<![CDATA[Postoperative recovery is commonly evaluated through complications and length of hospital stay, whereas the restoration of independence in daily activities and the ability to manage care at home may occur on a different trajectory. This narrative review synthesizes evidence published through 2025 on determinants, assessment, and nursing-sensitive strategies for functional independence and self-care among adults undergoing surgery. A targeted literature review of peer-reviewed studies, evidence syntheses, and perioperative guidelines was undertaken using PubMed-indexed records and publisher-hosted literature, prioritizing established Scopus-indexed journals. Studies were synthesized descriptively across functional decline, prehabilitation, early mobilization, rehabilitation, discharge education, and postoperative follow-up. Cohort studies demonstrate that functional decline is frequent among older patients and is associated with frailty, malnutrition, postoperative complications, and unfavorable postdischarge outcomes. Prehabilitation and enhanced recovery pathways can support recovery, but improvements in walking performance, complication rates, or length of stay do not necessarily demonstrate independence in basic activities of daily living. In randomized trials, structured rehabilitation improved ambulatory independence after hip fracture surgery, while nurse-led and teach-back-based education improved surgery-specific self-management skills among patients with stomas. Evidence remains heterogeneous across procedures, outcome measures, and observation periods. Perioperative nurses should assess baseline function, provide graded and safe mobilization, directly evaluate task-specific self-care competence, involve caregivers in discharge planning, and arrange individualized follow-up. Future studies should distinguish functional independence from mobility, discharge readiness, and self-efficacy and measure these outcomes longitudinally.]]>
