The Influence of Rural Healthcare Systems and Communities on Surgery and Recovery: A Qualitative Study.

Autor: Johnson JE; Department of Surgery, University of Utah, Salt Lake City, Utah. Electronic address: Jordan.esplin@hsc.utah.edu., Bleicher J; Department of Surgery, University of Utah, Salt Lake City, Utah., Blumling AN; Department of Communication, University of Utah, Salt Lake City, Utah., Cain BT; Department of Surgery, University of Utah, Salt Lake City, Utah., Cohan JN; Department of Surgery, University of Utah, Salt Lake City, Utah; Huntsman Cancer Institute, Salt Lake City, Utah., Savarise M; Department of Surgery, University of Utah, Salt Lake City, Utah., Harris AHS; VA HSR&D Center for Innovation to Implementation, Palo Alto VA Health Care System, Washington, District of Columbia., Kaphingst KA; Department of Communication, University of Utah, Salt Lake City, Utah; Huntsman Cancer Institute, Salt Lake City, Utah., Huang LC; Department of Surgery, University of Utah, Salt Lake City, Utah; Huntsman Cancer Institute, Salt Lake City, Utah.
Jazyk: angličtina
Zdroj: The Journal of surgical research [J Surg Res] 2023 Jan; Vol. 281, pp. 155-163. Date of Electronic Publication: 2022 Sep 22.
DOI: 10.1016/j.jss.2022.08.028
Abstrakt: Introduction: Successful recovery after surgery is complex and highly individual. Rural patients encounter greater barriers to successful surgical recovery than urban patients due to varying healthcare and community factors. Although studies have previously examined the recovery process, rural patients' experiences with recovery have not been well-studied. The rural socioecological context can provide insights into potential barriers or facilitators to rural patient recovery after surgery.
Methods: We conducted semi-structured qualitative interviews with a purposeful sample of 30 adult general surgery patients from rural areas in the Mountain West region of the United States. We used the socioecological framework to analyze their responses. Interviews focused on rural participants' experiences accessing healthcare and the impact of family and community support during postoperative recovery. Interviews were transcribed verbatim and coded using content and thematic analysis.
Results: All participants commented on the quality of their rural healthcare systems and its influence on postoperative care. Some enjoyed the trust developed through long-standing relationships with providers in their communities. However, participants described community providers' lack of money, equipment, and/or knowledge as barriers to care. Following surgery, participants recognized that there are advantages and disadvantages to receiving family and community support. Some participants worried about being stigmatized or judged by their community.
Conclusions: Future interventions aimed at improving access to and recovery from surgery for rural patients should take into account the unique perspectives of rural patients. Addressing the socioecological factors surrounding rural surgery patients, such as healthcare, family, and community resources, will be key to improving postoperative recovery.
(Copyright © 2022 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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