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倾听女性的声音:网片型中段尿道吊带术并发症后的定性分析。

Listening to Women: A Qualitative Analysis of Experiences after Complications from Mesh Mid-urethral Sling Surgery.

机构信息

Female Pelvic Medicine and Reconstructive Surgery, Section of Urology and Renal Transplantation, Virginia Mason Medical Center, Seattle, WA.

Female Pelvic Medicine and Reconstructive Surgery, Section of Urology and Renal Transplantation, Virginia Mason Medical Center, Seattle, WA.

出版信息

Urology. 2021 Feb;148:106-112. doi: 10.1016/j.urology.2020.11.006. Epub 2020 Nov 13.

Abstract

OBJECTIVE

To gain a detailed understanding of women's experiences after undergoing revision surgery for mesh mid-urethral sling (MUS) complications, qualitatively organize those experiences, and present insights as potential springboards for future research.

METHODS

We conducted a series of semistructured focus groups and interviews of patients who had undergone mesh MUS revision surgery at a single tertiary referral institution. Discussions were recorded, transcribed, de-identified, and analyzed using deductive and inductive content analysis. Two researchers independently performed line-by-line coding and 2 additional researchers reviewed the codes and transcripts as an audit.

RESULTS

Nineteen women participated in the study. Complications from mesh MUS surgery impacted participants psychologically, socially, sexually, and physically. Participants recounted that risks and alternatives to MUS surgery were understated during the informed consent process whereas benefits were overstated. Participants shared insights into negative and positive ways surgeons responded to postoperative complications and how their experiences impacted the patient-surgeon relationship.

CONCLUSION

The impact of complications from mesh MUS surgery is broad and can involve multiple domains of a woman's life. Improved pre-operative patient preparedness, empathetic response toward patients who present with complications, prompt referral to surgeons with experience in mesh MUS complications and multidisciplinary care will likely improve the patient experience and can serve as foci for future studies.

摘要

目的

深入了解女性在接受网片型中段尿道吊带(MUS)修复手术后的经历,对这些经历进行定性分析,并提出可能为未来研究提供启示的见解。

方法

我们对在一家三级转诊机构接受网片型 MUS 修复手术的患者进行了一系列半结构式焦点小组和访谈。讨论内容采用演绎和归纳内容分析法进行记录、转录、去识别和分析。两名研究人员对每条线进行编码,另外两名研究人员对代码和转录内容进行审核。

结果

19 名女性参与了研究。MUS 手术的网片相关并发症对参与者的心理、社交、性和身体方面都产生了影响。参与者表示,在知情同意过程中,MUS 手术的风险和替代方案被低估,而收益被夸大。参与者分享了有关外科医生对术后并发症的负面和积极反应的见解,以及他们的经历如何影响医患关系。

结论

网片型 MUS 手术相关并发症的影响广泛,可能涉及女性生活的多个领域。改进术前患者准备、对出现并发症的患者表示同情、及时向有网片型 MUS 并发症治疗经验的外科医生转诊和多学科护理,可能会改善患者体验,并为未来的研究提供重点。

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