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      “I Have Everything to Win and Nothing to Lose”: Patient Experiences of Mobilization Out of Bed Immediately After Abdominal Surgery

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          Abstract

          Objective

          Early mobilization is advocated for patients going through abdominal surgery; however, little is known about the patient experience of being mobilized immediately after surgery. The purpose of this study was to explore patient experiences of mobilization immediately after elective abdominal cancer surgery.

          Methods

          This interview study used qualitative content analysis. With the use of purposeful sampling, a total of 23 participants who had been mobilized immediately after abdominal surgery were recruited at a university hospital in Stockholm, Sweden. Individual face-to-face interviews were conducted within 1 to 4 days after surgery and took place at the surgical ward where the participants were treated. A semi-structured guide was used. All interviews were audio recorded and transcribed verbatim.

          Results

          The content analysis revealed 3 categories that emerged into 1 overarching theme: “to do whatever it takes to get home earlier.” The participants experienced that mobilization out of bed had an impact on their physical and mental well-being. Motivation and the experiences of themselves and others were factors that affected patient attitudes toward early mobilization. Preparation and competent caregivers were emphasized as important factors that enabled the patient to feel safe and confident during mobilization.

          Conclusions

          Patients experienced mobilization as an important part of the care that had an impact on recovery and well-being, physically as well as mentally, both immediately and over time.

          Impact

          As this is the first study to our knowledge to investigate patient experiences of mobilization immediately after abdominal surgery, this information can be used to support the development of early mobilization protocols in hospital settings.

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          Most cited references30

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          Qualitative content analysis in nursing research: concepts, procedures and measures to achieve trustworthiness.

          Qualitative content analysis as described in published literature shows conflicting opinions and unsolved issues regarding meaning and use of concepts, procedures and interpretation. This paper provides an overview of important concepts (manifest and latent content, unit of analysis, meaning unit, condensation, abstraction, content area, code, category and theme) related to qualitative content analysis; illustrates the use of concepts related to the research procedure; and proposes measures to achieve trustworthiness (credibility, dependability and transferability) throughout the steps of the research procedure. Interpretation in qualitative content analysis is discussed in light of Watzlawick et al.'s [Pragmatics of Human Communication. A Study of Interactional Patterns, Pathologies and Paradoxes. W.W. Norton & Company, New York, London] theory of communication.
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            Enhanced Recovery After Surgery: A Review.

            Enhanced Recovery After Surgery (ERAS) is a paradigm shift in perioperative care, resulting in substantial improvements in clinical outcomes and cost savings.
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              Qualitative Quality: Eight "Big-Tent" Criteria for Excellent Qualitative Research

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                Author and article information

                Contributors
                Journal
                Phys Ther
                Phys Ther
                ptj
                Physical Therapy
                Oxford University Press
                0031-9023
                1538-6724
                December 2020
                17 September 2020
                17 September 2020
                : 100
                : 12
                : 2079-2089
                Affiliations
                Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy , Karolinska Institutet, Alfred Nobels Allé 23, 141 83, Stockholm, Sweden; and Department of Allied Health Professionals, Functional Area Occupational Therapy and Physiotherapy, Karolinska University Hospital, Stockholm, Sweden
                Department of Molecular Medicine and Surgery, Karolinska Institute and Department of Anesthesiology and Intensive Care, Södersjukhuset , Stockholm, Sweden
                Department of Allied Health Professionals, Functional Area Occupational Therapy and Physiotherapy , Karolinska University Hospital
                Department of Neuroscience and Physiology, Division of Health and Rehabilitation/Physical Therapy, Sahlgrenska Academy, Gothenburg University , Göteborg, Sweden; and Department of Physiotherapy, Sahlgrenska University Hospital, Göteborg, Sweden
                Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet and Department of Allied Health Professionals , Functional Area Occupational Therapy and Physiotherapy, Karolinska University Hospital
                Author notes
                Address all correspondence to Ms Svensson-Raskh at: anna.svensson-raskh@ 123456ki.se .@AnnaRaskh.
                Article
                pzaa168
                10.1093/ptj/pzaa168
                7720638
                32941610
                02d32bdc-8a55-446e-87a6-7e38b2f2d874
                © The Author(s) 2020. Published by Oxford University Press on behalf of the American Physical Therapy Association.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 24 February 2020
                : 17 August 2020
                Page count
                Pages: 11
                Funding
                Funded by: Swedish Research Council, DOI 10.13039/501100004359;
                Funded by: Doctoral School of Health and Care Sciences at the Karolinska Institute;
                Categories
                Original Research
                AcademicSubjects/MED00110

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