Abstract
Patient-reported outcomes have grown in importance in assessing the value of a variety of treatments. One of the methods of assessing patient-reported outcomes is qualitative analysis. The purpose of this study was to assess if qualitative analysis can be used to assess patient expectations for antireflux surgery in different nationalities. Patients referred for antireflux surgery (ARS) in the US, Austria and Italy were prospectively studied. Preoperatively, they were asked: (i) 'How do you expect the surgery to affect your symptoms?'; (ii) 'What do you expect the possible complications or side effects to be?' These patients then underwent open or laparoscopic antireflux surgery. At 2-3 months postoperatively, they were asked: (i) 'Are you satisfied with your surgery? If so, why? If not, why not?'; (ii) 'Did your surgery meet your expectations? If not, why not?' Twenty patients in the US, 24 in Austria, and 18 in Italy completed the study. Preoperatively, there were significant differences between the patients in demographics and objective measurements of GERD. Symptomatic relief was the most common expectation. There was variation in question #2, with Austrian and Italian patients more likely to mention conversion and postoperative side effects. Postoperatively, 90% of American, 88% of Austrian, and 89% of Italian patients were satisfied. Causes for dissatisfaction were postoperative complications, symptomatic recurrences, or side effects. Ninety percent of American, 96% of Austrian, and 94% of Italian patients said that their expectations were met. Patients who did not mention the possibility of side effects or complications were more likely to be dissatisfied. Qualitative analysis is a useful tool in assessing patient expectations. Expectations were remarkably similar. Patients who did not mention postoperative adverse events as possibilities preoperatively were more likely to be dissatisfied.
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