A multicentre survey investigating the knowledge, behaviour, and attitudes of surgical healthcare professionals to frailty assessment in emergency surgery: DEFINE(surgery)

P. Braude; F. Parry; K. Warren; E. Mitchell; K. McCarthy; R. G. Khadaroo; B. Carter

doi:10.1007/s41999-024-00962-7

A multicentre survey investigating the knowledge, behaviour, and attitudes of surgical healthcare professionals to frailty assessment in emergency surgery: DEFINE(surgery)

P. Braude^*, F. Parry, K. Warren, E. Mitchell, K. McCarthy, R. G. Khadaroo, B. Carter

^*Corresponding author for this work

Biostatistics & Health Informatics

Research output: Contribution to journal › Article › peer-review

1 Citation (Scopus)

Abstract

Purpose: Screening for frailty in people admitted with emergency surgical pathology can initiate timely referrals to enhanced perioperative services such as intensive care and geriatric medicine. However, there has been little research exploring surgical healthcare professionals' opinions to frailty assessment, or accuracy in identification. This study aimed to assess the knowledge, behaviour, and attitudes of healthcare professionals to frailty assessment in emergency surgical admissions. Methods: We designed a cross-sectional multicentre study developed by a multiprofessional team of surgeons, geriatricians, and supported by patients. A semi-structured survey examined attitudes and behaviours. Knowledge was assessed by comparing respondents’ accuracy in scoring twenty-two surgical case vignettes using the Clinical Frailty Scale. Results: Eleven hospitals across England, Wales, and Scotland participated. Two hundred and eleven clinicians responded—20.4% junior doctors, 43.6% middle grade doctors, 24.2% senior doctors, 11.4% nurses and physician associates. Respondents strongly supported perioperative frailty assessment. Most were already assessing for frailty, although frequently not using a standardised tool. There was a strong call for more frailty education. Participants scored 2175 vignettes with 55.4% accurately meeting the gold standard; accuracy improved to 87.3% when categorised into “not frail/mildly frail/severely frail” and 94% when dichotomised to “not frail/frail”. Conclusion: Frailty assessment is well supported by healthcare professionals working in surgery. However, standardised tools are not routinely being used, and only half of respondents could accurately identify frailty. Better education around frailty assessment is needed for healthcare professionals working in surgery to improve perioperative pathway for people living with frailty.

Original language	English
Pages (from-to)	1047-1053
Number of pages	7
Journal	European Geriatric Medicine
Volume	15
Issue number	4
Early online date	18 Apr 2024
DOIs	https://doi.org/10.1007/s41999-024-00962-7
Publication status	Published - Aug 2024

Keywords

Attitudes
Frailty
National survey
Perioperative medicine
Surgery

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10.1007/s41999-024-00962-7

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title = "A multicentre survey investigating the knowledge, behaviour, and attitudes of surgical healthcare professionals to frailty assessment in emergency surgery: DEFINE(surgery)",

abstract = "Purpose: Screening for frailty in people admitted with emergency surgical pathology can initiate timely referrals to enhanced perioperative services such as intensive care and geriatric medicine. However, there has been little research exploring surgical healthcare professionals' opinions to frailty assessment, or accuracy in identification. This study aimed to assess the knowledge, behaviour, and attitudes of healthcare professionals to frailty assessment in emergency surgical admissions. Methods: We designed a cross-sectional multicentre study developed by a multiprofessional team of surgeons, geriatricians, and supported by patients. A semi-structured survey examined attitudes and behaviours. Knowledge was assessed by comparing respondents{\textquoteright} accuracy in scoring twenty-two surgical case vignettes using the Clinical Frailty Scale. Results: Eleven hospitals across England, Wales, and Scotland participated. Two hundred and eleven clinicians responded—20.4% junior doctors, 43.6% middle grade doctors, 24.2% senior doctors, 11.4% nurses and physician associates. Respondents strongly supported perioperative frailty assessment. Most were already assessing for frailty, although frequently not using a standardised tool. There was a strong call for more frailty education. Participants scored 2175 vignettes with 55.4% accurately meeting the gold standard; accuracy improved to 87.3% when categorised into “not frail/mildly frail/severely frail” and 94% when dichotomised to “not frail/frail”. Conclusion: Frailty assessment is well supported by healthcare professionals working in surgery. However, standardised tools are not routinely being used, and only half of respondents could accurately identify frailty. Better education around frailty assessment is needed for healthcare professionals working in surgery to improve perioperative pathway for people living with frailty.",

keywords = "Attitudes, Frailty, National survey, Perioperative medicine, Surgery",

author = "P. Braude and F. Parry and K. Warren and E. Mitchell and K. McCarthy and Khadaroo, {R. G.} and B. Carter",

