Ameliyat Sonrası Mobilizasyon için Teknoloji Tabanlı Girişimler: Cerrahi Hemşireliği Perspektifi

Öz

Ameliyat sonrası erken mobilizasyon iyileşmenin önemli bir belirleyicisidir ve hasta sonuçları ile yaşam kalitesini doğrudan etkilemektedir. Dijital sağlık teknolojilerindeki gelişmeler, giyilebilir cihazlar, mobil uygulamalar, robot destekli sistemler ve tele-rehabilitasyon platformları aracılığıyla mobilizasyon girişimlerini desteklemektedir. Bu derleme, söz konusu teknolojilerin fiziksel aktiviteyi artırma, komplikasyonları azaltma ve bakımı kişiselleştirme üzerindeki etkilerini incelemektedir. Tartışma bölümü, Orem’in Öz Bakım Teorisi, Neuman’ın Sistem Modeli, Roy’un Uyum Modeli ve Watson’ın İnsan Bakımı Teorisi çerçevesinde teknoloji kullanımının hem hasta hem de hemşire açısından güçlendirici rolünü değerlendirmektedir. Literatürdeki randomize kontrollü çalışmalar ve sistematik incelemeler, teknoloji destekli uygulamaların egzersiz uyumunu artırdığını, ağrıyı azalttığını, hastanede kalış süresini kısalttığını ve memnuniyeti yükselttiğini göstermektedir. Bu bağlamda, cerrahi hemşirelerinin değişen sorumlulukları ile dijital okuryazarlık ve sürekli mesleki gelişimin gerekliliği vurgulanmaktadır. Bulgular, yapay zeka ve büyük veri analitiği ile desteklenen dijital ekosistemlerin gelecekte cerrahi bakımın daha da kişiselleştirilmesine katkı sağlayacağını göstermektedir.

Anahtar Kelimeler

• Erken mobilizasyon
• giyilebilir cihazlar
• sanal gerçeklik
• cerrahi
• hemşirelik.
• Teknoloji

Technology-Based Interventions for Postoperative Mobilization: Surgical Nursing Perspective

Öz

Early postoperative mobilization is a critical determinant of recovery and directly influences patient outcomes and quality of life. Advances in digital health technologies have introduced tools, such as wearable devices, mobile applications, robot-assisted systems, and tele-rehabilitation platforms that support and enhance mobilization efforts in surgical nursing care. This review explores the role of these technologies in promoting physical activity, reducing complications, and enabling personalized care. The discussion section evaluates the empowering role of technology use for both the patient and the nurse within the framework of Orem's Self-Care Theory, Neuman's Systems Model, Roy's Adaptation Model, and Watson's Human Caring Theory. Evidence from randomized controlled trials and systematic reviews demonstrates that technology-supported interventions enhance exercise adherence, reduce pain, shorten hospital length of stay, and increase patient satisfaction. The review also underscores the evolving responsibilities of surgical nurses and the importance of digital literacy and ongoing professional development. Overall, the findings suggest that integrating artificial intelligence, big-data analytics, and comprehensive digital health ecosystems holds substantial potential for further personalizing surgical care and optimizing postoperative recovery.

Anahtar Kelimeler

• Early mobilization
• wearable devices
• virtual reality
• surgery
• nursing.
• Technology

