Effects of a Home-Based Recovery Program on Postoperative Recovery Among Older Patients Undergoing Major Abdominal Operation

Monday, 30 July 2012

Teerarat Momplad, MNS
Department of nursing surgery, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand

Learning Objective 1: To compare the postoperative pain and activities of daily living in the experimental group before and after received a home-based recovery program.

Learning Objective 2: To compare the experimental and control groupsí postoperative pain, activities of daily living, and postoperative complications at two weeks after discharge.

Purpose: explored the effects of a home-based recovery program on postoperative recovery among older patients undergoing a major abdominal operation.

Methods: quasi-experimental research using a two group pre-post test design. The conceptual framework of the study was derived from Orem’s self-care theory. The purposive sample consisted of 70 older patients undergoing a major abdominal operation at Ramathibodi hospital between June 2010 – January 2011. The subjects were equally assigned to the control (n=35) and the experimental group (n=35). The control group received only conventional nursing care, and the experimental group received conventional nursing care coupled with the home-based recovery program. Instruments used for data collection were demographic data form, the pain Numerical Rating Scale, the Barthel Index, and a postoperative complication form. The data were analyzed using descriptive statistics, the Chi-square test, the Mann-Whitney U test, the Wilcoxon signed ranks test, the independent t-test, and the paired t-test.

Results: 1) the experimental group, after participating in the home-based recovery program, had a significantly lower mean score of postoperative pain (p<.001) and a significantly higher mean score of activities of daily living (p<.001) than before participating in the program

            2) at two weeks  postdischarge, the patients in the experimental group had a significantly lower mean score of postoperative pain (p=.001) and a significantly higher mean score of activities of daily living (p<.05) than the control group. Patients in both groups did not have any lower respiratory tract infection, but three cases in the experimental group and seven cases in the control group had surgical site infection. However, the incidence of postoperative complications in the surgical site infection were not statistically significant (p>.05).

Conclusion: the findings of this study could be used as a guideline for the continuing care of older patients from hospital to home and to enhance efficiency in the quality of health services.