Khanmammadova Narmina, Shahait Mohammed, Nguyen Tuan Thanh, Basilius Jacob, Ali Sohrab Naushad, Tran Joshua, Gevorkyan Rafael, Fung Catherine, Ahlering Thomas E, Lee David I
Department of Urology, University of California, Irvine, Orange, California, USA.
Department of Surgery, Clemenceau Medical Center, Dubai, United Arab Emirates.
J Endourol. 2024 Jan;38(1):23-29. doi: 10.1089/end.2023.0332. Epub 2023 Nov 30.
After the introduction of same-day discharge (SDD) pathways for various surgeries, these pathways have demonstrated comparable complication rates and a reduced overall cost of care. Outpatient robot-assisted radical prostatectomy (RARP) is introduced in high-volume centers; however, patients' perspectives on the SDD RARP protocol are not well understood. A questionnaire consisting of 24 questions, including the Likert Decisional Regret Scale, was distributed to patients who underwent RARP at our center. The overall decision regret score was calculated as described in the literature. We used 15 as a cutoff point for differentiating between high- and low-regret rates. Median and interquartile range were determined for non-normally distributed variables, while mean ± standard deviation was calculated for continuous data. Of the 72 patients who completed the questionnaire, 65.7% ( = 44) of patients felt no regret about their decision of choosing the SDD RARP protocol and 90.3% ( = 65) of men stated that they would have made the same decision. At the same time, 97.1% ( = 68) of patients would also recommend this procedure to others. The median decisional regret score of the cohort ( = 67) was 0 (0-10). Fifty-four of 67 (80.6%) patients were in the low-regret score group, while 13 (19.4%) were in the high-regret group. Patients in the high-regret group were more likely to have low household income (<$30,000 a year) and they experienced postoperative pain more frequently compared with patients in the lower regret group (7.7% 1.9%, = 0.626, and 61.5% 38.9%, = 0.212, respectively). Most patients expressed low regret about choosing the SDD pathway for RARP, underscoring the importance of thorough explanation of the procedure and discharge process to enhance patient experience. However, a subset of patients did express regret, possibly due to an interplay of patient- and procedure-related factors.
在为各种手术引入当日出院（SDD）路径后，这些路径已显示出可比的并发症发生率，并降低了总体护理成本。高容量中心引入了门诊机器人辅助根治性前列腺切除术（RARP）；然而，患者对SDD RARP方案的看法尚未得到充分了解。一份包含24个问题的问卷，包括李克特决策后悔量表，被分发给在我们中心接受RARP手术的患者。总体决策后悔得分按照文献中所述进行计算。我们将15作为区分高后悔率和低后悔率的临界点。对于非正态分布变量，确定中位数和四分位数间距，而对于连续数据，计算平均值±标准差。在完成问卷的72名患者中，65.7%（n = 44）的患者对选择SDD RARP方案的决定不感到后悔，90.3%（n = 65）的男性表示他们会做出相同的决定。同时，97.1%（n = 68）的患者也会向其他人推荐这个手术。该队列（n = 67）的决策后悔得分中位数为0（0 - 10）。67名患者中有54名（80.6%）属于低后悔得分组，而13名（19.4%）属于高后悔组。高后悔组的患者家庭收入较低（每年<$30,000）的可能性更大，并且与低后悔组的患者相比，他们术后疼痛的频率更高（分别为7.7%对1.9%，P = 0.626，以及61.5%对38.9%，P = 0.212）。大多数患者对选择RARP的SDD路径表示低后悔，这凸显了对手术和出院过程进行充分解释以提升患者体验的重要性。然而，一部分患者确实表达了后悔，这可能是由于患者相关因素和手术相关因素的相互作用。
