A longitudinal qualitative evaluation of patient perspectives of adverse events after pelvic reconstructive surgery

Gena C. Dunivan, Brenna L. McGuire, Heidi A. Rishel Brakey, Yuko M. Komesu, Rebecca G. Rogers, Andrew L. Sussman

Research output: Contribution to journalArticle

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.

Original languageEnglish (US)
Pages (from-to)2023-2028
Number of pages6
JournalInternational Urogynecology Journal
Volume30
Issue number12
DOIs
StatePublished - Dec 1 2019

Fingerprint

Reconstructive Surgical Procedures
Pelvic Floor Disorders
Interviews
Longitudinal Studies
Software
Catheters
Anesthesia

Keywords

  • Functional outcomes
  • Pelvic floor disorders
  • Qualitative mixed method study
  • Surgical adverse events

ASJC Scopus subject areas

  • Obstetrics and Gynecology
  • Urology

Cite this

A longitudinal qualitative evaluation of patient perspectives of adverse events after pelvic reconstructive surgery. / Dunivan, Gena C.; McGuire, Brenna L.; Rishel Brakey, Heidi A.; Komesu, Yuko M.; Rogers, Rebecca G.; Sussman, Andrew L.

In: International Urogynecology Journal, Vol. 30, No. 12, 01.12.2019, p. 2023-2028.

Research output: Contribution to journalArticle

Dunivan, Gena C. ; McGuire, Brenna L. ; Rishel Brakey, Heidi A. ; Komesu, Yuko M. ; Rogers, Rebecca G. ; Sussman, Andrew L. / A longitudinal qualitative evaluation of patient perspectives of adverse events after pelvic reconstructive surgery. In: International Urogynecology Journal. 2019 ; Vol. 30, No. 12. pp. 2023-2028.
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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.",
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