TY - JOUR
T1 - Examining the surgical stress effects (SSE) framework in practice
T2 - A qualitative assessment of perceived sources and consequences of intraoperative stress in surgical teams
AU - Chrouser, Kristin L.
AU - Partin, Melissa R.
AU - Gainsburg, Izzy
AU - White, Katie M.
N1 - Publisher Copyright:
© 2023
PY - 2024/2
Y1 - 2024/2
N2 - Background: Surgical adverse events persist despite extensive improvement efforts. Emotional and behavioral responses to stressors may influence intraoperative performance, as illustrated in the surgical stress effects (SSE) framework. However, the SSE has not been assessed using “real world” data. Methods: We conducted semi-structured interviews with all surgical team roles at one midwestern VA hospital and elicited narratives involving intraoperative stress. Two coders inductively identified codes from transcripts. The team identified themes among codes and assessed concordance with the SSE framework. Results: Throughout 28 interviews, we found surgical stress was ubiquitous, associated with a variety of factors, including adverse events. Stressors often elicited frustration, anger, fear, and anxiety; behavioral reactions to negative emotions frequently were perceived to degrade individual/team performance and compromise outcomes. Narratives were consistent with the SSE framework and support adding a process outcome (efficiency) and illustrating how adverse events can feedback and acutely increase job demands and stress. Conclusion: This qualitative study describes narratives of intraoperative stress, finding they are consistent with the SSE while also allowing minor improvements to the current framework.
AB - Background: Surgical adverse events persist despite extensive improvement efforts. Emotional and behavioral responses to stressors may influence intraoperative performance, as illustrated in the surgical stress effects (SSE) framework. However, the SSE has not been assessed using “real world” data. Methods: We conducted semi-structured interviews with all surgical team roles at one midwestern VA hospital and elicited narratives involving intraoperative stress. Two coders inductively identified codes from transcripts. The team identified themes among codes and assessed concordance with the SSE framework. Results: Throughout 28 interviews, we found surgical stress was ubiquitous, associated with a variety of factors, including adverse events. Stressors often elicited frustration, anger, fear, and anxiety; behavioral reactions to negative emotions frequently were perceived to degrade individual/team performance and compromise outcomes. Narratives were consistent with the SSE framework and support adding a process outcome (efficiency) and illustrating how adverse events can feedback and acutely increase job demands and stress. Conclusion: This qualitative study describes narratives of intraoperative stress, finding they are consistent with the SSE while also allowing minor improvements to the current framework.
KW - Adverse event
KW - Emotion
KW - Qualitative research
KW - Stress
KW - Surgery
KW - Teamwork
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U2 - 10.1016/j.amjsurg.2023.08.024
DO - 10.1016/j.amjsurg.2023.08.024
M3 - Article
C2 - 37689567
AN - SCOPUS:85170232440
SN - 0002-9610
VL - 228
SP - 133
EP - 140
JO - American journal of surgery
JF - American journal of surgery
ER -