Patients' Experiences of Day Surgery: A Qualitative Systematic Review

ABSTRACT

Aim

To examine how patients experience day surgery.

Design

Systematic review using Thomas and Harden's framework for synthesis and analysed through Ricoeur's theory of interpretation.

Methods and Data Sources

Systematic searches in MEDLINE, CINAHL and EMBASE (September 2023) identified qualitative studies focusing on patients' lived experiences with day surgery (defined as < 24‐h hospital stay). Studies were required to provide qualitative data on patient experiences and be published in English or Scandinavian languages. Forward and backward citation searches were also conducted in Scopus.

Results

Thirty‐four studies met the inclusion criteria. The analysis revealed four key themes: (1) ‘Perceptions of the day surgery concept shape patient expectations’; (2) ‘Navigating expectation and reality: Surprises and challenges in day surgery’; (3) ‘Navigating through postoperative recovery: Feelings of responsibility and insecurity following day surgery’; and (4) ‘The vital role of support from both family and professionals during recovery after day surgery’.

Conclusion

Patients' expectations of day surgery strongly influence their overall experience, while the complex self‐care demands of postoperative recovery underscore the need for robust support systems involving families and healthcare professionals.

Implications for Patient Care

This review highlights the importance of thorough preoperative counselling and ongoing support for patients' complex postoperative self‐care. These findings suggest that improved patient‐centred care and targeted support could enhance recovery outcomes in day surgery pathways.

Impact

Problem addressed: The study explores the often‐overlooked challenges that patients face with postoperative self‐care following day surgery. Main findings: Expectations of day surgery as ‘minor’ often conflict with patients' emotional and physical self‐care needs, revealing a need for comprehensive support. Research impact: Insights from this review can inform patient‐centred care practices in day surgery settings globally, underscoring the critical role of family and professional support.

Patient or Public Contribution

No patient or public contribution.

Trial Registration

Registered with PROSPERO: CRD42023414310

Summary.

• What this paper contributes

  • ○
    This review reveals patients' misconceptions about day surgery and highlights their complex recovery needs.
  • ○
    It underscores the importance of support from family and professionals to alleviate postoperative responsibility and insecurity.
  • ○
    It advocates for patient‐centred improvements in day surgery to support patient recovery.

1. Introduction

The increase in day surgery worldwide may be attributed to advancements in surgical and anaesthetic techniques. These advancements have improved surgical outcomes, limited postoperative complications and reduced side effects such as nausea and vomiting as well as improved postoperative pain control (International Association for Ambulatory Surgery ²⁰¹⁴; Elhassan et al. ²⁰¹⁸). The global increase in both the number and complexity of day surgery procedures has been accompanied by financial benefits, such as reduced length of hospital stay as a result of enhanced recovery programmes (Muller et al. 2009). This has, however, increased the demand placed on patients and their families regarding pre‐ and postoperative self‐care. Previous studies suggest that there may be a perceived vulnerability and need for support for patients opting for day surgery (Halding et al. 2021). This observation prompts a closer examination of how the patients experience the day surgery pathway.

Numerous papers on the advantages of day surgery have been published. Although some qualitative studies have delved into patients' experiences with a specific surgical context in mind, there seems to be a lack of qualitative research specifically exploring patients' subjective experiences of day surgery.

Mitchell (2013) studied the experiences of patients and their caregivers during the initial phase at home after day surgery. The findings of this literature review indicated that facing the recovery process at home with restricted access to healthcare professionals posed several challenges, primarily associated with inadequate postoperative knowledge and information.

Recognising the importance of understanding patients' challenges and experiences in providing quality care within the day surgery setting, it is essential to identify common issues for patients undergoing day surgery.

2. Aim

The aim is to identify and synthesise the literature that explicitly examines patients' experiences with day surgery. By investigating such perspectives, this review aims to provide valuable insights and an in‐depth understanding of patient experiences for healthcare professionals and policymakers.

2.1. Research Question

The central question guiding this review is as follows: ‘What are the experiences and perspectives of patients who have undergone day surgery?’

3. Methods

3.1. Design

A thematic synthesis of qualitative studies, inspired by Thomas and Harden's framework (2008), guided the synthesis process. Ricoeur's theory of interpretation (Pedersen 1999; Ricoeur ^{1976, 1991}) was employed to support and strengthen the analytical rigour. The Enhancing Transparency in Reporting the Synthesis of Qualitative Research (ENTREQ) statement (Tong et al. 2012) was used to guide the reporting and structure of this qualitative research synthesis.

3.2. Systematic Literature Search

The comprehensive literature search strategy, refined by a librarian from the University of Southern Denmark, was applied in EMBASE, CINAHL and MEDLINE.

The databases were searched using two sets of search terms as free‐text keywords and thesaurus terms: (a) ‘day surgery’ and its synonyms (a total of 14 keywords) and (b) ‘qualitative research’ and synonyms of qualitative research methods (a total of 80 keywords). The full search in EMBASE is available in Appendix A. The free‐text search of qualitative research was inspired by (but not limited to) qualitative research filters by D. Evans (2002) and the Edward G. Miner Library (2002). No filters were applied to restrict publication dates.

Exclusions were made for studies involving inpatients, children, parents, or other caregivers' experiences. See Table 1 for inclusion and exclusion criteria.

TABLE 1.

Inclusion criteria.

Inclusion criteria	Definition and justification
Day surgery/ambulatory surgery	Includes patients with surgical treatment as outpatients or stays < 24 h Excludes inpatients with > 24 h stays
Patients' experiences only	Focuses on patients' experiences. Studies that include both patients and relatives are included only if findings can be stratified to reflect patients' experiences separately. Studies where relatives' statements cannot be separated are excluded
Original qualitative data	Includes qualitative studies on patients' experiences, needs, or perspectives. Excludes quantitative‐only studies but includes qualitative data from mixed‐methods research
Published in the English language or a Scandinavian language	Includes studies in English, Danish, Norwegian or Swedish. Excludes studies in other languages due to limited translation resources

Note: The table outlines the specific inclusion and exclusion criteria applied during the selection of studies for this manuscript, ensuring transparency and clarity for the reader.

The systematic literature search was conducted by the first author in September 2023. After the removal of duplicates, the titles and abstracts were screened by the first two authors, and full‐text articles were reviewed similarly. Only articles that included patients' experiences of day surgery were included in the synthesis. After forward and backward citation searches in Scopus of the included articles, a total of 34 articles were found to fulfil the inclusion criteria. Any disagreements were discussed and resolved through consensus, with input from the other authors when necessary. The selection process of the included articles is illustrated in the PRISMA flow diagram in Figure 1. Covidence was used to streamline the organisation of tasks in the review process.

FIGURE 1.

PRISMA flow diagram of article selection process. This diagram illustrates the process of identifying, screening and including studies in the review. It shows the number of records identified through database searching, the number of records screened, the number of full‐text articles assessed for eligibility and the number of studies included in the final qualitative synthesis.

3.3. Assessment of Critical Appraisal

The full text of all the relevant articles was independently reviewed and assessed using the JBI Critical Appraisal Checklist for Qualitative Research (Lockwood et al. 2020). Any discrepancies in the assessments were discussed between the first two authors, and consensus was reached through collaboration.