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month = aug,

doi = "10.1007/s41999-024-00962-7",

language = "English",

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AU - Braude, P.

AU - Parry, F.

AU - Warren, K.

AU - Mitchell, E.

AU - McCarthy, K.

AU - Khadaroo, R. G.

AU - Carter, B.

N1 - Publisher Copyright: © The Author(s) 2024.

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N2 - Purpose: Screening for frailty in people admitted with emergency surgical pathology can initiate timely referrals to enhanced perioperative services such as intensive care and geriatric medicine. However, there has been little research exploring surgical healthcare professionals' opinions to frailty assessment, or accuracy in identification. This study aimed to assess the knowledge, behaviour, and attitudes of healthcare professionals to frailty assessment in emergency surgical admissions. Methods: We designed a cross-sectional multicentre study developed by a multiprofessional team of surgeons, geriatricians, and supported by patients. A semi-structured survey examined attitudes and behaviours. Knowledge was assessed by comparing respondents’ accuracy in scoring twenty-two surgical case vignettes using the Clinical Frailty Scale. Results: Eleven hospitals across England, Wales, and Scotland participated. Two hundred and eleven clinicians responded—20.4% junior doctors, 43.6% middle grade doctors, 24.2% senior doctors, 11.4% nurses and physician associates. Respondents strongly supported perioperative frailty assessment. Most were already assessing for frailty, although frequently not using a standardised tool. There was a strong call for more frailty education. Participants scored 2175 vignettes with 55.4% accurately meeting the gold standard; accuracy improved to 87.3% when categorised into “not frail/mildly frail/severely frail” and 94% when dichotomised to “not frail/frail”. Conclusion: Frailty assessment is well supported by healthcare professionals working in surgery. However, standardised tools are not routinely being used, and only half of respondents could accurately identify frailty. Better education around frailty assessment is needed for healthcare professionals working in surgery to improve perioperative pathway for people living with frailty.

AB - Purpose: Screening for frailty in people admitted with emergency surgical pathology can initiate timely referrals to enhanced perioperative services such as intensive care and geriatric medicine. However, there has been little research exploring surgical healthcare professionals' opinions to frailty assessment, or accuracy in identification. This study aimed to assess the knowledge, behaviour, and attitudes of healthcare professionals to frailty assessment in emergency surgical admissions. Methods: We designed a cross-sectional multicentre study developed by a multiprofessional team of surgeons, geriatricians, and supported by patients. A semi-structured survey examined attitudes and behaviours. Knowledge was assessed by comparing respondents’ accuracy in scoring twenty-two surgical case vignettes using the Clinical Frailty Scale. Results: Eleven hospitals across England, Wales, and Scotland participated. Two hundred and eleven clinicians responded—20.4% junior doctors, 43.6% middle grade doctors, 24.2% senior doctors, 11.4% nurses and physician associates. Respondents strongly supported perioperative frailty assessment. Most were already assessing for frailty, although frequently not using a standardised tool. There was a strong call for more frailty education. Participants scored 2175 vignettes with 55.4% accurately meeting the gold standard; accuracy improved to 87.3% when categorised into “not frail/mildly frail/severely frail” and 94% when dichotomised to “not frail/frail”. Conclusion: Frailty assessment is well supported by healthcare professionals working in surgery. However, standardised tools are not routinely being used, and only half of respondents could accurately identify frailty. Better education around frailty assessment is needed for healthcare professionals working in surgery to improve perioperative pathway for people living with frailty.

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JF - European Geriatric Medicine

IS - 4

ER -

A multicentre survey investigating the knowledge, behaviour, and attitudes of surgical healthcare professionals to frailty assessment in emergency surgery: DEFINE(surgery)

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