Patient and family involvement in care after oncology surgery

In the forthcoming years, health care systems are anticipated to undergo drastic transformations, wherein the responsibility for providing care will also be partially delegated to the patient and their families. Evidence suggests that family involvement enhances patient outcomes, yet practical methods for engaging them remain limited. This thesis explores innovative strategies to involve patients and their families in fundamental care following oncological gastrointestinal surgery, with several interventions developed, tested, and evaluated in the surgical departments of the Amsterdam UMC.
In Chapter 2, a prospective cohort pilot study assessed the impact of a surgical ward breakfast buffet as a low-cost, simple intervention to involve patients in their post-surgery care. This approach not only engaged patients but also helped address postoperative undernourishment. Chapter 3 examines the challenges of involving family members, particularly during the COVID-19 pandemic when hospital visitations were restricted. A retrospective cohort study investigated the effects of these restrictions on complications such as delirium, falls, pneumonia, pressure ulcers, and readmissions among surgical patients. Chapters 4, 5, 6, and 7 focus on the Family Involvement Program (FIP), where family members actively participated in fundamental care post-surgery. These chapters include both qualitative evaluations using interpretative phenomenological analysis and a patient-preference cohort study examining surgical and caregiver outcomes. Lastly, Chapter 8 explores digital alternatives for patient and family involvement. A scoping review was conducted to assess the effectiveness of video calls in hospital wards as a method for maintaining family engagement in patient care.