3.4. Data Extraction

Data regarding authorship, year of publication, country of origin, aim, design, context, participants and findings were extracted (see Table 2). Moreover, all content from the findings sections were extracted for the synthesis. Various types of qualitative data, including diaries and free‐text survey responses, were included to capture a broad range of patient perspectives. This approach ensured rich, personal accounts alongside data from unstructured interviews, offering deep insights into the patients' lived experiences. The utilisation of NVivo software enabled efficient management of the analyses of the qualitative data derived from the review.

TABLE 2.

Overview of included articles and their characteristics.

Study	Aim	Design	Context	Participants	Findings
Mahmud et al. (2023) UK	These data provide first‐hand perspectives of the women that experienced the OPH journey. The main aim of this paper is therefore to share the findings and lessons from the qualitative data gathered as part of the OPH‐PSS benchmarking work	Free‐text comments in survey	Hysteroscopy	N = 1720 women	Positive experiences of outpatient hysteroscopy Negative experiences of outpatient hysteroscopy Potential areas of improvement Overall experience and advise to others
Larsson et al. (2022) Sweden	The aim for this study was to describe the experiences of postoperative recovery for patients who have undergone orthopaedic day surgery	Semi‐structured interview	Orthopaedic surgery	N = 18 14 women, 4 men Age 18–81 years	Question arose when I got home I wanted confirmation that I was on the right path I felt lonely and dependent on others I strove to find a balance between activity and rest
Halding et al. (2021) Norway	The aim of this study was to obtain increased understanding of orthopaedic day surgery patients' experiences with self‐management at home following day surgery through the following research questions: How do they experience the perioperative period and preparation for self‐management? How do they experience self‐management the first days post discharge?	Interview	Arthroscopic knee surgery	N = 16 5 women, 11 men Age 18–78 years	The self‐management information could be challenging to retrieve The strenuous travel Feeling safe at the hospital Eager to comply, but unsure of self‐tailoring The benefit of post discharge support
Ørving et al. (2021) Denmark	We aimed to assess postdischarge symptoms and concerns as perceived by patients' postoperative day (POD) 1 after gynaecologic and urogynaecologic outpatient surgery.	Semi‐structured interviews	Urogynaecologic and gynaecologic	N = 30 Age 33–89 years	Voiding difficulty Postoperative pain Being unprepared for bowel problems Unexpected fatigue limiting daily activities
Nilsson et al. (2020) Sweden	The aims of this study are threefold: ⯈To further develop the concept analysis by Alvin et al. and Lundmark et al. from the perspective of day surgery patients ⯈To describe how patients experience postoperative recovery in relation to the identified dimensions and subdimensions ⯈To interpret the findings in order to get a deeper understanding of the concept postoperative recovery	Interview	Not explicit	N = 38	Physical dimension Psychological dimension Social dimension Habitual dimension
Churchill et al. (2018) Canada	The aim of the present study was to gain insight into patient and caregiver perspectives regarding the advantages and disadvantages of outpatient THA to identify areas of care that can be improved	Semi‐structured interviews	Total hip arthroplasty (THA)	N = 8 3 women and 5 men Age 56–70 years	Supporting the transition home Challenges for transitioning home Unique considerations for same‐day discharge
Dahlberg et al. (2018) Sweden	The aim of this study was to explore the experience of postoperative recovery after day surgery in patients using a mobile app for systematic assessment of the quality of their recovery	Semi‐structured interview	General, orthopaedic, hand and ear, nose and throat surgery	N = 18 10 women, 8 men Age 21–80 years	Give it all you've got The importance of feeling safe and sound
Odom‐Forren et al. (2018) USA	The aims of this study were to (1) identify symptoms that cause postoperative distress after LC ambulatory surgery; (2) identify symptom management techniques that effectively reduce the distress of LC postoperative symptoms at home after ambulatory surgery; and (3) identify facilitators and barriers to self‐management of postoperative symptoms	Focus groups	Laparoscopic cholecystectomy	N = 7 6 women, 1 man Mean age 46.9	Symptoms and consequences of surgery that cause postoperative distress Postoperative pain Nausea and vomiting Constipation Sore throat Inability to sleep Mobility impairment Work‐related stress
Dåvøy et al. (2017) Norway	The purpose of the study was to explore how patients with chronic sinusitis experienced nursing care during an operation performed under local anaesthesia in an outpatient surgical ward. The objective was to investigate through semi‐structured interviews how 12 patients experienced the surgical intervention	Semi‐structured interview	Ear, nose and throat surgery	N = 12 6 women, 6 men Age 25–66 years	Management of information Pain, discomfort and impressions Nursing presence is missed when one must act as their own caregiver
Odom‐Forren et al. (2017) USA	The goals of this qualitative descriptive research study were to identify symptom management techniques that effectively reduce the distress of at‐home orthopaedic surgery recovery after ambulatory surgery and identify facilitators and barriers to the self‐management of postoperative symptoms	Focus groups	Orthopaedic surgery	N = 10 4 women, 6 men Mean age 46.9	Distressing symptoms Management of symptoms Self‐management facilitators and barriers
Dawe et al. (2014) Canada	The purpose of this paper is to report the findings of a study about the informational and emotional needs of women having outpatient surgery for breast cancer	Semi‐structured interviews	Lumpectomy, partial mastectomy, full mastectomy (breast cancer)	N = 19 Women Age 38–72 years	Emotional and informational needs prior to and immediately after surgery Emotional and informational supports while recovering at home Emotional responses to the outpatient surgery experience
Bryson et al. (2014) Canada	The primary objective of this study was to illuminate themes relevant to postdischarge care among a cohort of ambulatory surgery patients 65 years of age or older and their primary caregivers, as described in their written diaries	Diaries	Hip, knee and shoulder arthroscopy Foot surgery, lumbar discectomy, inguinal or ventral herniorrhaphy, laparoscopic biliary or gynaecological surgery, genitourinary repair surgeries	N = 90 65 years and older	Physical and emotional health Hospital Experience Caregiving
Berg et al. (2013) Sweden	The aim of this study was therefore to explore day surgery patients' different experiences of postoperative recovery	Semi‐structured interviews	Orthopaedic, general or urologic surgery	N = 31 8 women, 23 men Age 18–80 years	Conditions for recovery at home The rollback to ordinary life Being a cog in a flow of care
Haapala et al. (2013) Finland	The purpose of the study was to describe the shoulder operation counselling in day surgery from the patients' perspective. The aim was to produce information for patient counselling on the day surgery unit. The research function question is: Does counselling improve the experience of patients undergoing day shoulder surgery?	Thematic interviews	Shoulder operation	N = 9	The developed sense of safety and trust as the result of counselling The feeling of and coping with uncertainty arose from inadequate counselling
Mccloud et al. (2012) Australian	To co‐create an understanding between the researchers and the participants of the experience of vitreo‐retinal day surgery	In‐depth unstructured interviews—face‐to‐face	Vitreo‐retinal day surgery	N = 18 11 men and 7 women Age 45–87 years	The continuum of experience An existential framework The physical self The psychological self The historically located self The self located within the community The interconnected domains of self
Mottram (2012) UK	The existing day surgery literature examines risk largely from a bio‐medical perspective. This is essential to ensuring the safety of the patient undergoing day surgery. However they rarely examine the wider influences of patients' risk perception and implications for practice. This paper therefore seeks to make a modest contribution to the day surgery literature by considering these factors	Semi‐structured interview	Orthopaedic, ear nose and throat and general surgery	N = 145 Aged 18–75 years	Rational actor model Minimising risk of loss of personal autonomy Having a say—anaesthetic choices Risk to families Trust
