Patient Satisfaction In Women Research Articles

Health-Related Quality of Life Following Robotic Surgery: A Pilot Study

ObjectivesTo determine the relationship between BMI, age, and the physical, functional, and psychosocial areas of health-related quality of life (HRQoL) and patient satisfaction in women with endometrial cancer undergoing robotic-assisted surgery. MethodsDuring the first two years of the robotic surgery program, we prospectively collected data concerning patient demographics and surgical outcomes. At the first postoperative visit (21 to 28days after surgery), all participants completed a HRQoL questionnaire. We examined the association between BMI and age, as well as the different areas of HRQoL, using chi-square and ANOVA. ResultsOf 109 participants, 41 were 70years of age or older, and 51 had a BMI of 30kg/m2 or more. Following surgery, the mean (±SD) duration of hospital stay was 1.9±1.5days, and reported pain level was highest on the second postoperative day, with a mean score of 3.4±2.1 on a seven-point scale. Moreover, two thirds of women reported no pain by the first postoperative visit, and only 18.2% of women aged 70years or older used any narcotic for pain control. These results indicated that there was little influence of the surgery on HRQoL, and women resumed typical activities within an average of 11days after surgery. Lastly, participants’ average rating of satisfaction was 6.7 on a seven-point scale. ConclusionThis pilot study has demonstrated the advantages for HRQoL of robotic-assisted surgery in the management of endometrial cancer. Women with endometrial cancer benefited from use of robotic surgery regardless of age or BMI.

Radiation therapy after breast reconstruction: outcomes, complications, and patient satisfaction

The aim of this study was to evaluate treatment-related complications, outcomes, and patient satisfaction in women with locally advanced breast cancer who received post-mastectomy radiation therapy (PMRT) after breast reconstruction (BR). Between October 2007 and November 2010, 46 patients with locally advanced breast cancer who underwent mastectomy followed by BR received PMRT at our Department. Radiotherapy was delivered to the chest wall with a dose of 50 Gy in 25 fractions over 5 weeks. The median follow-up was 19 months. Skin erythema grade 1 and 2 was seen in 44 (96%) and two (4%) patients, respectively. Major complications, requiring additional corrective surgical procedure, occurred in three (7%) patients (one patient with prosthesis, one patient with tissue expander and one patient with deep inferior epigastric perforator flap). At univariate analysis, smoking, chemotherapy, hormone therapy with tamoxifen and reconstruction with implant were associated with overall complications (capsular contracture and reconstruction failure). Forty (86%) patients were very satisfied or satisfied with the cosmetic outcome of reconstruction. Radiotherapy can be safely delivered after BR, with a low complication rate and good patient satisfaction. Further randomised studies are needed to better define the optimal timing of breast reconstruction and post-mastectomy radiation therapy.

Postoperative Patient Satisfaction After Laparoscopic Supracervical Hysterectomy

The aim of this study was to evaluate postoperative patient satisfaction in women after laparoscopic supracervical hysterectomy (LASH). A retrospective study by a mailed questionnaire among 2334 women who underwent hysterectomy via LASH at the MIC-Klinik, Berlin, between 1998 and 2004 was conducted. Indications for LASH were uterus myomatosus, adenomyosis uteri, disorders of bleeding, and genital descensus. The LASH operation technique was standardized and remained consistent throughout the observation period. Pearson's test for metric variables, Spearman's rank correlation test for ordinal data, Mann-Whitney U test, and Kruskal-Wallis test were used. Of the 2334 questionnaires mailed, 1553 were returned and 1431 (61.3%) of those could be analyzed. Almost 94% (93.9%) of the women were highly satisfied with the outcome, 5.6% reported medium satisfaction, and 0.5% were not satisfied. There was no significant difference in patient satisfaction with regard to the different indication for LASH. This study demonstrates high postoperative patient satisfaction after LASH. The rate of highly satisfied women might be increased by carefully choosing the right indications for LASH and improving operation techniques. This is important for widening acceptance of this innovative new operation standard.

Long Term Outcomes and Patient Satisfaction in Women Undergoing Myomectomy Via Laparotomy and Two Minimally Invasive Approaches: Robot-Assisted Laparoscopy and Minilaparotomy

Long Term Outcomes and Patient Satisfaction in Women Undergoing Myomectomy Via Laparotomy and Two Minimally Invasive Approaches: Robot-Assisted Laparoscopy and Minilaparotomy

Patient Satisfaction in Obstetrics and Gynecology: Individualized Patient-centered Communication

Background Patient satisfaction is becoming an increasingly prevalent topic in medicine, but little is known about patient satisfaction in women's health and other specialties. We review current methods of improving patient satisfaction in the field of obstetrics and gynecology with the intent to increase patient satisfaction even further by enhancing and combining previously used strategies. Methods A search from inception to June 2010 for electronic literature was performed using Medline. The search strategy used the medical subject heading terms “patient satisfaction”, “obstetrics”, “gynecology”, “patient-centered communication”, “communication training”, and “malpractice”. The company websites for Press Ganey Associates, Inc and Integrated Health Associates' were also reviewed. Studies in both general medicine and the field of obstetrics and gynecology were reviewed to emphasize disparities between patients' satisfaction in diverse medical specialties. Results Studies indicating the importance of patient satisfaction, the factors contributing to patient satisfaction, and an evaluation of current, evidence-based methods of increasing patient satisfaction were reviewed. The studies included suggest that current methods of assessing/improving patient satisfaction are effective, but may not be the most productive. Conclusions We expect that the combination of previously successful methods of improving patient satisfaction to allow physicians to employ individualized patient-centered communication may improve patient satisfaction even further. Studying the use of our proposed enhancements in physician-patient communication may be worthwhile tools to increase patient satisfaction and optimize the quality of women's healthcare.

