Abstract
Objective
We conducted a scoping review to identify existing conceptual frameworks of postoperative
recovery (PR) and assess their content.
Background
PR is increasingly recognized by providers and third-party payers as a multidimensional
phenomenon. Efforts to optimize PR and reduce complications and readmissions continue
to evolve through changes in care (i.e., enhanced recovery protocols) and financial
incentives. Delineating all factors affecting PR using a conceptual framework should
aid in the design of effective interventions.
Methods
Web of Science and PubMed were queried to identify articles, between January 1980
and August of 2019, about conceptual frameworks of PR, using the search terms: “concept,”
“model,” “framework,” “recovery after surgery,” “conceptual framework” “postoperative,”
“surgery,” and “children.” Articles considering PR as a concept rather than an outcome
were included. Articles were examined in accordance with Walker and Avant's method
for the concept analysis. Concepts identified across articles were classified as domains
and subdomains of PR.
Results
The search yielded 183 unique articles; 8 met inclusion/exclusion criteria. Most articles
defined PR as a period of days to weeks (n = 7) rather than days (n = 1). PR was mostly conceptualized as a process involving the patient and the health
care system (n = 4) rather than the patient alone (n = 2). Physiological recovery (n = 8), activities of daily living (n = 8), pain (n = 5), cognitive/psychological recovery (n = 4), social recovery (n = 2), and patient perspective (n = 1) were the identified domains. Existing patient-reported outcome measures were
used to assess most PR domains; however, definitions of domains and subdomains differed.
None of the PR conceptual frameworks included were specific to children.
Conclusions
There are few conceptual frameworks of PR in adults, and the definitions of PR differ.
No framework was specific to children. Consensus on a conceptual framework of PR in
adults and development of a conceptual framework of PR specific to children are needed.
Keywords
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Article info
Publication history
Published online: March 16, 2021
Accepted:
January 29,
2021
Received in revised form:
December 6,
2020
Received:
April 17,
2020
Footnotes
The manuscript herein represents the results of a Scoping Review.
This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
Author’s contributions: B.T.M., M.H., and H.G. contributed to conception and design, analysis and interpretation, data collection, writing the article, and critical revision of the article. M.V.R. contributed to critical revision, J.L.H. contributed to critical revision and writing the article, and F.A. contributed to conception and design and critical revision.
This work was presented at the American College of Surgeons Clinical Congress Surgical Forum in October 2019.
Identification
Copyright
Published by Elsevier Inc.
