Abstract
BackgroundPreoperative assessment of mental health rarely occurs within routine surgery. Any screening tool selected to form part of this process must be deemed practical, acceptable and valid by clinicians and consumers alike. This study aims to assess the acceptability and face validity of two existing mental health screening tools to select one for further development and use in the routine surgical setting.MethodsA survey of clinicians and consumers was conducted from October 2020 to March 2021 at a tertiary hospital in Sydney, Australia. Using a Likert scale (1–5, lowest to highest rating), the clinicians evaluated four domains for acceptability and two for validity (six overall) and the consumers four domains for acceptability and one for validity (five overall) on the preoperative use of the amended Kessler Psychological Distress Scale (K10) and the Somatic and Psychological Health Report-12 (SPHERE-12). Consensus was achieved through a rating of 4 or 5 being given by 70% or more of participants with domains able to remain unchanged. Free text responses were analysed into themes.ResultsA total of 73 participants (51 clinicians; 22 consumers) were included. The K10 received consensus scores (≥ 70%) in four out of six domains for clinicians (4/4 acceptability; 0/2 validity), and all five domains for consumers (4/4 acceptability; 1/1 validity). The SPHERE-12 received consensus scores (≥ 70%) in three domains for clinicians (3/4 acceptability; 0/2 validity), and three domains for consumers (3/4 acceptability; 0/1 validity). Six qualitative themes were described including (1) amendments to tool structure and language; (2) scale response options; (3) difficulty with somatic questions; (4) practicality and familiarity with K10; (5) challenges for specific patient cohorts and (6) timing considerations for patients.ConclusionAdequate acceptability was established for the K10. However further development is required to strengthen its validity for this specific surgical cohort and purpose. Future research to determine the feasibility and acceptability of implementing and using the K10 in the routine surgical setting is now needed.
Highlights
In order to provide high-value care within surgery, identifying patient-specific preoperative risk factors is essential for optimising surgical treatment
Study design and ethics A survey of clinicians and consumers was conducted on Royal Prince Alfred (RPA) Hospital campus in Sydney, Australia between October 2020 and March 2021 to measure the acceptability and face validity of two amended mental health screening tools with the intention to select one for further development and pilot testing
Study sample Feedback was sought from a minimum of 50 clinicians and 20 consumers to voluntarily participate from the following groups: (i) Clinicians: Consultant level clinicians potentially involved in the surgical care of people with serious mental illness (SMI) including cardiothoracic and colorectal surgeons, anaesthetists, psychiatrists, psychologists and mental health or surgical clinical nurse consultants (CNC) were invited to participate in the study via email, which included a link to the online survey and a softcopy, by their own head of department; (ii) Consumers: Both surgical and mental health consumers were invited to participate in the study
Summary
In order to provide high-value care within surgery, identifying patient-specific preoperative risk factors is essential for optimising surgical treatment. SMI, which is defined as a mental, behavioural and/or emotional disorder that has episodic, recurrent or persistent features resulting in severe impairment [6], impacts on three percent of the population and includes a highly vulnerable group of patients due to the range of health, social and occupational challenges they face [7] Given this known gap in surgical practise and the critical needs of these patients, it is apparent that simple mental health screening may be a beneficial mechanism for proactively identifying those patients who need further support with their mental health. The aim of this study is to assess the acceptability and face validity of two existing mental health screening tools using clinician and consumer feedback, to enable selection of one for further development and use in the routine surgical setting. This study aims to assess the acceptability and face validity of two existing mental health screening tools to select one for further development and use in the routine surgical setting
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