Mottram (2011c) UK	The aim of the study was to explore the discharge experiences of patients undergoing day surgery using the grounded theory approach	Semi‐structured interview	General surgery, ear, nose and throat, and orthopaedic	N = 145	Unexpected occurrences Lack of aftercare Nostalgia
Mottram (2011a) UK	The study investigated patients' experiences of day surgery using a sociological frame of reference	Semi‐structured interview	General surgery, ear, nose and throat, and orthopaedic	N = 145 Age 18–70 years	Time and the day surgery patient Moral use of time Wasted time Time as a conveyor belt
Mottram (2011b) UK	The aim of the study was to explore patients' experiences of day surgery using a sociological framework of analysis	Semi‐structured	General surgery, ear, nose and throat, and orthopaedic	N = 145 87 women, 58 men Age 18–75 years	Resisting the sick role Limited ascription of the sick role—what do I tell my boss? Actively seeking the sick role
Greenslade et al. (2010) Canada	To investigate the lived experiences of women having same‐day breast cancer surgery	Unstructured interviews—telephone or in the participants' homes	Breast cancer	N = 13 Age 32–74 years All reported living with other family members	Preparation Timing Supports Community health nursing intervention Essence: coping
Rosen (2011) Sweden	The aim of this study is to describe patients' experiences and perceived causes of persisting discomfort following day surgery	Open‐ended questionnaire	General surgery, urology and orthopaedic	N = 298 women and men Age 18–88 years	Frequency of discomfort in Groups 1 (48 h), 2 (7 days) and 3 (3 months) Discomfort over time in Group 3 Types of discomfort in group 1 Types of discomfort in group 2 Types of discomfort in group 3 Factors leading to discomfort in Group 3 Impact on daily function on groups 1, 2 and 3
Flanagan (2009) USA	The research questions for this study were as follows: What is the recovery experience at 12, 24 and 72 h after same‐day outpatient knee arthroscopy? What information needs do patients identify in the recovery phase at home after same‐day outpatient knee arthroscopy and when in the recovery period do they identify these needs? How do patients describe the overall same‐day outpatient surgical experience related to knee arthroscopy and a postoperative same‐day outpatient surgery telephone program?	Open‐ended interview	Knee arthroscopy	N = 77 50 women, 27 men Aged 25–82 years	The patient experience after the first 12 h The patient experience at 24 h Added responsibilities and burden: role strain Vulnerable population The patient experience at 72 h
Mottram (2009) UK	The aim of the study was to examine the experiences of patients undergoing day surgery using the Grounded Theory approach	Semi‐structured	General surgery, ear, nose and throat, and orthopaedic	N = 145	Presence Extra special Befriending Comfort giving
Renholm et al. (2009) Finland	The research questions were: What are the important factors for patients in continuity of care in the ambulatory surgical critical pathway? How has continuity of care been implemented in the ambulatory surgical critical pathway? How should continuity of care in ambulatory surgery be improved? The ultimate goal was to improve the quality of ambulatory surgical nursing care	Interviews	Laparoscopic cholecystectomy, hernia operation	N = 25 9 women, 16 men Age 24–64	Important factors in the continuity of care in ambulatory surgery Implemented continuity of care in ambulatory surgical critical pathway How to improve the continuity of care in ambulatory surgery
Gilmartin and Wright (2008) UK	The aim of this study was to describe and interpret patients' experiences of contemporary day surgery	Unstructured interview	Gynaecology, urology and general surgery	N = 20 women and men Age 19–85 years	The feeling of empowerment during preparation The apprehensions encountered The feeling of abandonment in the preoperative waiting area The dynamics of recovery
Gilmartin (2007) UK	The aim of this study was to explore and reveal the patients' perceptions of discharge planning and recovery following day surgery	Unstructured interview	Gynaecology, urology, general surgery	N = 30 17 women, 13 men Age 19–85 years	Discharge arrangements Sense of pain, fatigue and skin discolouration Sense of swelling, bruising and voiding difficulty Sense of bleeding, mixed emotions and betterment
Hersht et al. (2007) Canada	The objective of our study was to investigate patient satisfaction with the experience	Open‐ended interviews	Lumbar microsurgical discectomy	N = 28 13 women, 15 men Aged 17–72 years	The overall experience was satisfactory The quality and amount of patient education was adequate Patients were surprised at the possibility of outpatient back surgery Trust in one's surgeon was important Postoperative pain was an issue
Gilmartin (2004) UK	To elucidate patients' perceptions of the preassessment preparation prior to day surgery	Interview	Gynaecology, urology and general surgery	N = 30 17 women, 13 men Age 19–85 years	Efficient functioning Assessment of patient suitability The experience of information giving The problem of cancellation
Markovic et al. (2004) Australian	We aim to (1) explore anxiety in the context of day surgery and (2) identify the issues pertinent to the experiences of day surgery patients	Semi‐structured interviews	Australian public hospital for women	N = 10 women	Anxiety and day surgery Post‐surgery experience Patient management Waiting time
Morgan et al. (2004) UK	The present study focused on patients' views regarding the provision of outpatient hysteroscopy with local anaesthetic	Semi‐structured interviews + diary	Hysteroscopy	N = 29 women Age 26–65 years	Attitude to general anaesthetic and hospitals Convenience Psychosocial aspects
Barthelsson, Lutzen, Anderberg, et al. (2003) Sweden	The aim of this study was to explore the patients' experiences related to this type of day surgical procedure	Interviews	Laparoscopic fundoplication	N = 7 2 women, 5 men Age 31–67 years	Living with GERD Anxiety and memory loss—experiences at the hospital on the day of surgery Pain and dysphagia—common experiences at home the first week after surgery A wish for a delayed period of follow‐up by the AMHC Return to the activities of daily life
Barthelsson, Lutzen, Anderberg and Nordstrom (2003) Sweden	The aim of this study was to explore patients' experiences related to this type of surgical procedure	Interviews	Laparoscopic cholecystectomy	N = 12 10 women, 2 men Age 28–60 years	Living with gallstone problems Experiences on the day of surgery Experiences at the first week after surgery Return to activities of daily life
Stevens et al. (2001) Australian	The aim of this research therefore is to build theory about the day surgery experience by examining the perceptions of group of women undergoing the same procedure; laparoscopic sterilisation	Semi‐structured interview	Laparoscopic sterilisation	N = 16 Only women Aged 26–42 years	Preoperative period (expectation of pain, doing the right thing, anxiety relief, privacy) The surgical period (privacy, pain) The postoperative recovery period (privacy during pain and nausea) On discharge At home (pain at home, return to normal, hubby a help or a hindrance)
Donoghue et al. (1997) Australian	The objective of the study was to report men's experiences of cystoscopic day surgery. The project aimed to: Determine aspects of the postoperative experience, such as difficulties with urination, discomfort, pain; emotional responses; limitations to normal activity; and duration of recovery Investigate if there was any difference in the reported experiences of men who had a cystoscopy in the day surgery unit for the first time, compared to those who have had previous day surgery cystoscopies Investigate patients' perceptions of their preparation for the procedure Investigate patients satisfaction with their day surgery experience	Semi‐structured interviews	Cystoscopy	N = 21 men	Patients' recovery Educational preparation Expectations of and satisfaction with the experience

Note: The table summarises the characteristics of the 34 articles included in the review. It includes details such as authors, publication year, design, context, participants, and findings.

