The value of teachable moments in surgical patient care and the supportive role of digital technologies

Robinson, Anna; Slight, Robert; Husband, Andy; Slight, Sarah P.

doi:10.1186/s13741-019-0133-z

Cited by 31 publications

(23 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Interventions that are initiated preoperatively and continued postoperatively were perceived as beneficial. Captivating the preoperative patient mindset and making use of the surgical teachable moment appears to be significant in encouraging perioperative behavior change and optimizing postoperative outcomes [68]. Being granted a sense of control and responsibility over their recovery by initiating and using interventions preoperatively were valued by participants.…”

Section: Principal Findingsmentioning

confidence: 99%

Designing the Optimal Digital Health Intervention for Patients’ Use Before and After Elective Orthopedic Surgery: Qualitative Study

Robinson¹,

Slight²,

Husband³

et al. 2021

J Med Internet Res

Self Cite

View full text Add to dashboard Cite

Background Health behavior changes made by patients during the perioperative period can impact the outcomes and success of elective surgeries. However, there remains a limited understanding of how best to support patients during this time, particularly through the use of digital health interventions. Recognizing and understanding the potential unmet needs of elective orthopedic surgery patients is central to motivating healthier behavior change, improving recovery, and optimizing overall surgical success in the short and long term. Objective The aim of this study is to explore patient perspectives on technology features that would help support them to change their lifestyle behaviors during the pre- and postoperative periods, and that could potentially maintain long-term healthy lifestyles following recovery. Methods Semistructured interviews with pre- and postoperative elective orthopedic patients were conducted between May and June 2020 using telephone and video call–based software. Patient perspectives on the use of digital technologies to complement current surgical care and support with lifestyle behavior changes were discussed. Interviews were audio recorded and transcribed verbatim. Reflexive thematic analysis enabled the development of themes from the data, with QSR NVivo software (version 12) facilitating data management. Ethical approval was obtained from the National Health Service Health Research Authority. Results A total of 18 participants were interviewed. Four themes were developed from the data regarding the design and functionality of digital technologies to best support the perioperative journey. These center around an intervention’s ability to incorporate interactive, user-centered features; direct a descriptive and structured recovery; enable customizable, patient-controlled settings; and deliver both general and specific surgical advice in a timely manner. Interventions that are initiated preoperatively and continued postoperatively were perceived as beneficial. Interventions designed with personalized milestones were found to better guide patients through a structured recovery. Individualized tailoring of preparatory and recovery information was desired by patients with previously high levels of physical activity before surgery. The use of personalized progression-based exercises further encouraged physical recovery; game-like rewards and incentives were regarded as motivational for making and sustaining health behavior change. In-built video calling and messaging features offered connectivity with peers and clinicians for supported care delivery. Conclusions Specific intervention design and functionality features can provide better, structured support for elective orthopedic patients across the entire surgical journey and beyond. This study provides much-needed evidence relating to the optimal design and timing of digital interventions for elective orthopedic surgical patients. Findings from this study suggest a desire for personalized perioperative care, in turn, supporting patients to make health behavior changes to optimize surgical success. These findings should be used to influence future co-design projects to enable the design and implementation of patient-focused, tailored, and targeted digital health technologies within modern health care settings.

show abstract

Section: Principal Findingsmentioning

confidence: 99%

Designing the Optimal Digital Health Intervention for Patients’ Use Before and After Elective Orthopedic Surgery: Qualitative Study

Robinson¹,

Slight²,

Husband³

et al. 2021

J Med Internet Res

Self Cite

View full text Add to dashboard Cite

show abstract

“…The exercise programme fostered a holistic concept of health i.e., gave rise to greater health awareness and appeared to be a trigger to make changes in order to reach an optimal level of health. The teachable moment has been reported to be an important concept to promote health and well-being amongst a surgical population [ 28 ]. Interestingly, participants expressed interest to continue their exercise programme post-surgery.…”

Section: Discussionmentioning

confidence: 99%

Perceptions of wellbeing and quality of life following participation in a community-based pre-operative exercise programme in men with newly diagnosed prostate cancer: A qualitative pilot study

