Challenges and solutions for colorectal surgery patients during hospital-to-home transitions: a scoping review

The aim of this study was to describe the literature that has been published on colorectal surgery patients' experiences, including the challenges and solutions related to the transition from hospital to home.

With surgery being an inevitable treatment for most individuals with colorectal disease, optimising the discharge transition from the hospital to home requires careful consideration of surgical patient experience, including a thorough understanding of their challenges during the transition period, particularly surrounding education.

A search was conducted of MEDLINE, Embase, the Cochrane Database of Systematic Reviews and the Cochrane Central Register of Controlled Trials. Inclusion criteria included peer-reviewed literature published between January 2012 and April 2023 involving adult (age ≥18) colorectal surgery patients from countries with healthcare systems comparable to Canada (ie, Canada, Australia, France, Germany, the Netherlands, New Zealand, Sweden, the UK and the USA). Patients or the public were not involved in the design of this scoping review.

41 articles were included, the majority of which were qualitative (73.1%) and conducted in the USA (29.3%). A total of 180 patient-reported challenges were identified; most occurred postoperatively (76.7%) and pertained to environmental factors (58.3%) and body functions (35.5%). The most frequently reported environmental challenge was insufficient patient education (30.9%), and the most frequent challenge related to body function was negative emotions (25.7%). Seven categories of solutions were identified, with education being the most frequently cited (36.0%) solution within the included literature.

Educational interventions addressing both bodily function and environmental factors are needed to improve colorectal surgery patients' experiences and care quality during their transition home from the hospital.