Rehabilitation Nursing Care in the Empowerment of Patients Undergoing Abdominal Surgery: A Qualitative Focus Group Study
Description
This study integrates a Phenomenological approach with Afaf Meleis’ Transitions Theory to analyze the professional experience of Rehabilitation Nurse Specialists (EEER), clarifying the nurse’s role as a therapeutic bridge that guides the patient from post-surgical vulnerability toward functional mastery and autonomy. The analytical process followed Bardin’s Thematic Content Analysis through three systematic stages: pre-analysis for corpus constitution, data exploration for coding and grouping, and results processing for inference and interpretation. To ensure objectivity and transparency, WebQDA® software was employed for data management, and data saturation was reached when additional discourses no longer provided new insights into the phenomenon. The quality of this qualitative research was sustained by several rigor criteria, including credibility through member checking (returning transcripts to participants), confirmability via researcher triangulation during coding, transferability through detailed descriptions of diverse clinical settings (from ICU to Community Care), and dependability documented by the 32-item COREQ checklist. Conducted strictly in accordance with the principles of the Declaration of Helsinki, the study received formal approval from the Ethics Committee (No. 2791/2024). The application of Bardin’s analysis demonstrated that specialized nursing intervention is a key driver for patient autonomy, organized across three main axes. First, "Anticipation as a Pillar of Stability" highlights that preoperative preparation and "Day 0" mobilization are strategic measures to reduce vulnerability, acting as a buffer against the disruptive nature of surgery. Second, the "Nurse as the Architect of Transition" positions the EEER as the primary facilitator of the health-illness transition, translating biological fragility into self-care skills. Finally, "Invisibility and Systemic Barriers" identifies significant obstacles, such as institutional resource shortages and a lack of sensitive outcome indicators, which limit the clinical recognition of the EEER’s specialized value. These findings provide a valuable comparative benchmark for researchers in different surgical settings and offer a qualitative evidence base for protocol optimization and the development of patient-centered clinical pathways, successfully integrating systematic analysis with Afaf Meleis’ Transitions Theory,
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Steps to reproduce
1. Participant Selection and Sampling The study employed a purposive sampling method, specifically a snowball approach, to recruit Rehabilitation Nurse Specialists (EEER). Eligibility criteria included: (a) holding a specialized degree in Rehabilitation Nursing; (b) having at least two years of clinical experience in perioperative settings; and (c) actively participating in the care of patients undergoing abdominal surgery. A total of seven experts were recruited to capture a diverse range of clinical perspectives. 2. Data Collection Instrument Semi-structured focus group guide. Designed to promote open dialogue and sharing of professional experiences, the guide served as a flexible roadmap rather than a strict script. This approach allowed the conversation to remain fluid, enabling participants to explore emerging themes while staying aligned with the three thematic sections. Data were collected during a synchronous e-Focus Group session via the Microsoft Teams® platform. Duration: 70 minutes. Moderation: Led by the principal researcher. Recording: Audio and video recordings were made directly through the platform’s encrypted cloud service. 3. Verbatim transcription was performed immediately after the session, and transcripts were sent back to participants via encrypted email for content validation; a 7-day feedback period was provided.Identifiers were replaced with alphanumeric codes (E1 to E7). WebQDA® software supported data management and organization, facilitating systematic categorization of the dataset, allow new themes to emerge naturally from participants' clinical discourse. 4. The process was reviewed using the Consolidated Criteria for Reporting Qualitative Research (COREQ).
Institutions
- Escola Superior de Enfermagem de LisboaLisbon, Lisbon