Surgical Recovery Scale Research Articles

The PSR13, a tool for evaluating patient-perceived recovery after vaginal prolapse repair surgery.

Surgical recovery is the return to preoperative functional, psychologic, and social activity, or a return to normalcy. To date, little is known about the global post-surgical recovery experience from the patients' perspective. The aim of this study was to validate the Post-Discharge Surgical Recovery scale 13 (PSR13) in women undergoing vaginal prolapse repair procedures and evaluate the patient-perceived postoperative recovery experience over a 12-week period. Fifty women undergoing vaginal prolapse repairs completed the PSR13 and global surgical recovery scale (GSR) at 1, 2, 4, 6, and 12 weeks post-surgery. Validity, the minimal clinically important difference (MCID), and responsiveness to change over time of the PSR13 was evaluated using descriptive statistics and linear regression models. The proportion of patients deemed fully recovered at each time point (defined as PSR13 score ≥ 80) was also assessed. The PSR13 correlated significantly (p < 0.001) with the single-item recovery scale and showed excellent internal consistency reliability (Cronbach α = 0.91, range 0.77 to 0.93). The MCID was estimated at 7.0 points. The PSR13 scores improved at varying rates over time, with the greatest amount of patient-perceived recovery occurring between 4 and 6 weeks after surgery. The proportion of patients deemed fully recovered at 6- and 12- weeks postoperatively was 37% and 56%, respectively. The PSR13 is a useful instrument to assess overall return to normalcy from the patient's perspective and can be applied to evaluate the recovery experience among women undergoing vaginal prolapse repairs, in both the research and clinical setting.

Validity and Reliability Study of the Turkish Form of Post-Discharge Surgical Recovery Scale.

AIMThis study was carried out to adapt the “Post-Discharge Surgical Recovery Scale “ developed by Kleinbeck into Turkish and analyze the scale’s validity and reliability.METHODSThe study sample consisted of 343 patients who underwent surgery in a state hospital operating in the province of Diyarbakır, in the province of Istanbul. The sample consisted of 271 people due to voluntary participation and reasons for not being able to reach. This research, which is of methodological type, was carried out between April and July 2019. The Individual Information Form and the Post-Discharge Surgical Recovery Scale, which the researchers developed by scanning the literature, were used to collect the data. In the validity and reliability study of the scale; Linguistic equivalence, content validity for expert assessment, the correlation between items for internal consistency/reliability, and calculating Cronbach alpha values and confirmatory and exploratory factor analyzes were performed for construct validity. IBM SPSS Statistics 25 and IBM SPSS Amos 21 programs were used for statistical evaluation of the data.RESULTSIt was determined that the content validity index of the scale was 0.96, the correlation values between the items were r=0.47–0.97, the explained variance was 75.238%, and it was gathered under a single factor. The general reliability of the scale is very high as alpha=0.975. In the confirmatory factor analysis for the scale, the fit indices of the scale were CFI = 0.76; NNFI = 0.93; It was determined that RMR =0.11 and RMSEA = 0.13, AGFI=0.69, GFI=0.77.CONCLUSIONThe research results suggest that the Turkish version of the “Post-Discharge Surgical Scale” is a valid and reliable measurement tool and can be used in scientific research and health care institutions to measure recovery post discharge.

Perioperative Dexmedetomidine Fails to Improve Postoperative Analgesic Consumption and Postoperative Recovery in Patients Undergoing Lateral Thoracotomy for Thoracic Esophageal Cancer: A Randomized, Double-Blind, Placebo-Controlled Trial.

