Journal articles on the topic 'Female Surgery Patients Interviews'
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Lynch, Rebecca, Philip Toozs-Hobson, Jonathan Duckett, Douglas Tincello, and Simon Cohn. "Making a decision about surgery for female urinary incontinence: a qualitative study of women’s views." International Urogynecology Journal 32, no. 1 (June 29, 2020): 127–33. http://dx.doi.org/10.1007/s00192-020-04383-5.
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Abstract Introduction and hypothesis This qualitative interview study explores aspects women with urinary incontinence(UI) reflect upon when considering whether or not to have surgery. Conducted prior to the recent mesh pause in the UK, the article provides insights for current and future approaches to shared decision-making. Methods Qualitative in-depth interviews of 28 patients referred to secondary care for stress and mixed UI who were considering UI surgery. Participants were recruited from four urogynaecology clinics in the Midlands and South England, UK. Interviews were conducted in clinics, in patient homes, and by telephone. Data analysis was based on the constant comparative method. Results Participants’ accounts comprised three key concerns: their experience of symptoms, the extent to which these impacted a variety of social roles and demands, and overcoming embarrassment. Accounts drew on individual circumstances, values, and concerns rather than objective or measurable criteria. In combination, these dimensions constituted a personal assessment of the severity of their UI and hence framed the extent to which women prioritized addressing their condition. Conclusions Acknowledging women’s personal accounts of UI shifts the concept of ‘severity’ beyond a medical definition to include what is important to patients themselves. Decision-making around elective surgery must endeavour to link medical information with women’s own experiences and personal criteria, which often change in priority over time. We propose that this research provides insight into how the controversy around the use of mesh in the UK emerged. This study also suggests ways in which facilitating shared decision-making should be conducted in future.
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Baker, Daniel Mark, Matthew James Lee, Georgina Louise Jones, Steven Ross Brown, and Alan Joseph Lobo. "The Informational Needs and Preferences of Patients Considering Surgery for Ulcerative Colitis: Results of a Qualitative Study." Inflammatory Bowel Diseases 24, no. 1 (December 19, 2017): 179–90. http://dx.doi.org/10.1093/ibd/izx026.
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Abstract Background Patients considering surgery for ulcerative colitis (UC) face a difficult decision as surgery may or may not improve quality of life. National Institute for Health and Care Excellence guidelines for UC emphasize the importance of providing quality preoperative information to patients but note no quality studies for the desired content of this information. Our aim was to explore patient information preferences prior to undergoing surgery for ulcerative colitis. Methods Semistructured interviews with patients who underwent an operation and patients who considered but declined an operation were conducted. Interviews explored informational preferences, with emphasis on preoperative information given, preoperative information desired but not received, and retrospective informational desires. Interviews were transcribed and coded using an inductive thematic analysis using NVivo software. Data saturation was assessed after 12 interviews, with interviews continuing until saturation was achieved. Ethical approval was gained prior to interviews commencing (16/NW/0639). Results A total of 16 interviews were conducted before data saturation was achieved (male n = 7, female n = 9). Eight patients declined surgery, and 8 opted for subtotal colectomy with permanent end ileostomy (n = 5) or ileoanal pouch (n = 3). A total of 4 themes and 14 subthemes were identified. Three dominant subthemes of informational shortcomings emerged: “long-term effects of surgery,” “practicalities of daily living,” and “long-term support.” Peer support was desired by patients but was infrequently supported by health care professionals. Conclusions Current preoperative information does not address patient informational needs. Surgical consultations should be adapted to suit patient preferences. Clinical practice may need to be altered to ensure that patients are better supported following surgery.
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Lisee, Caroline Michele, Justin S. DiSanti, Megan Chan, Jessica Ling, Karl Erickson, Michael Shingles, and Christopher M. Kuenze. "Gender Differences in Psychological Responses to Recovery After Anterior Cruciate Ligament Reconstruction Before Return to Sport." Journal of Athletic Training 55, no. 10 (September 23, 2020): 1098–105. http://dx.doi.org/10.4085/1062-6050-558.19.
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Context Female patients with anterior cruciate ligament reconstruction (ACLR) are less likely to return to sport than males. Psychological readiness predicts successful return to sport, but it is unclear if psychological experiences differ between males and females during recovery. Objective To explore gender differences in psychological readiness factors of return to sport after ACLR. Design Qualitative study. Setting Laboratory. Patients or Other Participants A total of 12 male (months since surgery = 6.2 ± 1.2) and 13 female (months since surgery = 6.4 ± 1.3) high school athletes with a history of ACLR. Data Collection and Analysis Participants were interviewed before physician clearance to return to activity. Transcribed interviews were analyzed using deductive thematic coding of 5 themes identified from previous research (psychological distress, self-efficacy, locus of control, athletic identity, and fear of reinjury) and inductive secondary subthematic coding. Gender comparisons were generated within primary themes and secondary subthemes. Results All deductive themes were consistently reinforced. Male and female participants reported fear of movement, loss of athletic identity, and motivational mindsets for return to sport and self-improvement. Males reported a stronger sense of internal locus of control using positive internal reinforcement, whereas females described balancing internal and external control and valuing external support systems. Male participants described mood changes influenced by physical and social limitations. Female participants closely monitored their emotions throughout recovery and were influenced by rehabilitation fluctuations. Conclusions Male and female high school athletes described different psychological factors related to return to sport and locus of control as well as psychological distress. Gender-specific psychological interventions may be warranted to overcome psychological barriers after ACLR.
