Developing patient education to enhance recovery after colorectal surgery through action research: a qualitative study

Poland, Fiona ORCID:, Spalding, Nicola, Gregory, Sheila, McCulloch, Jane, Sargen, Kevin and Vicary, Penny (2017) Developing patient education to enhance recovery after colorectal surgery through action research: a qualitative study. BMJ Open, 7 (6). ISSN 2044-6055

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Objectives: To understand the role of preoperative education for patients undergoing colorectal surgery by involving patients, carers and staff in: (1) identifying its perceived value and deficits for enhanced recovery; (2) modifying current education practices to address educational deficits; and (3) evaluating these changes for preparing patients to enhance their recovery. Design: Qualitative study of three cycles of action research using mixed methods within a 24-month naturalistic enquiry to identify, implement and evaluate changes through observations, questionnaires, semistructured longitudinal interviews, focus groups and documentation review. Setting: A UK 1200-bed National Health Service (NHS) hospital providing colorectal surgery in a small city in a rural county. Participants: Ninety-sevenpatients having colorectal surgery, 19 carers and 22 clinical staff. Rresults: Themes identified were: (1) knowledge and engagement; (2) situated understanding and confidence building; and (3) partnership and proactive involvement in enhancing recovery. All patients articulated needs to prepare mentally and physically to plan for colorectal surgery and rehabilitation. Patients and carers wanted to counter uncertainty about medical procedures: likely bodily changes, recovery timescales and future. They therefore sought as much personalised, relevant information as possible about their disease, planned surgery and recovery. Staff implemented preoperative education to more specifically inform and respond multimodally to individual needs. Conclusions: Patients wanted to be proactively involved in managing their recovery to re-engage with their everyday lives. Preoperative education supported this through developing patients' situated understanding of hospital and bodily processes related to colorectal surgery. Situated understanding was achieved through educational product to give knowledge and processes promoting engagement. Multimodal, comprehensive and timely preoperative education on the whole patient pathway facilitates active engagement. Situated understanding increased patients' confidence to work in partnership with healthcare professionals and proactively self-manage recovery.

Item Type: Article
Additional Information: © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
Faculty \ School: Faculty of Medicine and Health Sciences > School of Health Sciences
Faculty of Medicine and Health Sciences > Norwich Medical School
UEA Research Groups: Faculty of Medicine and Health Sciences > Research Groups > Dementia & Complexity in Later Life
Faculty of Medicine and Health Sciences > Research Groups > Health Promotion
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Depositing User: Pure Connector
Date Deposited: 04 Jul 2017 05:06
Last Modified: 24 Oct 2023 00:54
DOI: 10.1136/bmjopen-2016-013498


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