Preoperative concerns of patients undergoing general surgery

Abstract

Objectives: This qualitative review aims to provide a clearer understanding of concerns general surgery (GS) patients face in the preoperative period.

Methods: Medline, CINAHL, PsycINFO and Web of Science were searched for articles describing the preoperative concerns of GS patients. Qualitative and mixed method studies were included. Key quotes were extracted, coded, and thematically analyzed according to Thomas and Harden's methodology.

Results: 27 articles were included. Three main themes were generated: (1) lead-up to surgery, (2) postoperative recovery process and (3) standard of care. While waiting for surgery, patients were often shrouded with uncertainty and concerned themselves with the potential impacts of their disease and surgery on their wellbeing and recovery. Furthermore, patients' trust and confidence in Healthcare Professionals (HCPs) was compromised when standard of care was perceived to be deficient, resulting in doubts about HCPs' credibility and capabilities.

Conclusion: Patients' preoperative concerns often stem from the uncertainty and unfamiliarity surrounding surgery. To address this, a combination of effective preoperative education, individualised communication and involvement of social support should be considered.

Practice implications: Preoperative concerns can negatively impact patients and effective interventions will result in a better perioperative experience with fewer negative consequences arising from patients' fear and anxiety.

Keywords: Anxiety; Experience; General surgery; Preoperative; Qualitative review.