Patient Perspectives on Transitions of Surgical Care: Examining the Complexities and Interdependencies of Care

Maynor G. González, Kristin N. Kelly, Ann M. Dozier, Fergal Fleming, John R.T. Monson, Adan Z. Becerra, Christopher T. Aquina, Christian P. Probst, Bradley J. Hensley, Nick Sevdalis, Katia Noyes*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

6 Citations (Scopus)
374 Downloads (Pure)

Abstract

This study examined a thematic network aimed at identifying experiences that influence patients' outcomes (e.g., patients' satisfaction, anxiety, and discharge readiness) in an effort to improve care transitions and reduce patient burden. We drew upon the Sociology and Complexity Science Toolkit to analyze themes derived from 61 semistructured, longitudinal interviews with 20 patients undergoing either a benign or malignant colorectal resection (three interviews per patient over a 30-day after hospital discharge). Thematic interdependencies illustrate how most outcomes of care are significantly influenced by two cascades identified as patients' medical histories and home circumstances. Patients who reported previous medical or surgical histories also experienced less distress during the discharge process, whereas patients with no prior experiences reported more concerns and greater anxiety. Patient dissatisfactions and challenges were due in large part to the contrasts between hospital and home experiences. Our hybrid approach may inform patient-centered guidelines aimed at improving transitions of care among patients undergoing major surgery.

Original languageEnglish
Pages (from-to)1856-1869
Number of pages14
JournalQualitative Health Research
Volume27
Issue number12
Early online date10 May 2017
DOIs
Publication statusPublished - 1 Oct 2017

Keywords

  • complexity science
  • discharge process
  • northeastern US
  • patient perceptions
  • qualitative methods
  • surgical outcomes
  • transitions of care

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