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Gaining the patient perspective on pelvic floor disorders' surgical adverse events.

Publication ,  Journal Article
Dunivan, GC; Sussman, AL; Jelovsek, JE; Sung, V; Andy, UU; Ballard, A; Jakus-Waldman, S; Amundsen, CL; Chermansky, CJ; Bann, CM; Rogers, RG ...
Published in: Am J Obstet Gynecol
February 2019

BACKGROUND: The Institute for Healthcare Improvement defines an adverse event as an unintended physical injury resulting from or contributed to by medical care that requires additional monitoring, treatment, or hospitalization or that results in death. The majority of research has focused on adverse events from the provider's perspective. OBJECTIVE: The objective of this qualitative study was to describe patient perceptions on adverse events following surgery for pelvic floor disorders. STUDY DESIGN: Women representing the following 3 separate surgical populations participated in focus groups: (1) preoperative (women <12 weeks prior to surgery); (2) short-term postoperative (women up to 12 weeks after surgery); and (3) long-term postoperative (women 1-5 years after surgery). Deidentified transcripts of audio recordings were coded and analyzed with NVivo 10 software to identify themes, concepts, and adverse events. Women were asked to rank patient-identified and surgeon-identified adverse events in order of perceived severity. RESULTS: Eighty-one women participated in 12 focus groups. Group demographics were similar between groups, and all groups shared similar perspectives regarding surgical expectations. Women commonly reported an unclear understanding of their surgery and categorized adverse events such as incontinence, constipation, nocturia, and lack of improvement in sexual function as very severe, ranking these comparably with intensive care unit admissions or other major surgical complications. Women also expressed a sense of personal failure and shame if symptoms recurred. CONCLUSION: Women consider functional outcomes such as incontinence, sexual dysfunction, and recurrence of symptoms as severe adverse events and rate them as similar in severity to intensive care unit admissions and death.

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Published In

Am J Obstet Gynecol

DOI

EISSN

1097-6868

Publication Date

February 2019

Volume

220

Issue

2

Start / End Page

185.e1 / 185.e10

Location

United States

Related Subject Headings

  • Quality of Life
  • Qualitative Research
  • Postoperative Complications
  • Perception
  • Pelvic Floor Disorders
  • Patient Satisfaction
  • Obstetrics & Reproductive Medicine
  • Middle Aged
  • Humans
  • Gynecologic Surgical Procedures
 

Citation

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Dunivan, G. C., Sussman, A. L., Jelovsek, J. E., Sung, V., Andy, U. U., Ballard, A., … Eunice Kennedy Shriver National Institute of Child Health and Human Development Pelvic Floor Disorders Network, . (2019). Gaining the patient perspective on pelvic floor disorders' surgical adverse events. Am J Obstet Gynecol, 220(2), 185.e1-185.e10. https://doi.org/10.1016/j.ajog.2018.10.033
Dunivan, Gena C., Andrew L. Sussman, J Eric Jelovsek, Vivian Sung, Uduak U. Andy, Alicia Ballard, Sharon Jakus-Waldman, et al. “Gaining the patient perspective on pelvic floor disorders' surgical adverse events.Am J Obstet Gynecol 220, no. 2 (February 2019): 185.e1-185.e10. https://doi.org/10.1016/j.ajog.2018.10.033.
Dunivan GC, Sussman AL, Jelovsek JE, Sung V, Andy UU, Ballard A, et al. Gaining the patient perspective on pelvic floor disorders' surgical adverse events. Am J Obstet Gynecol. 2019 Feb;220(2):185.e1-185.e10.
Dunivan, Gena C., et al. “Gaining the patient perspective on pelvic floor disorders' surgical adverse events.Am J Obstet Gynecol, vol. 220, no. 2, Feb. 2019, pp. 185.e1-185.e10. Pubmed, doi:10.1016/j.ajog.2018.10.033.
Dunivan GC, Sussman AL, Jelovsek JE, Sung V, Andy UU, Ballard A, Jakus-Waldman S, Amundsen CL, Chermansky CJ, Bann CM, Mazloomdoost D, Rogers RG, Eunice Kennedy Shriver National Institute of Child Health and Human Development Pelvic Floor Disorders Network. Gaining the patient perspective on pelvic floor disorders' surgical adverse events. Am J Obstet Gynecol. 2019 Feb;220(2):185.e1-185.e10.
Journal cover image

Published In

Am J Obstet Gynecol

DOI

EISSN

1097-6868

Publication Date

February 2019

Volume

220

Issue

2

Start / End Page

185.e1 / 185.e10

Location

United States

Related Subject Headings

  • Quality of Life
  • Qualitative Research
  • Postoperative Complications
  • Perception
  • Pelvic Floor Disorders
  • Patient Satisfaction
  • Obstetrics & Reproductive Medicine
  • Middle Aged
  • Humans
  • Gynecologic Surgical Procedures