Adaptability in Aging Patients: Demonstrating Proof of Concept and Identifying Opportunities for Pre-Procedural Intervention

In the current study, researchers hypothesize that, in the US, patients that make the best recovery from illness or injury are neither those with the most doctors, nor those with the most health care, but rather, those most adaptable to change.  The concept of adaptability, operationally defined as the ratio of resilience to vulnerability, accounts for both resilience factors (including social connectedness, patient engagement, and health literacy) as well as potential vulnerabilities (including co-morbidities and perceived stress) and presents them in a way that encourages medical professionals to think beyond the elements of a traditional medical chart (Connor & Davidson, 2003; Curtis & Cicchetti, 2003; Luthar, Cicchetti & Becker, 2000; Masten, 2001; Zautra, Hall & Murray, 2008). 

Building on a previously-published conceptual model of patient adaptability (Neigher and Hakim, 2012), the current study examines adaptability in aging patients and its predictive relationship with recovery after surgery.  Two patient populations were included: orthopedic patients undergoing total joint replacement (N=150), and cardiac patients undergoing open heart surgery (data collection begins 3/2014).  An adaptability battery was built from existing, well-validated instruments and administered pre-procedure.  Follow-up instruments included measures of functional health status (SF-12) and depression (PHQ-9).  The goal of the study is to establish predictive validity, so we can understand, prior to treatment, how well a patient is likely to do.  This knowledge will enable us to develop targeted interventions that the healthcare system can implement in partnership with community organizations to build patient adaptability and promote positive outcomes for elderly patients.