Hospital Staffs’ Perceptions of Postoperative Nutrition Among Colorectal Patients: A Qualitative Study

Abstract

Background After lower gastrointestinal surgery, few patients start eating within timeframes outlined by evidence‐based guidelines or meet their nutrition requirements in hospital. The present study explored hospital staffs’ perceptions of factors influencing timely and adequate feeding after colorectal surgery to inform future interventions for improving postoperative nutrition practices and intakes. Methods This qualitative exploratory study was conducted at an Australian hospital where Enhanced Recovery After Surgery guidelines had not been formally implemented. One‐on‐one semistructured interviews were conducted with hospital staff who provided care to patients undergoing colorectal surgery. Interviews lasted from 21 to 47 minutes and were audio recorded and transcribed verbatim. Data were analyzed using inductive thematic analysis. Emergent themes and subthemes were discussed by all investigators to ensure consensus of interpretation. Results Eighteen staff participated in interviews, including 9 doctors, 5 nurses, 2 dietitians, and 2 foodservice staff. Staffs’ responses formed 3 themes: (1) variability in perceived acceptability of postoperative feeding; (2) improving dynamics and communication within the treating team; and (3) optimizing dietary intakes with available resources. Conclusion Staff and organizational factors need to be considered when attempting to improve postoperative nutrition among patients who undergo colorectal surgery. Introducing a feeding protocol, enhancing intraprofessional and interdisciplinary communication, and ensuring the availability of appropriate, nutrient‐dense foods are pivotal to improve nutrition practices and intakes.

Percepciones del paciente en realimentación tras cirugía colorrectal. Un estudio cualitativo

“…Los objetivos finales del paciente pueden ser similares a los del equipo de salud, quienes enfocan la nutrición en la curación y recuperación postoperatoria 6 , sin embargo, ellos también ven a la alimentación como un medio para alcanzar diferentes propósitos: regular su tránsito intestinal, alcanzar una adecuada consistencia de las heces, deambular, búsqueda de salud y lograr un alta precoz son algunos de ellos.…”

“…Los protocolos de recuperación optimizada y reinicio precoz de la alimentación han mostrado beneficios en parámetros clínicos como tiempo de estadía hospitalaria sin aumentar la tasa de complicaciones 4 . Se ha registrado la opinión de los pacientes y cirujanos 5,6 en estos programas, pero son escasos los estudios que evalúen cualitativamente la percepción de los pacientes respecto a la alimentación posoperatoria 7,8 y a nuestro conocimiento ninguno originado en nuestro país.…”

Dietitians’ Perspectives on the Coordination and Continuity of Nutrition Care for Malnourished or Frail Clients: A Qualitative Study

“…Participants were purposefully selected from the pool of those who expressed interest, to ensure maximum variation in relation to state, region, area of practice, and years of experience. It was estimated that around 15–20 dietitians would be interviewed based on studies with a similar design [ 24 ]; however, recruitment continued until data saturation was reached (i.e., when no more new information could be gathered) [ 25 ].…”

Assessment of an integrated knowledge translation intervention to improve nutrition intakes among patients undergoing elective bowel surgery: a mixed-method process evaluation

“…Lastly, the research team arranged regular face-to-face group and one-on-one meetings with staff on the study ward (in particular, colorectal surgical consultants) and the Nutrition Reference Committee to design the intervention over a 5-month period. The lead author acted as a knowledge broker by sharing existing evidence [ 1 , 3 – 6 , 33 ] and data generated from previous phases of the research [ 16 – 20 ] with knowledge users. The final intervention involved ten strategies aimed at organisational, HCP and patient levels, described briefly below and outlined in more detail in Table 1 .…”

“…bowel) surgery have consistently demonstrated variable and often poor adherence to EBG recommendations [ 14 – 17 ]. Collectively, professional, patient and organisational factors have been reported to contribute to suboptimal feeding practices and poor nutritional intakes among surgical patients [ 16 , 18 – 20 ]. Hence, efforts to close the gap between EBG recommendations and current practice for the provision of timely and adequate nutrition to patients following colorectal surgery are warranted.…”