Research Article
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Perceived Barriers and Factors Affecting Postoperative Mobilization and Related Outcomes in Surgical Patients

Year 2026, Volume: 10 Issue: 1, 49 - 63, 31.01.2026
https://doi.org/10.30621/jbachs.1671406

Abstract

References

  • Kırtıl İ, Kanan N. Early and targeted mobilization after surgical interventions. Balıkesir Med J. 2023;7(2):41-55.
  • Tazreean R, Nelson G, Twomey R. Early mobilization in enhanced recovery after surgery pathways: current evidence and recent advancements. J Comp Eff Res. 2022;11(2):121-129.
  • Omairan AM, Shujaa KA, Khawaji RE, et al. Effectiveness of early mobilization in reducing postoperative complications; nursing roles. J Int Crisis Risk Commun Res. 2024;7(S8):2972-2976.
  • Castelino T, Fiore JF, Niculiseanu P, Landry T, Augustin B, Feldman SL. The effect of early mobilization protocols on postoperative outcomes following abdominal and thoracic surgery: a systematic review. Surgery. 2016;159(4):991-1003
  • Yurko YY, Fearon KCH, Young-Fadok TM. Early nutrition and early mobilization: why they are important and how to make it happen. In: Feldman SL, Delaney CP, Ljungqvist O, Carli F, editors. The SAGES/ERAS Society manual of enhanced recovery programs for gastrointestinal surgery. Switzerland: Springer International Publishing; 2015. pp. 167-178. ISBN: 978-3-319-20364-5.
  • Feldheiser A, Aziz O, Baldini G, et al. Enhanced Recovery After Surgery (ERAS) for gastrointestinal surgery, part 2: consensus statement for anaesthesia practice. Acta Anaesthesiol Scand. 2016;60:289-334
  • Hussey JM, Yang T, Dowds J, O’Connor L, Reynolds JV, Guinan EM. Quantifying postoperative mobilisation following oesophagectomy. Physiotherapy. 2019;105:126-133
  • National Institute for Health and Care Excellence (NICE). Stroke and transient ischaemic attack in over 16s: diagnosis and initial management-Evidence review for very early mobilisation. 2019. [Accessed date: 28 September 2024].
  • Zhang L, Wu Q, Wang X, Zhu X, Shi Y, Wu CJ. Factors impacting early mobilization according to the Enhanced Recovery After Surgery guideline following gastrointestinal surgery: a prospective study. Geriatr Gerontol Int. 2024;24:234-239.
  • ACOG Committee on Gynecologic Practice. Perioperative pathways: enhanced recovery after surgery. Obstet Gynecol. 2018;132(3):e120-e130.
  • Ceresoli M, Braga M, Zanini N, et al. Enhanced perioperative care in emergency general surgery: the WSES position paper. World J Emerg Surg. 2023;18:47.
  • Turan A, Khanna AK, Brooker J, et al. Association between mobilization and composite postoperative complications following major elective surgery. JAMA Surg. 2023;158(8):825-830.
  • Koch PF, Moosburner S, Raschzok N, et al. Defining benchmarks for postoperative mobilization based on the recommendations of the Enhanced Recovery After Surgery (ERAS) program for liver surgery: a prospective study. Surg Endosc. 2025; 39(12):8159-8170.
  • Fagevik Olsén M, Sehlin M, Westerdahl E, et al. First mobilisation after abdominal and cardiothoracic surgery: when is it actually performed? A national, multicentre, cross-sectional study. BMJ Open. 2024;14:e082239.
  • Hogenbirk RNM, Wijma AG, van der Plas WY, et al. Actual physical activity after major abdominal cancer surgery: far from optimal. Eur J Surg Oncol. 2024;50:107949.
  • Halpern WL. Early ambulation is crucial for improving patient health. Am J Nurs. 2017;117(6):15
  • Gustafsson UO, Scott MJ, Hübner M, et al. Guidelines for perioperative care in elective colorectal surgery: Enhanced Recovery After Surgery (ERAS) Society recommendations: 2018. World J Surg. 2019;43:659-695.
  • Carmichael JC, Keller DS, Baldini G, et al. Clinical practice guidelines for enhanced recovery after colon and rectal surgery from the American Society of Colon and Rectal Surgeons and Society of American Gastrointestinal and Endoscopic Surgeons. Dis Colon Rectum. 2017;60(8):761-784.
  • Costa Torres D, Ramos dos Santos MP, Reis LJH, Paisani MD, Chiavegato DL. Effectiveness of an early mobilization program on functional capacity after coronary artery bypass surgery: a randomized controlled trial protocol. SAGE Open Med. 2017;4:1-8.
  • Low ED, Allum W, De Manzoni G, et al. Guidelines for perioperative care in esophagectomy: Enhanced Recovery After Surgery (ERAS) Society recommendations. World J Surg. 2019;43:299-330.
