Barriers faced by surgeons in identifying and managing malnutrition in emergency general surgery: A qualitative study
Fuente:
Wiley Open Access
Saved in:
| Main Authors: | , , , , |
|---|---|
| Format: | Artículo Open Access |
| Published: |
Wiley
2024
|
| Subjects: | |
| Online Access: | |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1867014275851091968 |
|---|---|
| author | Daniel L. Ashmore Daniel M. Baker Timothy R. Wilson Vanessa Halliday Matthew J. Lee |
| author_facet | Daniel L. Ashmore Daniel M. Baker Timothy R. Wilson Vanessa Halliday Matthew J. Lee Daniel L. Ashmore Daniel M. Baker Timothy R. Wilson Vanessa Halliday Matthew J. Lee |
| collection | Wiley Open Access |
| contents | Barriers faced by surgeons in identifying and managing malnutrition in emergency general surgery: A qualitative study Daniel L. Ashmore Daniel M. Baker Timothy R. Wilson Vanessa Halliday Matthew J. Lee Colorectal Disease AbstractAimMany patients undergoing emergency surgery are malnourished. Identifying malnutrition is a prerequisite to offering targeted nutritional support. Guidelines exist but little is known regarding exactly how surgeons identify malnutrition, or the barriers that influence surgeons' clinical decision‐making. The aim of this work was to explore how consultant surgeons identify malnutrition in emergency general surgery (EGS) patients and the barriers to nutritional assessment and intervention.MethodConsultant surgeons with emergency surgery duties were invited to participate. Semi‐structured interviews were conducted online, audiovisually recorded and transcribed. An inductive approach was used for data analysis using the framework method. Coding and analysis were performed by two independent researchers using NVivo software. Themes were developed and reviewed with the supervising team. Interviews continued until data saturation was reached. Ethical approval was gained prior to interviews.ResultsEighteen interviews were conducted across three hospital settings. Identification of malnutrition consisted of three themes: ‘The surgeon’ (knowledge, experience, planning ahead); ‘The patient’ (selection, composition, clinical progress, operative considerations); and ‘The institution’ (collaboration, extended surgical team). Three themes encompassed barriers experienced: ‘The surgeon’ (understanding, culture, ownership, time constraints); ‘The institution’ (provision, staffing, conflict, hospital setting); and ‘The wider context’ (research, external factors). These influenced clinical decision‐making, which had two themes: ‘To join or not to join’ (risk taking, site of anastomosis) and ‘Nutritional support’ (timing, referral pathways).ConclusionsThe identification and management of malnutrition in EGS is fraught with barriers, impacting operative and clinical decision‐making. Improvements in surgeon education, culture, collaborative working and resources are needed. 10.1111/codi.17261 http://creativecommons.org/licenses/by/4.0/ |
| doi_str_mv | 10.1111/codi.17261 |
| format | Artículo Open Access |
| id | wiley_oa_10_1111_codi_17261 |
| institution | Wiley Open Access |
| license_str_mv | http://creativecommons.org/licenses/by/4.0/ |
| publishDate | 2024 |
| publisher | Wiley |
| record_format | wiley_oa |
| spellingShingle | Barriers faced by surgeons in identifying and managing malnutrition in emergency general surgery: A qualitative study Daniel L. Ashmore Daniel M. Baker Timothy R. Wilson Vanessa Halliday Matthew J. Lee Colorectal Disease Barriers faced by surgeons in identifying and managing malnutrition in emergency general surgery: A qualitative study Daniel L. Ashmore Daniel M. Baker Timothy R. Wilson Vanessa Halliday Matthew J. Lee Colorectal Disease AbstractAimMany patients undergoing emergency surgery are malnourished. Identifying malnutrition is a prerequisite to offering targeted nutritional support. Guidelines exist but little is known regarding exactly how surgeons identify malnutrition, or the barriers that influence surgeons' clinical decision‐making. The aim of this work was to explore how consultant surgeons identify malnutrition in emergency general surgery (EGS) patients and the barriers to nutritional assessment and intervention.MethodConsultant surgeons with emergency surgery duties were invited to participate. Semi‐structured interviews were conducted online, audiovisually recorded and transcribed. An inductive approach was used for data analysis using the framework method. Coding and analysis were performed by two independent researchers using NVivo software. Themes were developed and reviewed with the supervising team. Interviews continued until data saturation was reached. Ethical approval was gained prior to interviews.ResultsEighteen interviews were conducted across three hospital settings. Identification of malnutrition consisted of three themes: ‘The surgeon’ (knowledge, experience, planning ahead); ‘The patient’ (selection, composition, clinical progress, operative considerations); and ‘The institution’ (collaboration, extended surgical team). Three themes encompassed barriers experienced: ‘The surgeon’ (understanding, culture, ownership, time constraints); ‘The institution’ (provision, staffing, conflict, hospital setting); and ‘The wider context’ (research, external factors). These influenced clinical decision‐making, which had two themes: ‘To join or not to join’ (risk taking, site of anastomosis) and ‘Nutritional support’ (timing, referral pathways).ConclusionsThe identification and management of malnutrition in EGS is fraught with barriers, impacting operative and clinical decision‐making. Improvements in surgeon education, culture, collaborative working and resources are needed. 10.1111/codi.17261 http://creativecommons.org/licenses/by/4.0/ |
| title | Barriers faced by surgeons in identifying and managing malnutrition in emergency general surgery: A qualitative study |
| topic | Colorectal Disease |
| url | https://onlinelibrary.wiley.com/doi/10.1111/codi.17261 |