Commissioner, clinician, and patient experiences of a pre‐surgical health optimisation programme:a qualitative study
| Autor: | Russell Jago, Cecily Palmer, Rebecca Reynolds, Elizabeth M Hill, Amanda Owen-Smith, Ruth R Kipping, Jenny L Donovan, Joanna C. McLaughlin, Sabi Redwood, Lauren J Scott, Lucie Owens |
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| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Referral medicine.medical_treatment Psychological intervention Context (language use) Health informatics State Medicine Health administration 03 medical and health sciences 0302 clinical medicine Nursing 030202 anesthesiology Behavioural change medicine Humans 030212 general & internal medicine Obesity Life Style Elective surgery Qualitative Research Health optimisation business.industry Health Policy Nursing research Public health Smoking United Kingdom Patient Outcome Assessment Smoking cessation Public aspects of medicine RA1-1270 business Prehabilitation Research Article |
| Zdroj: | McLaughlin, J, Palmer, C, Redwood, S, Kipping, R, Scott, L, Hill, E M, Donovan, J L, Jago, R & Owen-Smith, A 2021, ' Commissioner, clinician, and patient experiences of a pre-surgical health optimisation programme : a qualitative study ', BMC Health Services Research, vol. 21, no. 1, 409, pp. 409 . https://doi.org/10.1186/s12913-021-06434-z BMC Health Services Research, Vol 21, Iss 1, Pp 1-10 (2021) BMC Health Services Research |
| Popis: | BackgroundHealth optimisation programmes are an increasingly popular policy intervention that aim to support patients to lose weight or stop smoking ahead of surgery. There is little evidence about their impact and the experience of their use. The aim of this study was to investigate the experiences and perspectives of commissioners, clinicians and patients involved in a locality’s health optimisation programme in the United Kingdom. The programme alters access to elective orthopaedic surgery for patients who smoke or are obese (body mass index ≥ 30 kg/m2), diverting them to a 12-week programme of behavioural change interventions prior to assessment for surgical referral.MethodsA thematic analysis of semi-structured interviews (n = 20) with National Health Service and Local Authority commissioners and planners, healthcare professionals, and patients using the pathway.ResultsHealth optimisation was broadly acceptable to professionals and patients in our sample and offered a chance to trigger both short term pre-surgical weight loss/smoking cessation and longer-term sustained changes to lifestyle intentions post-surgery. Communicating the nature and purpose of the programme to patients was challenging and consequently the quality of the explanation received and understanding gained by patients was generally low. Insight into the successful implementation of health optimisation for the hip and knee pathway, but failure in roll-out to other surgical specialities, suggests placement of health optimisation interventions into the ‘usual waiting time’ for surgical referral may be of greatest acceptability to professionals and patients.ConclusionsPatients and professionals supported the continuation of health optimisation in this context and recognised likely health and wellbeing benefits for a majority of patients. However, the clinicians’ communication to patients about health optimisation needs to improve to prepare patients and optimise their engagement. |
| Databáze: | OpenAIRE |
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