  • Ni YX, Li Z, Zhou LL, Gong S. Factors influencing early mobilisation for patients undergoing pancreatic surgery from multiple perspectives: a qualitative descriptive study. BMJ Open. 2023;13:e077419.
  • Asada J, Ida M, Sato M, Okamoto N, Kawaguchi M. Associated factors with delayed ambulation after abdominal surgery. J Anesth. 2019;33:680-684.
  • Hodgson CL, Capell E, Tipping CJ. Early mobilization of patients in intensive care: organization, communication and safety factors that influence translation into clinical practice. Crit Care. 2018;22:1-7.
  • Burcharth J, Falkenberg A, Oreskov OJ, Ekeloef S, Gögenur I. Patients’ perceptions of barriers to enhanced recovery after emergency abdominal surgery. Langenbecks Arch Surg. 2021;406:405-412.
  • Buecking B, Bohl K, Eschbach D, et al. Factors influencing the progress of mobilization in hip fracture patients during the early postsurgical period: a prospective observational study. Arch Gerontol Geriatr. 2015;60(1):79-85.
  • Jønsson LR, Ingelsrud LH, Tengberg LT, Bandholm T, Foss NB, Kristensen MT. Physical performance following acute high-risk abdominal surgery: a prospective cohort study. Can J Surg. 2018;61(1):42-49.
  • Said CM, Delahunt M, Ciavarella V, et al. Factors impacting early mobilization following hip fracture: an observational study. J Geriatr Phys Ther. 2021;44(2):88-93.
  • Gray R, Lacey K, Whitehouse C, Dance R, Smith T. What factors affect early mobilisation following hip fracture surgery: a scoping review. BMJ Open Qual. 2024;12:e002281.
  • Xie J, Luo C, Du Q, et al. Factors associated with early mobilization among colorectal cancer patients after surgery: a cross-sectional study. Eur J Oncol Nurs. 2023;64:102317.
  • Koenders N, Weenk M, van de Belt TH, van Goor H, Hoogeboom TJ, Bredie SJH. Exploring barriers to physical activity of patients at the internal medicine and surgical wards: a retrospective analysis of continuously collected data. Disabil Rehabil. 2021;43(13):1883-1889.
  • Jønsson LR, Foss NB, Orbæk J, Lauritsen ML, Sejrsen HN, Kristensen MT. Early intensive mobilization after acute high-risk abdominal surgery: a nonrandomized prospective feasibility trial. Can J Surg. 2023;66(3):E236-E245.
  • Thörn RMW, Stepniewski J, Hjelmqvist H, Forsberg A, Ahlstrand R, Ljungqvist O. Supervised immediate postoperative mobilization after elective colorectal surgery: a feasibility study. World J Surg. 2021;46(1):34-42.
  • Münter KH, Clemmesen CG, Foss NB, Palm H, Kristensen MT. Fatigue and pain limit independent mobility and physiotherapy after hip fracture surgery. Disabil Rehabil. 2017;40(15):1808-1816.
  • Ünver S, Yildirim M, Akbal S, Sever S. Challenges experienced by cardiac intensive care nurses during first out-of-bed patient mobilization after open-heart surgery: a descriptive phenomenological qualitative study. J Adv Nurs. 2024;80(11):4616-4628.
  • Srivastava D, Hill S, Carty S, et al. Surgery and opioids: evidence-based expert consensus guidelines on the perioperative use of opioids in the United Kingdom. Br J Anaesth. 2021;126(6):1208-1216.
  • Faculty of Pain Medicine. Surgery and opioids: best practice guidelines 2021. [Accessed date: 25 September 2024].
  • Svensson-Raskh A, Schandl A, Holdar U, Fagevik Olsén M, Nygren-Bonnier M. “I have everything to win and nothing to lose”: patient experiences of mobilization out of bed immediately after abdominal surgery. Phys Ther. 2020;100:2079-2089.
  • Wang SK, Chai XY, Wang P, Kong C, Lu SB. Association between delayed ambulation and increased risk of adverse events after lumbar fusion surgery in elderly patients. BMC Musculoskelet Disord. 2024;25:501.
  • Nakai A, Nakada T, Okamoto S, et al. Risk factors for postoperative nausea and vomiting after thoracoscopic pulmonary wedge resection: pitfalls of an increased fentanyl dose. J Thorac Dis. 2021;13(6):3489-3496.
  • Canzan F, Longhini J, Caliaro A, et al. The effect of early oral postoperative feeding on the recovery of intestinal motility after gastrointestinal surgery: a systematic review and meta-analysis of randomized clinical trials. Front Nutr. 2024;11:1369141.
  • Foss NB, Kristensen MT, Kehlet H. Anaemia impedes functional mobility after hip fracture surgery. Age Ageing. 2008;37(2):173-178.

