Department of Plastic Surgery, 3rd Faculty of Medicine and University Hospital Kralovske Vinohrady, Charles University in Prague, Srobarova 50, 10034, Prague 10, Czech Republic.
Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford University School of Medicine, 1651 Page Mill Road, Palo Alto, CA, 94304, USA.
Aesthetic Plast Surg. 2022 Aug;46(4):1588-1599. doi: 10.1007/s00266-022-02985-6. Epub 2022 Jul 25.
Patient-reported outcome measures (PROMs) have become an integral part of the evaluation of reconstruction surgery outcomes. However, there are limitations in current PROMs when it comes to the assessment of well-being during inpatient stay, patient perception of health, relationship with partner, and vitality (i.e., mood and ability to work and pursue hobbies, carry out daily tasks, and sleep) following breast reconstructive surgery. The aim was to develop a novel set of measures to compare patient satisfaction and health-related quality of life following different types of postmastectomy breast reconstruction.
A novel questionnaire was created and refined through cognitive interviews with patients and expert feedback. A field test study was conducted, including patients who had undergone delayed postmastectomy breast reconstruction with implant, autologous tissue, or combination of implant and autologous tissue. Based on the results, confirmatory factor analysis and examination of reliability of the questionnaire were conducted. Results of patient responses were analyzed using Chi-square test, Kruskal-Wallis test, and Mann-Whitney U test.
Confirmatory factor analysis showed good model fit, and Cronbach's alpha indicated high internal consistency of the questionnaire. Besides that, patients with combination reconstruction reported significantly lower vitality than patients with implant and autologous reconstruction (p = 0.048).
This novel questionnaire expands the current knowledge base of postmastectomy breast reconstruction PROMs. Results of the field test study showed that combination reconstruction was associated with lower patient vitality than other reconstruction types.
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患者报告的结果测量（PROMs）已成为评估重建手术结果的重要组成部分。然而，目前的 PROMs 在评估住院期间的幸福感、患者对健康的感知、与伴侣的关系以及乳房重建手术后的活力（即情绪和工作、追求爱好、完成日常任务和睡眠的能力）方面存在局限性。目的是开发一套新的测量工具，以比较不同类型乳房重建手术后患者的满意度和健康相关生活质量。
通过对患者和专家的认知访谈，创建并完善了一套新的问卷。进行了一项现场测试研究，包括接受过延迟乳房再造术的患者，这些患者使用了植入物、自体组织或植入物和自体组织的组合。基于研究结果，进行了验证性因子分析和问卷可靠性的检验。使用卡方检验、克鲁斯卡尔-沃利斯检验和曼-惠特尼 U 检验分析患者的反应结果。
验证性因子分析显示模型拟合良好，问卷的克朗巴赫α值表明其内部一致性高。此外，与植入物和自体组织重建的患者相比，组合重建的患者活力明显较低（p=0.048）。
这套新问卷扩展了乳房切除术后重建 PROMs 的现有知识库。现场测试研究的结果表明，与其他重建类型相比，组合重建与患者活力降低相关。
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