PATIENT REPORTED OUTCOMES IN EMERGENCY GENERAL SURGERY A QUALITATIVE STUDY
Kevin M. Schuster*, Yasmin Ali, Rick O'Connor, Rachel Levinson
Yale School of Medicine, New Haven, CT
Objective: Patient Reported Outcomes (PROs) have been reported in many surgical specialties however there have been minimal efforts in emergency general surgery (EGS) patients. Design: A qualitative research design was used to identify unique PROs in a sample of EGS patients. A multidisciplinary team conducted the semi-structured patient interviews prior to discharge. Interviews were recorded and transcribed verbatim. Coding of the initial ten interviews was done independently. The team met, reviewed codes, discussed emerging concepts, and developed a code book. The code book was used to code subsequent interviews. Any new emerging codes were discussed in team meetings and the code book was modified. This process was iterative until saturation was achieved. Setting: Tertiary academic medical center. Patients: All patients undergoing an EGS procedure August 2019 through June 2022 were eligible. Interventions: None Main Outcome Measures: Unique PROs identified after saturation. Results: Thirty participants (mean age of 60.5 years, 50% male, 77% white and most either employed or retired) had undergone a variety of EGS surgeries from cholecystectomy to more complex bowel procedures and spent an average of 11.6 days in the hospital (table). The patients described several outcomes. Unique to EGS patients was not feeling like there was a choice when deciding on their options for surgery. Two additional PROs, communication and trust, were emphasized when choices were perceived as limited. They also identified additional outcomes important in their recovery and all had a goal of returning to their baseline health status as quickly as possible. Their hospital experience and recovery were also impacted by care team communication, surroundings, food, support systems, and the people caring for them. Conclusion: EGS patients commonly feel there is no choice when faced with a potential for an emergent operation. This creates a need for communication and trust. Patients feel a healing environment positively impacts their recovery. These findings require confirmation prior to PRO measure development.
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