Effect of Recovery Promotion Program with Family Support for Older Adults Undergoing Abdominal Operation: A Quasi-Experimental Study
DOI:
https://doi.org/10.60099/prijnr.2026.276442Keywords:
Abdominal surgery, Family support, Older adults, Recovery, Recovery promotion, ThailandAbstract
Older adults undergoing abdominal surgery may experience delayed recovery due to changes in physical and psychological aspects. Additionally, the process for effectively involving family members in enhancing recovery for older adults undergoing abdominal surgery in Thailand remains unclear. A quasi-experimental, two-group post-test-only design was employed to investigate the effects of the Recovery Promotion Program with Family Support for older adults undergoing abdominal surgery. The sample consisted of 66 older individuals who had abdominal surgery in the surgical department of a supertertiary hospital, in the lower North of Thailand. The participants in the control group (n = 33) were purposively selected and completed the study first. Then, the participants in the experiment group (n = 33) were recruited by pair matching to ensure similarity in gender, age, and the type of surgery with the participants in the control group. The instruments used to collect data were: a Demographic Data Form, a Convalescence and Recovery Evaluation Form, a Fall Risk Assessment Tool, and a Pressure Ulcer Risk Assessment Tool. Data were summarized with descriptive statistics and analyzed using the Chi-square and independent t-test.
The results showed that on day 5 post-surgery, older adults who received the Recovery Promotion Program with Family Support had a significantly better overall recovery, with an extremely large effect size, and also experienced substantially better recovery in terms of pain, gastrointestinal function, emotional status, and activity compared to participants who received routine care alone. In terms of safety, post-intervention analysis revealed no difference between the groups. When comparing the incidence of falls and pressure ulcers, both the experimental and control groups demonstrated 100% safety, with no reported adverse events, such as severe pain, persistent nausea or vomiting, or difficulty breathing. The study findings indicate that the Recovery Promotion Program with Family Support can enhance postoperative recovery in older adults undergoing abdominal surgery. Nurses can apply this intervention in promoting recovery among this population. However, further testing with a multisite study and randomized control is needed before it can be widely used.
References
Division of Public Health Administration, Ministry of Public Health. Summary Report on Government Operations, 2021–2023 [Internet]. 2023 [cited 2025 Feb 15]. Available from: https://cmi.moph.go.th/report/inspect/summary. (In Thai).
Zhang L, Hornor M, Robinson T, Rosenthal R, Ko C, Russell M. Evaluation of postoperative functional health status decline among older adults. JAMA Surg. 2020;155(10):950–8. doi: 10.1001/jamasurg.2020.2853.
Mithany RH, Daniel N, Shahid MH, Aslam S, Abdelmaseeh M, Gerges F, et al. Revolutionizing surgical care: The power of enhanced recovery after surgery (ERAS). Cureus. 2023;15(11):e48795. doi: 10.7759/cureus.48795.
Tazreean R, Gregg N, Twomey Rosie. Early mobilization in enhanced recovery after surgery pathways: Current evidence and recent advancements. J Comp Eff Res. 2021;11(2):121–9. doi: 10.2217/cer-2021-0258.
Pędziwiatr M, Mavrikis J, Witowski J, Adamos A, Major P, Nowakowski M, et al. Current status of enhanced recovery after surgery (ERAS) protocol in gastrointestinal surgery. Med Oncol. 2018;35(6):95. doi: 10.1007/s12032-018-1153-0.
Wang YY, Yue JR, Xie DM, Carter P, Li QL, Gartaganis SL, et al. Effect of the tailored, family-involved hospital elder life program on postoperative delirium and function in older adults: A randomized clinical trial. JAMA Intern Med. 2020;180(1):17–25. doi: 10.1001/jamainternmed.2019.4446.
Kreca SM, Musters SCW, Horst MEE, van Ingen CHNM, Nieveen van Dijkum EJM, Eskes AM. The experiences of patients who participated in a family involvement program after abdominal cancer surgery: An interpretative phenomenological analysis. Gastroenterol Nurs. 2025;48(2):91–9. doi: 10.1097/SGA.0000000000000857.
