RT Journal Article
SR Electronic
T1 Neurosurgical enhanced recovery after surgery (ERAS) programme for elective craniotomies: are patients satisfied with their experiences? A quantitative and qualitative analysis
JF BMJ Open
JO BMJ Open
FD British Medical Journal Publishing Group
SP e028706
DO 10.1136/bmjopen-2018-028706
VO 9
IS 11
A1 Bolin Liu
A1 Shujuan Liu
A1 Yuan Wang
A1 Binfang Zhao
A1 Tianzhi Zhao
A1 Lanfu Zhao
A1 Wenhai Lv
A1 Yufu Zhang
A1 Tao Zheng
A1 Yafei Xue
A1 Lei Chen
A1 Long Chen
A1 Yingxi Wu
A1 Guodong Gao
A1 Yan Qu
A1 Shiming He
YR 2019
UL http://bmjopen.bmj.com/content/9/11/e028706.abstract
AB Objective To evaluate patient satisfaction and associated predictors at discharge, as well as patient experience at 30-day follow-up, in a neurosurgical enhanced recovery after surgery (ERAS) programme.Design A single-centre, prospective, randomised controlled study.Setting A tertiary hospital in China.Participants A total of 140 neurosurgical patients aged 18–65 years old who had a single intracranial lesion and were admitted for elective craniotomy between October 2016 and July 2017 were included.Interventions Patients were randomised into two groups: 70 patients received care according to a novel neurosurgical ERAS protocol (ERAS group) and 70 patients received conventional perioperative care (control group).Outcome measures Patient satisfaction at discharge was evaluated using a multimodal questionnaire. A secondary analysis of patient experience regarding participation in the ERAS programme was conducted using a semistructured qualitative interview via telephone at 30-day follow-up.Results The mean patient satisfaction was significantly higher in the ERAS group than in the control group at discharge (92.2±4.3 vs 86.8±7.4, p=0.0001). The most important predictors of patient satisfaction included age (OR=6.934), postoperative nausea and vomiting (PONV) Visual Analogue Scale (VAS) score (OR=0.184), absorbable skin suture (OR=0.007) and postoperative length of stay (LOS) (OR=0.765). Analysis on patient experience revealed five themes: information transfer, professional support, shared responsibility and active participation, readiness for discharge, and follow-up, all of which are closely related and represent positive and negative aspects.Conclusions Measures that include decreasing PONV VAS score, incorporating absorbable skin suture and shortening LOS seem to increase patient satisfaction in a neurosurgical ERAS programme. Analysis of data on patient experience highlights several aspects to achieve patient-centred and high-quality care. Further studies are warranted to standardise the assessment of patient satisfaction and experience in planning, employing and appraising the ERAS programme.Trial registration number ChiCTR-INR-16009662.