Related Experiment Video
Updated: Aug 1, 2025
06:24
A Spine Robotic-Assisted Navigation System for Pedicle Screw Placement
Published on: May 11, 2020
8.9K
Opportunities for shared decision-making about major surgery with high-risk patients: a multi-method qualitative
Sara E Shaw1, Gemma Hughes1, Rupert Pearse2
1Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
British Journal of Anaesthesia
|April 28, 2023
Summary
Shared decision-making in major surgery is limited, especially for life-threatening conditions. Opportunities increase for life-enhancing procedures, influenced by patient factors and clinical pathways.
Area of Science:
- Medical Decision Making
- Surgical Patient Care
- Health Services Research
Background:
- Limited understanding of shared decision-making (SDM) in major surgery for older, high-risk patients.
- Need to explore how clinicians and patients engage in SDM for major surgical procedures.
Purpose of the Study:
- To examine the opportunities for, and dynamics of, shared decision-making in major surgery.
- To understand the factors influencing SDM in surgical consultations.
Main Methods:
- Multi-method qualitative study in five UK hospitals.
- Included video recordings of consultations, interviews, focus groups (patients, relatives, clinicians), observations, and documentary analysis.
- Study focused on major orthopaedic, colorectal, and cardiac surgery.
Main Results:
- Identified three types of consultations influencing SDM opportunities: resolution-focused, evaluative, and deliberative.
- Resolution-focused consultations (life-threatening issues) offered limited SDM.
- Evaluative (life-enhancing) and deliberative (complex comorbidities) consultations provided greater SDM opportunities.
Conclusions:
- Shared decision-making in major surgery is not consistently achieved.
- The nature of the presenting problem, patient comorbidities, and clinical pathways significantly impact SDM.
- SDM is most feasible when focusing on life-enhancing surgical treatments.
Keywords:
cardiac surgerycolorectal surgerydecision-making consultationhigh-risk patientsmajor surgerymulti-method qualitative studyorthopaedic surgeryshared decision-makingMore Related Videos
08:50Technique and Patient Selection Criteria of Right Anterior Mini-Thoracotomy for Minimal Access Aortic Valve Replacement
Published on: March 26, 2018
11.8K
13:56Robot Assisted Distal Pancreatectomy with Celiac Axis Resection DP-CAR for Pancreatic Cancer: Surgical Planning and Technique
Published on: August 14, 2021
6.4K
Related Concept Videos
01:28Cardiomyopathy VII: Pre and Post Operative Nursing Management
18
Patients with hypertrophic cardiomyopathy (HCM) and left ventricular outflow tract (LVOT) obstruction who remain symptomatic despite optimal medical therapy may undergo a septal myectomy (Morrow procedure). This procedure involves excising a portion of the hypertrophied septum below the aortic valve using a heart-lung machine to improve blood flow through the LVOT. Effective preoperative and postoperative nursing management ensures successful patient outcomes, minimizes complications, and...
18
01:21Inflammatory Bowel Disease V: Surgical Management
179
Surgical interventions for inflammatory bowel disease (IBD), which includes ulcerative colitis and Crohn's disease, are essential in managing symptoms and addressing complications. The selection of surgical procedures is contingent upon the specific conditions and complications that stem from these illnesses.
Here are some common surgical interventions for IBD:
Here are some common surgical interventions for IBD:
179
01:23Peripheral Artery Disease V: Postoperative Nursing Management
14
During the postoperative period, it is crucial to focus on maintaining circulation, identifying and managing potential complications, and planning for discharge.Nursing AssessmentVital signs monitoring: Regularly monitor vital signs, including blood pressure, heart rate, respiratory rate, and temperature, to detect early signs of complications such as bleeding and infection.Circulation assessment: Monitor pulses, perform Doppler assessments, and check capillary refill, color, temperature, and...
14
01:26Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy
136
Sigmoidoscopy and laparoscopy are distinct medical procedures that enable physicians to internally inspect different parts of the GI tract. Although they serve different purposes, each is essential for diagnosing and, in some cases, treating various medical conditions.
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
136
01:30Psychosurgery
85
Psychosurgery, the surgical alteration or permanent removal of brain tissue to alleviate severe psychological conditions, stands as one of the most radical and controversial treatments in the history of mental health care. Its development and application have evolved significantly, marked by dramatic shifts in scientific understanding and ethical perspectives.
Historical Development of Psychosurgery
In the 1930s, Portuguese neurologist Antonio Egas Moniz introduced a surgical procedure designed...
Historical Development of Psychosurgery
In the 1930s, Portuguese neurologist Antonio Egas Moniz introduced a surgical procedure designed...
85
01:22Aneurysm IV: Nursing Management
12
Vigilant monitoring for aneurysm rupture is essential for patients undergoing aortic surgery.Preoperative Nursing ManagementContinuously monitor the patient for manifestations of aneurysm rupture, such as pallor, weakness, tachycardia, hypotension, abdominal, back, groin, or periumbilical pain, changes in consciousness, and a pulsating abdominal mass. Regularly assess the patient's peripheral pulses.Instruct the patient to consume a clear liquid diet the day before surgery and administer...
12