Perioperative transition experience of patients undergoing shoulder arthroscopy day surgery: a qualitative exploratory study using patient journey mapping

With the advancement of orthopedic enhanced recovery after surgery (ERAS), the frequency of orthopedic procedures performed as day surgeries has increased. Improvements in shoulder arthroscopy techniques and updates in ERAS protocols have enabled arthroscopic rotator cuff repair (ARCR) to be conducted as a day surgery. However, the reduced hospital stay introduces significant challenges for patients. Limited research exists on how day surgery patients manage the transition between home and the surgical setting, although these experiences and coping strategies have a substantial impact on patient health outcomes. This study aimed to identify the perioperative healthcare experiences of patients undergoing ARCR day surgery, reduce perioperative risks, and improve patient satisfaction. A descriptive qualitative study was conducted. Interview guides were developed based on the Transition Theory. Semi-structured interviews were performed with 13 patients undergoing day surgery in the orthopedic ward of a tertiary hospital in Sichuan Province, China, between January and March 2025. Data were analyzed using content analysis, and patient journey maps (PJMs) were constructed. PJMs were created along the treatment timeline and perioperative phases. Patient experiences and needs during ARCR day surgery were categorized into 22 themes across 4 dimensions (Tasks, Emotions, Pain Points, Improvement Points) and 3 stages: Preoperative Stage (8 themes): Comprehensive assessment and examinations; Comorbidity management; Understanding the disease and treatment process; Helplessness; Anxiety; Preoperative preparation. Perioperative Stage (7 themes): Symptom management; Worry; Waiting; Information communication; Caregiving burden. Postoperative Stage (7 themes): Follow-up; Rehabilitation exercises; Listening; Discharge readiness; Telemedicine support. This exploratory study, employing patient journey mapping, identified critical themes in the perioperative experience of patients undergoing same-day ARCR. Key findings include preoperative challenges such as anxiety regarding comorbidities and fragmented information flow, intraoperative pain points like unstructured waiting and communication gaps during anesthesia consultation, and postoperative concerns including discharge unpreparedness and disrupted care continuity. The PJM visually synthesized these tasks, emotions, and pain points across the condensed surgical pathway. Utilizing PJMs in this context helps healthcare providers pinpoint specific interaction points and challenges, supporting optimized resource allocation, enhanced clinical services, and improved patient-centered care throughout the day surgery continuum.