4.4 Article

Understanding the surgical experience for Black and White patients with inflammatory bowel disease (IBD): The importance of health literacy

Journal

AMERICAN JOURNAL OF SURGERY
Volume 223, Issue 2, Pages 303-311

Publisher

EXCERPTA MEDICA INC-ELSEVIER SCIENCE INC
DOI: 10.1016/j.amjsurg.2021.06.003

Keywords

IBD; Surgery; Outcomes; Disparities; Health literacy

Categories

Funding

  1. (2017e2019) from the Agency for Healthcare Research and Quality (AHRQ) through the UAB Center for Outcomes and Effectiveness Research and Education (COERE) [K12 HS023009]
  2. Minority Health and Health Research Center (MHRC)
  3. National Institute on Minority Health and Health Disparities (NIMHD) [K23 MD013903]
  4. T32 Institutional National Research Service Awards (NRSA)
  5. American College of Surgeons (ACS) (2020e2022 Resident Research Scholarship Award)

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This study aimed to characterize the surgical experience for Black and White inflammatory bowel disease (IBD) patients using qualitative methods. Four themes emerged, including the impact of the IBD diagnosis, the quality of provided information, disease management, and the surgery itself. Both groups emphasized the importance of accurate, trustworthy, and understandable health information.
Background: Racial/ethnic disparities in outcomes exist for patients with inflammatory bowel disease (IBD) undergoing surgery. The underlying mechanism(s) remain unclear and patient perspectives are needed. We therefore aimed to characterize the surgical experience for Black and White IBD patients using qualitative methods. Methods: Patients with IBD who had undergone surgery were recruited to same-race qualitative interviews. Semi-structured interviews explored barriers and facilitators to a positive or negative surgical experience. Transcripts were analyzed with NVivo 12 software. Results: Six focus groups were conducted that included 10 Black and 17 White IBD participants. The mean age was 44.8 years (SD 13.2), 52% were male and 65% had Crohn's disease. Four themes emerged that most defined the surgical experience: the impact of the IBD diagnosis, the quality of provided information, disease management and the surgery itself. Within these themes, barriers to a positive surgical experience included inadequate personal knowledge of IBD, ineffective written and verbal communication, lack of a support system and complications after surgery. Both groups reported that information was provided inconsistently which led to unclear expectations of surgical outcomes. Conclusions: Black and White patients with IBD have varied surgical experiences but all stressed the importance of accurate, trustworthy and understandable health information. These findings highlight the value of providing health literacy-sensitive care in surgery. (C) 2021 Elsevier Inc. All rights reserved.

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