The experience of hospital care for older surgical patients and their carers: A mixed‐methods study

Author:

Thillainadesan Janani1234ORCID,Box Helen3,Kearney Leanne3,Naganathan Vasi123ORCID,Cunich Michelle24,Aitken Sarah J.256,Monaro Sue R.67

Affiliation:

1. Department of Geriatric Medicine Concord Hospital Sydney New South Wales Australia

2. Faculty of Medicine and Health The University of Sydney Camperdown, Sydney New South Wales Australia

3. Centre for Education and Research on Ageing Concord Hospital Sydney New South Wales Australia

4. Sydney Health Economics Collaborative Sydney Local Health District Camperdown, Sydney New South Wales Australia

5. Concord Institute of Academic Surgery, Concord Hospital Sydney New South Wales Australia

6. Department of Vascular Surgery Concord Hospital Sydney New South Wales Australia

7. Susan Wakil School of Nursing The University of Sydney Sydney New South Wales Australia

Abstract

AbstractObjectiveA growing proportion of older adults are undergoing surgery, but there is a paucity of patient and carer experience research in this group. This study investigated the experience of hospital care in an older vascular surgery population for patients and their carers.MethodsThis was a mixed‐methods convergent design, including simultaneous collection of quantitative and qualitative research strands by combining open‐ended questions with rating scales in a questionnaire. Recently hospitalised vascular surgery patients aged ≥65 years at a major teaching hospital were recruited. Carers were also approached to participate.ResultsForty‐seven patients (mean age 77 years, 77% male, 20% with a Clinical Frailty Scale score >4) and nine carers participated. The majority of patients reported that their views were listened to (n = 42, 89%), they were kept informed (n = 39, 83%), and were asked about their pain (n = 37, 79%). Among carers, seven reported their views were listened to and that they were kept informed. Thematic analysis of patients' and carers' responses to open‐ended questions about their experience of hospital care revealed four themes in terms of what mattered to them: fundamental care including hygiene and nutrition, comfort of the hospital environment such as sleep and meals, being informed and involved in health‐care decision‐making, and treating pain and deconditioning to help recovery.ConclusionsOlder adults admitted to hospital for vascular surgery and their carers, valued highly the care that met both their fundamental needs and facilitated shared decisions for care and recovery. These priorities can be addressed through Age‐Friendly Health System initiatives.

Funder

Medical Insurance Group of Australia

National Health and Medical Research Council

Publisher

Wiley

Subject

Geriatrics and Gerontology,Community and Home Care,General Medicine

Reference29 articles.

1. Research: The challenges of clinical trials in the exclusion zone: The case of the frail elderly

2. National Research Strategies: what outcomes are important in peri-operative elderly care?

3. Centre for Perioperative Care and British Geriatrics Society.Guideline for Perioperative Care for People Living with Frailty Undergoing Elective and Emergency Surgery.2021.https://cpoc.org.uk/guidelines‐resources‐guidelines/perioperative‐care‐people‐living‐frailty. Accessed 12 December 2022

4. New horizons in the perioperative care of older adults

5. Incorporating Outcomes that Matter to Older Adults into Surgical Research

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