Faculty Collaboration Database

Patient expectations for recovery after elective surgery: a common-sense model approach. J Behav Med 2020 Apr;43(2):185-197

Date

09/13/2019

Pubmed ID

31512105

DOI

10.1007/s10865-019-00097-2

Scopus ID

2-s2.0-85073970890 (requires institutional sign-in at Scopus site)   12 Citations

Abstract

Patient perceptions of the causes of preoperative symptoms, expected impact of surgery on symptoms and anticipated timeline of recovery are likely to affect the risk of readmission following elective surgical procedures. However, these perceptions have not been studied. A qualitative study was designed to explore these perceptions, using the common-sense model of self-regulation (CSM) as the conceptual framework. CSM is grounded in illness representations, describing how patients make sense of changes in physical well-being (e.g. symptoms) and develop and assess management plans. It also establishes a broader framework for examining patients' a priori expectations and timelines for outcomes based on comparisons to prior experiences and underlying self-prototypes, or "Self as Anchor". A convenience sample of 14 patients aged 56-81 who underwent elective surgery was recruited. Semi-structured interviews informed by the CSM were completed on the day of discharge. Content analysis with deductive coding was used, and emerging themes were fit to components of the CSM, including the five domains of Illness Representations-identity, cause, timeline, control, and consequences. Two additional themes, outlook (toward the health care system, providers and recovery efforts), and motivation (external or internal for recovering), relate to self-prototypes, expectations for outcomes, and search for coherence. Misattribution of symptoms, unrealistic expectations for outcomes (e.g. expecting complete resolution of symptoms unrelated to the surgical procedure) and timelines for recovery (unrealistically short), and the (baseline) "normal healthy self" as distinct from the (temporarily) "sick self" were recurrent themes. Findings suggest that patient perceptions and the actual recovery process may be misaligned. The results underscore the importance of assessing patients' perceptions and expectations, actively engaging patients in their own healthcare, and providing adequate support during the transition to home.

Author List

Gehring MB, Lerret S, Johnson J, Rieder J, Nelson D, Copeland L, Titan A, Hawn M, Morris M, Whittle J, Burns E

Authors

Stacee Lerret PhD Professor Hybrid in the Pediatrics department at Medical College of Wisconsin
David A. Nelson PhD Professor in the Family Medicine department at Medical College of Wisconsin
Jeffrey Whittle MD Professor in the Medicine department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adult
Aged
Aged, 80 and over
Elective Surgical Procedures
Female
Humans
Male
Middle Aged
Motivation
Patient Discharge
Qualitative Research