Kaynakça

1. Kırtıl İ, Kanan N, Karip AB. Effects of a mobilization program applied to bariatric surgery patients on preventing gastrointestinal complications: A quasi-experimental study. Obes Surg. 2023;33:1820-30. https://doi.org/10.1007/s11695-023-06609-z
2. Willner A, Teske C, Hackert T, Welsch T. Effects of early postoperative mobilization following gastrointestinal surgery: Systematic review and meta-analysis. BJS Open. 2023;7:zrad102. https://doi.org/10.1093/bjsopen/zrad102
3. Morri M, Ruisi R, Culcasi A, Peccerillo V. The effectiveness of telerehabilitation for functional recovery after orthopedic surgery: A systematic review and meta-analysis. Telemed Rep. 2024;5:78-88. https://doi.org/10.1089/tmr.2023.0057
4. Baron L, Chheang V, Chaudhari A, et al. Virtual therapy exergame for upper extremity rehabilitation using smart wearable sensors. In: Proceedings of the 8th ACM/IEEE International Conference on Connected Health: Applications, Systems and Engineering Technologies (CHASE '23):92-101. New York, Association for Computing Machinery, 2024. https://doi.org/10.1145/3580252.3586975
5. Daskivich TJ, Houman J, Lopez M, et al. Association of wearable activity monitors with assessment of daily ambulation and length of stay among patients undergoing major surgery. JAMA Netw Open. 2019;2(2):e187673.https://doi.org/10.1001/jamanetworkopen.2018.7673
6. Albayram T, Öztekin SD. Cerrahi alanlarda giyilebilir teknoloji kullanımı: Bir sistematik derleme. Mersin Univ Sağlık Bilim Derg. 2023;16. https://doi.org/10.26559/mersinsbd.1187001
7. O'Brien MK, Shin SY, Khazanchi R, et al. Wearable sensors improve prediction of post-stroke walking function following inpatient rehabilitation. IEEE J Transl Eng Health Med. 2022;10:2100711. https://doi.org/10.1109/JTEHM.2022.3208585
8. García-Sánchez M, García-Robles P, Osuna-Pérez MC, Lomas-Vega R, Obrero-Gaitán E, Cortés-Pérez I. Effectiveness of virtual reality-based early postoperative rehabilitation after total knee arthroplasty: A systematic review with meta-analysis of randomized controlled trials. Appl Sci. 2023;13(7):4597. https://doi.org/10.3390/app13074597

