title: Enhanced Recovery After Surgery (ERAS) multimodal programme as experienced by pancreatic surgery patients: Findings from an Italian qualitative study.
abstract: BACKGROUND
  ERAS has recently been implemented in pancreatic surgery settings, but there is little evidence regarding the effects as perceived by patients. Given the lack of the knowledge in the field, the aim of this study was to capture the experience of patients undergoing pancreatic surgery who received perioperative care based on the ERAS programme.
  
  
  METHODS
  We designed a qualitative study undertaken in the pancreatic surgery unit of San Raffaele Hospital in Milan, Italy. Twenty-two consecutive patients were invited to participate in the study and 13 patients were interviewed. Data was collected between March and December 2012 either through face-to-face or semi-structured telephone follow-up from three to six weeks after discharge. Data was analysed using the interpretative phenomenological approach.
  
  
  RESULTS
  Patients who underwent surgical pancreatic procedures and treated with ERAS programme reported experiences based on four themes: (1) Feeling prepared to face surgery, (2) Being actively "inside" or "outside" the programme, (3) Healing at home: the best setting, and (4) "Perceiving the ordinary as extraordinary": reaching independence, once at home.
  
  
  CONCLUSIONS
  According to the findings, uncomplicated pancreatic surgery patients may benefit from the ERAS programme. Preadmission counselling should help patients to assume an active role. Once the patient returns home, the availability of a caregiver should be thoroughly assessed to guarantee the support needed by patients to successfully complete the ERAS(programme. Surgery and nursing staff should carefully monitor patients and suggest whether they continue, interrupt, or individualise the scheduled ERAS interventions in accordance with a patient's clinical condition and preferred personal timing.
authors.affiliation: San Raffaele Hospital, Vita-Salute San Raffaele University, Milan, Italy. Electronic address: galli.emanuele@hsr.it.
authors.forename: Emanuele
authors.initials: E
authors.lastname: Galli
authors.affiliation: Urologic-Orthopaedic-Otorhinolaringologic Surgery Unit, Vimercate Hospital, Vimercate, Monza, Italy.
authors.forename: Cristina
authors.initials: C
authors.lastname: Fagnani
authors.affiliation: San Raffaele Hospital, Vita-Salute San Raffaele University, Milan, Italy.
authors.forename: Ilaria
authors.initials: I
authors.lastname: Laurora
authors.affiliation: San Raffaele Hospital, Vita-Salute San Raffaele University, Milan, Italy.
authors.forename: Carmen
authors.initials: C
authors.lastname: Marchese
authors.affiliation: Department of Surgery, San Raffaele Hospital, Vita-Salute San Raffaele University, Milan, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Capretti
authors.affiliation: Department of Surgery, San Raffaele Hospital, Vita-Salute San Raffaele University, Milan, Italy.
authors.forename: Nicolò
authors.initials: N
authors.lastname: Pecorelli
authors.affiliation: San Raffaele Hospital, Vita-Salute San Raffaele University, Milan, Italy.
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Marzo
authors.affiliation: Department of Medicine and Biological Sciences, University of Udine, Italy.
authors.forename: Alvisa
authors.initials: A
authors.lastname: Palese
authors.affiliation: Department of Biomedical Sciences for Health, University of Milan, Milan, Italy.
authors.forename: Lucia
authors.initials: L
authors.lastname: Zannini
mesh_terms: D000328:Adult; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007558:Italy; D008297:Male; D008875:Middle Aged; D010179:Pancreas / Q000601:surgery*; D010180:Pancreatectomy / Q000523:psychology*; D010351:Patient Discharge; D019990:Perioperative Care; D015397:Program Evaluation; D036301:Qualitative Research; D013997:Time Factors
keywords: ERAS; Enhanced Recovery After Surgery; Italian; Latin culture; Pancreatic surgery; Patient' experience; Qualitative study