A qualitative study of older adults' and family caregivers' perspectives regarding their preoperative care transitions.
Ann M Malley, Mary Bourbonniere, Mary Naylor
PMID 29633436WHAT IT FOUND
Older hip or knee surgery patients and caregivers described standardized computer-based preoperative instructions as hard to use, rushed visits, and poor coordination.
They relied on family and other patients for preparation.
Key findings
01Some older adults and caregivers described standardized email or website preoperative instructions as difficult to access or understand, so patients often sought information from other people who had had surgery.
02Family caregivers described taking on coordination and advocacy when many providers and preoperative visits left responsibility unclear.
03Three patients were readmitted after discharge, and caregivers described being unprepared for postoperative complications such as delirium and infection.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study was done at a single academic center in the Northeast United States, so its findings may not transfer to other hospitals or community settings. The sample had little cultural diversity and included more female than male patients. Researchers stopped recruiting when they judged they had heard enough, so the themes may not capture all older adults or caregivers. The study did not test whether changes to preoperative education or caregiver assessment improve outcomes.
The easy way to misread this
Do not read these accounts as proof that electronic preoperative instructions caused poor recovery or that caregiver assessment improves outcomes. The study describes experiences and does not test an intervention.