Objectives Dexmedetomidine is widely used as an adjunct to general anesthesia. In this study, we evaluated the effects of perioperative dexmedetomidine infusion on postoperative analgesia in patients undergoing lateral thoracotomy for thoracic esophageal cancer. Methods A total of 62 patients undergoing lateral thoracotomy for thoracic esophageal cancer were randomized to receive adjuvant therapy with either dexmedetomidine (0.5 μg/kg intravenous bolus injection for 10 min before induction of anesthesia, followed by continuous infusion of 0.2–0.4 μg/kg/h until the end of surgery, and 0.06 μg/kg/h for 5 days after surgery) or equal volumes of saline. Acute postoperative pain was treated with patient-controlled intravenous sufentanil and flurbiprofen axetil. The primary outcomes of this study were the numbers of analgesic requirements in the first postoperative 72 h. Results Perioperative dexmedetomidine did not decrease the numbers of analgesic requirements in the first postoperative 72 h (dexmedetomidine group: 12.14 ± 4.76, saline group: 10.89 ± 5.66; p=0.367). Likewise, the groups did not differ with respect to total postoperative analgesic requirements, postoperative pain, perioperative inflammation, blood cell count, incidence of adverse events, surgical recovery (assessed at postoperative days 2 and 5 using the surgical recovery scale), length of hospital stay, hospital cost, incidence of chronic pain, or quality of life. Notably, dexmedetomidine had beneficial effects on decreasing intraoperative opioid consumption and improving postoperative sleep quality. Discussion. Perioperative dexmedetomidine has limited analgesic benefits in lateral thoracotomy for esophageal cancer when added to an opioid-based multimodal anesthetic regimen but can reduce opioid consumption.

Protocol, and practical challenges, for a randomised controlled trial comparing the impact of high intensity interval training against standard care before major abdominal surgery: study protocol for a randomised controlled trial

BackgroundRisk factors, such as the number of pre-existing co-morbidities, the extent of the underlying pathology and the magnitude of the required operation, cannot be changed before surgery. It may, however, be possible to improve the cardiopulmonary fitness of the patient with an individualised exercise program. We are performing a randomised controlled trial (RCT) assessing the impact of High Intensity Interval Training (HIIT) on preoperative cardiopulmonary fitness and postoperative outcomes in patients undergoing major abdominal surgery.MethodsConsecutive eligible patients undergoing elective abdominal surgery are being randomised to HIIT or standard care in a 1:1 ratio. Participants allocated to HIIT will perform 14 exercise sessions on a stationary cycle ergometer, over a period of 4–6 weeks before surgery. The sessions, which are individualised, aim to start with ten repeated 1-min blocks of intense exercise with a target of reaching a heart rate exceeding 90% of the age predicted maximum, followed by 1 min of lower intensity cycling. As endurance improves, the duration of exercise is increased to achieve five 2-min intervals of high intensity exercise followed by 2 min of lower intensity cycling. Each training session lasts approximately 30 min. The primary endpoint, change in peak oxygen consumption (Peak VO2) measured during cardiopulmonary exercise testing, is assessed at baseline and before surgery. Secondary endpoints include postoperative complications, length of hospital stay and three clinically validated scores: the surgical recovery scale; the postoperative morbidity survey; and the SF-36 quality of life score. The standard deviation for changes in Peak VO2 will be assessed after the first 30 patients and will be used to calculate the required sample size.DiscussionWe want to assess if 14 sessions of HIIT is sufficient to improve Peak VO2 by 2 mL/kg/min in patients undergoing major abdominal surgery and to explore the best clinical endpoint for a subsequent RCT designed to assess if improving Peak VO2 will translate into improving clinical outcomes after surgery.Trial registrationAustralian New Zealand Clinical Trials Registry, ACTRN12617000587303. Registered on 26 April 2017.

Factors associated with the risk of fall in adults in the postoperative period: a cross-sectional study.

ABSTRACTObjective: to assess the factors associated with the risk of fall in patients undergoing surgical procedures.Method: quantitative and cross-sectional study carried out with 257 adult patients in a hospital in the state of Minas Gerais, Brazil. Data were collected using the sociodemographic and clinical questionnaire, the Morse Fall Scale, and the Quality of Recovery Score. Data were submitted to descriptive statistical analysis and multinomial logistic regression. The level of significance was set at 0.05.Results: 35.4% of patients had high risk of falls, 38.9% had moderate risk and 25.7% had low risk. The mean value in the surgical recovery scale was 175.37 points and no patient presented poor surgical recovery. Regarding the results of the bivariate analysis, it was found that age (p<0.001), SAH (p<0.001) and diabetes (p=0.017) were positively associated with high risk of fall, whereas cancer (p=0.004) was positively associated with moderate risk of fall. Surgical recovery (p=0,008) was inversely associated with high risk of fall.Conclusion: the results of this study allowed the identification of five factors associated with the risk of fall in adults in the postoperative hospital stay. These findings may support the planning of nursing actions aimed at preventing the risk of fall in the postoperative period.

