Factors Affecting Recovery
The patient/employee, GP and employer should jointly decide on how soon a patient can return to work following a surgical procedure. In making such a decision it may be helpful to consider the following:
- The GP's own clinical judgment in light of the patient’s circumstances (how they heal, how they respond to surgery, the type of job they do, any relevant personal circumstances)13 the current clinical guidelines available (see section 'Helping a patient prepare for return to work' - Figure 7) and the risk factors for chronicity identified in Figure 3 below.
- Employer’s policies and procedures.
Figure 3: Risk Factors for Chronicity4
• Dysfunctional attitudes, beliefs and expectations about pain and disability.
• Inappropriate attitudes, beliefs and expectations about healthcare
• Uncertainty, anxiety, fear-avoidance
• Depression, distress, low mood, negative emotions
• Passive or negative coping strategies (eg catastrophising)
• Lack of ‘motivation’ and readiness to change, failure to take responsibility for rehabilitation, awaiting a ‘fix’, lack of effort
• Illness behaviours
Below are the 3 golden rules for a speedy recovery following a surgical procedure9 & 13.
• Stay Active
• Maintain a Normal Daily Routine
• Maintain Social Contact with People
Three Golden Rules for a Speedy Recovery
1. Stay Active - Build Up Gradually
Patients should have a go at doing some of the things they would normally do, but should build up gradually. Some suggestions are included in the condition specific Recovery Tracker in the Royal College of Surgeons website (click on the appropriate condition and select recovery tracker). Obviously, everyone recovers at a different speed, so not all of the suggestions will be suitable for everybody. When your patient is building up their activities, they may feel more tired than normal. If so, they should stop, and rest until their strength returns.
2. Maintain a Normal Daily Routine
Encourage your patients to get up at a normal time in the morning, get dressed and move about the house. Fatigue is normal.
Don’t sleep in: They can always rest later. Staying in bed can cause depression. If they live alone, and they do not have family or friends close by, advice them to organise support in advance e.g. have family or friends come to stay with them for the first few days after surgery if possible.
Eat Healthily: Eating a healthy diet will help to ensure that your patient’s body has all the nutrients it needs to heal.
Stop Smoking: By not smoking, your patient’s circulation and breathing will start to improve immediately, even if they only stop for the recovery time.
Why not refer the patient to Stop Smoking Wales14? (Freephone 0800 085 2219)
3. Maintain Social Contact with People
Family and friends can help support your patients with two important things:
• Practical help with the tasks the patient might be temporarily unable to do while they recover - such as driving, the weekly shop, or lifting heavier items.
• Keeping their spirits up - the novelty soon wears off being home alone all day, and it’s easy to feel isolated by this. Having company can help your patient to worry less. Warn your patients to try not to let anxiety set in, as it can become a problem in itself which stands in the way of them getting back to their normal routine.