ArticleColorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland2024
Barriers faced by surgeons in identifying and managing malnutrition in emergency general surgery: A qualitative study.
Article in Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed.
- The influence of surgeon seniority and intestinal failure experience on identifying malnourished patients in emergency general surgery: a national survey.Annals of the Royal College of Surgeons of England · 2026Article
- What influences emergency general surgeons' treatment preferences for patients requiring nutritional support? A discrete choice experiment.Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland · 2025Article
- Barriers faced by surgeons in identifying and managing malnutrition in emergency general surgery: A qualitative study.Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland · 2024Article
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5 authors.
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Abstract
aimMany patients undergoing emergency surgery are malnourished. Identifying malnutrition is a prerequisite to offering targeted nutritional support. Guidelines exist but little is known regarding exactly how surgeons identify malnutrition, or the barriers that influence surgeons' clinical decision-making. The aim of this work was to explore how consultant surgeons identify malnutrition in emergency general surgery (EGS) patients and the barriers to nutritional assessment and intervention.
methodConsultant surgeons with emergency surgery duties were invited to participate. Semi-structured interviews were conducted online, audiovisually recorded and transcribed. An inductive approach was used for data analysis using the framework method. Coding and analysis were performed by two independent researchers using NVivo software. Themes were developed and reviewed with the supervising team. Interviews continued until data saturation was reached. Ethical approval was gained prior to interviews.
resultsEighteen interviews were conducted across three hospital settings. Identification of malnutrition consisted of three themes: 'The surgeon' (knowledge, experience, planning ahead); 'The patient' (selection, composition, clinical progress, operative considerations); and 'The institution' (collaboration, extended surgical team). Three themes encompassed barriers experienced: 'The surgeon' (understanding, culture, ownership, time constraints); 'The institution' (provision, staffing, conflict, hospital setting); and 'The wider context' (research, external factors). These influenced clinical decision-making, which had two themes: 'To join or not to join' (risk taking, site of anastomosis) and 'Nutritional support' (timing, referral pathways).
conclusionsThe identification and management of malnutrition in EGS is fraught with barriers, impacting operative and clinical decision-making. Improvements in surgeon education, culture, collaborative working and resources are needed.
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