None listed
Conditions
Brief summary
Over the last 10 years, Enhanced Recovery After Surgery (ERAS) programmes have been introduced into hospitals worldwide for a number of procedures, including colorectal cancer surgery (Gustafsson et al., 2013). Patients included in ERAS programmes in comparison to standard care are discharged from hospital twice as quickly and have fewer illness-related complications, while experiencing no increased rates of hospital re-admission or mortality. For this reason, ERAS programmes have been adopted in hospitals worldwide, including New Zealand. The ERAS programme involves early mobilisation and the early re-introduction of food and drink following surgery. Performing these behaviours enhances recovery, but both behaviours could be anxiety provoking if they contrast patients’ views regarding what recovery should be in hospital. Patients may believe that bed-rest, minimal physical exertion and intravenous fluids are likely to ensure optimal recovery from surgery such as colorectal resection. The ERAS programme will therefore challenge such ideas and possibly discourage such behaviour. The objective of the study is to determine the efficacy of a visualisation intervention in improving adherence to the recovery behaviour of exercise in patients following surgery for colorectal cancer. The study also aims to investigate the utility of using visualisation versus standard forms of information (such as verbal). The intervention will use animations to show patients how early mobilisation and eating and drinking following surgery will help their body to recover faster by demonstrating the anatomical processes occurring inside the body when these behaviours are performed. The intervention will be shown to patients on an iPad computer tablet at their bedside, day one following their surgery. This research is a parallel design, 3-arm randomised controlled intervention. The intervention has three different conditions, standard care, the visualisation intervention, and verbal information only (active-control group). These three conditions allow the effects of the visualisation over and above receiving verbal information only to be examined Participants will be patients undergoing colorectal resection at Auckland City Hospital. Patients will be recruited at the pre-admission clinic at Greenlane Clinical Centre and complete the first study questionnaire. The day following surgery, the student researcher will randomise each patient into one of the 3 conditions and deliver the intervention where applicable. Participants will then complete a second questionnaire and be given a fitness tracker watch to wear for the rest of their admission and 1 week following discharge. At the end of the 1 week follow-up, participants will complete a final questionnaire via phone, and post back their fitness tracker watch in a pre-paid courier bag. Participants will receive a $20 Westfield voucher after posting back their fitness tracker.
Interventions
The current study includes 3 conditions, two of which are intervention arms: the visualisation intervention and a verbal information only group (active control). The final group is a standard care group. The intervention group will receive an animated intervention depicting the purpose of the recovery behaviours of early re-mobilisation and the early re-introduction of food and drink following surgery. These animations will be displayed on an iPad and shown to patients at their bedside at day 1
The current study includes 3 conditions, two of which are intervention arms: the visualisation intervention and a verbal information only group (active control). The final group is a standard care group. The intervention group will receive an animated intervention depicting the purpose of the recovery behaviours of early re-mobilisation and the early re-introduction of food and drink following surgery. These animations will be displayed on an iPad and shown to patients at their bedside at day 1 following their surgery and takes approximately 10 minutes to deliver.. The intervention will be administered by the student researcher (Annie Jones, PhD student in Health Psychology). The intervention will provide information about how these two behaviours (which are part of the standard Enhanced Recovery After Surgery programme which all patients undergo) will help the patient to recover faster from their surgery. There are two versions of the intervention where either a male or female actor patient is used. The version of the intervention the patient sees will be their gender match. The intervention will begin by highlighting common beliefs that patients have about recovering from a surgical procedure, such as ideas around bed rest being the fastest way to heal. These ideas will be challenged by providing information about the ERAS programme including evidence from previous clinical trials. The intervention then explains the recovery behaviour of early mobilisation. The presentation incorporates real life footage of an ‘actor’ with animations depicting the internal bodily processes occurring while either resting, or when mobile. The animations show the heart, the lungs, and bodily circulation. The second part of the intervention shows the importance of the early re-introduction of food and drink following surgery. An animation explaining the digestive system is used here. The intervention also outlines to patients their daily goals for each of the behaviours. These are pre-existing goals that are given to all patients in their information booklet. Finally, the intervention ends with an elaborative reasoning task, which tries to get the patient to contextualise their ideas about exercising with their own life. The patient is asked to discuss two questions: “In what ways could you incorporate exercise into something specific that you might do on the ward while in hospital?” and “In what specific ways can you try and incorporate daily exercise into your routine once you are discharged and back home?”.
Sponsors
Keith Petrie
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Educational / counselling / training
Masking
Open (masking not used)
Eligibility
Sex/Gender
All
Age
18 Years to 80 Years
Healthy volunteers
No
Inclusion criteria
Patients will be included in the study if they are undergoing colorectal or gynaecological oncology surgery at Auckland City Hospital during our recruitment period (July 2017-July 2018), over the age of 18.
Exclusion criteria
Participants will be excluded if they feel unable to complete the questionnaires and if they cannot understand English.
Outcome results
None listed