9. Lee J, Kong S, Shin S, et al. Wearable device–based intervention for promoting patient physical activity after lung cancer surgery: A nonrandomized clinical trial. JAMA Netw Open. 2024;7:e2434180. https://doi.org/10.1001/jamanetworkopen.2024.34180
10. Pritwani S, Shrivastava P, Pandey S, et al. Mobile and computer-based applications for rehabilitation monitoring and self-management after knee arthroplasty: scoping review. JMIR Mhealth Uhealth. 2024;12:e47843. https://doi.org/10.2196/47843 Peters DM, O’Brien ES, Kamrud KE, et al. Utilization of wearable technology to assess gait and mobility post-stroke: a systematic review. J Neuroeng Rehabil. 2021;18:67. https://doi.org/10.1186/s12984-02100863-x
11. Amin T, Mobbs RJ, Mostafa N, Sy LW, Choy WJ. Wearable devices for patient monitoring in the early postoperative period: A literature review. mHealth. 2021;7:50. https://doi.org/10.21037/mhealth-20-131
12. Li L. Effect of remote control augmented reality multimedia technology for postoperative rehabilitation of knee joint injury. J Healthc Eng. 2022;2022:9320063. https://doi.org/10.1155/2022/9320063
13. Szeto K, Arnold J, Singh B, Gower B, Simpson CEM, Maher C. Interventions using wearable activity trackers to improve patient physical activity and other outcomes in adults who are hospitalized: A systematic review and meta-analysis. JAMA Netw Open. 2023;6(6):e2318478. https://doi.org/10.1001/jamanetworkopen.2023.18478
14. Yin TC, Huang CW, Tsai HL, et al. Smartband use during enhanced recovery after surgery facilitates inpatient recuperation following minimally invasive colorectal surgery. Front Surg. 2021;7:608950. https://doi.org/10.3389/fsurg.2020.608950
15. Lu L, Zhang J, Xie Y, et al. Wearable health devices in health care: Narrative systematic review. JMIR Mhealth Uhealth. 2020;8(11):e18907. https://doi.org/10.2196/18907
16. Longo UG, De Salvatore S, Sassi M, Carnevale A, De Luca G, Denaro V. Motion tracking algorithms based on wearable inertial sensor: A focus on shoulder. Electronics (Basel). 2022;11(11):1741. https://doi.org/10.3390/electronics11111741
17. Papi E, Koh WS, McGregor AH. Wearable technology for spine movement assessment: A systematic review. J Biomech. 2017;64:186-97. https://doi.org/10.1016/j.jbiomech.2017.09.037
18. El-Rashidy N, El-Sappagh S, Islam SMR, et al. Mobile health in remote patient monitoring for chronic diseases: Principles, trends, and challenges. Diagnostics. 2021;11:607. https://doi.org/10.3390/diagnostics11040607
19. Gimenez VCA, Almeida GMF, Cyrino CMS, Lemos CS, Favoretto C, Avila MAG. Telenursing in the postoperative period: A scoping review. Rev Bras Enferm. 2024;77(3):e20240066. https://doi.org/10.1590/0034-7167-2024-0066
20. Warmbein A, Schroeder I, Mehler-Klamt A, et al. Robot-assisted early mobilization for ICU patients: Feasibility and first-time clinical use. Int J Nurs Stud. 2024;152:104702. https://doi.org/10.1186/s40814022-01191-0
21. Su S, He J, Wang R, Chen Z, Zhou F. The effectiveness of virtual reality, augmented reality, and mixed reality rehabilitation in total knee arthroplasty: A systematic review and meta-analysis. J Arthroplasty. 2024;39:582-90. https://doi.org/10.1016/j.arth.2023.08.051
22. Calabrò RS, Naro A, Russo M, et al. Shaping neuroplasticity by using powered exoskeletons in patients with stroke: A randomized clinical trial. J Neuroeng Rehabil. 2018;15(1):35. https://doi.org/10.1186/s12984-018-0377-8
23. Molteni F, Gasperini G, Cannaviello G, Guanziroli E. Exoskeleton and end-effector robots for upper and lower limbs rehabilitation: Narrative review. PM R. 2018;10(9 Suppl 2):174–88. https://doi.org/10.1016/j.pmrj.2018.06.005
24. Huebner L, Warmbein A, Scharf C, et al. Effects of robotic-assisted early mobilization versus conventional mobilization in intensive care unit patients: Prospective interventional cohort study with retrospective control group analysis. Crit Care. 2024;28:112. https://doi.org/10.1186/s13054-024-04896-1
25. Parco C, Kreuels V, Kelm M, Jung C, Wolff G. Robotic-assisted early mobilization and virtual reality: a perspective on innovative support strategies for critically ill patients. ICMx. 2023;11:86. https://doi.org/10.1186/s40635-023-00571-x
26. He Y, Yang Q, Dai X, et al. Effects of virtual reality technology on early mobility in critically ill adult patients: A systematic review and meta-analysis. Front Neurol. 2025;15:1469079. https://doi.org/10.3389/fneur.2024.1469079
27. Gangemi A, De Luca R, Fabio RA, et al. Effects of virtual reality cognitive training on neuroplasticity: A quasi-randomized clinical trial in patients with stroke. Biomedicines. 2023;11:3225. https://doi.org/10.3390/biomedicines11123225
