Preparing for colorectal surgery: a qualitative study of experiences and preferences of patients in Western Canada

BMC Health Services Research

Research

Christopher Yao¹  Jason M. Sutherland²  Ahmer Karimuddin³  Kristin L. Campbell⁴  Logan Meyers⁵  Stanley H. Hung⁵  Rebecca Wang⁶  Annalijn I. Conklin⁷ 

[1] Centre for Health Evaluation and Outcome Sciences, Providence Health Care Research Institute, Vancouver, Canada;Department of Occupational Therapy, University of British Columbia, Vancouver, Canada;Centre for Health Evaluation and Outcome Sciences, Providence Health Care Research Institute, Vancouver, Canada;School of Population and Public Health, Centre for Health Services and Policy Research, University of British Columbia, Vancouver, Canada;Colorectal Surgery, St. Paul’s Hospital, Providence Health Care, and General Surgery Residency Training Program at the University of British Columbia, Vancouver, Canada;Department of Occupational Therapy, University of British Columbia, Vancouver, Canada;Department of Physical Therapy, University of British Columbia, Vancouver, Canada;Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, Canada;Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, Canada;Centre for Health Evaluation and Outcome Sciences, Providence Health Care Research Institute, Vancouver, Canada;

关键词: Preoperative care;    Prehabilitation;    Colorectal cancer;    Abdominal surgery;    Quality improvement;   

DOI  :  10.1186/s12913-022-08130-y

 received in 2021-10-28, accepted in 2022-05-16,  发布年份 2022

来源: Springer

【 摘 要 】

ObjectivesThe burden and costs of abdominal surgery for chronic conditions are on the rise, but could be reduced through self-management support. However, structured support to prepare for colorectal surgery is not routinely offered to patients in Canada. This study aimed to describe experiences and explore preferences for multimodal prehabilitation among colorectal surgery patients.MethodsA qualitative descriptive study using three focus groups (FG) was held with 19 patients who had a surgical date for abdominal surgery (April 2017-April 2018) and lived close (≤ 50 km radius) to a tertiary hospital in Western Canada (including a Surgical Lead for the British Columbia Enhanced Recovery After Surgery (ERAS) Collaborative). FGs were audio-taped and verbatim transcribed with coding and pile-and-sort methods performed by two independent reviewers, confirmed by a third reviewer, in NVivo v9 software; followed by thematic analysis and narrative synthesis.ResultsFour themes emerged: support, informed decision-making, personalization of care, and mental/emotional health, which patients felt was particularly important but rarely addressed. Patient preferences for prehabilitation programming emphasised regular support from a single professional source, simple health messages, convenient access, and flexibility.ConclusionsThere is an unmet need for structured preoperative support to better prepare patients for colorectal surgery. Future multimodal prehabilitation should be flexible and presented with non-medical information so patients can make informed decisions about their preoperative care and surgical outcomes. Healthcare providers have an important role in encouraging healthy lifestyle changes before colorectal surgery, though clearer communication and accurate advice on self-care, particularly mental health, are needed for improving patient outcomes.

【 授权许可】

CC BY   
© The Author(s) 2022

【 图 表 】

Fig. 2

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