Learning How Preoperative Communication Relates to Postoperative Experiences for Older Veterans Having Inguinal Hernia Surgery.

BACKGROUND: For older adults to decide whether inguinal hernia repair will meaningfully improve their lives, it is critical to (1) understand how the operation affects them and whether it enhances outcomes that matter to them, and (2) identify ways to improve how surgeons discuss the benefits of surgery and how they prepare older adults for postoperative recovery. METHODS: We conducted semi-structured interviews with 40 Veterans ≥ 65 years old who had inguinal hernia repair at two high-volume Veterans Affairs hospitals. RESULTS: Participants were all men; their mean age was 73 years, 65% were White, and 33% were Black. Older adults felt that the surgical team provided excellent reassurance regarding the safety and efficacy of surgery but expressed a desire for improved listening during preoperative counseling and for clearer communication regarding the reality of postoperative recovery. Veterans reported a return to baseline physical and cognitive function between 2 days and 6 weeks after surgery, though two Veterans experienced significant short-term cognitive dysfunction. Those who reported dissatisfaction with preoperative communication were more likely to be surprised or concerned about postoperative symptoms. CONCLUSIONS: Our study provides critical information on how hernia repair affects the lives of older adults, and this can be used to better prepare the patients for surgery and to help them decide whether surgery will meaningfully enhance their quality of life.

Duke Scholars

Author Miles Berger Anesthesiology, Neuroanesthesia