Patient and caregiver preferences and prioritized outcomes for cardiac surgery: A scoping review and consultation workshop

Nebojša Oravec; Rakesh C Arora; Brian Bjorklund; April Gregora; Caroline Monnin; Mudra G Dave; Todd A Duhamel; David E Kent; Annette S H Schultz; Anna M Chudyk

doi:10.1016/j.jtcvs.2021.11.052

Patient and caregiver preferences and prioritized outcomes for cardiac surgery: A scoping review and consultation workshop

J Thorac Cardiovasc Surg. 2023 Aug;166(2):598-609.e7. doi: 10.1016/j.jtcvs.2021.11.052. Epub 2021 Nov 27.

Authors

Affiliations

¹ Section of Cardiac Surgery, Department of Surgery, Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada.
² Section of Cardiac Surgery, Department of Surgery, Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada; Department of Cardiac Sciences, St Boniface General Hospital, Winnipeg, Manitoba, Canada.
³ Enhanced Recovery Protocols for Cardiac Surgery Patient Researcher Group, St Boniface General Hospital, Winnipeg, Manitoba, Canada.
⁴ Neil John Maclean Health Sciences Library, University of Manitoba, Winnipeg, Manitoba, Canada.
⁵ Department of Cardiac Sciences, St Boniface General Hospital, Winnipeg, Manitoba, Canada; Faculty of Kinesiology and Recreation Management, University of Manitoba, Winnipeg, Manitoba, Canada.
⁶ Faculty of Kinesiology and Recreation Management, University of Manitoba, Winnipeg, Manitoba, Canada; Institute of Cardiovascular Sciences, St Boniface General Hospital Albrechtsen Research Centre, Winnipeg, Manitoba, Canada.
⁷ Department of Cardiac Sciences, St Boniface General Hospital, Winnipeg, Manitoba, Canada.
⁸ Rady Faculty of Health Sciences, College of Nursing, University of Manitoba, Winnipeg, Manitoba, Canada; Health Services & Structural Determinants of Health Research Group, St Boniface General Hospital Albrechtsen Research Centre, Winnipeg, Manitoba, Canada.
⁹ Rady Faculty of Health Sciences, College of Nursing, University of Manitoba, Winnipeg, Manitoba, Canada; Health Services & Structural Determinants of Health Research Group, St Boniface General Hospital Albrechtsen Research Centre, Winnipeg, Manitoba, Canada. Electronic address: anna.chudyk@umanitoba.ca.

PMID: 34924192
DOI: 10.1016/j.jtcvs.2021.11.052

Abstract

Objective(s): In light of the absence of patient and caregiver input in Enhanced Recovery After Surgery Cardiac Surgery guideline development, we conducted a scoping review to identify patient and caregiver preferences and prioritized outcomes related to perioperative care in cardiac surgery and its lifelong impact.

Methods: Five electronic databases were searched to retrieve studies investigating patient or caregiver preferences and prioritized outcomes. Information was charted in duplicate and analyzed using descriptive statistics or thematic analysis. A patient and caregiver consultation workshop validated scoping review findings and solicited novel preferences and outcomes.

Results: Of the 5292 articles retrieved, 43 met inclusion criteria. Most were from Europe (n = 19, 44%) or North America (n = 15, 35%) and qualitative and quantitative designs were represented in equal proportions. Fifty-two methods were used to obtain stakeholder preferences and prioritized outcomes, the majority being qualitative in nature (n = 32, 61%). Based on the collective preferences of 3772 patients and caregivers from the review and 17 from the consultation workshop, a total of 108 patient preferences, 32 caregiver preferences, and 19 prioritized outcomes were identified. The most commonly identified theme was "information and education." Improved quality of life was the most common patient-prioritized outcome, and all caregiver-prioritized outcomes were derived from the consultation workshop.

Conclusions: Patient and caregiver preferences overlap with Enhanced Recovery After Surgery Cardiac Surgery recommendations targeting preoperative risk reduction strategies, prehabilitation, patient engagement technology, and intra- and postoperative strategies to reduce discomfort. To support clinical practice, future research should investigate associations with key surgical outcomes.

Keywords: ERAS; engagement; enhanced recovery protocols; preferences; scoping review; stakeholder consultation.

Publication types

Review

MeSH terms

Cardiac Surgical Procedures* / adverse effects
Caregivers*
Humans
North America
Quality of Life
Referral and Consultation