Postoperative Symptom Distress of Laparoscopic Cholecystectomy Ambulatory Surgery Patients: A Qualitative Study

Approximately 60% of all surgeries in the U.S. are performed in the ambulatory setting annually. Over 50% of ambulatory surgery patients report moderate to severe postoperative pain and up to 60% of these patients experience post discharge nausea and/or vomiting (PDNV). Other symptoms reported include sore throat, hoarseness, urinary retention, constipation, fatigue, and headache. Because these symptoms occur at home, many are underreported by patients and caregivers and affect the quality of patient recovery. Postoperative symptom distress prevents timely resumption of activity resulting in prolonged recovery, resource use, and costly delay in resumption of work related activities. Patients who have undergone a laparoscopic cholecystectomy procedure can experience severe nausea and pain in the ambulatory setting. The purposes of this study are to: 1) identify all symptoms that cause postoperative distress; 2) identify symptom management techniques that effectively reduce the distress of laparoscopic cholecystectomy postoperative symptoms at home after ambulatory surgery; and 3) identify facilitators and barriers to self-management of postoperative symptoms. We propose a qualitative study that will use two focus groups of ambulatory surgery patients who have experienced a laparoscopic cholecystectomy procedure and their caregivers (N = 12 each group) and two focus groups of multidisciplinary clinicians (N = 12 each group) to elicit understanding of postoperative symptoms and symptom management techniques that effectively reduce the distress of postoperative symptoms. We believe that the use of four focus groups will allow for saturation of the data. The proposed study will have a substantial impact on postoperative care because it will provide information that will allow development of a tailored intervention for management of postoperative symptoms.