A Patient-Centered Perioperative Mental Health Intervention Bundle: A Multi- and Mixed-Method Adaptation Study

Area of Science:

• Geriatric medicine
• Psychiatry
• Surgical care

Background:

• Anxiety and depression are prevalent in older adults, especially during the perioperative period.
• Existing mental health interventions often do not meet the specific needs of older surgical patients.

Approach:

• Developed and adapted a perioperative mental health (PMH) bundle using mixed-methods.
• Incorporated behavioral activation (BA) and medication optimization (MO) tailored for older surgical patients.
• Utilized patient and caregiver feedback, workshops, and analysis of intervention components for refinement.

Key Points:

• Adaptations focused on intervention content (43.1%), context (41.2%), and training/evaluation (15.7%).
• Key adaptations included tailoring content to patient preferences, addressing stigma, and enhancing patient buy-in.
• Patient-centered needs and compassion were central to intervention modifications.

Conclusions:

• Created a pragmatic, patient-centered PMH bundle that is acceptable and feasible for older surgical populations.
• The adapted intervention is responsive to the unique needs of older adults undergoing surgery.
• Identified strategies to enhance the reach, scalability, and sustainability of the PMH bundle for future implementation.