Abstract
BackgroundSupport for guiding and monitoring postoperative recovery and resumption of activities is usually not provided to patients after discharge from the hospital. Therefore, a perioperative electronic health (eHealth) intervention (“ikherstel” intervention or “I recover” intervention) was developed to empower gynecological patients during the perioperative period. This eHealth intervention requires a need for further development for patients who will undergo various types of general surgical and gynecological procedures.ObjectiveThis study aimed to further develop the “ikherstel” eHealth intervention using Intervention Mapping (IM) to fit a broader patient population.MethodsThe IM protocol was used to guide further development of the “ikherstel” intervention. First, patients’ needs were identified using (1) the information of a process evaluation of the earlier performed “ikherstel” study, (2) a review of the literature, (3) a survey study, and (4) focus group discussions (FGDs) among stakeholders. Next, program outcomes and change objectives were defined. Third, behavior change theories and practical tools were selected for the intervention program. Finally, an implementation and evaluation plan was developed.ResultsThe outcome for an eHealth intervention tool for patients recovering from abdominal general surgical and gynecological procedures was redefined as “achieving earlier recovery including return to normal activities and work.” The Attitude-Social Influence-Self-Efficacy model was used as a theoretical framework to transform personal and external determinants into change objectives of personal behavior. The knowledge gathered by needs assessment and using the theoretical framework in the preparatory steps of the IM protocol resulted in additional tools. A mobile app, an activity tracker, and an electronic consultation (eConsult) will be incorporated in the further developed eHealth intervention. This intervention will be evaluated in a multicenter, single-blinded randomized controlled trial with 18 departments in 11 participating hospitals in the Netherlands.ConclusionsThe intervention is extended to patients undergoing general surgical procedures and for malignant indications. New intervention tools such as a mobile app, an activity tracker, and an eConsult were developed.Trial RegistrationNetherlands Trial Registry NTR5686; http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=5686
Highlights
BackgroundThe length of in-hospital stay after general surgical and gynecological procedures has decreased significantly due to a growing trend in day-care surgery, introduction of minimal invasive techniques, and enhanced recovery after surgery programs (ERAS) [1,2,3]
A perioperative electronic health intervention (“ikherstel” intervention or “I recover” intervention) was developed to empower gynecological patients during the perioperative period. This eHealth intervention requires a need for further development for patients who will undergo various types of general surgical and gynecological procedures
The knowledge gathered by needs assessment and using the theoretical framework in the preparatory steps of the Intervention Mapping (IM) protocol resulted in additional tools
Summary
The length of in-hospital stay after general surgical and gynecological procedures has decreased significantly due to a growing trend in day-care surgery, introduction of minimal invasive techniques, and enhanced recovery after surgery programs (ERAS) [1,2,3]. Due to this shortening of in-hospital stay, perioperative in-hospital care has been reduced and the greater part of the recovery period takes place at home [4,5]. This eHealth intervention requires a need for further development for patients who will undergo various types of general surgical and gynecological procedures
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