title: Attitudes of patients and care providers to enhanced recovery after surgery programs after major abdominal surgery.
abstract: BACKGROUND
  Enhanced recovery after surgery (ERAS) is a well-established pathway of perioperative care in surgery in an increasing number of specialties. To implement protocols and maintain high levels of compliance, continued support from care providers and patients is vital. This survey aimed to assess the perceptions of care providers and patients of the relevance and importance of the ERAS targets and strategies.
  
  
  METHODS
  Pre- and post-operative surveys were completed by patients who underwent major hepatic, colorectal, or oesophagogastric surgery in three major centers in Scotland, Norway, and The Netherlands. Anonymous web-based and article surveys were also sent to surgeons, anesthetists, and nurses experienced in delivering enhanced recovery protocols. Each questionnaire asked the responder to rate a selection of enhanced recovery targets and strategies in terms of perceived importance.
  
  
  RESULTS
  One hundred nine patients and 57 care providers completed the preoperative survey. Overall, both patients and care providers rated the majority of items as important and supported ERAS principles. Freedom from nausea (median, 10; interquartile range [IQR], 8-10) and pain at rest (median, 10; IQR, 8-10) were the care components rated the highest by both patients and care providers. Early return of bowel function (median, 7; IQR, 5-8) and avoiding preanesthetic sedation (median, 6; IQR, 3.75-8) were scored the lowest by care providers.
  
  
  CONCLUSIONS
  ERAS principles are supported by both patients and care providers. This is important when attempting to implement and maintain an ERAS program. Controversies still remain regarding the relative importance of individual ERAS components.
authors: Department of Clinical Surgery, Royal Infirmary of Edinburgh, Edinburgh, Scotland, United Kingdom. Electronic address: michaelh@doctors.net.uk.
authors: Michael
authors: M
authors: Hughes
authors: Department of Surgery, University Hospital Maastricht, Maastricht, The Netherlands.
authors: Marielle M E
authors: MM
authors: Coolsen
authors: Department of Gastrointestinal Surgery, University Hospital Northern Norway and Institute of Clinical Medicine, University of Tromsø, Tromsø, Norway.
authors: Eirik K
authors: EK
authors: Aahlin
authors: Department of Clinical Surgery, Royal Infirmary of Edinburgh, Edinburgh, Scotland, United Kingdom.
authors: Ewen M
authors: EM
authors: Harrison
authors: Department of Clinical Surgery, Royal Infirmary of Edinburgh, Edinburgh, Scotland, United Kingdom.
authors: Stephen J
authors: SJ
authors: McNally
authors: Department of Surgery, University Hospital Maastricht, Maastricht, The Netherlands.
authors: C H C
authors: CH
authors: Dejong
authors: Department of Gastrointestinal Surgery, University Hospital Northern Norway and Institute of Clinical Medicine, University of Tromsø, Tromsø, Norway.
authors: Kristoffer
authors: K
authors: Lassen
authors: Department of Clinical Surgery, Royal Infirmary of Edinburgh, Edinburgh, Scotland, United Kingdom.
authors: Stephen J
authors: SJ
authors: Wigmore
mesh_terms: D000005:Abdomen / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001291:Attitude of Health Personnel; D019091:Critical Pathways; D013505:Digestive System Surgical Procedures / Q000523:psychology / Q000592:standards*; D004947:Esophagus / Q000601:surgery; D005260:Female; D005767:Gastrointestinal Diseases / Q000601:surgery*; D019538:Health Care Surveys / Q000592:standards; D006306:Health Surveys / Q000592:standards; D006801:Humans; D008099:Liver / Q000601:surgery; D008297:Male; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care / Q000379:methods / Q000592:standards; D017060:Patient Satisfaction; D020127:Recovery of Function; D011795:Surveys and Questionnaires / Q000592:standards
keywords: Colorectal surgery; ERAS; Enhanced recovery after surgery; Fast track recovery program; Liver surgery; Oesophagogastric surgery