Conceptual Frameworks of Postoperative Recovery: A Scoping Review

Benjamin T. Many*, Mohamed Hasan, Mehul V. Raval, Jane L. Holl, Fizan Abdullah, Hassan Ghomrawi

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

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.

Original languageEnglish (US)
Pages (from-to)265-273
Number of pages9
JournalJournal of Surgical Research
Volume263
DOIs
StatePublished - Jul 2021

Keywords

  • Children
  • Conceptual framework
  • Postoperative
  • Recovery
  • Scoping review

ASJC Scopus subject areas

  • Surgery

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