(Poster 106) POWURS: Peri-Operative Education for Women Undergoing Reconstructive Surgery

Objectives: Our tertiary care Pelvic Floor Clinic experiences numerous unscheduled peri-operative information seeking encounters despite prior provision of a wealth of pelvic reconstructive surgery patient education resources. This additional information seeking suggested that something was lacking in our peri-operative counselling. Existing literature on peri-operative education interventions almost universally lacks patient input. Therefore, before optimizing our peri-operative education resources, we sought to understand the patient perspective on peri-operative counselling when undergoing pelvic reconstructive surgery.

Methods: Mariam’s basic qualitative research design was used. The purpose of this research methodology is to explore multiple perspectives and understand how participants make sense of their experience. Maslow’s Hierarchy of Needs was our theoretical framework. Three enabling questions explored preoperative and postoperative patient perspectives on educational content and preferred route of information delivery. Data collected included clinic surgical nurses’ phone- logs, all existing peri-operative patient education written materials, and semi-structured participant interviews. Participants were recruited through convenience sampling. Inclusion criteria were age over 18 and undergoing or recently undergone pelvic reconstructive surgery at the institution under study. Interview questions were informed by common peri-operative patient inquiries documented in the phone-logs. Interviews were transcribed and analysed iteratively using a general inductive approach in MaxQDA24.

Results: Review of phone-logs revealed two common pre-operative (procedure related, peri-operative logistics) and seven common post-operative (bowels, bladder, vaginal discharge, pain, medications, post-operative activity, incisional care) information seeking topics. 67% of calls were NON-emergent and reflected patients' desire for information that would or should have been provided in routine peri-operative counselling.
Review of written peri-operative educational resources uncovered that this material is inconsistent, conflicting, and vague.
Thirty participants were recruited and interviewed between September 2023-May 2024. Six overarching themes emerged from the data: 1.Information received is heterogeneous; 2.Foreign physical post-op sensations/states; 3.Lived experience; 4.Proactive delivery of information; 5.Multiple sources to meet different needs; and 6. Access. The themes that emerged spoke to the three foundational levels of Maslow’s hierarchy: physiological, safety and security, and love and belonging.

Conclusions: This study sheds light on the patient perspective on peri-operative educational content and mode of delivery. It is clear that post-operative physical changes threaten basic human needs which may lead to some information seeking encounters being primarily to seek out reassurance and validation, rather than to fill a gap in information provided. Each patient’s peri-operative experience is unique, and counselling should be individualized to the best of our capacity to ensure patients receive information that is both proactive and reactive, continuously accessible, and meets their needs. This data will inform how we approach optimization of our peri-operative education.