SP7.8 Qualitative exploration of gastrointestinal recovery following surgical admission: Phase I of the PRO-diGI study
Daniel Baker,- Surgery
Abstract
Background
Patients admitted to hospital for abdominal surgery often experience gastrointestinal dysfunction. Recovery of gastrointestinal function is poorly measured and only briefly assessed by clinicians. There is a need for a patient reported outcome measure to assess gastrointestinal recovery. The first stage of development requires qualitative methodology to identify key concepts.
Methods
Adult patients admitted to hospital for major gastrointestinal, urological, or gynaecological surgery, in an emergency or elective setting were eligible to participate. Patients treated non-operatively for small bowel obstruction were also eligible. Interviews were conducted by telephone, audio-recorded and transcribed. Interviews were coded and analysed in the NVivo software by two researchers and reviewed by lay members of the steering group. Interviews continued until saturation was reached. Ethical approval was gained prior to interviews (21/WA/0231).
Results
Twenty-nine interviews were completed (17 male, median age 64) across three specialties (20 gastrointestinal, 6 gynaecological, 3 urological). Two overarching themes of ‘general recovery’ and ‘gastrointestinal symptoms’ were identified. General recovery included 3 themes of; ‘life impact’, ‘mental impact’ including anxiety, and ‘physical impact’ including fatigue. Gastrointestinal symptoms included 3 themes of; ‘abdominal symptoms’ such as pain, ‘diet and appetite’, and ‘expulsory function’ such as stool frequency. A total of 18 gastrointestinal symptoms were identified during patient recovery – many of which lasted several weeks following discharge.
Discussion
This study highlights a broad range of gastrointestinal and non-gastrointestinal symptoms experienced by patients during their gastrointestinal recovery. Patients remain symptomatic following discharge. Clinicians should consider assessing recovery thoroughly at discharge and follow up.