Related Experiment Video
Updated: Feb 15, 2026
E-Patient Counseling Trial E-PACO: Computer Based Education versus Nurse Counseling for Patients to Prepare for Colonoscopy
Published on: August 1, 2019
Effectiveness of an internet-based perioperative care programme to enhance postoperative recovery in gynaecological
Esther V A Bouwsma1,2,3, Judith A F Huirne1,3, Peter M van de Ven4
1Department of Obstetrics and Gynaecology, VU University Medical Center, Amsterdam, The Netherlands.
Objective:
To evaluate the implementation and effectiveness of an internet-based perioperative care programme for patients following gynaecological surgery for benign disease.
Design:
Stepped-wedge cluster randomised controlled trial.
Setting:
Secondary care, nine hospitals in the Netherlands, 2011-2014.
Participants:
433 employed women aged 18-65 years scheduled for hysterectomy and/or laparoscopic adnexal surgery.
Interventions:
An internet-based care programme was sequentially rolled out using a multifaceted implementation strategy. Depending on the implementation phase of their hospital, patients were allocated to usual care (n=206) or the care programme (n=227). The care programme included an e-health intervention equipping patients with tailored personalised convalescence advice.
Main Outcome Measures:
The primary outcome was duration until full sustainable return to work (RTW). The degree of implementation of the care programme was evaluated at the level of the patient, healthcare provider and organisation by indicators measuring internet-based actions by patients and providers.
Results:
Median time until RTW was 49 days (IQR 27-76) in the intervention group and 62 days (42-85) in the control group. A piecewise Cox model was fitted to take into account non-proportionality of hazards. In the first 85 days after surgery, patients receiving the intervention returned to work faster than patients in the control group (HR 2.66, 95% CI 1.88 to 3.77), but this effect was reversed in the small group of patients that did not reach RTW within this period (0.28, 0.17 to 0.46). Indicators showed that the implementation of the care programme was most successful at the level of the patient (82.8%) and professional (81.7%).
Conclusions:
Implementation of an internet-based care programme has a large potential to lead to accelerated recovery and improved RTW rates following different types of gynaecological surgeries.
Trial Registration Number:
NTR2933; Results.
More Related Videos
13:37A Mouse Tumor Model of Surgical Stress to Explore the Mechanisms of Postoperative Immunosuppression and Evaluate Novel Perioperative Immunotherapies
Published on: March 12, 2014
08:13Development and Implementation of a Multi-Disciplinary Technology Enhanced Care Pathway for Youth and Adults with Concussion
Published on: January 20, 2019
Related Concept Videos
01:13Patient-centered Care
01:16Tracheostomy Care I: Pre-procedural Steps
Required Equipment
The equipment necessary for tracheostomy care includes:
01:24Wedges
Consider using a wedge to lift a heavy slab. Here, the wedge functions by converting the applied force into a much larger force directed almost perpendicular to the initial force. This...
01:24Nursing Process for Patient and Caregiver Teaching II: Planning and Implementation
01:27Pharmacodynamics in Geriatric Patients: Effects of Age
01:15Nursing Implementation
The five steps to implementing effective nursing care include reassessing the patient, reviewing and revising the existing nursing care plan, organizing the resources and care delivery, anticipating and preventing complications, and implementing nursing interventions.