Development and Validation of the Surgical Recovery Scale (SRS)

At the present, no fully validated instrument is available for the assessment of general postoperative recovery. Such an instrument would form a useful patient-centered outcome measure in studies evaluating surgical and perioperative interventions. The aim of our study is to develop and validate a summary score based on the Identity Consequence Fatigue Scale (ICFS), for the specific purpose of reliably measuring functional patient recovery following surgery. Patients who underwent elective open or laparoscopic colonic resection between June 2006 and June 2009 were included. The 31 item ICFS was administered at baseline and postoperative d 3, 7, 30, and 60. Item reduction was applied based on defined parameters, to derive a single summary score capable of predicting >90% of the variance present in the original ICFS and maximizing sensitivity to changes over time. The final score was then validated against published criteria as set out by Terwee et al. [2]. Data from 150 patients were included in the analysis. Application of the item reduction process retained 13 items. These items form the Surgical Recovery Scale (SRS). The SRS was able to predict 94% (89.4%-98.1%) of the ICFS subscale variances, and was successfully validated against seven out of eight published validation criteria. The new SRS is a simple and sensitive tool for the assessment of functional recovery following major surgery. Seven of the eight Terwee et al. validation criteria have been addressed, making this the most broadly validated measure of surgical recovery available.

Psychometric evaluation of the post‐discharge surgical recovery scale

RATIONALE, AIM AND OBJECTIVES: Day surgery patients are discharged after a short period of postoperative surveillance, and reliable and valid instruments for assessment at home are needed. The aim of this study was to evaluate the psychometric properties of a Swedish version of the post-discharge surgical recovery (PSR) scale, an instrument to monitor the patient's recovery after day surgery, in terms of data quality, internal consistency, dimensionality and responsiveness. Data were collected on postoperative days 1 and 14 and included 525 patients. Data quality and internal consistency were evaluated using descriptive statistics, correlation analyses and Cronbach's alpha. The dimensionality of the scale was determined through an exploratory factor analysis. Responsiveness was evaluated using the standardized response mean and the area under the receiver operating characteristics curve (AUC). The correlation between change score in PSR and change score in self-rated health was assessed using Pearson's correlation coefficient. Patients' ability to work and their self-rated health on postoperative day 14 were used as external indicators of change. Six items showed floor or ceiling effects. Cronbach's coefficient alpha was 0.90 and the average inter-item correlation coefficient was 0.44 after the deletion of two items. The items were closely related to each other, and a one-factor solution was decided on. A robust ability to detect changes in recovery (standardized response mean = 1.14) was shown. The AUC for the entire scale was 0.60. When initial PSR scores were categorized into three intervals, the ability to detect improved and non-improved patients varied (AUC 0.58-0.81). There was a strong correlation between change scores in PSR and health (0.63). The Swedish version of the PSR scale demonstrates acceptable psychometric properties of data quality, internal consistency, dimensionality and responsiveness. In addition to previous findings, these results strengthen the PSR scale as a potential instrument of recovery at home.

Systematic review on recovery specific quality-of-life instruments

Postoperative recovery is a considerable issue in studies comparing operative techniques of similar effectiveness. In recent years, a shift has occurred toward patient-centered study outcomes such as quality-of-life questionnaires. The objective of this article is to provide a systematic review of the literature on general postoperative, recovery-specific quality-of-life instruments and their measurement properties. We searched the databases EMBASE.com, Cinahl, PsycINFO, and PubMed for articles reporting on postoperative, recovery-specific quality-of-life instruments. A checklist was used to assess the revealed studies and instruments. Existing quality criteria were applied to the measurement properties to compare the instruments. The search strategy identified 620 studies, of which 18 studies reported on 12 different postoperative, recovery-specific quality-of-life instruments. None of the instruments had been validated completely in line with the 8 quality criteria, which were used to assess the measurement properties. Two instruments were clearly superior, which were the Postdischarge surgical recovery scale and the Quality of recovery-40. No fully validated instrument is available for the assessment of general postoperative recovery. We advise to use the Postdischarge surgical recovery scale and the Quality of recovery-40 in future validation and application studies on short-term postoperative recovery.