et al. 2021

View full text Add to dashboard Cite

Background Men with a newly diagnosed prostate cancer are often treated by surgery. The time window between cancer diagnosis and surgery causes high levels of uncertainty and stress, which negatively impact quality of life (QoL). We previously reported a larger intervention pilot study which demonstrated that participation in a community-based pre-operative exercise programme significantly improved physical fitness and health-related quality of life in men with prostate cancer prior to surgery. The aim of the current pilot study was to get an insight into men’s perceptions of wellbeing and QoL following completion of the pre-operative exercise programme. Methods From November 2017 to June 2018, men scheduled for prostate cancer surgery were recruited and took part in a prescribed community-based pre-operative exercise programme in the time available between referral and surgery. Following completion of the pre-operative exercise programme (within 1 week before surgery), participants took part in one semi-structured interview which explored four broad QoL domains: physical, psychological, social, and spiritual wellbeing. Data were analysed using thematic analysis (a bottom up/inductive analysis). Results Eleven men were recruited: mean standard deviation (SD) age was 60 ± 7 years. Data supported four main themes. Participation in the community-based pre-operative exercise training programme (over a mean (SD) of 4 ± 2 weeks) provided participants with: 1) a teachable moment; 2) a journey of preparation; 3) a sense of optimism; and 4) social connectedness prior to surgery. Conclusion This study provides an insight into how the exercise programme impacted wellbeing and QoL in men preparing for prostate cancer surgery. These findings highlight the important role that exercise prehabilitation plays for men preparing for prostate cancer surgery. Such exercise programmes can be easily implemented into standard cancer pathways by establishing relationships between hospital teams and community exercise programmes.

show abstract

“…(18,19,55) This is closely linked with theories of surgical teachable moments, arguing that patients are highly susceptible and motivated to change following the initial decision to undergo surgery. (56,57) Highlighting the perspectives of participants in this study, digital health technologies may present a promising opportunity to prepare patients prior to surgery, as well as provide continued support between routine post-operative follow-up appointments.…”

Section: Study Participants Describedmentioning

confidence: 99%

“We Need to Be Told What to Do and What to Eat”: A Qualitative Study Exploring Perioperative Patient Desires, Suggestions and Reflections on Using Digital Health Technology Before and After Bariatric Surgery. 

Robinson¹,

Husband²,

Slight³

et al. 2020

Preprint

Self Cite

View full text Add to dashboard Cite

BackgroundA patient’s capability, motivation, and opportunity to change their lifestyle are significant determinants of successful outcomes following bariatric surgery. Healthier lifestyle changes before and after surgery, including improved dietary intake and physical activity levels, have been shown to contribute to greater post-surgical weight loss and improved long-term health. Integrating patient-centred digital technologies within the bariatric surgical pathway could form part of an innovative strategy to promote and sustain healthier behaviours and provide holistic patient support, to improve surgical success. This study explores the desires, suggestions, and reflections of perioperative patients in the context of integrating digital technologies within the surgical pathway. MethodsPatients attending bariatric surgery clinics within one hospital in the North of England were invited to take part in the study. Semi-structured interviews were conducted with pre- and post-operative patients to discuss lifestyle behaviour change and perspectives of using digital technologies to complement current care. Interviews were audio-recorded and transcribed verbatim. Thematic analysis enabled the development of themes from the data. Ethical approval was obtained from the NHS Health Research Authority.ResultsEighteen patients were interviewed. Four overarching themes were identified relating to patient perspectives of optimised technology functionality to: 1) provide tailored content and support, 2) facilitate self-monitoring and goal-setting, 3) deliver information in an accessible, trusted, and usable manner, and 4) meet patient information-seeking and engagement needs. ConclusionsWe make recommendations to address the unmet needs of this patient cohort. These findings have the potential to influence the design of person-centred, perioperative technologies.

show abstract

The value of teachable moments in surgical patient care and the supportive role of digital technologies

Cited by 31 publications

References 17 publications

Designing the Optimal Digital Health Intervention for Patients’ Use Before and After Elective Orthopedic Surgery: Qualitative Study

Designing the Optimal Digital Health Intervention for Patients’ Use Before and After Elective Orthopedic Surgery: Qualitative Study

Perceptions of wellbeing and quality of life following participation in a community-based pre-operative exercise programme in men with newly diagnosed prostate cancer: A qualitative pilot study

“We Need to Be Told What to Do and What to Eat”: A Qualitative Study Exploring Perioperative Patient Desires, Suggestions and Reflections on Using Digital Health Technology Before and After Bariatric Surgery.

Contact Info

Product

Resources

About

The value of teachable moments in surgical patient care and the supportive role of digital technologies

Cited by 31 publications

References 17 publications

Designing the Optimal Digital Health Intervention for Patients’ Use Before and After Elective Orthopedic Surgery: Qualitative Study

Designing the Optimal Digital Health Intervention for Patients’ Use Before and After Elective Orthopedic Surgery: Qualitative Study

Perceptions of wellbeing and quality of life following participation in a community-based pre-operative exercise programme in men with newly diagnosed prostate cancer: A qualitative pilot study

“We Need to Be Told What to Do and What to Eat”: A Qualitative Study Exploring Perioperative Patient Desires, Suggestions and Reflections on Using Digital Health Technology Before and After Bariatric Surgery.&nbsp;

Contact Info

Product

Resources

About

“We Need to Be Told What to Do and What to Eat”: A Qualitative Study Exploring Perioperative Patient Desires, Suggestions and Reflections on Using Digital Health Technology Before and After Bariatric Surgery.