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Gaining the patient perspective on pelvic floor disorders' surgical adverse events.

Abstract：

BACKGROUND:The Institute for Healthcare Improvement defines an adverse event as an unintended physical injury resulting from or contributed to by medical care that requires additional monitoring, treatment, or hospitalization or that results in death. The majority of research has focused on adverse events from the provider's perspective. OBJECTIVE:The objective of this qualitative study was to describe patient perceptions on adverse events following surgery for pelvic floor disorders. STUDY DESIGN:Women representing the following 3 separate surgical populations participated in focus groups: (1) preoperative (women <12 weeks prior to surgery); (2) short-term postoperative (women up to 12 weeks after surgery); and (3) long-term postoperative (women 1-5 years after surgery). Deidentified transcripts of audio recordings were coded and analyzed with NVivo 10 software to identify themes, concepts, and adverse events. Women were asked to rank patient-identified and surgeon-identified adverse events in order of perceived severity. RESULTS:Eighty-one women participated in 12 focus groups. Group demographics were similar between groups, and all groups shared similar perspectives regarding surgical expectations. Women commonly reported an unclear understanding of their surgery and categorized adverse events such as incontinence, constipation, nocturia, and lack of improvement in sexual function as very severe, ranking these comparably with intensive care unit admissions or other major surgical complications. Women also expressed a sense of personal failure and shame if symptoms recurred. CONCLUSION:Women consider functional outcomes such as incontinence, sexual dysfunction, and recurrence of symptoms as severe adverse events and rate them as similar in severity to intensive care unit admissions and death.

journal_name

Am J Obstet Gynecol

journal_title

American journal of obstetrics and gynecology

authors

Dunivan GC,Sussman AL,Jelovsek JE,Sung V,Andy UU,Ballard A,Jakus-Waldman S,Amundsen CL,Chermansky CJ,Bann CM,Mazloomdoost D,Rogers RG,Eunice Kennedy Shriver National Institute of Child Health and Human Development Pelvic Floor Di

doi

10.1016/j.ajog.2018.10.033

subject

Has Abstract

pub_date

2019-02-01 00:00:00

pages

185.e1-185.e10

issue

eissn

0002-9378

issn

1097-6868

pii

S0002-9378(18)30917-7

journal_volume

220

pub_type

杂志文章,多中心研究

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Gaining the patient perspective on pelvic floor disorders' surgical adverse events.