A Randomized Comparison of Programmed Intermittent Epidural Bolus with Continuous Epidural Infusion for Labor Analgesia

Bolus injection through an epidural catheter may result in better distribution of anesthetic solution in the epidural space compared with continuous infusion of the same anesthetic solution. In this randomized, double-blind study we compared total bupivacaine consumption, need for supplemental epidural analgesia, quality of analgesia, and patient satisfaction in women who received programmed intermittent epidural boluses (PIEB) compared with continuous epidural infusion (CEI) for maintenance of labor analgesia. The primary outcome variable was bupivacaine consumption per hour of analgesia. Combined spinal epidural analgesia was initiated in multiparas scheduled for induction of labor with cervical dilation between 2 and 5 cm. Subjects were randomized to PIEB (6-mL bolus every 30 min beginning 45 min after the intrathecal injection) or CEI (12-mL/h infusion beginning 15 min the after the intrathecal injection). The epidural analgesia solution was bupivacaine 0.625 mg/mL and fentanyl 2 microg/mL. Breakthrough pain in both groups was treated initially with patient-controlled epidural analgesia (PCEA) followed by manual bolus rescue analgesia using bupivacaine 0.125%. The median total bupivacaine dose per hour of analgesia was less in the PIEB (n = 63) (10.5 mg/h; 95% confidence interval, 9.5-11.8 mg/h) compared with the CEI group (n = 63) (12.3 mg/h; 95% confidence interval, 10.5-14.0 mg/h) (P < 0.01), fewer manual rescue boluses were required (rate difference 22%, 95% confidence interval of difference 5% to 38%), and satisfaction scores were higher. Labor pain, PCEA requests, and delivered PCEA doses did not differ. PIEB combined with PCEA provided similar analgesia, but with a smaller bupivacaine dose and better patient satisfaction compared with CEI with PCEA for maintenance of epidural labor analgesia.

Long-term outcome of women who undergo panniculectomy at the time of gynecologic surgery

Objective. While panniculectomy has been shown to be a useful technique in obese women undergoing gynecologic surgery, the long-term outcome of these patients has been poorly described. The goal of this study was to determine the long-term outcomes and patient satisfaction of women who underwent panniculectomy at the time of pelvic surgery. Methods. A retrospective review of patients who underwent panniculectomy at the time of pelvic surgery between 1996 and 2004 was performed. Postoperative complications and long-term trends in weight were evaluated. Patient satisfaction was assessed by telephone survey. Results. Forty-two patients were identified. The mean EBL was 522 ml, the mean operating time was just over 4 h. Wound complications were noted in 36% of the subjects. Two weeks after the procedure, 86% of the women had a weight that was lower than their preoperative weight. Weight loss peaked 3 months postoperatively, 97% of the subjects had a net lower weight, with a mean loss of nearly 20 lb. Over the ensuing 2 years, weight loss gradually declined. After 2 years of follow-up, 62% of the women were below their preoperative body weights. The mean weight loss at 24 months was 7 lb. Overall patient satisfaction with the procedure was high. Eighty-six percent of the subjects responded that they would undergo the procedure again given their outcome. Conclusions. Panniculectomy is well tolerated and associated with a high rate of patient satisfaction. Panniculectomy is a valuable component of gynecologic surgery in morbidly obese women.

Prophylactic ondansetron does not improve patient satisfaction in women using PCA after Caesarean section

Eighty-one consenting women undergoing elective Caesarean section under spinal anaesthesia were randomly divided into two groups. In Group O patients, ondansetron 4 mg was given intravenously at the end of the surgery and 8 mg added to the morphine solution in the PCA syringe. Patients in Group P received only morphine via PCA syringe. Analgesia and nausea were measured until PCA was discontinued 24 h after the operation. Women in the two groups were similar with respect to age, duration of use of the PCA, amount of morphine used, previous history of PONV, and incidence of motion sickness and morning sickness during the current pregnancy. The number of women who complained of nausea and those needing rescue antiemetic medication was significantly less in Group O. However, there was no statistically significant difference between the two groups in the patient's perception of the control of nausea and their overall satisfaction. It was noted that PONV was more frequent among women who had significant morning sickness during early pregnancy and ondansetron was beneficial in reducing PONV in these women. Although the ondansetron reduced the incidence of PONV and the need for further antiemetic medication, this did not affect patient's satisfaction regarding their postoperative care.