Changing multiple health behaviours prior to major surgery: surgery as a teachable moment

Abstract

Background There is compelling evidence showing that unhealthy behaviours such as physical inactivity, smoking, poor diet, and excess alcohol consumption are associated with an increased risk of post-surgical complications in patients undergoing major surgery. Changing unhealthy behaviours before surgery to reduce the risk of short-term post-operative complications might be more motivating to patients than the prospect of permanent behaviour change to promote longer-term health benefits. This study aimed to explore patient attitudes towards changing health behaviours before surgery. Methods 150 patients attending pre-surgical assessment at two hospital sites were recruited. Participants answered a questionnaire exploring motivation, confidence and priority in relation to changing their health behaviours. The questionnaire specifically compared attitudes towards changing individual and multiple health behaviours in the short-term versus the long-term. Responses were analysed using t-tests. Findings Patients were more motivated, confident and placed higher priority on increasing their physical activity and reducing alcohol intake when these changes were considered for short-term (i.e. post-surgical) versus long-term benefits. There was no significant difference in patients’ views for maintaining a healthy weight and smoking cessation. In addition, patients were more motivated, confident and placed higher priority on changing multiple behaviours for short-term versus long-term benefits. Discussion Patients are willing to make changes to multiple health behaviours prior to major surgery. Therefore, the pre-surgical period may represent a 'teachable moment' which can be used to promote both short-term (post-surgical) and long-term health benefits. Future research should explore the feasibility and acceptability of interventions targeting multiple behaviours in the pre-surgical context.