Healthcare workers' attitudes toward laparoscopic surgery for gallbladder disease in the Caribbean

Abstract

BackgroundThere are many well-documented obstacles to routine laparoscopy, but the contribution of healthcare workers' (HCWs') attitudes has not been examined. MethodsA questionnaire study was performed to evaluate HCWs' attitudes toward laparoscopic cholecystectomy (LC) in operating rooms of all public hospitals in Jamaica. ResultsThere were 285 HCWs interviewed from 12 hospitals across the nation. All HCWs were aware of the theoretic advantages of LC, but 56% opposed a suggestion to routinely offer LC to elective patients and 89% opposed LC for acute cholecystitis. Those in opposition were more commonly members of the nursing profession (71.8% vs 25.8%; P < 0.0001), older than 50 years (79.3% vs 50.2%; P < 0.0001), and those who graduated from their basic medical degree >20 years ago (72% vs 42.5%; P < 0.0001).Although some HCWs cited valid reasons to oppose LC, some made erroneous statements such as LC was for patients who were overly concerned with esthetics (48%), LC was unsafe when a conversion was required (35%), LC compromised patient safety for esthetics (25%), LC was inferior to open surgery (21%), LC brought no advantage over open surgery (21%), and LC was harmful (20%). These beliefs are not aligned with local or international data, and they add drag to the lethargic pace of laparoscopy in Jamaica. ConclusionA change in HCWs' attitudes is necessary to overcome the stagnation in laparoscopic practice. We propose short-term and long-term strategies that may potentially change HCWs' attitudes. This study identified the HCW population to be targeted.