Abstract
BackgroundConvalescence advice is often based on tradition and anecdote from health care providers, rather than being based on experiences from patients themselves. The aim of this study was to analyse recovery in terms of resumption of various daily activities including work, following different laparoscopic and abdominal surgery in order to optimize an expert-based guideline on convalescence recommendations.MethodsThis is a prospective cohort study conducted in nine general and one university hospital in the Netherlands. Women aged 18–65 years and scheduled for a hysterectomy (laparoscopic, vaginal, abdominal) and/or laparoscopic adnexal surgery (n = 304) were eligible to participate. Preoperatively, participants were provided with tailored expert-based convalescence recommendations on the graded resumption of several daily activities including sitting, standing, walking, climbing stairs, bending, lifting, driving, cycling, household chores, sport activities and return to work (RTW). Postoperatively, time until the resumption of these activities was tracked. Convalescence recommendations were considered correct when at least 25% and less than 50% of the women were able to resume an activity before or at the recommended recovery time.ResultsThere was a wide variation in the duration until the resumption of daily activities within and between groups of patients undergoing different types of surgery. Recovery times lengthened with increasing levels of physical burden as well as with increasing levels of invasiveness of the surgery. For the majority of activities actual recovery times exceeded the recovery time recommended by the expert panel.ConclusionsThis study provided insight in the resumption of daily activities after gynecological surgery and the adequacy of an expert-based convalescence guideline in clinical practice. Patient data was used to optimize the convalescence recommendations.Trial registrationDutch trial registry, NTR2087 (August 2009) and NTR2933 (June 2011).
Highlights
Convalescence advice is often based on tradition and anecdote from health care providers, rather than being based on experiences from patients themselves
In total 337 patients were exposed to the expertbased convalescence recommendations and were eligible for data analysis for this current study
Median times to return to work (RTW) were 21 days for laparoscopic adnexal surgery (LAS), 56 days for laparoscopic hysterectomy (LH), 55 days for vaginal hysterectomy (VH), and 68 days for abdominal hysterectomy (AH)
Summary
Convalescence advice is often based on tradition and anecdote from health care providers, rather than being based on experiences from patients themselves. There is only little evidence on the duration needed to resume various daily activities following different surgeries [15,16,17,18,19,20]. This leads to convalescence advise being based on tradition and anecdote from health care providers, rather than being based on experiences from patients themselves [14, 15, 18, 21,22,23,24]. Due to the current trend towards day care and short stay surgery, patient contact is very brief and time available for patient education has practically evaporated [25,26,27,28,29]
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