Thoughts and concerns of patients at hospital discharge after lumbar spine surgery. A qualitative study

Abstract

Purpose The increased rate of surgical interventions point to the necessity to investigate the patient’s experience from a biopsychosocial perspective. The aim of this study was to investigate the thoughts and concerns of patients undergoing spinal surgery for lumbar degenerative disease at the time of their discharge from hospital. Methods Semi-structured interviews were conducted with 28 patients. The questions investigated possible concerns associated to discharging them home. A content analysis was performed by a multidisciplinary group to identify the main themes that emerged from the interviews. Results The patients were satisfied with the surgeons’ preoperative explanations and description of expected prognosis. However, they were disappointed with the lack of information at hospital discharge, in particular regarding practical and behavioral recommendations. The patients expressed clear concerns about being left alone to deal with possible complications or difficulties they may encounter when returning home. Conclusion This study underlined the patients’ need for a comprehensive psychological guidance and possibly a person of reference during the post-operative process. Discussing discharge with the patient was emphasized as an important issue to improve patients’ compliance to the recovery process itself. Putting these elements into practice should help spine surgeons to manage better hospital discharge. IMPLICATIONS FOR REHABILITATION A comprehensive discussion with the patient at the time of hospital discharge is clearly stressed as an important issue to improve patients’ adherence to the recovery process. The patients complained of a lack of information when returning home, in particular regarding practical and behavioral recommendations. The patients expressed clear concerns about possible complications or difficulties they may encounter when returning home and they expressed their need to know whom they can contact for help if needed. A better understanding of the thoughts and concerns of patients undergoing spinal surgery at the time of their discharge from hospital should help spine surgeons to improve the management of hospital discharge and the post-operative recovery.