Perceived Barriers and Factors Affecting Postoperative Mobilization and Related Outcomes in Surgical Patients

Year 2026, Volume: 10 Issue: 1, 49 - 63, 31.01.2026
https://doi.org/10.30621/jbachs.1671406

Abstract

Background and Purpose: This study aimed to identify the mobilization barriers experienced/perceived by surgical patients and determine the relationship between these factors.
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: 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).
Conclusion: Postoperative pain was identified as a significant barrier to mobilization. The average time to postoperative mobilization was later than recommended by guidelines. The duration of surgery and postoperative fasting were identified as strong predictors of the time to first mobilization. Gender, preoperative hemoglobin levels, postoperative fasting duration, and the use of walking aids were strong predictors of anxiety/fear experienced prior to first mobilization.

References

  • Kırtıl İ, Kanan N. Early and targeted mobilization after surgical interventions. Balıkesir Med J. 2023;7(2):41-55.
  • Tazreean R, Nelson G, Twomey R. Early mobilization in enhanced recovery after surgery pathways: current evidence and recent advancements. J Comp Eff Res. 2022;11(2):121-129.
  • Omairan AM, Shujaa KA, Khawaji RE, et al. Effectiveness of early mobilization in reducing postoperative complications; nursing roles. J Int Crisis Risk Commun Res. 2024;7(S8):2972-2976.
  • Castelino T, Fiore JF, Niculiseanu P, Landry T, Augustin B, Feldman SL. The effect of early mobilization protocols on postoperative outcomes following abdominal and thoracic surgery: a systematic review. Surgery. 2016;159(4):991-1003
  • Yurko YY, Fearon KCH, Young-Fadok TM. Early nutrition and early mobilization: why they are important and how to make it happen. In: Feldman SL, Delaney CP, Ljungqvist O, Carli F, editors. The SAGES/ERAS Society manual of enhanced recovery programs for gastrointestinal surgery. Switzerland: Springer International Publishing; 2015. pp. 167-178. ISBN: 978-3-319-20364-5.
  • Feldheiser A, Aziz O, Baldini G, et al. Enhanced Recovery After Surgery (ERAS) for gastrointestinal surgery, part 2: consensus statement for anaesthesia practice. Acta Anaesthesiol Scand. 2016;60:289-334
  • Hussey JM, Yang T, Dowds J, O’Connor L, Reynolds JV, Guinan EM. Quantifying postoperative mobilisation following oesophagectomy. Physiotherapy. 2019;105:126-133
  • National Institute for Health and Care Excellence (NICE). Stroke and transient ischaemic attack in over 16s: diagnosis and initial management-Evidence review for very early mobilisation. 2019. [Accessed date: 28 September 2024].
  • Zhang L, Wu Q, Wang X, Zhu X, Shi Y, Wu CJ. Factors impacting early mobilization according to the Enhanced Recovery After Surgery guideline following gastrointestinal surgery: a prospective study. Geriatr Gerontol Int. 2024;24:234-239.
  • ACOG Committee on Gynecologic Practice. Perioperative pathways: enhanced recovery after surgery. Obstet Gynecol. 2018;132(3):e120-e130.
  • Ceresoli M, Braga M, Zanini N, et al. Enhanced perioperative care in emergency general surgery: the WSES position paper. World J Emerg Surg. 2023;18:47.
  • Turan A, Khanna AK, Brooker J, et al. Association between mobilization and composite postoperative complications following major elective surgery. JAMA Surg. 2023;158(8):825-830.
  • Koch PF, Moosburner S, Raschzok N, et al. Defining benchmarks for postoperative mobilization based on the recommendations of the Enhanced Recovery After Surgery (ERAS) program for liver surgery: a prospective study. Surg Endosc. 2025; 39(12):8159-8170.
  • Fagevik Olsén M, Sehlin M, Westerdahl E, et al. First mobilisation after abdominal and cardiothoracic surgery: when is it actually performed? A national, multicentre, cross-sectional study. BMJ Open. 2024;14:e082239.
  • Hogenbirk RNM, Wijma AG, van der Plas WY, et al. Actual physical activity after major abdominal cancer surgery: far from optimal. Eur J Surg Oncol. 2024;50:107949.
  • Halpern WL. Early ambulation is crucial for improving patient health. Am J Nurs. 2017;117(6):15
  • Gustafsson UO, Scott MJ, Hübner M, et al. Guidelines for perioperative care in elective colorectal surgery: Enhanced Recovery After Surgery (ERAS) Society recommendations: 2018. World J Surg. 2019;43:659-695.
  • Carmichael JC, Keller DS, Baldini G, et al. Clinical practice guidelines for enhanced recovery after colon and rectal surgery from the American Society of Colon and Rectal Surgeons and Society of American Gastrointestinal and Endoscopic Surgeons. Dis Colon Rectum. 2017;60(8):761-784.
