PATIENT-ORIENTED AND PATIENT-DRIVEN POSTOPERATIVE PAIN AND NAUSEA OUTCOME

This thesis explores the development, implementation and evaluation of a patient-centered smarthphone application designed to allow postoperative patients to self-record pain and nausea. The central aim of this work was to enhance the quality of recovery by empowering patients, improving documentation of postoperative symptoms and enabling better communication with healthcare providers. The research is presented as a series of studies. A large multicentre registry analysis identified orthopaedic surgical procedures associated with high pain intensity enabling personalized postoperative care. Usability and implementation studies demonstrated the feasability and acceptance of the application among patients, nurses and healthcare professionals. Further, a randomized trial and observational study evaluated the applications impact on recovery after day surgery and showed that monitoring via a smartphone app did not improve patients' experienced quality of recovery at home. The integration of eHealth tools, like the application researched in this thesis, into clinical practice requires thoughtful implementation. Important is the attention to workflow alignment, engaging stakeholders, and assigning appropriate leaders to offer guidance and an ongoing evaluation. In conclusion, patient-driven postoperative follow-up of pain and nausea using a smartphone application is feasible, but we were unable to demonstrate improvement in patient-reported quality of recovery after day care surgery.