Value-Based Medical History in patients undergoing major oncological surgery – a pilot study
Authors:
Radovan Turek 1; Klára Nekvindová 1,3; Tomáš Gabrhelík 1,3; Lenka Doubravská 2; Olga Klementová 2
Authors‘ workplace:
ARIM, Krajská nemocnice Tomáše Bati, Zlín
1; KARIM, Fakultní nemocnice Olomouc
2; Fakulta humanitních studií, Univerzita Tomáše Bati ve Zlíně
3
Published in:
Geriatrie a Gerontologie 2026, 15, č. 3: 114-119
Category:
Original Article
doi:
https://doi.org/10.61568/geri/50-6779/20260805/144185
Overview
Objective: This pilot study evaluates changes in the value system of older adults undergoing major oncological surgery and subsequent intensive care unit hospitalization, using the Value-Based Medical History (VBMH) framework.
Methods: Patients aged ≥ 65 years, classified as ASA III and scheduled for postoperative intensive care admission, were prospectively enrolled. The Value-Based Medical History (VBMH) was obtained through a structured interview at two predefined time points: preoperatively in the anesthesia clinic and between postoperative days 2–30 in the intensive care. All interviews were transcribed verbatim and analyzed using descriptive thematic analysis
Results: Before surgery, patients predominantly focused on the technical aspects of the procedure and demonstrated limited understanding of their illness. Postoperatively, while their core value orientation remained stable, there was a significant shift in emphasis toward priorities such as family support, autonomy, dignity, and overall quality of life. The perceived importance of a key close person increased during the ICU stay, and several patients expressed new spiritual or existential reflections.
Conclusion: The core value system of elderly surgical patients remains stable during the perioperative course, yet the hierarchy and perceived urgency of individual priorities change dynamically. These findings support the integration of VBMH into routine perioperative care, as it enhances understanding of individual patient priorities and strengthens communication and shared decision-making.
Keywords:
intensive care – elderly patients – value-based medical history – oncological surgery – shared decision-making
Sources
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Labels
Geriatrics General practitioner for adults Orthopaedic prostheticsArticle was published in
Geriatrics and Gerontology
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