3.5. Data Analysis and Synthesis

The synthesis was guided by a thematic analysis approach inspired by Thomas and Harden (2008), wherein findings from multiple qualitative studies were synthesised. The goal was to surpass the original intentions of the authors so as to gain new interpretations and insights (Thomas and Harden 2008). Drawing from Ricoeur's theory of interpretation (Ricoeur 1976, 1991; Pedersen ¹⁹⁹⁹), we employed a phenomenological–hermeneutical approach, enabling a thorough analysis and interpretation. This approach involves understanding and interpreting the lived experiences of individuals, allowing us to gain deep insights into their subjective experiences and the meanings they ascribe to them. By integrating patient quotations, researchers' interpretations and statements from the included articles into a unified text, we aimed to generate novel interpretations, consistent with Ricoeur's philosophy of understanding and interpretation, which involves the analysis of three levels: naïve reading, structural analysis and critical interpretation and discussion.

Initially, at the naïve reading level, we approached the unified text to grasp its meaning by repeatedly reading and gaining an overall understanding of the extracted data. The focus was on the surface meanings without interpretation to capture the general meaning (Pedersen 1999; Ricoeur ^{1976, 1991}). Subsequently, at the structural analysis level, we conducted a detailed, line‐by‐line examination of the text to identify units of meaning. This process involved breaking down the text to uncover underlying patterns and relationships, leading to the emergence of deeper layers of significance (Pedersen 1999, Ricoeur ¹⁹⁷⁶, Ricoeur ¹⁹⁹¹). Using Ricoeur's philosophy, we identified what the text says and what the text speaks about. The iterative dialectical process between the units of meaning and units of significance led to the emergence of themes based on the lived experience of day surgery (Pedersen 1999, Ricoeur ^{1976, 1991}). This process allowed us to achieve a nuanced understanding of the text's importance.

Finally, we conducted a critical interpretation and discussion of the identified themes, integrating relevant theory and research. Using Ricoeur's concept of distanciation, by stepping back to view the text objectively, we engaged in a critical reflection on the findings (Ricoeur 1976). This involved examining the themes from a broader perspective involving theory in nursing. This phase of the analysis is presented in the discussion, where we further explore the implications of the themes and their significance within the context of day surgery. The Ricoeur‐inspired analysis was primarily conducted by the first and second authors, with findings subsequently discussed with the other authors. The emerging themes were refined and agreed upon through a collaborative process, involving discussions and consensus‐building among all authors in the iterative process of the analysis to ensure consistency and rigor.

3.6. Ethics

All the included articles had undergone ethical review and adhered to relevant ethical considerations, as indicated by the authors, in accordance with the standards for qualitative research.

4. Results

The comprehensive literature search resulted in 3776 papers, of which 482 were identified as duplicates. Following the screening of titles and abstracts, 74 papers were selected for full‐text review, and of these, 32 were included in the review and underwent the forward and backward citation search. During the full‐text review, we identified two additional studies, which were included in the study. Thus, a total of 34 studies were included (see Table 1). The PRISMA flowchart visually represents the stages of the review process, resulting in a dataset comprising 151 pages ¹ of data for analysis.

5. Findings

The naïve reading of the text revealed that the patients' experiences of day surgery were closely related to information, preparation, support and the complexity of the operation.

Four themes emerged through the structural analysis: (1) ‘Perceptions of the day surgery concept shape patient expectations’, (2) ‘Navigating expectation and reality: Surprises and challenges in day surgery’, (3) ‘Navigating through postoperative recovery: Feelings of responsibility and insecurity following day surgery’ and (4) ‘The vital role of support from both family and professionals during recovery after day surgery’.

The findings are presented in order of their relation to one another as they are closely related. The quotations in the findings represent both author reflections from the cited studies and direct citations from patients, each underlining the themes identified in the analysis. For an example of the analysis, see Table 3.

TABLE 3.

Example from the analysis process.

Units of meaning	Units of significance	Theme
‘When the prescribed pain medication was insufficient, participants tried to solve the problem themselves by asking family members or friends if they had other pain medication’ (Nilsson et al. 2020) ‘“They asked me if I lived with anyone who could help me out, and I said, “Yeah, I have roommates.” Well, they yelled in to me this morning sometime and asked if I was OK. They've been gone all day and are at a party tonight. I crawled to the bathroom, haven't eaten all day, and haven't moved from my bed. My family is halfway across the country. I have no one except for you”’ (Flanagan 2009) ‘“the caregiver needs to monitor it [pain medication]. You don't know the first few days if you have taken it or not”’ (Odom‐Forren et al. 2018)	Patients often rely on their family members for help and care during their recovery process, drawing upon their experiences and support. Additionally, they may seek guidance from peers to navigate their journey Patients who lack a support network may encounter difficulties in the recovery process, as they may not have access to the assistance and guidance provided by family members or peers Additionally, support from specialists is crucial in addressing the needs of these patients	The vital role of family and professional support in day surgery recovery
‘Others had previous knee surgery and took advantage of their experience or consulted the internet or fellow knee patients for advice’ (Halding et al. 2021) ‘The participants had received advice from their friends and relatives on how to handle issues and symptoms’ (Dahlberg et al. 2018) ‘Most patients were aware that they could use stool softeners to aid with constipation. Some had received prescriptions before discharge. Others were told by friends who had previously undergone surgery or by family members’ (Odom‐Forren et al. 2017)
‘The patients, above, all spoke of the need for ‘someone’ to call in on them, preferably a nurse to give them advise or just to reassure the patient and their carers that what were perceived to be complications of surgery by the patients and their families were normal reactions to a surgical assault on the body’ (Mottram 2011c)

Note: The table provides an example of the analysis process, showing the progression from ‘Units of meaning’ to ‘Units of significance’ and the emerge of a theme. It demonstrates how raw data is transformed into significant insights through systematic analysis.

5.1. Perceptions of the Day Surgery Concept Shape Patient Expectations

Patients have predefined expectations for their day surgery experience. These expectations are notably influenced by their perception of what day surgery entails. This is exemplified in the following quotations:

Other patients did not prepare themselves at all. Reasons for this could include enthusiasm for a long‐awaited procedure, expected pain relief, or simply the assumption that a day surgical procedure ought to be minor and should not require preparation…. Since it was supposed to be a simple operation, I didn't look up anything special about it. Author Reflection (Berg et al. 2013)

Most suggested that they had to return to normal duties immediately so were not given any opportunity to “mope around and feel sorry for themselves”. Author Reflection (Stevens et al. 2001)

The concept of day surgery carries predefined expectations that significantly influence perceptions of navigating through the day surgery pathway. Day surgery is perceived as a minor and straightforward procedure, which can lead one to neglect the importance of preparation for the postoperative period. The perception of day surgery is minor, regardless of the magnitude of the operation, with an assumption that if it can be completed within a day, it must be relatively insignificant.

