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

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.