Exploring elderly patient’s experience and concerns of early ambulation implemented in postoperative care following lumbar spinal surgery: a qualitative study

Background: Given the apparent benefits, the implementation of early ambulation is becoming increasingly important in spinal surgery. The timing for patients first time get out of bed for ambulation after spinal surgery has a wide range. Since Jan 2022, we conducted a study of early ambulation (ambulated within 4h postoperatively) in elderly patients following long-segments lumbar decompression and fusion surgery. In order to better understand elderly patients’ perceptions of the early ambulation, clarify controversies, and ultimately contribute to the improvement of elderly patients’ perioperative experience and also the quality of life, we carried out this qualitative approach. Methods: A qualitative description design with face-to-face semi-structured interviews was used. Twenty-four patients were enrolled in participating and completing this qualitative investigation from February to June 2022. Interviews were audio-recorded, and content analysis was used for data analysis. Results: Six themes were identified from this study about patient’s experience and concerns on early ambulation: Worries, Benefits, Daily Routines, Pain, Education and Supports. The findings showed the obstacles in early ambulation practice and highlighted the importance of education on early ambulation in the perioperative hospitalization. Conclusions: Unequivocal guidance for early ambulation and multidisciplinary ambulation protocol, including comprehensive pain management plan are essential to induce patient education, which may have positive effects on reducing stress and getting rid of anxiety for postoperative early ambulation.