Center for Devices and Radiological Health, U.S. Food and Drug Administration, 10903 New Hampshire Avenue Bldg. 66 Rm. G428, Silver Spring, MD, 20993, USA.
Hernia. 2019 Oct;23(5):995-1001. doi: 10.1007/s10029-019-02015-6. Epub 2019 Aug 5.
More than 350,000 ventral hernia repairs are performed in the U.S. each year. However, long-term quality of life of patients living with hernia repair is less known. Follow-up using patient-reported outcomes (measures) is an important representation of the patient experience and can inform quality improvements of hernia treatments. This study aims to understand the patients' experience after ventral hernia repair, to enhance quality of care and long-term hernia treatment outcomes.
To better understand long-term outcomes of ventral hernia repair and to enhance an existing PRO tool, two rounds of semi-structured interviews and focus groups were conducted. In total, 22 patients who had ventral hernia repair were enrolled. The patient perspectives obtained were grouped into themes to inform the further development of the PRO tool. Data were transcribed and analyzed using atlas.ti and Microsoft Word.
Ten major themes were identified in this analysis. Patients' quality of life was impacted by hernia repairs and hernia recurrences, including chronic pain, effects on daily activities and social relationships, and the challenge in finding new treatments. The lack of provider-patient communication and patient understanding of hernia repairs highlighted the need for providing patients with more comprehensive information regarding repair options and outcomes prior to surgery.
PRO assessments and meaningful communications between the physician and the patient can provide a comprehensive benefit-risk assessment prior to surgery, and may also improve patient understanding of what to expect during recovery from surgery.
美国每年进行超过 35 万例腹疝修复手术。然而,患有疝修补术的患者的长期生活质量知之甚少。使用患者报告的结果(措施)进行随访是患者体验的重要表现形式,并可以为疝治疗的质量改进提供信息。本研究旨在了解腹疝修复后的患者体验,以提高护理质量和长期疝治疗效果。
为了更好地了解腹疝修复的长期结果,并增强现有的 PRO 工具,进行了两轮半结构化访谈和焦点小组。总共招募了 22 名接受过腹疝修复的患者。将获得的患者观点分为主题,以告知 PRO 工具的进一步开发。使用 atlas.ti 和 Microsoft Word 对数据进行转录和分析。
在这项分析中确定了十个主要主题。疝修复和疝复发影响了患者的生活质量,包括慢性疼痛、对日常活动和社交关系的影响,以及寻找新治疗方法的挑战。缺乏医患沟通和患者对疝修复的理解,突出了在手术前向患者提供更全面的关于修复选择和结果的信息的必要性。
PRO 评估和医生与患者之间的有意义的沟通可以在手术前提供全面的获益-风险评估,也可以提高患者对手术后恢复期间预期的理解。