Roshni Alam1,2, Joel Montanez3, Susan Law4,5, Lawrence Lee1,2, Nicolò Pecorelli6, Yusuke Watanabe7, Luciana D Chiavegato8, Massimo Falconi6, Satoshi Hirano7, Nancy E Mayo9,10,11, Liane S Feldman1,2,11, Julio Flavio Fiore12,13,14. 1. Steinberg-Bernstein Centre for Minimally Invasive Surgery and Innovation, McGill University Health Centre, Montreal, QC, Canada. 2. Department of Surgery, McGill University Health Centre, Montreal General Hospital, McGill University, 1650 Cedar Ave, L8-121, Montreal, QC, H3G 1A4, Canada. 3. St. Mary's Research Centre, St. Mary's Hospital, Montreal, QC, Canada. 4. Institute for Better Health, Trillium Health Partners, Mississauga, ON, Canada. 5. Institute for Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada. 6. Division of Pancreatic Surgery, Pancreas Translational & Clinical Research Centre, San Raffaele Scientific Institute, Milan, Italy. 7. Department of Gastroenterological Surgery II, Hokkaido University Graduate School of Medicine, Sapporo, Japan. 8. Department of Medicine, Pulmonary Division, Federal University of São Paulo, São Paulo, Brazil. 9. School of Physical and Occupational Therapy, McGill University, Montreal, QC, Canada. 10. Division of Clinical Epidemiology, McGill University, Montreal, QC, Canada. 11. Centre for Outcomes Research and Evaluation (CORE), Research Institute of the McGill University Health Centre, Montreal, QC, Canada. 12. Steinberg-Bernstein Centre for Minimally Invasive Surgery and Innovation, McGill University Health Centre, Montreal, QC, Canada. julio.fiorejunior@mcgill.ca. 13. Department of Surgery, McGill University Health Centre, Montreal General Hospital, McGill University, 1650 Cedar Ave, L8-121, Montreal, QC, H3G 1A4, Canada. julio.fiorejunior@mcgill.ca. 14. Centre for Outcomes Research and Evaluation (CORE), Research Institute of the McGill University Health Centre, Montreal, QC, Canada. julio.fiorejunior@mcgill.ca.
Abstract
BACKGROUND: There is a lack of patient-reported outcome measures (PROMs) with robust measurement properties to assess postoperative recovery and support patient-centered care after abdominal surgery. The aim of this study was to establish a conceptual framework of recovery after abdominal surgery to support the development of a conceptually relevant and psychometrically sound PROM. METHODS: Patients from four different countries (Canada, Italy, Brazil, and Japan) participated in qualitative interviews focusing on their lived experiences of recovery after abdominal surgery. Interviews were guided by a previously developed hypothesized conceptual framework established based on a literature review and expert consensus. Interviews were analyzed according to a modified grounded theory approach and transcripts were coded according to the International Classification of Functioning, Disability and Health (ICF). Codes for which thematic saturation was reached were classified into domains of health that are relevant to the process of recovery after abdominal surgery. These domains were organized into a structured diagram. RESULTS: 30 Patients with diverse demographics and surgical characteristics were interviewed (50% female, age 57 ± 18 years, 66% major or major extended surgery). 39 Unique domains of recovery emerged from the interviews, 17 falling under the ICF category of "Body Functions" and 22 under "Activities and Participation". These domains constitute the conceptual framework of recovery after abdominal surgery. CONCLUSIONS: This study provides comprehensive insight into patients' perspectives of the recovery process after abdominal surgery. This conceptual framework will support content validity and provide the pivotal basis for the development of a novel PROM to inform quality improvement initiatives and patient-centered research in abdominal surgery.
BACKGROUND: There is a lack of patient-reported outcome measures (PROMs) with robust measurement properties to assess postoperative recovery and support patient-centered care after abdominal surgery. The aim of this study was to establish a conceptual framework of recovery after abdominal surgery to support the development of a conceptually relevant and psychometrically sound PROM. METHODS:Patients from four different countries (Canada, Italy, Brazil, and Japan) participated in qualitative interviews focusing on their lived experiences of recovery after abdominal surgery. Interviews were guided by a previously developed hypothesized conceptual framework established based on a literature review and expert consensus. Interviews were analyzed according to a modified grounded theory approach and transcripts were coded according to the International Classification of Functioning, Disability and Health (ICF). Codes for which thematic saturation was reached were classified into domains of health that are relevant to the process of recovery after abdominal surgery. These domains were organized into a structured diagram. RESULTS: 30 Patients with diverse demographics and surgical characteristics were interviewed (50% female, age 57 ± 18 years, 66% major or major extended surgery). 39 Unique domains of recovery emerged from the interviews, 17 falling under the ICF category of "Body Functions" and 22 under "Activities and Participation". These domains constitute the conceptual framework of recovery after abdominal surgery. CONCLUSIONS: This study provides comprehensive insight into patients' perspectives of the recovery process after abdominal surgery. This conceptual framework will support content validity and provide the pivotal basis for the development of a novel PROM to inform quality improvement initiatives and patient-centered research in abdominal surgery.