Impact of Patient’s Pain and Fatigue on Decision of Discharge After Laparoscopic Surgery for Colorectal Cancer

ABSTRACT

PURPOSE: Hospital stays after laparoscopic surgery for colorectal cancer tend to be much shorter than those after conventional open surgery. Many factors, including surgical outcomes and complications, are associated with patient discharge planning. However, few studies have analyzed the impact of patient subjective discomfort (including pain and fatigue) on the decision to discharge after surgery. Therefore, the purpose of this study was to determine how patient pain and fatigue play a role in the decision to discharge after laparoscopic surgery for colorectal cancer. METHODS: Between March 2014 and February 2015, we conducted a questionnaire survey of 91 patients who underwent laparoscopic surgery for colorectal cancer to estimate the expectation criteria for discharge and patient subjective discomfort at that time. Patients were divided into the following 2 groups group A, those who complied with the medical professional’s decision to discharge; and group B, those who refused discharge despite the medical professional’s decision. The participants’ subjective factors were analyzed. RESULTS: Preoperatively, 78 of 91 patients (85.7%) identified activity level, amount of food (tolerance), and bowel movements as important factors that should be considered in the decision to discharge a patient postoperatively. Postoperatively, 17 patients (18.7%) refused discharge despite a discharge recommendation. Subjective pain and fatigue were significantly different in linear-by-linear association between the group of patients who agreed to be discharge and those who disagreed. Despite this difference, there was no significant difference in mean length of hospital stay between the 2 groups. CONCLUSION: A patient’s subjective feelings of pain and fatigue can impact their decision regarding hospital discharge.