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Janse Van Vuuren, Michele, Esben Strodl, Katherine M. White, and Philip D. Lockie. "Psychosocial presentation of female bariatric surgery patients after multiple revisional surgeries: A qualitative study." Journal of Health Psychology 23, no. 10 (June 7, 2016): 1261–72. http://dx.doi.org/10.1177/1359105316648673.
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Bariatric surgery is currently the most viable and cost-effective treatment for obesity. This study aimed to understand, from a female patient’s perspective, what contributed to not achieving or maintaining excess weight loss from a primary laparoscopic adjustable gastric band surgery, leading to subsequent multiple revisional bariatric surgeries. The purposive sample of participants ( N = 17 females) were over 18 years, had a primary failed laparoscopic adjustable gastric band and had more than three revisional procedures. Participants were individually interviewed and data were analysed from a grounded theory methodology to build a causal model with the core category of unrealistic expectations of bariatric surgery and other important conceptual categories.
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Adachi, Tomoaki, Shoko Kochi, and Tai Yamaguchi. "Characteristics of Nonverbal Behavior in Patients with Cleft Lip and Palate during Interpersonal Communication." Cleft Palate-Craniofacial Journal 40, no. 3 (May 2003): 310–16. http://dx.doi.org/10.1597/1545-1569_2003_040_0310_conbip_2.0.co_2.
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Objective This study examined characteristics of nonverbal behavior that patients with cleft lip and palate (CLP) presented during interpersonal communication. Design This was a case-control design comparing nonverbal behavior of adult women with CLP with females without CLP. Participants Subjects were 20 adult women with CLP and 20 noncleft control women matched for age and educational experience. Main Outcome Measures Subject gestures and facial expressions were videotaped during interviews and analyzed with a computer-based kinematic measurement system. Results The clinical group displayed significantly fewer head movements and a lower smile frequency than the control group. Furthermore, head and hand movements and smiles were less coordinated or congruent for the subjects with CLP than for the comparison group. Conclusions Even slight facial disfigurement could have a harmful effect on communication behavior in female patients with CLP.
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Lama Yonzon, Choden, Retna Siwi Padmawati, Raj Kumar Subedi, Sagun Paudel, Ashmita Ghimire, and Elsa Herdiana Murhandarwati. "Exploring determinants of hydrocele surgery coverage related to Lymphatic Filariasis in Nepal: An implementation research study." PLOS ONE 16, no. 2 (February 26, 2021): e0244664. http://dx.doi.org/10.1371/journal.pone.0244664.
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Background Hydrocele is a chronic condition in males in which there is an excessive collection of straw-colored fluid, which leads to enlargement of the scrotum. It is a common manifestation of lymphatic filariasis (LF) affecting nearly 25 million men worldwide. Surgery is the recommended treatment for hydrocele and is available free of cost in all government hospitals in Nepal. This research explored patient, provider, and community factors related to accessing hydrocele surgery services by the patients. Methods This study employed a qualitative method. The research was conducted in two LF endemic districts, namely Kanchanpur and Dhading, which are reported to have the highest number of hydrocele cases during morbidity mapping conducted in 2016. In addition to five key informant interviews with the LF focal persons (one national and 4 district-level), nine in-depth interviews were conducted with hydrocele patients (5 of whom had undergone surgery and 4 who had not undergone surgery) and with 3 family members, and two focus group discussions with the female community health volunteers. Results Most of the respondents did not have knowledge of hydrocele as one of the clinical manifestations of LF nor that it is transmitted through a mosquito bite. Although perceived as treatable with surgery, most of the patients interviewed believed in as well as practiced home remedies. Meanwhile, fear of surgery, embarrassment, lack of money, along with no knowledge of the free hydrocele surgery acted as barriers for accessing the surgery. On the other hand, financial support, flexible guidelines enabling the hospital to conduct surgery, decentralization and scaling up of morbidity mapping along with free hydrocele surgery camps in any remaining endemic districts were identified as enablers for accessing surgery. Conclusion Hydrocele surgery coverage could be improved if the program further addresses community awareness. There is a need for more focus on information dissemination about hydrocele and hydrocele surgery.
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Ikeda, Allison, Robin Marsh, Crystina McShay, Shireen Saini, Maya Sardesai, Edward Weaver, and Emily Boss. "452 Patient Factors and Preferences in Decision for Sleep Surgery: A Qualitative Analysis." Sleep 44, Supplement_2 (May 1, 2021): A179. http://dx.doi.org/10.1093/sleep/zsab072.451.
