GYNOTEL: telephone advice to gynaecological surgical patients after discharge (original) (raw)
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Journal of Occupational Rehabilitation, 2013
Purpose This study describes the process evaluation of an innovative multidisciplinary care program for patients undergoing benign gynaecologic surgery. This care program aims at improving recovery and preventing delayed return to work and consists of two steps: (1) an interactive e-health intervention for all participants, and (2) integrated clinical and occupational care management for those participants whose sick leave exceeds 10 weeks. Methods Eligible for this study were employed women aged between 18-65 years scheduled for a laparoscopic adnexal surgery and/or hysterectomy. Data were collected from patients, their supervisors and their gynaecologists, by means of electronic questionnaires during a 6 month follow-up period and an automatically generated, detailed weblog of the patient web portal (www.ikherstel.nl). Investigated process measures included: reach, dose delivered, dose received, and fidelity. In addition, attitudes towards the intervention were explored among all stakeholders. Results 215 patients enrolled in the study and accounted to a reach of 60.2 % (215/357). All intervention group patients used their account at least once and total time spent on the patient web portal was almost 2 h for each patient (median 118 min, IQR 64-173 min). Most patients visited the website several times (median 11 times, IQR 6-16). Perceived effectiveness among patients was high (74 %). In addition, gynaecologists (76 %) and employers (61 %) were satisfied with the web portal as well. Implementation of the second step of the intervention was suboptimal. Motivating patients to consent to additional guidance and developing an accurate return-to-workprognosis were two important obstacles. Conclusions The results of this study indicate good feasibility for implementation on a broad scale of the e-health intervention for patients undergoing benign gynaecological surgery. To enhance the implementation of the second step of the perioperative care program, adaptations in the integrated care protocol are needed.
Enhanced recovery in elective gynaecological surgeries
International Journal of Clinical Obstetrics and Gynaecology, 2020
Background: Enhanced Recovery after Surgery [ERAS] program is an evidenced based model of care for elective surgery that enables patient to recover more quickly and have shorter hospital stay. Fast track surgical program allows early discharge with low risk of readmission and improved outcomes. Method: This study was prospective non-randomised observational study and was conducted in the department of Obstetrics and Gynaecology, Berhampur, Odisha from October 2015 to September 2017. A total of 100 cases were included in the study. Criteria of inclusion was patients undergoing elective gynaecological surgeries for benign conditions which included TAH by small transverse incision (<6cm), NDVH, LAVH/TLH. Results: In our study most of the patients presented with heavy menstrual bleeding. The most common clinical diagnosis in patients who underwent hysterectomy was fibroid uterus. In our study the commonest surgical method was abdominal (49%) followed by vaginal (32%) & laparoscopically (19%). There was significant decrease in duration of hospital stay when compared with the duration of hospital stay in conventional abdominal hysterectomy by other studies. Conclusion: According to this study, no surgical technique has shown to eliminate postoperative morbidity, strong consideration must be given to minimally inavasive surgeries and ERAS pathways which may lead to major reduction in undesirable sequale postoperatively and results in faster convalescence and improved recovery.
Perioperative care in gynaecology
Obstetrics, Gynaecology & Reproductive Medicine, 2012
Perioperative care in gynaecology aims at optimizing patient's condition prior to surgery, ensuring the provision of most individually appropriate treatment, minimizing postoperative morbidity, improving patient's experience and reducing the length of stay in hospital.
BJOG An International Journal of Obstetrics & Gynaecology
To generate structured detailed uniform convalescence recommendations after gynaecological surgery by a modified Delphi method amongst experts and a representative group of physicians. Modified Delphi study. Expert physicians recruited by their respective medical boards and employed at different hospitals, doctor's surgeries and healthcare services. Twelve experts (five gynaecologists, two general practitioners [GPs] and five occupational physicians [OPs]) and a representative sample of 63 medical doctors. Multidisciplinary detailed recommendations for graded resumption of relevant activities after uncomplicated hysterectomy (laparoscopic supracervical, total laparoscopic/laparoscopic-assisted, vaginal and abdominal hysterectomies) and laparoscopic adnexal surgery were developed. Recommendations were based on a literature review and a modified Delphi procedure among 12 experts, recruited in collaboration with the participating medical boards of gynaecologists, GPs and OPs. A mul...
Gynaecological day surgery and quality of care
Australian Health Review, 2002
The aim of the study was to explore the experiences of Australian public and private patients undergoing gynaecological day surgery in a public hospital. A telephone survey was conducted with 315 women within two days of hospital discharge. The findings indicate that patients generally favour the "in and out" experience of day surgery, with some reservations. Prior to hospital admission, private patients were less likely to have access to multiple sources of information as well as information that they found easy to understand. Alternative means of supporting women recovering from day surgery may be needed for those whose family members and/or friends cannot provide sufficient support following discharge. This study contributes to discussion on setting objective standards to evaluate the health system in the field of day surgery.