Supawatankaul A, Tanmahasmut P. Intergenerational living: Thai cultural frictions and taboos in changing times. In: Friction EPIC 2023 [Internet]. Chicago, 2023. p. 66–79. Available from: https://www.epicpeople.org/intergenerational-living-thai-cultural-frictions-and-taboos/
Jensen BT. Organization factors in the ERAS bladder cancer pathway: The multifarious role of the ERAS nurse, why and what is important? Bladder Cancer Implic Pract. 2021;37(1):151106. doi: 10.1016/j.soncn.2020.151106.
De Leon-Demare K, Macdonald J, Gregory D, Katz A, Halas G. Articulating nurse practitioner practice using King’s theory of goal attainment. J Am Assoc Nurse Pract. 2015;27(11):631–6. doi: 10.1002/2327-6924.12218.
Rajabiyazdi F, Alam R, Pal A, Montanez J, Law S, Pecorelli N, et al. Understanding the meaning of recovery to patients undergoing abdominal surgery. JAMA Surg. 2021;156(8):758–65. doi: 10.1001/jamasurg.2021.1557.
Changyai K. Concept analysis of post-operative recovery after abdominal surgery: State of the science. Open Nurs J. 2024;18(1):1–9. doi: 10.2174/0118744346333487240821100900.
Penphumphuang I, Matchim Y, Mahawongkhajit P, Boontoi T. Enhancing recovery in older patients undergoing abdominal surgery: Examining the effect of a preoperative preparation program using a quasi-experimental design. Belitung Nurs J. 2023;9(4):339–48. doi: 10.33546/bnj.2629.
Termkunanon T, Pokpalagon P, Chaiviboontham S. Effects of an early promoting mobility program on postoperative recovery outcomes in people with critical Illness after major abdominal surgery: A quasi-experimental study. Pac Rim Int J Nurs Res. 2025;29(4):700–17. doi: 10.60099/prijnr.2025.273862.
Parks L, Routt M, De Villiers A. Enhanced recovery after surgery. J Adv Pract Oncol. 2018;9(5):511–9.
Altman AD, Helpman L, McGee J, Samouëlian V, Auclair MH, Brar H, et al. Enhanced recovery after surgery: Implementing a new standard of surgical care. Can Med Assoc J. 2019;191(17):E469–75. doi: 10.1503/cmaj.180635.
Gustafsson UO, Scott MJ, Hubner M, Nygren J, Demartines N, Francis N, et al. Guidelines for perioperative care in elective colorectal surgery: Enhanced recovery after surgery (ERAS®) Society recommendations: 2018. World J Surg. 2019;43(3):659–95. doi: 10.1007/s00268-018-4844-y.
Kata A, Dillon EC, Christina Keny RN, Yank V, Covinsky KE, Raue PJ, et al. There’s so much that they’re enduring: Experiences of older adults undergoing major elective surgery. Ann Surg. 2025;282(2):242–8. doi: 10.1097/SLA.0000000000006293.
Susana S, Rekawati E, Sahar J, Putri Y. The effect of early ambulation on postoperative elderly: A systematic review. Indones J Glob Health Res. 2025;7(2):465–72. doi: 10.37287/ijghr.v7i2.5412.
Penphumphuang S, Matchim Y, Mahawongkajit P. Older adult patients’ convalescence and recovery within one week after abdominal surgery at Thammasat University Hospital. J R Thai Army Nurses. 2020;21(2):203–12. (In Thai).
Khoyun S, Poothawee W, Srisoy A. Effect of post-operative recovery program with the use of easy walk equipment to prevent complications in abdominal surgery patients. Srinagarind Med J. 2019;34(4):386–92. (In Thai).
Schepp, KG. Psychometric assessment of the preferred participation scale for parents of hospitalized children [Unpublished manuscript]. [School of Nursing, Seattle]: University of Washington; 1995.
