Charlie Dharmasukrit1, Malini Ramaiyer, Ellis C Dillon, Marcia M Russell, Meghan Dutt, Alexis Colley, Victoria L Tang. 1. Veterans Affairs Quality Scholars Program, San Francisco Veterans Affairs Medical Center, San Francisco, CA, USA Division of Geriatrics, Department of Medicine, University of California, San Francisco, San Francisco, CA, USA Division of Geriatrics, San Francisco Veterans Affairs Medical Center, San Francisco, CA, USA Center for Health Systems Research, Sutter Health, and Palo Alto Medical Foundation Research Institute, Palo Alto, CA, USA Department of Surgery, University of California, Los Angeles, Los Angeles, CA, USA Department of Surgery, Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, CA, USA College of Medicine, California Northstate University, Elk Grove, CA, USA Department of Surgery, University of California, San Francisco, San Francisco, CA, USA.
Abstract
OBJECTIVE: To examine public opinions of surgery in older adults. BACKGROUND: Increasing numbers of older adults are undergoing surgery. National healthcare organizations recognize the increased risks of postoperative complications and mortality in the older surgical population and have made efforts to improve the care of older adults undergoing surgery through hospital-level programs. However, limited research has explored the opinions and responses of the wider U.S. public regarding surgery in older adults. METHODS: We performed a qualitative, thematic analysis of reader comments posted in response to online newspaper articles relating to surgery in older adults. Articles were published in 2019-2020 and targeted for a popular press audience. RESULTS: 908 reader comments posted in response to 6 articles relating to surgery in older adults were identified. Articles were published in online editions of print newspapers with a digital circulation between 1.3 and 5.7 million subscribers. Three themes were identified: 1) wariness/distrust towards healthcare: including general distrust of medicine and distrust of surgery, 2) problems experienced: ineffective communication and unrealistic expectations, and 3) recommended solutions: the need for multidisciplinary teams and patient-centered communication. CONCLUSIONS: Overall, the public viewed surgery in older adults with wariness/distrust due to ineffective communication and unrealistic expectations. Specialized surgical care tailored to the unique needs of older adults is needed. The public perspective suggests that U.S. health systems should strongly consider adopting programs that provide care to meet the unique needs of older adults undergoing surgery and ultimately improve both patient outcomes as well as their surgical experience.
OBJECTIVE: To examine public opinions of surgery in older adults. BACKGROUND: Increasing numbers of older adults are undergoing surgery. National healthcare organizations recognize the increased risks of postoperative complications and mortality in the older surgical population and have made efforts to improve the care of older adults undergoing surgery through hospital-level programs. However, limited research has explored the opinions and responses of the wider U.S. public regarding surgery in older adults. METHODS: We performed a qualitative, thematic analysis of reader comments posted in response to online newspaper articles relating to surgery in older adults. Articles were published in 2019-2020 and targeted for a popular press audience. RESULTS: 908 reader comments posted in response to 6 articles relating to surgery in older adults were identified. Articles were published in online editions of print newspapers with a digital circulation between 1.3 and 5.7 million subscribers. Three themes were identified: 1) wariness/distrust towards healthcare: including general distrust of medicine and distrust of surgery, 2) problems experienced: ineffective communication and unrealistic expectations, and 3) recommended solutions: the need for multidisciplinary teams and patient-centered communication. CONCLUSIONS: Overall, the public viewed surgery in older adults with wariness/distrust due to ineffective communication and unrealistic expectations. Specialized surgical care tailored to the unique needs of older adults is needed. The public perspective suggests that U.S. health systems should strongly consider adopting programs that provide care to meet the unique needs of older adults undergoing surgery and ultimately improve both patient outcomes as well as their surgical experience.
Authors: Shelley R McDonald; Mitchell T Heflin; Heather E Whitson; Thomas O Dalton; Michael E Lidsky; Phillip Liu; Cornelia M Poer; Richard Sloane; Julie K Thacker; Heidi K White; Mamata Yanamadala; Sandhya A Lagoo-Deenadayalan Journal: JAMA Surg Date: 2018-05-01 Impact factor: 14.766
Authors: Daniel E Hall; Shipra Arya; Kendra K Schmid; Mark A Carlson; Pierre Lavedan; Travis L Bailey; Georgia Purviance; Tammy Bockman; Thomas G Lynch; Jason M Johanning Journal: JAMA Surg Date: 2017-03-01 Impact factor: 14.766
Authors: Rachelle Bernacki; Joanna Paladino; Bridget A Neville; Mathilde Hutchings; Jane Kavanagh; Olaf P Geerse; Joshua Lakin; Justin J Sanders; Kate Miller; Stuart Lipsitz; Atul A Gawande; Susan D Block Journal: JAMA Intern Med Date: 2019-06-01 Impact factor: 21.873
Authors: Victoria L Tang; Bocheng Jing; John Boscardin; Sarah Ngo; Molly Silvestrini; Emily Finlayson; Kenneth E Covinsky Journal: JAMA Surg Date: 2020-05-01 Impact factor: 14.766
Authors: Joanna Paladino; Luca Koritsanszky; Lauren Nisotel; Bridget A Neville; Kate Miller; Justin Sanders; Evan Benjamin; Erik Fromme; Susan Block; Rachelle Bernacki Journal: Cancer Med Date: 2020-05-04 Impact factor: 4.452
Authors: Rachelle Bernacki; Mathilde Hutchings; Judith Vick; Grant Smith; Joanna Paladino; Stuart Lipsitz; Atul A Gawande; Susan D Block Journal: BMJ Open Date: 2015-10-06 Impact factor: 2.692