title: Structure and content in consultations with patients undergoing surgery for colorectal cancer.
abstract: OBJECTIVE
  To explore the structure and content of pre-planned consultations as part of the care and treatment of patients undergoing surgery for colorectal cancer.
  
  
  METHODS
  The study was based on 50 transcripts of audio-recorded pre-planned consultations between seven patients and 36 healthcare professionals from the time of diagnosis, pre-operative consultation, discharge consultation and pathology report in a colorectal unit.
  
  
  RESULTS
  The spread of consultation time between professions was considerable. Total mean consultation time for patients during the care process (7 consultations/patient) was 111 min (range 83-191). The mean consultation time for surgeons was 18 min (7-40), anaesthesiologists 12 min (5-18) and nurses 14 min (5-49). Patients took up 40% of the word space, healthcare professionals used 59% and significant others 1%. Word space changed in such a way that the patient became more active towards the final consultation. Neither during the diagnosis consultation nor during the pre-operative consultation did the patients meet the operating surgeon. Six major subjects emerged: general health, diagnosis, surgical procedure, pre-operative preparations, recovery and treatment and follow-up.
  
  
  CONCLUSIONS
  There is a need for clearer structure in the consultations. Most consultations lacked a clear introduction to the subject of the conversation. The study makes it possible to develop methods and structure for supporting conversations in which the patient is given space to help with the difficult issues present after undergoing surgery for colorectal cancer. The study also contributes to providing knowledge of how to organise surgical consultations in order to optimise person-centeredness, teamwork and clinical efficiency.
authors.affiliation: Colorectal Unit, Sahlgrenska University Hospital, Gothenburg, Sweden; Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Sweden; University of Gothenburg Centre for Person-centred Care (GPCC), Sweden. Electronic address: eva.k.carlsson@vgregion.se.
authors.forename: E
authors.initials: E
authors.lastname: Carlsson
authors.forename: M
authors.initials: M
authors.lastname: Pettersson
authors.forename: L-C
authors.initials: LC
authors.lastname: Hydén
authors.forename: J
authors.initials: J
authors.lastname: Öhlén
authors.forename: F
authors.initials: F
authors.lastname: Friberg
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001291:Attitude of Health Personnel; D015179:Colorectal Neoplasms / Q000175:diagnosis / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020380:Needs Assessment; D010348:Patient Care Team / Q000458:organization & administration*; D018802:Patient-Centered Care / Q000379:methods*; D010817:Physician-Patient Relations; D011300:Preoperative Care / Q000379:methods*; D012017:Referral and Consultation / Q000458:organization & administration*; D011795:Surveys and Questionnaires; D013548:Sweden; D013997:Time Factors
keywords: Colorectal cancer; Communication analysis; Consultations; ERAS; Partnership; Person-centred care; Surgery; Teamwork