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Wiesenberger, Rico; Müller, Julian; Kaufmann, Mario; Weiß, Christel; Ghezel-Ahmadi, David; Hardt, Julia; Reissfelder, Christoph; Herrle, Florian

Influence of motivational interviewing on postoperative mobilization in the enhanced recovery after surgery (ERAS®) pathway in elective colorectal surgery - a randomized patient-blinded pilot study

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  • Medientyp: E-Artikel
  • Titel: Influence of motivational interviewing on postoperative mobilization in the enhanced recovery after surgery (ERAS®) pathway in elective colorectal surgery - a randomized patient-blinded pilot study
  • Beteiligte: Wiesenberger, Rico; Müller, Julian; Kaufmann, Mario; Weiß, Christel; Ghezel-Ahmadi, David; Hardt, Julia; Reissfelder, Christoph; Herrle, Florian
  • Erschienen: Springer Science and Business Media LLC, 2024
  • Erschienen in: Langenbeck's Archives of Surgery
  • Sprache: Englisch
  • DOI: 10.1007/s00423-024-03321-z
  • ISSN: 1435-2451
  • Entstehung:
  • Anmerkungen:
  • Beschreibung: <jats:title>Abstract</jats:title><jats:sec> <jats:title>Purpose</jats:title> <jats:p>Early mobilization is an essential component of the Enhanced Recovery after Surgery (ERAS®)-pathway. However, a large percentage of patients fail to achieve the ERAS<jats:bold>®</jats:bold> recommended goal (360 min out of bed from post-operative day 1/POD1). Motivational Interviewing (MI) is an evidence-based type of patient-centered consultation to promote intrinsic motivation. This study aims to evaluate if MI can improve postoperative mobilization.</jats:p> </jats:sec><jats:sec> <jats:title>Methods</jats:title> <jats:p>This two-arm, patient-blinded pilot randomized controlled trial included ERAS<jats:bold>®</jats:bold>-patients undergoing elective bowel resections. Conversations were validated by MI Treatment Integrity. Two validated motion sensors (movisens) and self-assessments were used to measure mobilization (POD1–POD3: Time out of bed, time on feet and step count).</jats:p> </jats:sec><jats:sec> <jats:title>Results</jats:title> <jats:p>97 patients were screened, 60 finally included and randomized. Cumulatively across POD1–3, the intervention group (IG) was longer out of bed than the control group (CG) (median: 685 vs. 420 min; <jats:italic>p</jats:italic>=0.022). The IG achieved the ERAS<jats:bold>®</jats:bold>-goal of 360 min/day more frequently across POD1–3 (27.4% vs. 10.61%; <jats:italic>p</jats:italic>=0.013). Time on feet was 131.5 min/day (median per POD) in IG vs. 95.8 min/day in the CG (<jats:italic>p</jats:italic>=0.212), step count was 1347 in IG vs. 754 steps/day in CG (<jats:italic>p</jats:italic>=0.298).</jats:p> </jats:sec><jats:sec> <jats:title>Conclusion</jats:title> <jats:p>MI could be conducted low threshold and was well accepted by patients. MI can improve mobilization in the context of ERAS<jats:bold>®</jats:bold>. Despite better performance, it should be noted that only 27.4% of the IG reached the ERAS<jats:bold>®</jats:bold>-compliance goal of 360 min/day. The findings of this pilot study stipulate to further test the promising perioperative effects of MI within a multicenter superiority trial.</jats:p> </jats:sec><jats:sec> <jats:title>Registration</jats:title> <jats:p>This study was registered prospectively in the German Clinical Trials Register on 25.02.2022. Trial registration number is “DRKS00027863”.</jats:p> </jats:sec>