In terms of expectations, there is an anticipation of immediately resuming everyday life after surgery. Moreover, societal discourse and perceptions associate day surgery with rapid recovery or minimal operation complexity, shaping expectations regarding the day surgery pathway. Indeed, both the patients and their surroundings are influenced by the preconception of day surgery as a predetermined concept. Families and workplaces also tend to share the notion that avoiding hospitalisation implies quick or minimal recovery.

In addition, the concept of day surgery implies an expectation of an efficient patient pathway. Patients describe this, noting both positive and negative associations with it.

Most were very pleased with the coordination of all aspects of their care on the day of the surgery. A major facet of patient satisfaction was that each department ran in a timely and efficient manner. Author Reflection (Hersht et al. 2007)

Some patients felt like objects—metaphorically mentioned as cars on a conveyor belt or a parcel sent here and there—and exceptions to organisational rules were unusual. Others experienced stress because of an organisation with tight time schedules; this experience of stress made them feel they were being “kicked out” of the surgery unit. Author Reflection (Berg et al. 2013)

Overall, there is satisfaction with the coordination of the pathway on the day of surgery, emphasising the efficient functioning of each unit. However, there are instances where patients describe a feeling of being dehumanised, comparing their pathway to being processed like objects on a conveyor belt or parcels sent between locations. Furthermore, while exceptions to organisational rules are rare, tight time schedules can cause stress, leading to feelings of being rushed or prematurely discharged from the surgery unit. This efficiency also fosters a sense among patients of not wanting to disturb the hospital after discharge.

The threshold for initiating contact was high. Some said they would have made the call if “something serious” occurred but doubted that the problems they actually experienced were important enough to warrant bothering the hospital. The doctors and nurses all seemed so busy, and they all did a great job. The patients were therefore hesitant to trouble them again. Author Reflection (Halding et al. 2021)

Despite the patients experiencing problems, there is a reluctance to reach out to healthcare professionals as there are uncertainties about the significance of their concerns. This hesitancy is influenced by perceptions of busy healthcare professionals and a system that does not encourage additional requests. Consequently, there can be a barrier to effective communication and follow‐up care, arising from a reluctance to bother healthcare professionals.

Just as patients hold specific expectations regarding the concept of day surgery, they also maintain expectations regarding being inpatients. When patients compare the day surgery pathway with being inpatients, they express concerns about risking their integrity. This emphasises the patients' anticipation of maintaining their integrity throughout the day surgery process.

The perception of day surgery as efficient and simple influences expectations and experiences of the pathway. Expectations of an efficient pathway, shaped by comparisons with inpatient experiences and societal perceptions of quick recovery or surgery simplicity, shape patients' approach to day surgery and contribute to a reluctance to disrupt hospitals post discharge. However, the reality is that day surgery today is not always simple, and recovery is not guaranteed to be quick. This situation exposes patients to potential risks and uncertainties as they are unprepared for the recovery period, leaving them vulnerable to unforeseen challenges and lacking adequate support and guidance.

5.2. Navigating Expectation and Reality: Surprises and Challenges in Day Surgery

Patients often express surprise upon discovering that their surgery can be conducted on a day surgery basis, especially if they had expected to require inpatient care afterward. This shift in perception often stems from the realisation that the procedure, previously perceived as fearsome, becomes less daunting when envisioned as day surgery.

Most began to perceive the procedure as less fearsome than an inpatient procedure might be. “I was very excited about the fact that it was day surgery…. How could you possibly have major or invasive surgery if you are not being kept in the hospital?” Patient, and Author Reflection (Hersht et al. 2007)

During the diagnosis and pre‐operative period, some women learned that the operation would be completed as day surgery and reacted with shock. One woman said, “When he [the doctor] said day surgery, I said, ‘What!’ and he said, ‘Oh yes, a couple of hours, and you'll be in and out.’ And it took me aback, you know”. Another woman said, “I was shocked that it was going to be done in day surgery”. Patient, and Author Reflection (Dawe et al. 2014)

Perceptions of day surgery impact the experience and readiness for the procedure. The surprise expressed by patients upon discovering that their surgery can be conducted on a day surgery basis contrasts with the anticipation of requiring inpatient care afterwards. However, the perception of day surgery as simple contributes to underestimating its significance. This may lead to inadequate preparation for postoperative recovery at home, posing potential challenges.

This expectation also affects their willingness to accept the sick role and seek assistance, as shown in the following quotations:

A forceful reason for preferring day surgery was caring responsibilities patients felt towards significant family members. Eleven of the patients interviewed were over the age of 66 years. Several of these had either ill partners or dependent parents. Although they had been in pain for some time, they had delayed surgery because of concern for their loved ones' well‐being. As well as caring for the elderly, the worry of caring for young children was also a strong reason for choosing day surgery. Author Reflection (Mottram 2012)

I had decided to work the day after the operation because I do not need to move much at work—no heavy lifting, but I wouldn't have managed because of the pain.

Patient (Barthelsson, Lutzen, Anderberg, et al. ²⁰⁰³)

Following day surgery, there is often a struggle with accepting the sick role, a difficulty influenced by initial expectations of the procedure. There exists an expectation of how long recovery will take, which results in surprise when the recovery exceeds their expectations. This experience is connected to the idea that day surgery equals same‐day recovery. Despite efforts by some nurses or units to convey otherwise, the patients struggle to release the preconceived notion of quick recovery.

My expectations were I would be mobile and able to care for myself and make my own meals. The reality was I was confined to bedroom and nearby bathroom. Patient (Bryson et al. 2014)

Paul was determined he was not going to be ill. He was resolute in his intention to get back to work as soon as possible. When telephoned 48 h after surgery, he reported that he was feeling “very poorly”. Despite day surgery staff taking time to explain that “same day surgery does not mean same day recovery”, one man had difficulty with this concept:

That nurse in pre‐op assessment … she tried to tell me, she said I would be laid up for 6 weeks. I wasn't having any of it. I thought they would not be doing this in a day if I was going to be that bad. I just wasn't ready to listen. Patient, and Author Reflection (Mottram ^2011b)

The concept of day surgery contradicts expectations, exposing disparities between anticipated and actual outcomes. Some patients are surprised by the possibility of day surgery, anticipating postoperative inpatient care. Moreover, there is difficulty in assuming the sick role after day surgery, influenced by their preconceived ideas about recovery time. Despite healthcare professionals' attempts to communicate the reality of longer recovery periods, patients persist in expecting immediate postoperative recovery, thereby influencing the experiences of day surgery.

In summary, expectations significantly influence experiences and preparations for day surgery, often leading to surprise and difficulty in assuming the sick role postoperatively. This theme of navigating expectation and reality underscores the importance of effective communication and patient education.

5.3. Navigating Through Postoperative Recovery: Feelings of Responsibility and Insecurity Following Day Surgery

Preparation and information provided by the hospital are crucial for the experience of undergoing day surgery. Patients benefit from both oral and written information, which complement each other effectively. The timing of information in relation to preparation, operation, anaesthesia and discharge is also essential.

