needed for recovery of instrumental activities of daily living to enable them to make alternate plans as necessary. Furthermore, because pain on POD 2 was the single most significant predictor of delayed recovery, moving the follow-up phone call from the morning to the late afternoon of POD 1 may help the nurse to identify patients who will need extra assistance with pain management.