Expressions of conflict following postoperative complications in older adults having major surgery

Elle L. Kalbfell, Anne Buffington, Anna Kata, Karen J. Brasel, Anne C. Mosenthal, Zara Cooper, Emily Finlayson, Margaret L. Schwarze

Research output: Contribution to journalArticlepeer-review

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 languageEnglish (US)
Pages (from-to)670-676
Number of pages7
JournalAmerican journal of surgery
Volume222
Issue number4
DOIs
StatePublished - Oct 2021

Keywords

  • Goals of care
  • High-risk surgery
  • Older adults
  • Postoperative conflict
  • Surgical complications

ASJC Scopus subject areas

  • Surgery

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