After discharge from day surgery, patients experience a variety of symptoms, with pain and nausea being the most common. In addition, they encounter issues such as bowel symptoms, voiding difficulties, inability to sleep, immobilisation and wound and skin care, all requiring the patients' attention. Some postoperative symptoms prove to be more challenging for patients to manage than the operation itself. Emotional imbalance and fatigue are two such difficulties that patients must understand and address. These symptoms are more concealed and present greater challenges as they are not purely physiological.

Some participants described an emotional transition from being very energised and positive immediately after the surgery to experiencing a setback after this positive period and described it as being “wound up … then, some days later, you lose your breath”. Patient, and Author Reflection (Nilsson et al. 2020)

The failure to address psychological issues left a number of participants struggling to cope, and they displayed feelings of depression, anxiety, and loneliness, exemplified in the following statement: “I cried and cried: that's the sort of effect it had on me”. Patient, and Author Reflection (Mccloud et al. 2012)

Emotional and psychological experiences following surgery, particularly related to coping with emotional transitions—feelings of depression, anxiety, loneliness and sadness—significantly impact energy levels and participation in daily activities. These emotional experiences catch the patients off guard, leading to symptoms of depression without any information regarding these symptoms.

Further, there is insecurity when managing self‐care, particularly when lacking the knowledge to handle problems efficiently. This insecurity brings distress and worries, triggering anxiety and concerns. Patients, furthermore, express a sense of responsibility for ensuring the recovery process proceeds correctly and on time.

When contacted, the patients wanted to have their actual health status confirmed and an opportunity to discuss the progression of their recovery and specific postoperative issues. Author Reflection (Berg et al. 2013)

Participants experienced feelings of being unsafe when they did not know if their recovery trajectory was proceeding as expected. In cases where the recovery was perceived as longer than expected or where participants did not know what to do to recover properly, feelings of both frustration and insecurity occurred. Author Reflection (Larsson et al. 2022)

Upon discharge, patients desire confirmation of their actual health status and an opportunity to discuss the progression of their recovery and specific postoperative issues. In cases where recovery seems longer than expected or where patients feel uncertain about the proper course of action, frustration and insecurity arise.

The participants experienced that insufficient information and support as well as lack of acknowledgment from health care created a feeling of being forsaken. This lack of support and information left them by themselves to deal with their worries about symptoms and distress, and this made them feel abandoned by the healthcare service. Author Reflection (Dahlberg et al. 2018)

Insufficient information and support from healthcare professionals create a feeling of abandonment. This lack of support leaves patients to deal with symptoms and distress on their own, making their suffering, worries and symptoms worse. Just as the lack of support affects recovery at home, experiences are also influenced by earlier encounters.

In light of these considerations, hospital‐provided preparation and information for day surgery patients emerge as essential elements, highlighting the importance of both oral and written formats and the critical need for timely delivery. Postoperatively, a myriad of symptoms, ranging from pain and nausea to emotional imbalances and fatigue, often prove more challenging to manage than the operation itself. This prompts feelings of insecurity among those lacking the knowledge to handle self‐care efficiently, compounded by a profound sense of responsibility for the recovery process. Furthermore, the absence of acknowledgment and support from healthcare professionals exacerbates feelings of abandonment and distress.

5.4. The Vital Role of Support From Both Family and Professionals During Recovery After Day Surgery

Patients undergoing day surgery highlight the significance of familial support in managing postoperative care at home.

In short, the participants expressed the need for and benefit of practical and emotional support both from their family and friends and from professionals to facilitate their self‐management. Author Reflection (Halding et al. 2021)

Additionally, one patient shared the following:

Just to take a shower was so hard in the beginning. I needed help from my husband to deal with my personal hygiene: to take showers and to wash my hair, things that are hard to do with only one arm available. It has been hard accepting that. I am used to fending for myself. Patient (Larsson et al. 2022)

The experiences highlight the critical role of family support in addressing both practical challenges and emotional needs during the recovery period. As illustrated by the quotations, there is a struggle with simple tasks, such as those involving personal hygiene, and expressing the need for emotional support, emphasising the indispensable nature of familial assistance for comprehensive care in the recovery period.

Patients lacking familial or robust support networks face considerable challenges in managing their recovery without assistance. One patient recounted the following:

They asked me if I lived with anyone who could help me out, and I said, “Yeah, I have roommates”. Well, they yelled in to me this morning sometime and asked if I was OK. They've been gone all day and are at a party tonight. I crawled to the bathroom, haven't eaten all day, and haven't moved from my bed. My family is halfway across the country. I have no one except for you. Patient (Flanagan 2009)

This highlights the profound isolation and vulnerability experienced by patients without immediate support, accentuating the critical need for accessible assistance and a strong support network.

Patients, whether they have familial support or not, may initially attempt to manage self‐care tasks independently. However, given the lack of necessary knowledge or resources, situations may deteriorate. For instance, some patients refrain from fluid or food intake because of pain, finding it challenging to leave their resting places, resulting in complications such as bowel dysfunctions and muscle loss. Patients express distress about having to manage their recovery on their own, highlighting the critical role of phone calls from the department or visits from community health nurses.

In particular, the role of the community health nurse (CHN) was critical to their recovery at home. One woman said, “Every day I was in contact with her [CHN] for two weeks. So … that was a kind of secure feeling … cause you know that if anything came up, there was someone. I always had the feeling that there was someone I could rely on”. Another woman stated, “They [the CHN] came every second day, and that was really … I mean to me, that was better than staying in the hospital”. Patient, and Author Reflection (Dawe et al. 2014)

Insecurity causes distress and creates a need of reassurance from healthcare professionals or peers. This underscores the varying levels of support needed by patients but highlights the consistent need for reassurance during the home recovery period, which healthcare professionals play a crucial role in providing.

There is a necessity for support from families, peers or healthcare professionals for optimal recovery as patients may struggle with self‐care postoperatively. Support from family members is recognised as crucial for managing care at home. There are feelings of insecurity and a need for support and reassurance from healthcare professionals or peers to navigate the recovery journey effectively. This underscores the importance of both professional and peer support systems in addressing physical, emotional and psychological needs during the recovery process.

6. Discussion

The findings in this review provide new insights into the experiences of the day surgery pathway, demonstrating how perceptions of day surgery significantly influence patients' experiences. While patients express satisfaction with the day surgery pathway, their expectations of a simple procedure and quick recovery often conflict with the reality of undergoing day surgery. During the postoperative period, patients struggle with both physical and emotional symptoms related to the operation. They experience distress and insecurity about the recovery plan and feel a heavy responsibility for its timely progression. Navigating day surgery demands substantial family support. Patients often require assistance from healthcare professionals or peers to manage the complexity of postoperative care and the recovery trajectory.

6.1. Patient Satisfaction

Patients' satisfaction with day surgery is notable given its importance in evaluating healthcare service quality. However, patients report a high responsibility for recovery and the need for assistance in managing postoperative self‐care. Therefore, further investigation into the factors contributing to satisfaction within the day surgery concept is relevant.

