Elkadry Eman A, Kenton Kimberly S, FitzGerald Mary P, Shott Susan, Brubaker Linda
Division of Female Pelvic Medicine and Reconstructive Surgery, Loyola University Medical Center, Maywood, IL, USA.
Am J Obstet Gynecol. 2003 Dec;189(6):1551-7; discussion 1557-8. doi: 10.1016/s0002-9378(03)00932-3.
This study was undertaken to study the relationship between achievement of patient goals, overall satisfaction, and objective outcome measures.
After Institutional Review Board approval, we prospectively evaluated 78 women undergoing pelvic reconstructive surgery at Loyola University Medical Center. After informed consent for surgery, patients were asked to state their goals for surgery. In a follow-up telephone conversation, these goals were reviewed and negotiated to modify expectations. The same physician investigator contacted women 3 months after surgery to assess goal achievement, overall satisfaction, and their surgical experience. Date were analyzed with Spearman correlation and Mann-Whitney tests.
Of 78 women, 75% indicated that they met most of their goals, and 72% were more than 80% satisfied. Patient satisfaction was moderately correlated to goal achievement (rho=0.57, P<.001). Objective cure, defined as no urodynamic stress incontinence and stage 0 or I prolapse, was not related to satisfaction (P=.14). Dissatisfaction was highly associated with feeling "unprepared for surgery" (P<.001).
Objective and subjective outcomes are necessary to predict patient satisfaction.
本研究旨在探讨患者目标达成情况、总体满意度与客观结果指标之间的关系。
经机构审查委员会批准后，我们对洛约拉大学医学中心接受盆腔重建手术的78名女性进行了前瞻性评估。在获得手术知情同意后，要求患者陈述其手术目标。在后续的电话交谈中，对这些目标进行回顾和协商，以调整预期。同一位医生研究人员在术后3个月联系这些女性，评估目标达成情况、总体满意度及她们的手术体验。数据采用Spearman相关性分析和Mann-Whitney检验进行分析。
78名女性中，75%表示她们实现了大部分目标，72%的满意度超过80%。患者满意度与目标达成情况呈中度相关（rho = 0.57，P <.001）。定义为无尿动力学压力性尿失禁且脱垂为0期或I期的客观治愈情况与满意度无关（P =.14）。不满意与感觉“对手术未做好准备”高度相关（P <.001）。
客观和主观结果对于预测患者满意度是必要的。
