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Patient Perspectives on Perioperative Supportive Care Needs Surrounding Major Abdominal Operations for Cancer

  • Global Health Services Research
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Purpose

The development of supportive care interventions delivered by surgeons for their patients is a major research priority. Designing such interventions requires understanding patients’ supportive care needs for major operations. This qualitative analysis aimed to determine the supportive care needs of patients undergoing major abdominal operations for cancer.

Methods

We conducted semi-structured interviews with a subset of participants in a randomized, controlled trial of a specialist palliative care intervention for patients undergoing abdominal resections for cancer (NCT 03436290). Sampling was designed to balance the population by sex, age (older vs. younger than 65 years), and treatment group assignment (intervention vs. control). The interview guide was developed to elicit patient perceptions of their supportive care needs from diagnosis to the time of interview, about 1 month after their operation. Two coders used an iterative, inductive method to identify recurring themes in the interviews.

Results

Analysis of interview transcripts revealed five primary themes: preoperative preparation, postoperative recovery, expectation setting, coordination of care, and provider characteristics. Cutting across these themes were patients’ focus on time, timeliness, and timelines, as well as their desires for information both from their surgeons and other sources. Surgeons inspired trust through the quality of their communication and their responsiveness to questions. Patients were sensitive to perceived deviations from their expectations and spoke of the need to develop patience and to expect the unexpected.

Conclusions

Patients expressed several needs for supportive care that surgical teams can potentially address to improve the experience of major cancer surgery.

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Acknowledgment

Dr. Shinall was supported by the National Cancer Institute (K12CA090625) and the National Institute on Aging (R03AG060085, K76AG068436).

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Authors and Affiliations

  1. Department of Surgery, Vanderbilt University Medical Center, Nashville, TN, USA

    Myrick C. Shinall Jr. MD, PhD

  2. Section of Palliative Care, Vanderbilt University Medical Center, Nashville, TN, USA

    Myrick C. Shinall Jr. MD, PhD

  3. Critical Illness, Brain Dysfunction, and Survivorship Center, Vanderbilt University Medical Center, Nashville, TN, USA

    Myrick C. Shinall Jr. MD, PhD & E. Wesley Ely MD, MPH

  4. Center for Biomedical Ethics and Society, Vanderbilt University Medical Center, Nashville, TN, USA

    Myrick C. Shinall Jr. MD, PhD & Laura M. Beskow PhD, MPH

  5. Division of Allergy, Pulmonology, and Critical Care, Vanderbilt University Medical Center, Nashville, TN, USA

    E. Wesley Ely MD, MPH

  6. Tennessee Valley Geriatrics Research Education and Clinical Center (GRECC), Nashville Veterans Affairs Medical Center, Nashville, TN, USA

    E. Wesley Ely MD, MPH

  7. Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, TN, USA

    Carolyn Diehl BLS

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  1. Myrick C. Shinall Jr. MD, PhD
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  2. E. Wesley Ely MD, MPH
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  3. Carolyn Diehl BLS
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Correspondence to Myrick C. Shinall Jr. MD, PhD.

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Shinall, M.C., Ely, E.W., Diehl, C. et al. Patient Perspectives on Perioperative Supportive Care Needs Surrounding Major Abdominal Operations for Cancer. Ann Surg Oncol 30, 2597–2605 (2023). https://doi.org/10.1245/s10434-022-12895-1

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  • DOI: https://doi.org/10.1245/s10434-022-12895-1

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