Satisfaction is intricately tied to patients' expectations (Kalaja 2023). These expectations are socially and culturally constructed as well as influenced by individual perceptions and context (Janzen et al. 2006). Despite the conflict between patients' expectation of rapid recovery and the actual complexity of the process, the common perception of day surgery as a predetermined concept appears to contribute to patients' overall satisfaction with the experience. This perception is shaped by the community and time. However, measuring satisfaction is complex, and high satisfaction does not necessarily equate to high‐quality care delivery (Kalaja 2023). Patients may express satisfaction with the day surgery pathway given factors such as convenience, reduced hospital stays and perceived efficiency, aligning with their preconceived expectations. However, expectations have both cognitive and affective origins. Patients' expectations as a cognitive cause relate to the services they anticipate receiving (Thompson and Suñol 1995). Satisfaction with day surgery can thereby be superficial and primarily cognitive, based on initial expectations of simplicity and no expectation of care from healthcare professionals at home. This expectation aligns well with the actual care provided by the hospital and the reduced hospital stay, resulting in no conflict between experience and expectation. Nevertheless, when their expectations conflict with the reality of complex recoveries, patients experience emotional distress and insecurity, revealing a gap between cognitive satisfaction and emotional well‐being.

Using satisfaction as the sole measure in healthcare systems can fail to capture the nuanced emotional experiences and challenges patients face as it only measures the structured aspects of the patient pathway. The patient journey refers to the complete patient experience within the healthcare system and encompasses patients' experiences of the emotional and physical journey as well as the touchpoints with the healthcare system (Beleffi et al. 2021).

6.2. The Nursing Process in a Day Surgery Setting

Our review demonstrates that patients struggle with both physical and emotional symptoms in the postoperative period at home after day surgery. Nursing care is a complex factor that encompasses both physical and emotional support. It is defined as follows: ‘To assist the individual, sick or well, in the performance of those activities contributing to health or its recovery (or to peaceful death) that he would perform unaided if he had the necessary strength, will, or knowledge’ (Kitson et al. 2013). In other words, nursing care extends beyond performing tasks for patients to recognising patients' self‐care needs and providing support or education when previously straightforward tasks become challenging for the patient.

Day surgery embodies patient participation, engaging and empowering patients' self‐care capacity. However, for effective patient empowerment, patients need to feel capable of managing the care responsibilities they assume. This requires effective communication, education and cooperation with the healthcare professionals (Mbamalu et al. 2021). Many symptoms patients struggle with at home after day surgery can be alleviated by nurses as these symptoms often relate to basic needs and well‐being and are the target of nursing interventions (Kitson et al. 2013). Furthermore, preoperative and postoperative nursing care has evolved significantly, with evidence‐based guidelines designed to promote rapid patient recovery. These guidelines ensure patient safety and comfort, and the nursing process facilitates continuous and adequate care planning throughout a hospital stay. Within the nursing process of developing care plans, a systematic guide consisting of five steps (assessment, diagnosis, planning, implementation and evaluation) can be used (Toney‐Butler and Thayer ²⁰²⁴). These need to be continuously adjusted to provide optimal support for the patients. However, patients and their relatives often lack the necessary competencies to effectively perform this nursing process, which involves assessing self‐care needs, implementing interventions, evaluating outcomes and adjusting the care plan. Critical thinking skills and professional knowledge are essential for developing an effective care plan for patients. Without knowledge, training, or assistance, patients and their relatives may struggle to navigate the care challenges on their own. This discrepancy underscores the importance of providing adequate professional support to bridge the gap in care during the postoperative period at home. If the symptoms and challenges experienced by patients undergoing day surgery were compared with those of inpatients, these patients would likely not be discharged. Patients undergoing day surgery often encounter challenges with pain management, bowel function, nutrition and ambulation, which would typically necessitate continued inpatient care to ensure proper management and recovery (Kalisch 2006; Jones et al. ²⁰¹⁵). Furthermore, emotional distress following surgery can necessitate nursing care to support recovery. Patients often experience feelings akin to depression, which can be a normal reaction to surgery, medications and physical stress (O'Hara et al. ¹⁹⁸⁹). They require guidance on managing rest and activity, as they may be unprepared for this aspect of recovery.

A recent meta‐ethnography by Thoen et al. (2024) on patients' experiences with day surgery and recovery concludes that there is a need to improve information for the provision of better preparation of patients for the surgery and recovery processes, thereby enhancing their self‐care abilities. The study corroborates the findings in our synthesis, particularly emphasising the importance of enhancing information, preparing patients for self‐care during the postoperative period and assessing patients' home conditions and access to assistance from family and friends.

7. Strengths and Limitations

A limitation of this study is the challenge of identifying the complete body of relevant literature. We may not have identified the entire body of literature available on this topic as locating all qualitative studies can be challenging given the lack of detailed thesaurus terms (Lockwood et al. 2020), compounded by the diverse definitions and terminology used in qualitative research. Furthermore, we only included studies written in English and Scandinavian languages, possibly resulting in the exclusion of relevant literature. Another limitation is that research in this area has been sparse, leaving some experiences undocumented in the literature. However, given the interpretive nature of the study, locating every available study is not essential as the aim is to provide an explanatory interpretation rather than a predictive analysis, offering insight into what can be at stake for the patients in the day surgery setting.

A strength of the review is the use of a protocol, ensuring a systematic and structured approach to the review process. Additionally, involving a research librarian from the University of Southern Denmark in the search strategy ensured comprehensive and efficient identification of relevant literature as well as improved the overall quality of the search process. Having two authors participate in the selection process and analysis reduced bias and further enhanced the review's rigour.

The research findings from primary qualitative studies are the researchers' representations of the experiences told to them by the research participants; they are, thus, told experiences retold (Sandelowski and Barroso 2007). Qualitative research syntheses are at least three times removed from the lived experiences of the research participants they aim to represent (Sandelowski and Barroso 2007), which can be a limitation. However, this is a well‐recognised limitation in the field of qualitative reviews, which can be accepted in light of the nature of analysing lived experiences. Such analyses inevitably move away from individual accounts to identify broader, overarching themes. In the context of Ricoeur's theory of interpretation, the unified text has its own story to tell. It is no longer about what the text says but what it speaks about (Pedersen 1999). Thus, the analysis gathers all studies and makes visible what emerges in the text, regardless of the specific surgery, and provides insights into the experiences of patients undergoing day surgery as a concept.

The wide range of included studies is a strength as we interpreted all the findings following Ricoeur's interpretation theory as a unified text, providing insights into patients' experiences across the entire body of day surgery procedures. However, 34 studies on patients' experiences may not be much considering they encompass all identified studies of patients' experiences in the day surgery pathway, regardless of the specific procedures involved. This highlights a potential gap in the literature regarding comprehensive exploration of the lived experiences of patients undergoing day surgery.

The recent systematic review by Thoen et al. addressed a similar research question (Thoen et al. 2024). However, our review included 34 studies, offering a large amount of data to substantiate the analysis and conclusion. In our synthesis, we included not only studies with interview data but also diary notes and open‐ended questionnaires, where the participants have written about their experiences. Our inclusion criteria were broad, allowing us to capture a wide range of studies and providing a different scope of analysis. Moreover, we employed a different analysis method. While Thoen et al. utilised a meta‐ethnography to guide their review, we employed thematic synthesis to guide ours and applied Ricoeur's theory of interpretation in analysing the findings. This approach makes our review phenomenological‐hermeneutical in orientation, offering inductive themes and an interpretation that goes beyond the primary studies. Our findings and discussion reflect and extend the conclusions of Thoen et al., particularly in areas such as nursing, offering additional evidence and a nuanced understanding of the patients' experiences of day surgery.

