TY - JOUR
T1 - Conceptual Frameworks of Postoperative Recovery
T2 - A Scoping Review
AU - Many, Benjamin T.
AU - Hasan, Mohamed
AU - Raval, Mehul V.
AU - Holl, Jane L.
AU - Abdullah, Fizan
AU - Ghomrawi, Hassan
N1 - Funding Information:
This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
Publisher Copyright:
© 2021
PY - 2021/7
Y1 - 2021/7
N2 - 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.
AB - 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.
KW - Children
KW - Conceptual framework
KW - Postoperative
KW - Recovery
KW - Scoping review
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U2 - 10.1016/j.jss.2021.01.031
DO - 10.1016/j.jss.2021.01.031
M3 - Article
C2 - 33740574
AN - SCOPUS:85102805097
SN - 0022-4804
VL - 263
SP - 265
EP - 273
JO - Journal of Surgical Research
JF - Journal of Surgical Research
ER -