  • Costa Torres D, Ramos dos Santos MP, Reis LJH, Paisani MD, Chiavegato DL. Effectiveness of an early mobilization program on functional capacity after coronary artery bypass surgery: a randomized controlled trial protocol. SAGE Open Med. 2017;4:1-8.
  • Low ED, Allum W, De Manzoni G, et al. Guidelines for perioperative care in esophagectomy: Enhanced Recovery After Surgery (ERAS) Society recommendations. World J Surg. 2019;43:299-330.
  • Ni YX, Li Z, Zhou LL, Gong S. Factors influencing early mobilisation for patients undergoing pancreatic surgery from multiple perspectives: a qualitative descriptive study. BMJ Open. 2023;13:e077419.
  • Asada J, Ida M, Sato M, Okamoto N, Kawaguchi M. Associated factors with delayed ambulation after abdominal surgery. J Anesth. 2019;33:680-684.
  • Hodgson CL, Capell E, Tipping CJ. Early mobilization of patients in intensive care: organization, communication and safety factors that influence translation into clinical practice. Crit Care. 2018;22:1-7.
  • Burcharth J, Falkenberg A, Oreskov OJ, Ekeloef S, Gögenur I. Patients’ perceptions of barriers to enhanced recovery after emergency abdominal surgery. Langenbecks Arch Surg. 2021;406:405-412.
  • Buecking B, Bohl K, Eschbach D, et al. Factors influencing the progress of mobilization in hip fracture patients during the early postsurgical period: a prospective observational study. Arch Gerontol Geriatr. 2015;60(1):79-85.
  • Jønsson LR, Ingelsrud LH, Tengberg LT, Bandholm T, Foss NB, Kristensen MT. Physical performance following acute high-risk abdominal surgery: a prospective cohort study. Can J Surg. 2018;61(1):42-49.
  • Said CM, Delahunt M, Ciavarella V, et al. Factors impacting early mobilization following hip fracture: an observational study. J Geriatr Phys Ther. 2021;44(2):88-93.
  • Gray R, Lacey K, Whitehouse C, Dance R, Smith T. What factors affect early mobilisation following hip fracture surgery: a scoping review. BMJ Open Qual. 2024;12:e002281.
  • Xie J, Luo C, Du Q, et al. Factors associated with early mobilization among colorectal cancer patients after surgery: a cross-sectional study. Eur J Oncol Nurs. 2023;64:102317.
  • Koenders N, Weenk M, van de Belt TH, van Goor H, Hoogeboom TJ, Bredie SJH. Exploring barriers to physical activity of patients at the internal medicine and surgical wards: a retrospective analysis of continuously collected data. Disabil Rehabil. 2021;43(13):1883-1889.
  • Jønsson LR, Foss NB, Orbæk J, Lauritsen ML, Sejrsen HN, Kristensen MT. Early intensive mobilization after acute high-risk abdominal surgery: a nonrandomized prospective feasibility trial. Can J Surg. 2023;66(3):E236-E245.
  • Thörn RMW, Stepniewski J, Hjelmqvist H, Forsberg A, Ahlstrand R, Ljungqvist O. Supervised immediate postoperative mobilization after elective colorectal surgery: a feasibility study. World J Surg. 2021;46(1):34-42.
  • Münter KH, Clemmesen CG, Foss NB, Palm H, Kristensen MT. Fatigue and pain limit independent mobility and physiotherapy after hip fracture surgery. Disabil Rehabil. 2017;40(15):1808-1816.
  • Ünver S, Yildirim M, Akbal S, Sever S. Challenges experienced by cardiac intensive care nurses during first out-of-bed patient mobilization after open-heart surgery: a descriptive phenomenological qualitative study. J Adv Nurs. 2024;80(11):4616-4628.
  • Srivastava D, Hill S, Carty S, et al. Surgery and opioids: evidence-based expert consensus guidelines on the perioperative use of opioids in the United Kingdom. Br J Anaesth. 2021;126(6):1208-1216.
  • Faculty of Pain Medicine. Surgery and opioids: best practice guidelines 2021. [Accessed date: 25 September 2024].
  • Svensson-Raskh A, Schandl A, Holdar U, Fagevik Olsén M, Nygren-Bonnier M. “I have everything to win and nothing to lose”: patient experiences of mobilization out of bed immediately after abdominal surgery. Phys Ther. 2020;100:2079-2089.
  • Wang SK, Chai XY, Wang P, Kong C, Lu SB. Association between delayed ambulation and increased risk of adverse events after lumbar fusion surgery in elderly patients. BMC Musculoskelet Disord. 2024;25:501.
  • Nakai A, Nakada T, Okamoto S, et al. Risk factors for postoperative nausea and vomiting after thoracoscopic pulmonary wedge resection: pitfalls of an increased fentanyl dose. J Thorac Dis. 2021;13(6):3489-3496.
  • Canzan F, Longhini J, Caliaro A, et al. The effect of early oral postoperative feeding on the recovery of intestinal motility after gastrointestinal surgery: a systematic review and meta-analysis of randomized clinical trials. Front Nutr. 2024;11:1369141.
  • Foss NB, Kristensen MT, Kehlet H. Anaemia impedes functional mobility after hip fracture surgery. Age Ageing. 2008;37(2):173-178.
There are 41 citations in total.

