The day surgery experience from the perspective of service users

Construction of the whole-process nursing service system for day surgery patient based on the Kano model: A pilot cluster randomized controlled trial

Objective

The types and number of day surgeries have significantly increased, but the construction of the whole process nursing service system (WPNSS) for preoperative education, intraoperative cooperation, postoperative knowledge, and follow-up for day surgery patients is still in the exploratory stage. The aim of this study is to establish the WPNSS for day surgery patients using the Kano model and to preliminarily assess its efficacy.

Methods

WPNSS for day surgery was devised leveraging Internet hospital information systems and patient mobile terminals (WeChat), guided by the World Health Organization's conceptual framework for scaling-up strategies. The system was methodically developed, progressing from defining the overall framework to delineating modular functions and developing specific educational materials and tools. A pilot test was conducted in a hospital in China.

Results

WPNSS, a patient-centric remote education and monitoring system, seamlessly amalgamates health education, online consultations, and follow-up functionalities; offering semi-automated surgical consultations, inquiry services, and postoperative follow-ups, as well as autonomously disseminating perioperative health education content. Comprising both client and server components, patients utilizing the system are inclined to recommend day surgery at the hospital to others.

Conclusions

WPNSS delivers personalized and precise health education, consultation, and postoperative follow-up services for day surgery patients. Current results suggest that the WPNSS may improve patients' experience.

Trial Registration

Chinese Clinical Trial Register (ChiCTR2200066782).

A planned but vulnerable pathway towards self-management following day surgery. Orthopaedic patients' experiences

INTRODUCTION

An increasing share of surgical activity is organised as day surgery, thus giving more responsibility for care to patients and their next of kin.

PURPOSE

To obtain increased understanding of orthopaedic day surgery patients' experiences with self-management.

METHODS

A descriptive interview study. Eleven men and five women aged 18-78 years, who had undergone arthroscopic knee surgery in rural Norway participated in qualitative individual interviews during autumn 2018. Systematic text condensation was used as analysis strategy.

RESULTS

The main theme a planned but vulnerable pathway towards self-management and five subthemes were highlighted. The interviewees were satisfied with most aspects of the day surgery. However, challenges in adapting oral and written information to self-management postdischarge, a need for further self-management support at home, and strenuous travel increased the strain.

CONCLUSION

The written and oral information and support that was planned and provided by the hospital did not meet the patients' needs for self-management support postdischarge. The day surgery care pathway seemed to lack effective educational interventions for strengthening the patients' self-efficacy and control and to have potential for improvements.

Testing Measurement Properties of the Norwegian Version of Electronic Health Literacy Scale (eHEALS) in a Group of Day Surgery Patients

Background and Aim

In order to assess patients’ ability to search, understand, and benefit from Internet-based information, several screening tools have been developed. One of these tools, which has been widely used, is the eHealth Literacy Scale (eHEALS). The aim of this study was to examine the measurement properties of the Norwegian version of the eHEALS, as it was used in a group of patients undergoing day surgery.

Methods

A cross-sectional survey study was conducted among 119 patients scheduled for day surgical treatment in a Norwegian hospital. The questionnaire included the screening tool eHEALS, which contains 8 items for assessing a person’s information awareness skills, information seeking skills, and skills to evaluate and act based on the information. Cronbach’s alpha coefficients and item-total correlations were assessed for estimating reliability of the eHEALS. Exploratory factor analysis with Oblimin rotation was used for assessing the validity of the scale. Eigenvalue was set to 1.0.

Results

A Cronbach’s alpha coefficient of 0.89 for the total scale, values >0.82 for Alpha if Item Deleted, and moderate to high item-total correlations supported the homogeneity and internal consistency of the scale. A two-component solution explained a total of 74.8% of the variance, with the first component explaining 59.53% of the variance in the scale and included the items reflecting information awareness and seeking. The second component explained 15.23% of the variance, including items reflecting the ability to evaluate and act.

Conclusion

The reliability of the Norwegian version of eHEALS, used in a group of patients undergoing day surgery, was good. The internal structure, with two distinct factors, is in line with several previous studies. The eHEALS appears to be an appropriate tool for assessing eHealth literacy among this patient group.