Surgeons' Perspective of Decision Making in Recurrent Diverticulitis: A Qualitative Analysis

Area of Science:

• Surgical decision-making
• Gastrointestinal surgery
• Qualitative research methodology

Background:

• The decision for colectomy in recurrent diverticulitis is complex and not standardized.
• Understanding surgeons' perspectives is crucial for improving patient-centered care strategies.

Purpose of the Study:

• To explore surgeons' viewpoints on managing recurrent diverticulitis.
• To identify factors influencing surgical decision-making in recurrent diverticulitis.
• To inform the development of patient-centered decision-making approaches.

Main Methods:

• Qualitative study using semi-structured interviews with 25 North American general and colorectal surgeons.
• Purposive sampling based on surgeon and practice characteristics.
• Iterative inductive/deductive coding and analysis to develop a conceptual framework.

Main Results:

• Surgeons' decision-making has shifted from counting diverticulitis episodes to prioritizing patient quality of life.
• Key themes identified include psychosocial factors influencing quality of life more than physiological dysfunction.
• A conceptual model illustrating the complexity of surgical decision-making was developed.

Conclusions:

• Current surgical recommendations for recurrent diverticulitis are moving beyond traditional episode-based criteria.
• Decision-making is multifactorial, incorporating surgeon and patient elements and evolving over time.
• Interventions promoting shared decision-making are needed to address the complexities and surgeon challenges in this area.