Perceived barriers and factors affecting postoperative mobilization and related outcomes in surgical patients

Abstract

Purpose: Postoperative mobilization (including the patient’s initial and early mobilization after surgery) is a cornerstone of postoperative care and an essential component of surgical nursing practice. However, various patient-, surgery-, and system-related factors may hinder effective mobilization after surgery. This study aimed to identify the perceived barriers to postoperative mobilization and to determine how patientand surgery-related factors influence key mobilization outcomes. Material and Methods: This cross-sectional study was conducted between July 2023-August 2024 with 229 surgical patients undergoing different types of surgery. Data were obtained through the Patient Data Form. The data were analyzed using descriptive, comparative, correlation, and regression tests. Results: Severe pain (40.2%), fatigue (25.8%), the presence of drains or catheters (19.7%), feeling more comfortable at bed rest (19.2%), and fear or anxiety (18.8%) were identified as the most common perceived barriers to early mobilization. The mean time to first postoperative mobilization was 10.55±7.25 hours, which was later than recommended by current guidelines. A positive statistically significant correlations were observed between time to first mobilization and age, body mass index, preoperative fasting duration, and time to start postoperative oral intake, while a negative correlation was found with education level (p<0.05). Surgery duration and time to start postoperative oral intake significantly affected the timing of the first postoperative mobilization (β=0.029, 0.249, respectively, p<.001). Gender, preoperative hemoglobin level, postoperative fasting duration, and the use of walking aids significantly predicted patients’ anxiety/fear before the first mobilization (Nagelkerke R²=0.329, p<0.05). Conclusion: Postoperative pain was identified as a significant barrier to mobilization. The delay in early mobilization suggests a need to strengthen patient education and pain management strategies to promote earlier mobilization in surgical nursing practice. The duration of surgery and postoperative fasting were identified as strong predictors of the time to first mobilization. Gender, preoperative hemoglobin level, postoperative fasting duration, and the use of walking aids were strong predictors of anxiety/fear experienced prior to first mobilization.