Symptom assessment in surgical recovery: A scoping review of structured assessment supporting nurses' recognition of in-hospital postoperative care needs

BACKGROUND: In-hospital patients undergoing surgical treatment experience postoperative symptoms that nurses can inadvertently overlook. Postoperative structured assessments identify these symptoms and their severity, supporting individualized care and facilitating enhanced recovery without complications. However, the existing literature lacks an overview of the underlying fundamental nursing care needs these structured assessments address. Such an overview would enhance nurses' postoperative observation practices by guiding systematic symptom recognition of postoperative care needs and thereby supporting patient-centred postoperative care. OBJECTIVES: To identify and map structured assessments used in-hospital to assess postoperative symptoms in surgical patients, with a focus on their alignment with nursing care needs. DESIGN: Scoping review following the Joanna Briggs Institute (JBI) methodology. METHODS: Five databases were systematically searched on 30 June 2025. Peer-reviewed studies reporting on the development, use, or evaluation of structured assessments assessing postoperative symptoms during the immediate in-hospital period were included. Two reviewers independently screened and retrieved citations against the inclusion criteria. Eligible studies were published in English, Danish, Swedish, Norwegian, or German. Structured assessments without full access to all items were excluded. Data were extracted using a standardized form. Structured assessments were mapped against fundamental nursing care needs derived from Henderson's conceptual framework. RESULTS: Sixty-nine studies were included, identifying 28 structured assessments. Twelve of the 28 structured assessments were measurement instruments, which were psychometrically tested and used in multiple studies. The most frequently used measurement instruments were the Quality of Recovery and the Postoperative Recovery Profile. Pain and sensory perception was the most assessed nursing care need (in 26 structured assessments), followed by Elimination (in 24 structured assessments) and Sleep & rest (in 18 structured assessments). No structured assessment covered all fundamental nursing care needs. While items related to Respiration & Circulation, Nutrition, Elimination, Skin & Mucous membranes, and Psychosocial were present in some structured assessments, they lacked sufficient content relevance to adequately represent the postoperative nursing care needs. CONCLUSIONS: Existing postoperative structured assessments vary in scope and validation, with limited alignment to comprehensive fundamental nursing care needs. There is a need for practical, structured assessments to support real-time symptom recognition and individualized patient-centred recovery.