8. Conclusion

Our findings emphasise that patients' perceptions of day surgery significantly influence their overall experience and satisfaction. While patients generally express satisfaction, this often stems from initial expectations of simplicity and rapid recovery. However, this perception may not align with the complex reality of the recovery process as patients experience distress and insecurity during the postoperative recovery phase.

The recovery process involves both physical and emotional self‐care needs. Patients often experience these needs going unmet in the absence of adequate patient and family care competencies, underscoring the important role of nursing care or information in bridging these gaps. There is a need to focus on patient education and information provision, including assessing patients' home conditions and ensuring access to support from family, friends and healthcare professionals.

In conclusion, our synthesis provides insights into the multifaceted experiences and perspectives of patients undergoing day surgery. It highlights the influence of patient perceptions on satisfaction, the disparity between expectations and the complex reality of recovery, and the critical role of nursing care and information provision in addressing patients' physical and emotional needs. There is a potential for enhanced patient education, assessment of home conditions and support from family, friends and healthcare professionals throughout the day surgery pathway. These findings underscore the importance of adopting a holistic approach that comprehensively addresses patient expectations, challenges and support requirements.

8.1. Relevance to Clinical Practice

This review underscores the importance of incorporating patients' experiences into the planning and execution of day surgery pathways. Clinical practice should prioritise enhanced preoperative counselling and provide continuous support to address patients' insecurities about postoperative self‐care at home. Collaboration with patients and their families is essential to ensure that they receive the ongoing support needed throughout the recovery process. By adjusting protocols and patient education to better address the specific needs and expectations of patients undergoing day surgery, healthcare providers can foster a more patient‐centred care model, ultimately enhancing patient satisfaction and improving clinical outcomes.

Conflicts of Interest

The authors declare no conflicts of interest.

Supporting information

Data S1.

Appendix A.

Search History in EMBASE

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73	Nonparticipant observation.mp. [mp=title, abstract, heading word, drug trade name, original title, device manufacturer, drug manufacturer, device trade name, keyword heading word, floating subheading word, candidate term word]
74	non experimental studies.mp. [mp=title, abstract, heading word, drug trade name, original title, device manufacturer, drug manufacturer, device trade name, keyword heading word, floating subheading word, candidate term word]
75	non experimental study.mp. [mp=title, abstract, heading word, drug trade name, original title, device manufacturer, drug manufacturer, device trade name, keyword heading word, floating subheading word, candidate term word]
76	nonexperimental studies.mp. [mp=title, abstract, heading word, drug trade name, original title, device manufacturer, drug manufacturer, device trade name, keyword heading word, floating subheading word, candidate term word]
77	nonexperimental study.mp. [mp=title, abstract, heading word, drug trade name, original title, device manufacturer, drug manufacturer, device trade name, keyword heading word, floating subheading word, candidate term word]
78	observation studies.mp. [mp=title, abstract, heading word, drug trade name, original title, device manufacturer, drug manufacturer, device trade name, keyword heading word, floating subheading word, candidate term word]
79	observation study.mp. [mp=title, abstract, heading word, drug trade name, original title, device manufacturer, drug manufacturer, device trade name, keyword heading word, floating subheading word, candidate term word]
80	observational studies.mp. [mp=title, abstract, heading word, drug trade name, original title, device manufacturer, drug manufacturer, device trade name, keyword heading word, floating subheading word, candidate term word]
81	participant observation.mp. [mp=title, abstract, heading word, drug trade name, original title, device manufacturer, drug manufacturer, device trade name, keyword heading word, floating subheading word, candidate term word]
82	Participation observation.mp. [mp=title, abstract, heading word, drug trade name, original title, device manufacturer, drug manufacturer, device trade name, keyword heading word, floating subheading word, candidate term word]
83	narrative.mp. [mp=title, abstract, heading word, drug trade name, original title, device manufacturer, drug manufacturer, device trade name, keyword heading word, floating subheading word, candidate term word]
84	Narratives.mp. [mp=title, abstract, heading word, drug trade name, original title, device manufacturer, drug manufacturer, device trade name, keyword heading word, floating subheading word, candidate term word]
85	Ethnography.mp. [mp=title, abstract, heading word, drug trade name, original title, device manufacturer, drug manufacturer, device trade name, keyword heading word, floating subheading word, candidate term word]
86	Ethnographic research.mp. [mp=title, abstract, heading word, drug trade name, original title, device manufacturer, drug manufacturer, device trade name, keyword heading word, floating subheading word, candidate term word]
87	Ethnological research.mp. [mp=title, abstract, heading word, drug trade name, original title, device manufacturer, drug manufacturer, device trade name, keyword heading word, floating subheading word, candidate term word]
88	Ethnonursing research.mp. [mp=title, abstract, heading word, drug trade name, original title, device manufacturer, drug manufacturer, device trade name, keyword heading word, floating subheading word, candidate term word]
89	Hermeneutics.mp. [mp=title, abstract, heading word, drug trade name, original title, device manufacturer, drug manufacturer, device trade name, keyword heading word, floating subheading word, candidate term word]
90	phenomenology.mp. [mp=title, abstract, heading word, drug trade name, original title, device manufacturer, drug manufacturer, device trade name, keyword heading word, floating subheading word, candidate term word]
91	phenomenologic research.mp. [mp=title, abstract, heading word, drug trade name, original title, device manufacturer, drug manufacturer, device trade name, keyword heading word, floating subheading word, candidate term word]
92	phenomenological research.mp. [mp=title, abstract, heading word, drug trade name, original title, device manufacturer, drug manufacturer, device trade name, keyword heading word, floating subheading word, candidate term word]
93	phenomenological study.mp. [mp=title, abstract, heading word, drug trade name, original title, device manufacturer, drug manufacturer, device trade name, keyword heading word, floating subheading word, candidate term word]
94	thematic analysis.mp. [mp=title, abstract, heading word, drug trade name, original title, device manufacturer, drug manufacturer, device trade name, keyword heading word, floating subheading word, candidate term word]
95	15 or 16 or 17 or 18 or 19 or 20 or 21 or 22 or 23 or 24 or 25 or 26 or 27 or 28 or 29 or 30 or 31 or 32 or 33 or 34 or 35 or 36 or 37 or 38 or 39 or 40 or 41 or 42 or 43 or 44 or 45 or 46 or 47 or 48 or 49 or 50 or 51 or 52 or 53 or 54 or 55 or 56 or 57 or 58 or 59 or 60 or 61 or 62 or 63 or 64 or 65 or 66 or 67 or 68 or 69 or 70 or 71 or 72 or 73 or 74 or 75 or 76 or 77 or 78 or 79 or 80 or 81 or 82 or 83 or 84 or 85 or 86 or 87 or 88 or 89 or 90 or 91 or 92 or 93 or 94
96	14 and 95

Data Availability Statement

The data that support the findings of this study are derived from published journal articles, all of which are publicly available and referenced in the article.