Journal article
Factors Influencing Patient Work to Recover After Spine Surgery: A Patient-centered Systems Approach
The Journal of neuroscience nursing, Vol.58(1), pp.5-10
01/2026
DOI: 10.1097/JNN.0000000000000853
PMID: 41187314
Abstract
INTRODUCTION:
A global aging population seeking resolution of pain and functional decline from degenerative spine conditions is leading to an increasing number of spine surgeries. The recovery process is complex with many cognitive and physical actions performed by the patient, which can be conceptualized as patient work. Shaped by the dynamic patient work system (PWS), patient work is the time and effort patients complete at home and across health settings to meet their health goals. Our aim was to define factors in the PWS that influence the patient work of older adults' recovery during the hospital and posthospitalization phases as well as by discharge location after spine surgery.
METHODS: Secondary data analysis (28 interviews) using deductive and inductive qualitative content analysis methods was used to describe PWS influencing factors. The Systems Engineering Initiative for Patient Safety 2.0 human factors framework (person, organization, task, tools and technology, and internal and external environments) guided independent (3 members) coding, codebook evolution, and team deductive analysis. Care phase and discharge location were further analyzed using team inductive analysis.
RESULTS: In nearly all components, factor differences were present between discharge to home or skilled nursing facility or inpatient rehabilitation. These differences included pain severity, mobility, unexpected experiences, education not meeting their needs, the level of problem-solving required, and types of benchmarks to their goal of recovery.
CONCLUSIONS: Our findings show that regardless of discharge disposition, older adults experience uncertainty and different needs during recovery that often generate invisible work in navigating the recovery process. Participants describe significant work to clarify any uncertainty and meet their recovery needs. Nursing has a pivotal role to further investigate strategies to help patients achieve their recovery goals.
Details
- Title: Subtitle
- Factors Influencing Patient Work to Recover After Spine Surgery: A Patient-centered Systems Approach
- Creators
- Andrea L Strayer - University of IowaSamantha Webb - Samantha Webb, MS, BSN, PMGT-BC, PhD Student, College of Nursing, University of Iowa, Iowa City, IANicole E Werner - Vanderbilt University Medical CenterAnna Krupp - University of Iowa
- Resource Type
- Journal article
- Publication Details
- The Journal of neuroscience nursing, Vol.58(1), pp.5-10
- DOI
- 10.1097/JNN.0000000000000853
- PMID
- 41187314
- NLM abbreviation
- J Neurosci Nurs
- ISSN
- 1945-2810
- eISSN
- 1945-2810
- Publisher
- LIPPINCOTT WILLIAMS & WILKINS
- Grant note
- National Center for Advancing Translational Sciences: UL1TR002373 Department of SurgeryOffice of Academic Affiliations, Department of Veterans Affairs: 3Q052019C Barbara Bates Center for The Study of the History of Nursing, University of PennsylvaniaAgnes Marshall Walker Foundation
This study was supported by Barbara and Richard Csomay Center for Gerontological Excellence; Agnes Marshall Walker Foundation; Jean E. Johnson Research Fund, University of Wisconsin-Madison School of Nursing. Scientific editing supported by the Clinical and Translational Science Award (CTSA) program, through the National Institutes of Health (NIH) National Center for Advancing Translational Sciences (NCATS), grant UL1TR002373; the National Center for Advancing Translational Sciences of the National Institutes of Health under Award Number UM1TR004403. This work was supported by the Department of Veterans Affairs, Veterans Health Administration, Office of Academic Affiliations VA Quality Scholars Advanced Fellowship Program. The views expressed in this article are those of the authors and do not necessarily reflect the position or policy of the Department of Veterans Affairs or the United States government. Program Award Number [3Q052019C].
- Language
- English
- Electronic publication date
- 11/03/2025
- Date published
- 01/2026
- Academic Unit
- Nursing; Neurosurgery
- Record Identifier
- 9985024139002771
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