POSTDISCHARGE SURGICAL RECOVERY OF ADULT LAPAROSCOPIC OUTPATIENTS (HOME CARE).
Contributors: University of Kansas.
Published: 1995
Number of pages: 219
Subjects: Health Sciences, Nursing.; Health Sciences, Medicine and Surgery.
Description: Although 75% of all surgical procedures performed in the United States are done on an outpatient basis (Burns, 1994), there are no instruments to measure the extent of at-home recovery, nor has the process of at-home recovery been documented. The purposes of this correlational descriptive study were to determine the psychometric properties of the Postdischarge Surgical Recovery (PSR) scale and to compare outpatients' reported levels of perceived recovery on the second postoperative day.

The Biobehavioral Symptom Management model, derived from self-care theory (Orem, 1991), self-regulation theory (Levanthal, 1983, Levanthal & Johnson, 1983) and the biological theory of homeostasis first proposed by Cannon (1929), guided the study. Registered nurses from 12 surgery centers in 10 different states were trained and collected data from a purposive sampling (N = 171) of adults scheduled for elective laparoscopic surgery. Subjects completed a survey of variables posited to impact postdischarge recovery preoperatively and three measures of perceived recovery (PSR, Wolfer-Davis (WD) Recovery Inventory, Global Surgical Recovery Index) on the second postoperative day.

Psychometric analysis of the PSR scale revealed the instrument is reliable ($\alpha$ =.87) with evidence of construct validity (validity coefficient using the previously tested WD inventory r =.76, p = $<$.001); linear relationship in the expected direction between subjects' reported percentage of recovery and the PSR scale (F(1,145) = 156.62, p = $<$.001). A two factor solution of the PSR, progressive activity and usual-self, coincided with the labels identified in a prior qualitative study of at-home surgical recovery (Kleinbeck & Hoffart, 1994).

Study results suggest that predisposing characteristics of perceived recovery are subjective fatigue (Christensen, Bendix & Kehlet, 1982) and the patients' presurgical expected length of time to recuperate. Subjects who reported less than 40% of recovery (n = 27) by the second postoperative day indicated an inability to perform their usual activities, moderate pain, limited work ability as well as the need for frequent daytime naps, more time to recover, and help with personal care. Further research is needed to measure the biological mechanisms of at-home surgical recovery and to predict patients at risk for delayed recovery.
Notes: Source: Dissertation Abstracts International, Volume: 57-02, Section: B, page: 0989.

Thesis (PH.D.)--UNIVERSITY OF KANSAS, 1995.

School code: 0099.