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Factors Influencing Patient Work to Recover After Spine Surgery: A Patient-centered Systems Approach.

Andrea L Strayer1, Samantha Webb2, Nicole E Werner3

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Older adults undergoing spine surgery face complex recovery, or "patient work," influenced by their patient work system (PWS). Factors like pain and mobility differ significantly based on discharge location, impacting recovery navigation.

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Area of Science:

  • Gerontology
  • Health Services Research
  • Human Factors Engineering

Background:

  • Global aging population drives increased spine surgeries for degenerative conditions.
  • Patient recovery involves complex cognitive and physical actions, termed 'patient work'.
  • The patient work system (PWS) dynamically shapes patient work during recovery.

Purpose of the Study:

  • To define factors within the PWS influencing older adults' patient work.
  • To analyze these factors during hospital and post-hospitalization phases.
  • To examine influences based on discharge location after spine surgery.

Main Methods:

  • Secondary data analysis of 28 interviews.
  • Deductive and inductive qualitative content analysis.
  • Application of the Systems Engineering Initiative for Patient Safety 2.0 human factors framework.

Main Results:

  • Significant differences in recovery factors were observed based on discharge location (home, SNF, IRF).
  • Factors included pain severity, mobility, unexpected events, and educational needs.
  • Older adults reported substantial 'invisible work' to clarify uncertainty and meet recovery needs.

Conclusions:

  • Older adults experience significant uncertainty and varied needs during spine surgery recovery.
  • Navigating recovery involves considerable patient effort, often unseen.
  • Nursing interventions are crucial to support patients in achieving recovery goals.