Gastrointestinal Surgical Patient and Multidisciplinary Healthcare Provider Beliefs and Practices Around Perioperative Nutrition: A Mixed Methods Study

Introduction: Nutrition is critical to gastrointestinal (GI) disease prevention and treatment, including operations, yet perioperative nutrition practices vary widely. We aimed to understand GI surgical patient and healthcare provider perioperative nutrition beliefs and practices. 

Methods: We used a mixed methods approach including a patient survey (n=19), provider survey (n=26), and semi-structured interviews with a subset of providers (n=15). Providers included surgeons, gastroenterologists, medical oncologists, advanced practice providers, and dietitians. Provider interviews were transcribed, iteratively coded, and thematically analyzed. Quantitative and qualitative data were integrated. 

Results: 94.7% of patients and 100% of providers surveyed believe that nutrition affects outcomes. Patients seek nutrition information from diverse resources (73.7% from websites/blogs, 42.1% from documentaries, 36.8% from books/magazines) and people (52.6% from family members, 42.1% from a significant other/partner/spouse, 36.8% from a dietitian/nutritionist). Providers cited lack of quality information, misinformation, and inconsistency among healthcare providers as barriers to high-quality nutrition care. Both patients and providers noted that nutritional supplements have drawbacks, with 100% of patients and 96.2% of providers expressing interest in house made plant-based protein smoothie or soup alternatives. 

Conclusion: This study led to the development of a multidisciplinary task force which has collaborated on multiple interventions to improve inpatient perioperative surgical nutrition (e.g. smoothie pilot and postoperative menu revisions).