What Matters? The Valued Life Activities of Older Adults Undergoing Elective Surgery - PubMed (original) (raw)

Observational Study

. 2019 Nov;67(11):2305-2310.

doi: 10.1111/jgs.16102. Epub 2019 Aug 10.

Affiliations

Observational Study

What Matters? The Valued Life Activities of Older Adults Undergoing Elective Surgery

Anna Kata et al. J Am Geriatr Soc. 2019 Nov.

Abstract

Objectives: Valued life activities are those activities an individual deems particularly important or meaningful. Surgery in older adults can affect their ability to perform valued activities, but data are lacking. We characterized these activities and assessed performance of them following surgery.

Design: Retrospective observational study.

Setting: Preoperative program for older adults undergoing elective surgery at an academic hospital.

Participants: Older adults (N = 194) in the program from February 2015 to February 2018.

Measurements: A preoperative written questionnaire asked, "What are the activities that are most important to you to be able to do when you return home from surgery?" Participants could list up to three activities. Content analysis was used to develop domains of valued life activities and categorize responses. Postoperative questionnaires and medical records were used to determine ability to perform activities 6 months after surgery.

Results: Of 194 participants (mean age = 74.9 ± 9.1 y), 57.7% were female; 33.5% had more than two comorbid conditions. We elicited 510 valued activities, with a mean of 2.6 (± .7) activities per participant. Content analysis revealed five categories: (1) recreational activities (28.9%); (2) mobility (24.9%); (3) activities of daily living (ADLs; 17.5%); (4) instrumental activities of daily living (IADLs; 16.9%); and (5) social activities (12.0%). Ultimately, 154 participants had surgery, of which 27.3% were unable to perform one of their valued activities at 6 months. Performance varied between activity categories; 91.9% of mobility activities, 90.8% of ADLs, 80.3% of IADLs, 77.3% of social activities, and 65.5% of recreational activities were able to be performed after surgery.

Conclusion: Older adults expressed a wide range of valued life activities. More than one-quarter were unable to engage in at least one valued life activity after surgery, with recreation the most commonly affected. Assessment of valued life activities should be incorporated into the perioperative management of older adults. J Am Geriatr Soc 67:2305-2310, 2019.

Keywords: function; geriatric surgery; older adults; valued life activity.

© 2019 The American Geriatrics Society.

PubMed Disclaimer

Conflict of interest statement

Conflict of Interest: Dr. Finlayson reports being founding shareholder of Ooney Inc., a digital health company. Remaining authors have no conflicts to report.

Figures

Figure 1.

Figure 1.

Characterization of Valued Life Activities (N= 510 activities). ADLs = Activities of Daily Living. IADLs = Instrumental Activities of Daily Living. Mobility includes ambulation and driving. Example of social activity: “attending church”, and recreational activity: “watch TV”, and “golf”.

Comment in

References

    1. National Center for Health Statistics. Number of all-listed procedures for discharges from short-stay hospitals, by procedure category and age: United States, 2010. Available at: https://www.cdc.gov/nchs/data/nhds/4procedures/2010pro4_numberprocedurea.... Accessed December 18, 2018.
    1. Etzioni DA, Liu JH, Maggard MA, Ko CY. The Aging Population and Its Impact on the Surgery Workforce. Ann Surg 2003;238(2):170–177. -PMC -PubMed
    1. Hshieh TT, Saczynski J, Gou RY, et al. Trajectory of Functional Recovery After Postoperative Delirium in Elective Surgery. Ann Surg 2017;265(4):647–653. -PMC -PubMed
    1. Katz P Function, disability, and psychological well-being. Adv Psychosom Med 2004;25:41–62. -PubMed
    1. Ditto PH, Druley JA, Moore KA, Danks JH, Smucker WD. Fates worse than death: The role of valued life activities in health-state evaluations. Health Psychol 1996;15(5):332–343. -PubMed

Publication types

MeSH terms

Grants and funding

LinkOut - more resources