Barbara van Munster
Internist, Gelre Ziekenhuis
I am a geriatrician, and head of the department of geriatrics in Gelre Hospitals in Apeldoorn since 2010. I am also a senior researcher in the University of Groningen since 2015. I did my PhD in 2009 about the pathophysiology of delirium, but after this I specialized in research related to day to day patient care. My inner drive is to improve the quality of complex, multidisciplinary care in vulnerable elderly people with multimorbidity. I do this by combining patient care, quality policy and scientific research. The common ground for me is that the evidence will eventually contribute to a better insight in the best patient-related outcome for the individual patient.
Frailty is the concept of accumulating physiologic deficits that make people less able to deal with stressors, including surgery. The exact definition of frailty varies in scientific research and is subjectively determined in daily practice. It is associated with postoperative complications and functional decline. Prehabilitation is intervention to enhance functional capacity before surgery. The concept of resilience may explain why the impact of prehabilitation varies among patients.
Quote: “1. It is better to continuously rehabilitate then just for the moment you have to undergo surgery. 2, The commitment in prehabilitation of the individual patient is probably predictive for the commitment in postoperative rehabilitation. Commitment can therefore be seen as a prerequisite for surgery in a frail population.”