Details

Primary Language English
Subjects Health Services and Systems (Other)
Journal Section Research Article
Authors

İnci Kırtıl 0000-0002-1731-5282

Pınar Ongün 0000-0003-2935-7583

Şevval Çağan Kişin 0009-0004-5511-9751

Submission Date April 7, 2025
Acceptance Date December 9, 2025
Publication Date January 31, 2026
Published in Issue Year 2026 Volume: 10 Issue: 1

Cite

APA Kırtıl, İ., Ongün, P., & Çağan Kişin, Ş. (2026). Perceived Barriers and Factors Affecting Postoperative Mobilization and Related Outcomes in Surgical Patients. Journal of Basic and Clinical Health Sciences, 10(1), 49-63. https://doi.org/10.30621/jbachs.1671406
AMA Kırtıl İ, Ongün P, Çağan Kişin Ş. Perceived Barriers and Factors Affecting Postoperative Mobilization and Related Outcomes in Surgical Patients. JBACHS. January 2026;10(1):49-63. doi:10.30621/jbachs.1671406
Chicago Kırtıl, İnci, Pınar Ongün, and Şevval Çağan Kişin. “Perceived Barriers and Factors Affecting Postoperative Mobilization and Related Outcomes in Surgical Patients”. Journal of Basic and Clinical Health Sciences 10, no. 1 (January 2026): 49-63. https://doi.org/10.30621/jbachs.1671406.
EndNote Kırtıl İ, Ongün P, Çağan Kişin Ş (January 1, 2026) Perceived Barriers and Factors Affecting Postoperative Mobilization and Related Outcomes in Surgical Patients. Journal of Basic and Clinical Health Sciences 10 1 49–63.
IEEE İ. Kırtıl, P. Ongün, and Ş. Çağan Kişin, “Perceived Barriers and Factors Affecting Postoperative Mobilization and Related Outcomes in Surgical Patients”, JBACHS, vol. 10, no. 1, pp. 49–63, 2026, doi: 10.30621/jbachs.1671406.
ISNAD Kırtıl, İnci et al. “Perceived Barriers and Factors Affecting Postoperative Mobilization and Related Outcomes in Surgical Patients”. Journal of Basic and Clinical Health Sciences 10/1 (January2026), 49-63. https://doi.org/10.30621/jbachs.1671406.
JAMA Kırtıl İ, Ongün P, Çağan Kişin Ş. Perceived Barriers and Factors Affecting Postoperative Mobilization and Related Outcomes in Surgical Patients. JBACHS. 2026;10:49–63.
MLA Kırtıl, İnci et al. “Perceived Barriers and Factors Affecting Postoperative Mobilization and Related Outcomes in Surgical Patients”. Journal of Basic and Clinical Health Sciences, vol. 10, no. 1, 2026, pp. 49-63, doi:10.30621/jbachs.1671406.
Vancouver Kırtıl İ, Ongün P, Çağan Kişin Ş. Perceived Barriers and Factors Affecting Postoperative Mobilization and Related Outcomes in Surgical Patients. JBACHS. 2026;10(1):49-63.