The Psychological Effect of an Emphatic Remote Monitoring Application in Day Surgery

Abstract Background: As day surgery becomes more common and patients are discharged only a few hours after surgery, recovery happens more at home, which can elicit feelings of anxiety and insecurity. This presents a need for patient tailored support during the postoperative phase. Aim: The aim of this study was to examine the effect of an application that combines self- assessment with emphatic remote monitoring on the psychological aspects of recovery. Methods: The study was part of a multicentre study. For this two-arm non-blinded randomized controlled trial we aimed to recruit 100 patients at the day care of OLVG hospital. Patients in the intervention group received a smartphone application to record pain and nausea, and send messages to the hospital. Data was monitored by a medical assistant and patients were contacted in case of i) an increase in pain or nausea, ii) if answered yes to ‘Do you want something to be done about your pain or nausea?’ or iii) when a message was sent....Show moreAbstract Background: As day surgery becomes more common and patients are discharged only a few hours after surgery, recovery happens more at home, which can elicit feelings of anxiety and insecurity. This presents a need for patient tailored support during the postoperative phase. Aim: The aim of this study was to examine the effect of an application that combines self- assessment with emphatic remote monitoring on the psychological aspects of recovery. Methods: The study was part of a multicentre study. For this two-arm non-blinded randomized controlled trial we aimed to recruit 100 patients at the day care of OLVG hospital. Patients in the intervention group received a smartphone application to record pain and nausea, and send messages to the hospital. Data was monitored by a medical assistant and patients were contacted in case of i) an increase in pain or nausea, ii) if answered yes to ‘Do you want something to be done about your pain or nausea?’ or iii) when a message was sent. Patients in the control group received standard discharge instructions. The main outcome was the difference in psychological aspects of recovery between the intervention group and the control group at day seven after surgery, measured with selected items from the QoR15. Secondary outcomes were i) an evaluation of comments after the questionnaires about general experiences after surgery and ii) semi-structured interviews (N=8) with patients in the intervention group. Results: A Mann-Whitney U test showed no differences between the groups at day seven after surgery in feelings of support (U=596.50, p=0.43), feeling comfortable and in control (U=558.50, p=0.23), general well-being (U=562.50, p=0.25), feelings of anxiety (U=623.50, p=0.62) and depressed feelings (U=525.50, p=0.10) and satisfaction (U=613.00, p=0.55) and trust towards the provided care (U=633.50, p=0.71). Comments after the questionnaires showed mostly physical problems experienced after surgery. Data from the interviews showed patients reporting some positive effects from the intervention, such as reassurance and awareness. Conclusion: Despite not finding significant results, some patients experienced positive effects from our intervention. Overall, we think an application that combines self-assessment with remote monitoring has potential to improve some patient outcomes, but more research is needed.Show less

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The Psychological Effect of an Emphatic Remote Monitoring Application in Day Surgery