A qualitative exploration of companion involvement in the presurgical consent visit for patients undergoing major surgery for advanced cancer.

29Background: The decision to undergo non-emergent cancer surgery is complicated by risk of mortality and diminished quality of life weighed against potential benefits of extended life and symptom management. Sometimes, unanticipated clinical information or quality of life considerations (“disruptions”) arise during these pre-surgical visits, which can lead to to the surgery’s reconsideration, postponement, or cancelation. Little is known about disruptions. This paper explores case studies of how patients, companions, and surgeons negotiate surgical plan disruptions. Methods: This study is based on secondary analysis of pre-surgical recordings with 61 patients and nine surgeons. Patients were recruited at nine surgical oncology clinics at an academic tertiary care hospital from July 2015-September 2016. Qualitative analysis incorporated existing theory and inductively developed codes. Results: Four of the 61 pre-surgical visits were identified as having a disruption. Each case study explores the presentat...