Evidence map›Paper›PMID 37500919›Full record

ArticleSurgical endoscopy2023

Life after "no": barriers to behavior change for persons declined hernia repair due to high-risk features.

Anne P Ehlers, Wilson Nham, C Ann Vitous, Forrest Hosea, Krisinda P Palazzolo, Ryan Howard, Lia Delaney, Jenny M Shao, Michael Rubyan, Dana A Telem

Abstract read
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In one paragraph

Article in Surgical endoscopy, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
1.3field-weighted citation impact, top 20% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 4 citations in OpenAlex.

  1. Article
  2. Article
  3. Article
  4. The effect of clinically significant weight loss prior to open ventral hernia repair.Hernia : the journal of hernias and abdominal wall surgery · 2024
    Article
  5. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 1 institution in 1 country.

Anne P EhlersDepartment of Surgery, University of Michigan, 1500 E Medical Center Drive, SPC 5343, 2210 Taubman Center, Ann Arbor, MI, 48109, USA. aehlers@med.umich.edu.ORCID 0000-0002-0332-2676
Wilson NhamMichigan Medicine Emergency Medicine Research, Ann Arbor, MI, USA.
C Ann VitousCenter for Healthcare Outcomes and Policy, Ann Arbor, MI, USA.
Forrest HoseaMichigan Surgical Quality Collaborative-Core Optimization Health Registry (MSQC-COHR), Ann Arbor, MI, USA.
Krisinda P PalazzoloCenter for Healthcare Outcomes and Policy, Ann Arbor, MI, USA.
Ryan HowardDepartment of Surgery, University of Michigan, 1500 E Medical Center Drive, SPC 5343, 2210 Taubman Center, Ann Arbor, MI, 48109, USA.
Lia DelaneyHenry Ford Health, Detroit, MI, USA.
Jenny M ShaoDepartment of Surgery, University of Michigan, 1500 E Medical Center Drive, SPC 5343, 2210 Taubman Center, Ann Arbor, MI, 48109, USA.
Michael RubyanHenry Ford Health, Detroit, MI, USA.
Dana A TelemDepartment of Surgery, University of Michigan, 1500 E Medical Center Drive, SPC 5343, 2210 Taubman Center, Ann Arbor, MI, 48109, USA.
Henry Ford Health System · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionDelaying an elective operation to mitigate risk factors improves patient outcomes. Elective ventral hernia repair is one such example. To address this issue, we developed a pre-operative optimization clinic to support high-risk patients seeking elective ventral hernia repair. Unfortunately, few patients progressed to surgery. Within this context, we sought to understand the barriers to behavior change among these patients with the goal of improving care for patients undergoing elective surgery.

methodsWe performed semi-structured, qualitative interviews with 20 patients who were declined ventral hernia repair due to either active tobacco use or obesity. Patients were recruited from a pre-operative optimization clinic at an academic hospital. Interviews sought to characterize patients' perceived barriers to behavior change. Interviews were concluded once thematic saturation was reached. We used an inductive thematic analysis to analyze the data. All data analysis was performed using MAXQDA software.

resultsAmong 20 patients (mean age 50, 65% female, 65% White), none had yet undergone ventral hernia repair. While most patients had a positive experience in the clinic, among those who did not, we found three dominant themes around behavior change: (1) Patient's role in behavior change: how the patient perceived their role in making behavior changes optimize their health for surgery; (2) Obtainability of offered resources: the need for more support for patients to access the recommended healthcare; and (3) Patient-provider concordance: the extent to which patients and providers agree on the relative importance of different attributes of their care.

conclusionBehavior change prior to elective surgery is complex and multifaceted. While improving access to tobacco cessation resources and obesity management may improve outcomes for some, patients may benefit from increased on-site facilitation to promote access to resources as well as the use of patient-facing decision support tools to promote patient-provider concordance.

Indexed as

Hernia, VentralHerniorrhaphyElective Surgical ProceduresFemaleHumansMaleMiddle AgedObesityRisk FactorsPre-operative optimizationQualitative researchVentral hernia

Identifiers

PMID37500919
OpenAlexW4385298946

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.