At-home monitoring after surgery/anaesthesia – a challenge

Rationale, aims and objectives: Day surgery is evolving, with a majority of recoveries occurring at home. There is, in parallel, an evolution in telemedical technology. The aim of the present project was to identify patients’ willingness to use predefined follow-up techniques and to clinically test preferred techniques at home using a two-step study.┅. Methods: In Part I, a paper-based questionnaire study of identified patients’ attitudes with three follow-up techniques was used. In Part II, a feasibility test of a mobile (smart-phone) application for follow-up at home was used. Results: Part I showed overall positive attitudes to telemedical follow-ups. Part II showed the preference for a follow-up technique with a mobile application was not fully consistent with the clinical study of the smart-phone app, where there was a large non-response. The application provided safe transfer of data to the hospital and helped make it easy to retrieve and analyse patient self-assessment of recovery. This application is one-way directed, and no feedback to the patient was given, which may have influenced the non-response. Conclusion: Bringing telemedicine into follow-up after surgery/anaesthesia is requested, and furthermore, the feasibility study on day surgery presented here shows that it is technically easy to perform and will provide robust information. It should be noted that further studies are needed in order to find better patient cooperation

Evaluation of the Postoperative Quality of Recovery Scale test and re-test in Swedish among healthy volunteers [version 1; referees: 2 approved]

Introduction Patient outcome measures are required to assess the quality of healthcare. Tools for a patients’ self-assessment of quality of recovery, during perioperative care, have been developed during the last decade. The Postoperative Quality of Recovery Scale (PostopQRS) questionnaire is one of the most well-accepted and validated tools available. Here we assess the PostopORS questionnaire in Swedish. Methods Sixty-one students from the Bachelor Program in Nursing, (50 female and 11 male; mean age, 25; range, 21-46) filled in the Swedish translation of the PostopQRS questionnaire twice. They also evaluated whether they found the queries easy to understand and respond to. Results The participants found the Swedish translation of the PostopQRS questionnaire easy to read and understand. There were minor differences in test responses between the initial test and the re-test 48 hours later. We found that the PostopQRS questionnaire has some background noise; 12 out of 61 participants (20%) reported mild pain, 25 (41%) scored some depression and 33 scored mild anxiety (54%). The cognitive domain showed a learning effect between tests in “word recall” and “word generation”, while “digit recall forward” and “digit recall backward” showed no change. We found a difference in cognitive test performance with age; younger participants had higher mean cognitive test scores compared to participants >30 years. Overall, nine participants showed a decrease in re-test scores; two experienced a mild increase in pain; one experienced a mild increase in anxiety; and six performed more poorly on cognitive tests. Conclusion The Swedish translation of the PostopQRS was found to be adequate for use in the assessment of quality of recovery, and the questions were well understood by participants. Our study shows the importance of baseline testing for assessment of recovery, since recovery is assessed as a return to or improvement in each individual’s baseline score