What is the clinical evidence from this study?

Study design: Other. Population: Preoperative shared decision-making (n=18). Primary outcome: Surgeon perspectives on decisional antecedents and opportunities to strengthen shared decision-making.

What question did this study set out to answer?

This study aims to understand surgeon perspectives on factors influencing shared decision-making before surgery.

February 28, 2026

Surgeon Perspectives on Decisional Antecedents in Preoperative Decision-Making

Key Result

Qualitative interviews with 18 surgeons revealed that time constraints and structural barriers limit the incorporation of patient decisional antecedents into preoperative shared decision-making.

Key Points

This study aims to understand surgeon perspectives on factors influencing shared decision-making before surgery.
Conducted in-depth, semistructured interviews with surgeons at an academic medical center.
Analyzed interviews thematically using NVivo, with independent coding by team members.
Identified themes on surgeon approaches to decision-making in preoperative consultations.
Eighteen surgeons from six subspecialties participated in the study.
Identified five themes including variability in patient engagement and the role of decisional antecedents.
Surgeons noted structural barriers that hindered the incorporation of patient values during consultations.

Structured PICO

Population

18 surgeons from six subspecialties at a single academic medical center

Intervention

In-depth, semistructured interviews

Outcome

Surgeon perspectives on decisional antecedents and opportunities to strengthen shared decision-making (SDM) within routine surgical workflows

Surgeons view decisional antecedents and third-party perspectives as central to shared decision-making but face structural barriers to incorporating them during time-limited preoperative consultations.

Abstract

INTRODUCTION Shared decision-making (SDM) is widely endorsed in surgical care, yet it is inconsistently applied. A lack of attention to decisional antecedents, including patients' beliefs, goals, experiences, emotions, and social context, may contribute to this gap, particularly in time-constrained preoperative settings. The current study sought to characterize surgeon perspectives on decisional antecedents and identify opportunities to strengthen SDM within routine surgical workflows. METHODS In-depth, semistructured interviews were conducted with surgeons at a single academic medical center. Surgeons were identified through departmental faculty lists and invited by email. Interviews were conducted via Zoom, transcribed verbatim, and analyzed thematically in NVivo using an inductive approach. Two team members independently coded transcripts and developed themes through iterative discussion. RESULTS Eighteen surgeons from six subspecialties participated. Five themes characterized how surgeons approached SDM in preoperative consultations: (1) variability in patient engagement, (2) role of decisional antecedents, (3) time and cognitive constraints, (4) value of pre-encounter context, and (5) third parties reveal patient values. Surgeons reported that patients differ widely in their readiness, informational needs, prior experiences, and desired involvement, yet this information was often not available to them because routine workflows provided few opportunities to uncover it. Surgeons viewed decisional antecedents and third-party perspectives (e.g., family, caregivers) as central to SDM but reported structural barriers to incorporate these factors during time-limited consultations. CONCLUSIONS Pre-visit strategies are needed to surface key contextual factors to support SDM within existing surgical workflows.

Perguntar à IA

Bookmark