28. de Vries M, Beumeler LFE, van der Meulen J, Bethlehem C, den Otter R, Boerma EC. The feasibility of virtual reality therapy for upper extremity mobilization during and after intensive care unit admission. PeerJ. 2024;12:e18461. https://doi.org/10.7717/peerj.18461
29. Kanschik D, Bruno RR, Wolff G, Kelm M, Jung C. Virtual and augmented reality in intensive care medicine: a systematic review. Ann Intensive Care. 2023;13:81. https://doi.org/10.1186/s13613-02301176-z
30. Wang JY, Yin TC, Huang CW, et al. Smartband use during enhanced recovery after surgery facilitates inpatient recuperation following minimally invasive colorectal surgery. Front Surg. 2025;7:608950. https://doi.org/10.3389/fsurg.2020.608950
31. Çelik EB. Kas iskelet sistemi hastalıklarında telerehabilitasyon. J Med Top Updat. 2023;2(3):74–80. https://doi.org/10.58651/jomtu.1389337
32. Ramli AA, Liu X, Henricson EK. Walk4Me: Telehealth community mobility assessment, an automated system for early diagnosis and disease progression. arXiv. [Preprint]. 2023. https://doi.org/10.48550/arXiv.2305.05543
33. Latif A, Al Janabi HF, Joshi M, et al. Use of commercially available wearable devices for physical rehabilitation in healthcare: A systematic review. BMJ Open. 2024;14:e084086. https://doi.org/10.1136/bmjopen-2024-084086
34. Yayla EN, Çizmeci B. T.C. Sağlık Bakanlığı’nın mobil sağlık uygulamalarının bilinirliğine yönelik bir araştırma. Süleyman Demirel Univ Vizyoner Derg. 2022;13(33):254–70. https://doi.org/10.21076/vizyoner.897754
35. Patel B, Thind A. Usability of mobile health apps for postoperative care: Systematic review. JMIR Perioper Med. 2020;3(2):e19099. https://doi.org/10.2196/19099
36. Wolk S, Meißner T, Linke S, et al. Use of activity tracking in major visceral surgery—The Enhanced Perioperative Mobilization (EPM) trial: Study protocol for a randomized controlled trial. Trials. 2017;18:77. https://doi.org/10.1186/s13063-017-1782-1
37. Shah SS, Gvozdanovic A, Knight M, Gagnon J. Mobile app–based remote patient monitoring in acute medical conditions: Prospective feasibility study exploring digital health solutions on clinical workload during the COVID crisis. JMIR Form Res. 2021;5(1):e23190. https://doi.org/10.2196/23190
38. George JB. Nursing theories: The base for professional nursing practice. 6th ed. Boston: Pearson Education; 2014.
39. Bignami EG, Panizzi M, Bezzi F, Mion M, Bagnoli M, Bellini V. Wearable devices as part of postoperative early warning score systems: A scoping review. J Clin Monit Comput. 2025;39:233–44. https://doi.org/10.1007/s10877-024-01224-4
40. Kim JW, Ryu B, Cho S, et al. Impact of personal health records and wearables on health outcomes and patient response: Three-arm randomized controlled trial. JMIR Mhealth Uhealth. 2019;7(1):e12070. https://doi.org/10.2196/12070
41. Cottrell MA, Galea OA, O’Leary SP, Hill AJ, Russell TG. Real-time telerehabilitation for the treatment of musculoskeletal conditions is effective and comparable to standard practice: A systematic review and meta-analysis. Clin Rehabil. 2017;31(5):625–38. https://doi.org/10.1177/0269215516645148
42. Adeyemo A, Coffey A, Kingston L. Utilisation of robots in nursing practice: an umbrella review. BMC Nurs. 2025;24:247. https://doi.org/10.1186/s12912-025-02842-2
43. El-Gazar HE, Abdelhafez S, Ali AM, et al. Are nurses and patients willing to work with service robots in healthcare? A mixed-methods study. BMC Nurs. 2024;23:718. https://doi.org/10.1186/s12912-02402336-7
44. Warmbein A, Rathgeber I, Seif J, et al. Barriers and facilitators in the implementation of mobilization robots in hospitals from the perspective of clinical experts and developers. BMC Nurs. 2023;22:45. https://doi.org/10.1186/s12912-023-01202-2
45. Pratiwi BRA, Kurniawati ND, Pratiwi IN. Effect of digital health on mobilization in post-operative fracture patients: A systematic review. Indones J Glob Health Res. 2025;7(1):779–88. https://doi.org/10.37287/ijghr.v7i1.5057
46. Lonner JH, Naidu-Helm A, Van Andel D, et al. Smartphone-based care platform versus traditional care in primary knee arthroplasty in the United States: Cost analysis. JMIR Mhealth Uhealth. 2025;13:e46047. https://doi.org/10.2196/46047
47. Zain Z, Almadhoun MKIKH, Alsadoun L, Bokhari SFH. Leveraging artificial intelligence and machine learning to optimize enhanced recovery after surgery (ERAS) protocols. Cureus. 2024;16(3):e56668. https://doi.org/10.7759/cureus.56668
48. Knight SR, Ng N, Tsanas A, Mclean K, Pagliari C, Harrison EM. Mobile devices and wearable technology for measuring patient outcomes after surgery: A systematic review. NPJ Digit Med. 2021;4:157. https://doi.org/10.1038/s41746-021-00525-1