Abstract
The purpose of this study was to describe the concrete situations in which patients got out of bed after colorectal surgery.
Data were collected from participant observations of the behavior of five patients following Enhanced Recovery After Surgery (ERAS) protocols, which recommend them being out of bed for two hours on the day of surgery and six hours a day thereafter. Observations were conducted for each patient for four consecutive days, from the day of surgery through the third postoperative day, at one hospital each in Japan and England.
Based on these observations, patients’ actions were classified into 12 activities, including eating a meal, going to the restroom, and interacting with others. Patients could get out of bed when they recognized the necessity of early mobilization, when they did not have any pain, nausea, or dizziness, and when their actions were not restricted by tubes attached to their body. Furthermore, they felt encouraged to be mobile when there were places to go to other than bed, materials making it possible to spend time being out of bed, interactions with individuals other than healthcare workers, and situations in which they had no choice but to get out of bed.
In conclusion, these findings suggest that early mobilization after surgery can be achieved not only by urging patients to walk but also by urging patients to leave the bed in order to pursue activities of daily living. In addition, efforts should be made to improve the clinical environment of patients.