Haynes AB, Haukoos JS, Dimick JB. TREND reporting guidelines for nonrandomized/quasi-experimental study designs. JAMA Surg. 2021;156(9):879–80. doi: 10.1001/jamasurg.2021.0552.
Kojaie-Bidgoli A, Fadayevatan R, Sharifi F, Alizadeh-Khoei M, Vahabi Z, Aminalroaya R. Applicability of SPMSQ in illiterate outpatients in clinics: The validity and reliability of the Short Portable Mental Status Questionnaire. Appl Neuropsychol Adult. 2022;29(4):591–7. doi: 10.1080/23279095.2020.1792909.
Yi Y, Ding L, Wen H, Wu J, Makimoto K, Liao X. Is Barthel Index suitable for assessing activities of daily living in patients with dementia? Front Psychiatry. 2020;8(11):282. doi: 10.3389/fpsyt.2020.00282.
Hollenbeck BK, Dunn RL, Wolf JS, Sanda MG, Wood DP, Gilbert SM, et al. Development and validation of the convalescence and recovery evaluation (CARE) for measuring quality of life after surgery. Qual Life Res. 2008;17(6):915–26. doi: 10.1007/s11136-008-9366-x.
Krisanabud P, Thosingha O, Danaidutsadeeku S, Iramaneera C. Factors associated with recovery among patients undergoing non-traumatic general abdominal surgery within one week. Thai J Nurs Coun. 2012;27(1):39–48. (In Thai).
Kim YJ, Choi KO, Cho SH, Kim SJ. Validity of the Morse Fall Scale and the Johns Hopkins Fall Risk Assessment Tool for fall risk assessment in an acute care setting. J Clin Nurs. 2022;31(23–24):3584–94. doi: 10.1111/jocn.16185.
Buakaeo P, Chaichanawirote U, Chairat R. Factors associated with fall risks among older patients of inpatient department in a secondary hospital. J R Thai Army Nurses. 2024;25(3):276–84. (In Thai).
Bergstrom N, Braden B, Laguzza A, Holman V. The Braden Scale for predicting pressure sore risk. Nurs Res. 1987;36(4):205–10.
Mehicic A, Burston A, Fulbrook P. Psychometric properties of the Braden scale to assess pressure injury risk in intensive care: A systematic review. Intensive Crit Care Nurs. 2024 Aug 1;83:103686. doi: 10.1016/j.iccn.2024.103686.
Dongpho P. Effectiveness of clinical practice guidelines implementation for pressure sore prevention. Thammasat Med J. 2019;19(2):315–23. (In Thai).
Chae FH, Stiegmann GV. Ambulation and early postoperative performance criteria. In: Whelan RL, Fleshman JW, Fowler DL, editors. The Sages Manual: Perioperative care in minimally invasive surgery [Internet]. New York, NY: Springer New York; 2006. p. 314–7. Available from: https://doi.org/10.1007/0-387-29050-8_41
Penphumphuang S. The effect of a pre-operative preparation program integrated with family support on the recovery and pulmonary complications among older adult patients undergoing major abdominal surgery [Thesis]. [Faculty of Nursing]: Thammasat University; 2019. (In Thai).
Park BM. Effects of nurse-led intervention programs based on Goal Attainment Theory: A systematic review and meta-analysis. Healthcare. 2021;9(6):699. doi: 10.3390/healthcare9060699.
Qu L, Ma R, Ma YK, Zhao X, Jin J, Zhu QQ, et al. Influence of preoperative comprehensive education on anxiety, depression, pain, and sleep in elderly patients operated under general anesthesia. World J Psychiatry. 2024;14(12):1845–53. doi: 10.5498/wjp.v14.i12.1845.
LeLaurin JH, Shorr RI. Preventing falls in hospitalized patients: State of the science. Clin Geriatr Med. 2019;35(2):273–83. doi: 10.1016/j.cger.2019.01.007.
Moore Z, Patton D. Risk assessment tools for the prevention of pressure ulcers. Cochrane Database Syst Rev. 2019;1(1): CD006471. doi: 10.1002/14651858.CD006471.pub4.
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