Factors Influencing Postoperative Recovery after Lower Extremity Surgery: A Prospective Cohort Study

Amornrat Sangsaikaew; Apinya Koontalay; Khunphitha Junsevg; Arunrat Utaisang

doi:10.14710/nmjn.v16i2.80772

DOI: https://doi.org/10.14710/nmjn.v16i2.80772

Factors Influencing Postoperative Recovery after Lower Extremity Surgery: A Prospective Cohort Study

*Amornrat Sangsaikaew - Department of Adult and Aging Nursing, Boromarajonani College of Nursing Nakhon Phanom, Nakhon Phanom University, Thailand

Apinya Koontalay - Australia, Australia

Khunphitha Junsevg - Department of Adult and Aging Nursing, Boromarajonani College of Nursing Nakhon Phanom, Nakhon Phanom University, Thailand

Arunrat Utaisang - Department of Adult and Aging Nursing, Boromarajonani College of Nursing Nakhon Phanom, Nakhon Phanom University, Thailand

This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.

BibTex Citation Data :

@article{NMJN80772,
    author = {Amornrat Sangsaikaew and Apinya Koontalay and Khunphitha Junsevg and Arunrat Utaisang},
    title = {Factors Influencing Postoperative Recovery after Lower Extremity Surgery: A Prospective Cohort Study},
    journal = {Nurse Media Journal of Nursing},
  volume = {16},
    number = {2},
    year = {2026},
    keywords = {Cohort study; health-related quality of life; lower extremity surgery; postoperative recovery; self-efficacy},
    abstract = {  Background:  Suboptimal health-related quality of life (HRQoL) during postoperative recovery following lower extremity surgery increases healthcare costs and reduces patients’ overall well-being. However, evidence regarding factors influencing HRQoL trajectories remains limited.   Objective:  This study examined predictors of HRQoL and self-efficacy at weeks 1 and 4 post-discharge.   Methods:  This prospective cohort study used consecutive sampling to recruit 90 patients undergoing lower extremity orthopedic surgery (hip, femur, knee, or tibia) at a tertiary hospital in Thailand. Data collected included demographic characteristics, clinical factors, anthropometric measurements, and surgical variables. Outcomes were assessed at weeks 1 and 4 post-discharge using the 12-Item Short Form Health Survey (SF-12) to measure HRQoL and a validated 25-item questionnaire to measure self-efficacy. Multiple regression analysis was used to identify independent predictors of postoperative HRQoL and self-efficacy.   Results:  Among 90 participants (mean age = 58.3 ± 12.4 years; 53.3% female), higher BMI independently predicted poorer physical HRQoL at week 1 (β = −0.54,  p  = .023) and week 4 (β = −0.62,  p  = .008). Waist circumference was an additional predictor of physical HRQoL at week 4 (β = 0.58,  p  = .002), with both variables explaining 34.6% of the variance (R² = .346,  p  < .001). Self-efficacy improved substantially from week 1 (109.14 ± 9.86) to week 4 (123.47 ± 0.64), with a mean difference of 14.33 points (95% CI [12.27, 16.39], Cohen’s  d  = 2.03,  p  < .001). In contrast, SF-12 Physical Component Scores remained unchanged (week 1: 28.21 ± 1.66; week 4: 28.11 ± 1.30,  p  = .571).   Conclusions:  Higher BMI was consistently associated with poorer postoperative physical HRQoL following lower extremity surgery, while physical HRQoL remained unchanged despite improvements in self-efficacy. Perioperative nurses should emphasize routine BMI assessment, targeted weight-management education, and support for patients’ self-efficacy during postoperative recovery.    },
   issn = {2406-8799},  doi = {10.14710/nmjn.v16i2.80772},
    url = {https://ejournal.undip.ac.id/index.php/medianers/article/view/80772}
}

Citation Format:

Abstract

Background: Suboptimal health-related quality of life (HRQoL) during postoperative recovery following lower extremity surgery increases healthcare costs and reduces patients’ overall well-being. However, evidence regarding factors influencing HRQoL trajectories remains limited.

Objective: This study examined predictors of HRQoL and self-efficacy at weeks 1 and 4 post-discharge.

Methods: This prospective cohort study used consecutive sampling to recruit 90 patients undergoing lower extremity orthopedic surgery (hip, femur, knee, or tibia) at a tertiary hospital in Thailand. Data collected included demographic characteristics, clinical factors, anthropometric measurements, and surgical variables. Outcomes were assessed at weeks 1 and 4 post-discharge using the 12-Item Short Form Health Survey (SF-12) to measure HRQoL and a validated 25-item questionnaire to measure self-efficacy. Multiple regression analysis was used to identify independent predictors of postoperative HRQoL and self-efficacy.

Results: Among 90 participants (mean age = 58.3 ± 12.4 years; 53.3% female), higher BMI independently predicted poorer physical HRQoL at week 1 (β = −0.54, p = .023) and week 4 (β = −0.62, p = .008). Waist circumference was an additional predictor of physical HRQoL at week 4 (β = 0.58, p = .002), with both variables explaining 34.6% of the variance (R² = .346, p < .001). Self-efficacy improved substantially from week 1 (109.14 ± 9.86) to week 4 (123.47 ± 0.64), with a mean difference of 14.33 points (95% CI [12.27, 16.39], Cohen’s d = 2.03, p < .001). In contrast, SF-12 Physical Component Scores remained unchanged (week 1: 28.21 ± 1.66; week 4: 28.11 ± 1.30, p = .571).

Conclusions: Higher BMI was consistently associated with poorer postoperative physical HRQoL following lower extremity surgery, while physical HRQoL remained unchanged despite improvements in self-efficacy. Perioperative nurses should emphasize routine BMI assessment, targeted weight-management education, and support for patients’ self-efficacy during postoperative recovery.

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Keywords: Cohort study; health-related quality of life; lower extremity surgery; postoperative recovery; self-efficacy

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Section: Articles

Language : EN

In Vol 16, No 2 (2026): (August 2026) [In Progress]

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Factors Influencing Postoperative Recovery after Lower Extremity Surgery: A Prospective Cohort Study

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