Self-assessment and woman’s health control location after gynaecological operations
2016
Introduction: Surgical treatment in gynaecology has a specific influence on a woman’s life and has a psychological effect because of the organs involved. Self-assessment and women’s health control location after gynaecological operation determine the treatment and rehabilitation process. Aim of the research: Self-assessment and women’s health control location after gynaecological operation evaluation was the aim of this study. Material and methods: There were 167 women after gynaecological treatment evaluated. Patients were registered in the Obstetrics and Gynaecology department and the Gynaecology outpatient Clinic in Chełm Public Specialist Hospital. MHCL version B scale with polish adaptation (Z. Juszyński) and sociodemographic, self-evaluation, and health control questionnaires created by the authors were used. This analysis used Kołmogorow-Smirnow, U Mann-Whitney and Kruskal-Wallis tests. Confidence intervals of p < 0.05 and p < 0.01 were established. IBM SPSS Statistics ...
Efficacy of Implementing Discharge Plan on Women Undergoing Hysterectomy
Assiut Scientific Nursing Journal, 2021
Context: Hysterectomy is the most common gynecologic surgical procedure among reproductive aged women in which complications with serious consequences may occur, thereby discharge planning for women undergoing hysterectomy is considered a strategy for promoting their health and wellbeing. Aim: The aim of this study was to assess the efficacy of implementing a discharge plan on women undergoing Hysterectomy. Methods: A Quasiexperimental (study/control group) design was utilized in this study. A purposive sample of 60 women recruited in this study that conducted at the Gynecological unit at Ain shames university maternity hospital. The study utilizes Four tools, I) Structured Interviewing Questionnaire, II) Structured self-care ability questionnaire III) Visual Analogue Scale (VAS), IIIV) in addition to follow up record and developed supportive material (discharge plan). Results: The present study revealed statistically significant differences between the study and control group regarding their total practice scores, mean pain score as well as health problems after hysterectomy pre, post, and follow up of intervention (P ≤ 0.001). Conclusions: The present study concluded that the implementation of a discharge plan has improved women's self-care practices post-hysterectomy in addition to a reduction in health problems and pain scores among studied women. The study Recommended: an updated discharge plan regarding self-care should be included in routine care for women undergoing hysterectomy. Also, further research is still needed to investigate the association between discharge plan and developing complications.
BMC Health …, 2012
Background: Return to work after gynaecological surgery takes much longer than expected, irrespective of the level of invasiveness. In order to empower patients in recovery and return to work, a multidisciplinary care program consisting of an e-health intervention and integrated care management including participatory workplace intervention was developed. Methods/Design: We designed a randomized controlled trial to assess the effect of the multidisciplinary care program on full sustainable return to work in patients after gynaecological surgery, compared to usual clinical care. Two hundred twelve women (18-65 years old) undergoing hysterectomy and/or laparoscopic adnexal surgery on benign indication in one of the 7 participating (university) hospitals in the Netherlands are expected to take part in this study at baseline. The primary outcome measure is sick leave duration until full sustainable return to work and is measured by a monthly calendar of sickness absence during 26 weeks after surgery. Secondary outcome measures are the effect of the care program on general recovery, quality of life, pain intensity and complications, and are assessed using questionnaires at baseline, 2, 6, 12 and 26 weeks after surgery. Discussion: The discrepancy between expected physical recovery and actual return to work after gynaecological surgery contributes to the relevance of this study. There is strong evidence that long periods of sick leave can result in work disability, poorer general health and increased risk of mental health problems. We expect that this multidisciplinary care program will improve peri-operative care, contribute to a faster return to work of patients after gynaecological surgery and, as a consequence, will reduce societal costs considerably. Trial registration: Netherlands Trial Register (NTR): NTR2087
BMC Health Services Research, 2012
Background: Return to work after gynaecological surgery takes much longer than expected, irrespective of the level of invasiveness. In order to empower patients in recovery and return to work, a multidisciplinary care program consisting of an e-health intervention and integrated care management including participatory workplace intervention was developed. Methods/Design: We designed a randomized controlled trial to assess the effect of the multidisciplinary care program on full sustainable return to work in patients after gynaecological surgery, compared to usual clinical care. Two hundred twelve women (18-65 years old) undergoing hysterectomy and/or laparoscopic adnexal surgery on benign indication in one of the 7 participating (university) hospitals in the Netherlands are expected to take part in this study at baseline. The primary outcome measure is sick leave duration until full sustainable return to work and is measured by a monthly calendar of sickness absence during 26 weeks after surgery. Secondary outcome measures are the effect of the care program on general recovery, quality of life, pain intensity and complications, and are assessed using questionnaires at baseline, 2, 6, 12 and 26 weeks after surgery. Discussion: The discrepancy between expected physical recovery and actual return to work after gynaecological surgery contributes to the relevance of this study. There is strong evidence that long periods of sick leave can result in work disability, poorer general health and increased risk of mental health problems. We expect that this multidisciplinary care program will improve peri-operative care, contribute to a faster return to work of patients after gynaecological surgery and, as a consequence, will reduce societal costs considerably. Trial registration: Netherlands Trial Register (NTR): NTR2087