Martin J Carney1, Kate E Golden2, Jason M Weissler1, Michael A Lanni1, Andrew R Bauder1, Brigid Cakouros2, Fabiola Enriquez1, Robyn Broach1, Frances K Barg2,3, Marilyn M Schapira4, John P Fischer5. 1. Division of Plastic Surgery, Department of Surgery, Penn Presbyterian Medical Center, University of Pennsylvania, Perelman School of Medicine, 2nd Floor Wright-Saunders Building, 51 N. 39th Street, Philadelphia, PA, 19104, USA. 2. Mixed Methods Research Lab, University of Pennsylvania, Philadelphia, PA, USA. 3. Department of Family Medicine and Community Health, University of Pennsylvania, Philadelphia, PA, USA. 4. Division of General Internal Medicine, University of Pennsylvania, Philadelphia, PA, USA. 5. Division of Plastic Surgery, Department of Surgery, Penn Presbyterian Medical Center, University of Pennsylvania, Perelman School of Medicine, 2nd Floor Wright-Saunders Building, 51 N. 39th Street, Philadelphia, PA, 19104, USA. John.Fischer2@uphs.upenn.edu.
Abstract
BACKGROUND: Current hernia patient-reported outcome (PRO) measures were developed without patient input, greatly impairing their content validity. OBJECTIVE: The purpose of this study was to develop a conceptual model for PRO measures for ventral hernia (VH) patients. METHODS: Fifteen semi-structured, concept elicitation interviews and two focus groups employing nominal group technique were conducted with VH patients. Patients were recruited between November 2015 and July 2016 over the telephone from a five-surgeon patient cohort at our institution. Iterative thematic analysis identified domains. Reliability and validation were achieved using inter-rater reliability checks and triangulation. RESULTS: Seven framework domains were established: (1) expectations; (2) self and others; (3) surgeon and surgical team; (4) sensation; (5) function; (6) appearance; and (7) overall satisfaction. Overall patient satisfaction was associated with two themes: (1) provider-patient relationship; and (2) patient assessment of post-repair improvement. CONCLUSIONS: VH patients experience a profoundly broad range of reactions to VH repair. A patient-informed PRO instrument that addresses the spectrum of patient-identified outcomes can guide practice, optimizing care targeting VH patients' needs.
BACKGROUND: Current herniapatient-reported outcome (PRO) measures were developed without patient input, greatly impairing their content validity. OBJECTIVE: The purpose of this study was to develop a conceptual model for PRO measures for ventral hernia (VH) patients. METHODS: Fifteen semi-structured, concept elicitation interviews and two focus groups employing nominal group technique were conducted with VH patients. Patients were recruited between November 2015 and July 2016 over the telephone from a five-surgeon patient cohort at our institution. Iterative thematic analysis identified domains. Reliability and validation were achieved using inter-rater reliability checks and triangulation. RESULTS: Seven framework domains were established: (1) expectations; (2) self and others; (3) surgeon and surgical team; (4) sensation; (5) function; (6) appearance; and (7) overall satisfaction. Overall patient satisfaction was associated with two themes: (1) provider-patient relationship; and (2) patient assessment of post-repair improvement. CONCLUSIONS: VH patients experience a profoundly broad range of reactions to VH repair. A patient-informed PRO instrument that addresses the spectrum of patient-identified outcomes can guide practice, optimizing care targeting VH patients' needs.
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