Exploring Emotional Responses After Postoperative Complications

Abstract

Objective: This qualitative study explored the impact of postoperative complications on surgeons and their well-being. Background: Complications are an inherent component of surgical practice. Although there have been extensive efforts to reduce postoperative complications, the impact of complications on surgeons have not been well-studied. Surgeons are often left to process their own emotional responses to these complications, the effects of which are not well characterized. Methods: We conducted 46 semi-structured interviews with a diverse range of surgeons practicing across Michigan to explore their responses to postoperative complications and the effect on overall well-being. The data were analyzed iteratively, through steps informed by thematic analysis. Results: Participants described feelings of sadness, anxiety, frustration, grief, failure, and disappointment after postoperative complications. When asked to elaborate on these responses, participants described internal processes such as feelings of personal responsibility and failure, self-doubt, and failing the patient and family. Participants also described external pressures influencing the responses, which included potential impact to reputation and medicolegal issues. Experience level, type of complication, and the surgeon's individual personality were specific factors that influenced the intensity of these responses. Conclusion: Surgeons' emotional responses after postoperative complications may negatively impact individual well-being, and may represent a threat to the profession altogether if these issues remain inadequately recognized and addressed. Knowledge of the impact of unwanted or unexpected outcomes on surgeons is critical in developing and implementing strategies to cope with the challenges frequently encountered in the surgical profession.

Complication Is Inevitable, but Suffering is Optional—Psychological Aspects of Dealing with Complications in Surgery

“…Deeper preoperative relationships with patients and their families can amplify the response to adverse events. 27,34,39 This response mirrors our natural tendency to be more distraught when accidents happen to loved ones rather than strangers. Among residents, the intensity of the perceived personal involvement in the patient's care increases their emotional response to complications.…”

“…37 Other responses include wanting to hide, feeling professionally unworthy, or questioning one' specialty choice. 27,28,34 Cognitive impairments such as difficulty concentrating, poor decision-making, and compromised dexterity may also occur. 26 The effects of complications on surgeons can persist for months after the initial event.…”

Protocol of an iterative qualitative study to develop a molecular testing decision aid for shared decision-making in patients with lung cancer after surgery

“…By referring to other literature38 39 and in order to achieve information saturation as far as possible, it is preliminarily estimated that data from approximately 30 cases must be included in the final analysis. Considering that approximately 20% of the data may not qualify for final analysis, data from at least 38 cases are needed in each section of the study.…”

Environmental Factors Impacting Wellness in the Trauma Provider

“…Surgeons noted feelings of sadness, anxiety, frustration, grief, and failure when encountering operative complications. They related their feelings of personal responsibility and of failing the patient and their family which lead to lack of self-confidence [ 31 ].…”