Abstract
Background: After serious postoperative complications, patients and families may experience conflict about goals of care. Methods: We performed a multisite randomized clinical trial to test the effect of a question prompt list on postoperative conflict. We interviewed family members and patients age ≥60 who experienced serious complications. We used qualitative content analysis to analyze conflict and characterize patient experiences with complications. Results: Fifty-six of 446 patients suffered a serious complication. Participants generally did not report conflict relating to postoperative treatments and expressed support for the care they received. We did not appreciate a difference in conflict between intervention and usual care. Respondents reported feeling unprepared for complications, witnessing heated interactions among team members, and a failure to develop trust for their surgeon preoperatively. Conclusion: Postoperative conflict following serious complications is well described but its incidence may be low. Nonetheless, patient and family observations reveal opportunities for improvement.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 670-676 |
| Number of pages | 7 |
| Journal | American journal of surgery |
| Volume | 222 |
| Issue number | 4 |
| DOIs | |
| State | Published - Oct 2021 |
Keywords
- Goals of care
- High-risk surgery
- Older adults
- Postoperative conflict
- Surgical complications
ASJC Scopus subject areas
- Surgery