Development of a patient-reported outcome measure for recovery after major abdominal surgery: Stage 1 concept elicitation interviews

This project is part of a programme to develop a patient-reported outcome measure (PROM) for adults recovering after major abdominal surgery (MAS). Existing perioperative outcome assessment often relies on clinician-recorded endpoints (e.g., complications, length of stay), which do not fully reflect patients’ lived experience of recovery beyond the hospital setting. The purpose of this study is to define, from the patient perspective, the key domains and concepts that constitute recovery after MAS and to organise these into a conceptual framework suitable for PROM item generation. Adults (≥18 years) who have undergone MAS for benign or malignant indications (elective or emergency) are recruited from multiple hospital settings within Greater London to support demographic and clinical diversity. Participants complete electronic consent and provide brief demographic/clinical details prior to taking part in one-to-one semi-structured interviews conducted remotely via Microsoft Teams. Interviews are audio-recorded, transcribed verbatim, checked for accuracy, and de-identified prior to analysis. Identifiable contact information is collected only for study administration and stored separately from research data on secure institutional servers. Data are analysed using framework analysis, combining structured coding guided by an initial evidence-informed framework with inductive identification of new concepts emerging from participant accounts. Two researchers independently code at least 50% of transcripts, reconcile differences through consensus, and iteratively refine the codebook. Recruitment and analysis proceed in parallel until conceptual saturation is reached, tracked using systematic saturation logs. Minority and discrepant perspectives are actively retained where they represent meaningful aspects of recovery. Expected outcomes include a patient-informed conceptual framework of recovery after MAS and a comprehensive set of candidate concepts to support subsequent PROM item drafting and testing.