Gena C Dunivan1, Brenna L McGuire2, Heidi A Rishel Brakey3, Yuko M Komesu4, Rebecca G Rogers5, Andrew L Sussman6. 1. Division of Urogynecology, Department of OBGYN, University of New Mexico, 1 University of New Mexico, MSC 10-5580, Albuquerque, NM, 87131-0001, USA. gdunivan@salud.unm.edu. 2. Department of OBGYN, University of New Mexico, Albuquerque, NM, USA. 3. Clinical and Translational Science Center, University of New Mexico, Albuquerque, NM, USA. 4. Division of Urogynecology, Department of OBGYN, University of New Mexico, 1 University of New Mexico, MSC 10-5580, Albuquerque, NM, 87131-0001, USA. 5. Department of Women' Health, Dell Medical School, University of Texas at Austin, Austin, TX, USA. 6. Department of Family and Community Medicine, University of New Mexico, Albuquerque, NM, USA.
Abstract
INTRODUCTION AND HYPOTHESIS: Patient perception of adverse events (AEs) after pelvic floor disorder surgery is incompletely understood and may differ from providers' views of AEs. Our objective is to describe patient perceptions of AEs related to pelvic floor disorder surgery and how perceptions change over time. METHODS: Mixed-method study of longitudinal patient interviews and surveys. Women planning pelvic floor disorder surgery completed three one-on-one interviews: preoperatively (< 12 weeks before surgery), 6-8 weeks postoperatively, and 6 months postoperatively. Interviews explored the patient experience of surgery and their perception of AEs over time. Participants ranked self-identified AEs by severity. De-identified transcripts of audio recordings were coded and analyzed using an iterative, thematic, team-based process using NVivo software (QSR International). RESULTS: Twenty women each completed three separate interviews for a total of 60 interviews. Their mean age was 55.3 (± 12.7) years, and 50% were Non-Hispanic white. Women's perceptions of AEs changed as more time passed from surgery. Women identified potential problems related to surgery such as anesthesia complications, pain, injury, catheter issues, and an unsuccessful surgery as the most concerning AEs preoperatively. Postoperatively (6-8 weeks), women expressed concern about functional outcomes (e.g., performing daily activities, symptom reduction). Late postoperatively (6 months), the majority identified unsuccessful surgery, incontinence, and sexual dysfunction as severe AEs. These findings are consistent with prior work that suggests women perceive functional outcomes as fundamental to their recovery. CONCLUSIONS: These findings contribute to a more nuanced understanding of patient-centered perspectives on AEs. Patients view poor functional outcomes as severe AEs.
INTRODUCTION AND HYPOTHESIS: Patient perception of adverse events (AEs) after pelvic floor disorder surgery is incompletely understood and may differ from providers' views of AEs. Our objective is to describe patient perceptions of AEs related to pelvic floor disorder surgery and how perceptions change over time. METHODS: Mixed-method study of longitudinalpatient interviews and surveys. Womenplanning pelvic floor disorder surgery completed three one-on-one interviews: preoperatively (< 12 weeks before surgery), 6-8 weeks postoperatively, and 6 months postoperatively. Interviews explored the patient experience of surgery and their perception of AEs over time. Participants ranked self-identified AEs by severity. De-identified transcripts of audio recordings were coded and analyzed using an iterative, thematic, team-based process using NVivo software (QSR International). RESULTS: Twenty women each completed three separate interviews for a total of 60 interviews. Their mean age was 55.3 (± 12.7) years, and 50% were Non-Hispanic white. Women's perceptions of AEs changed as more time passed from surgery. Women identified potential problems related to surgery such as anesthesia complications, pain, injury, catheter issues, and an unsuccessful surgery as the most concerning AEs preoperatively. Postoperatively (6-8 weeks), women expressed concern about functional outcomes (e.g., performing daily activities, symptom reduction). Late postoperatively (6 months), the majority identified unsuccessful surgery, incontinence, and sexual dysfunction as severe AEs. These findings are consistent with prior work that suggests women perceive functional outcomes as fundamental to their recovery. CONCLUSIONS: These findings contribute to a more nuanced understanding of patient-centered perspectives on AEs. Patients view poor functional outcomes as severe AEs.
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