Assessing Awareness and Attitudes Toward Enhanced Recovery After Surgery (ERAS) Protocols Among Surgeons in Palestinian Hospitals: A Cross-Sectional Study

Background Enhanced Recovery After Surgery (ERAS) is a multidisciplinary, evidence-based set of perioperative care protocols designed to reduce surgical stress, optimize recovery, and improve patient outcomes. It integrates practices such as early mobilization, optimized pain control, reduced fasting, and goal-directed fluid therapy, requiring collaboration among surgeons, anesthesiologists, nurses, and allied health professionals. This study aimed to assess surgeons’ awareness, attitudes, and acceptance of ERAS protocols and to identify factors influencing their adoption in Palestinian hospitals. Methods A cross-sectional study was conducted among 143 surgeons working in governmental, private, and teaching hospitals. Data were collected using a structured, self-administered questionnaire developed through a literature review and validated by an expert panel. Reliability testing demonstrated strong internal consistency (Cronbach’s α = 0.88 overall). Descriptive statistics summarized demographic characteristics, awareness, and attitudes, while ordinal logistic regression analysis was used to identify predictors of ERAS acceptance. Results Surgeons demonstrated high awareness of core ERAS principles, particularly early mobilization (84.6%), early urinary catheter removal (82.5%), and intraoperative thermoregulation (80.4%). Awareness of preoperative carbohydrate loading (67.1%) and goal-directed fluid therapy (72.7%) was comparatively lower. Attitudes toward ERAS were generally positive, with most surgeons recognizing its potential to improve patient outcomes, reduce complications, and enhance satisfaction. Regression analysis showed that concern about increased team workload was the only significant predictor of lower ERAS acceptance (β = −1.12, p = 0.011). Conclusions Surgeons in Palestinian hospitals conceptually support ERAS and acknowledge its benefits; however, practical barriers, particularly concerns related to team workload, limit its broader adoption. Addressing these challenges requires institutional support, adequate staffing, and strengthened multidisciplinary collaboration.