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Abstract Introduction Patients with obstructive sleep apnea (OSA) are offered many treatment options spanning the spectrum of lifestyle modification, device therapy, and surgery. Sleep surgery, while often effective, results in moderate morbidity and has variable effectiveness on OSA improvement. Little is known about what patients consider when choosing treatment. We aim to identify factors that influenced the decision for sleep surgery among adults with OSA. Methods We conducted semi-structured virtual interviews with patients (≥18 years) with OSA (apnea-hypopnea index ≥5 events per hour of sleep) who underwent sleep surgery at a tertiary academic center, querying patients about factors in their decision for OSA treatment. Interviews were audio-recorded, transcribed, and analyzed for thematic content. We anticipate enrolling 10–18 total participants based on previously reported sample size in specialty groups for thematic saturation in specialty groups (ie, when no new concepts or factors emerge from interviews). Here we report pilot qualitative analysis results. Results Of nine eligible patients, eight enrolled (mean +/- standard deviation age 45.8 +/- 13.4 years, 2 female/6 males). Four patients underwent nasal surgery only, two patients underwent staged procedures, one underwent pharyngeal surgery only, and the last underwent nasal surgery with tori removal. Patients reported decision making duration of days to years for scheduling surgery. Reasons for pursuing sleep surgery included fatigue, quality of life, work performance, and safety. Overarching thematic domains related to decision for surgery were (1) major concerns, (2) external factors influencing decision, and (3) retrospective satisfaction/regret with decision. Major concerns involved factors beyond surgeon’s control, such as anesthesia and postoperative pain management, not surgery itself. Family and friends were reported to be highly influential in the process, both in favor and against surgery. Social media features and celebrity patients with OSA heightened awareness of sleep surgery and set preconceived expectations. Patients were mostly satisfied with outcomes, despite unanticipated acute recovery challenges. Conclusion This pilot qualitative analysis identifies factors influencing patients’ OSA treatment decisions. Understanding patients’ major concerns and sources of information may help to guide physician counseling, set realistic expectations, offer peri-operative support, and better engage parents in shared decision-making for sleep surgery. Support (if any) None.
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Mariano, Maria Luiza Lobato, Maria Angela Boccara de Paula, Deomir Germano Bassi, and Pedro Roberto de Paula. "Bariatric surgery: impact on sexuality of the obese person." Revista do Colégio Brasileiro de Cirurgiões 41, no. 6 (December 2014): 412–20. http://dx.doi.org/10.1590/0100-69912014006006.
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Objective: To assess the impact of surgical treatment in the sexuality of the obese.Methods: We conducted a qualitative / quantitative research with 30 patients who had undergone Fobi-Capella Roux-Y gastric bypass for at least one year. We collected data through individual interviews using a questionnaire with 10 mixed questions and one open, between May and June 2011. The objective data were quantified in absolute numbers and percentages, and the subjective ones were analyzed using the Discourse of the Collective Subject (DCS) and discussed in view of reference published on the subject.Results: 30 patients were enrolled, with a mean age 44 ± 12 years, 24 (80%) were female and six (20%) were male, 23 (77%) were married, 23 (96%) were hypertensive and eight (33%) were diagnosed with Diabetes Mellitus. After the operation, 11 (37%) individuals reported no change in the number sexual intercourses, but 19 (63%) reported that this number was altered, 16 (53%) informed increased frequency, one (3%) reported a decrease in frequency, one (3%) did not practice sexual intercourse anymore and one (3%) did not report the frequency. The central ideas (CI) raised originated four DCSs: Experience of female sexuality; No experience of female sexuality; Experience of male sexuality; and improvements of comorbidities and psychological factor.Conclusion: there are positive repercussions of physical and emotional orders of the surgical treatment of obesity, favoring the quality of life, including sexuality.
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Broder, Hillary L., Fraser B. Smith, and Ronald P. Strauss. "Habilitation of Patients with Clefts: Parent and Child Ratings of Satisfaction with Appearance and Speech." Cleft Palate-Craniofacial Journal 29, no. 3 (May 1992): 262–67. http://dx.doi.org/10.1597/1545-1569_1992_029_0262_hopwcp_2.3.co_2.
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This study examined ratings regarding satisfaction with facial appearance and speech performance from 495 parent-child pairs. Data were obtained from school-aged children (5–18 years old) and their parents using standardized independent interviews. Results revealed that 54 percent of the children with cleft lip (CL) or cleft lip and palate (CLP) were very pleased with their appearance, and 62 percent of the cleft palate or CLP subjects were very pleased with speech. Low, but statistically significant correlations exist between the female subjects and their parents in satisfaction with appearance. Although older cleft lip and/or palate patients reported increased satisfaction with speech, no age differences in patient satisfaction with appearance were observed in subjects with CL/CLP. Parents of females expressed more concern about their daughters' appearance than parents of males, while parents of males were more concerned about speech. Implications for craniofacial habilitation teams and research suggestions are discussed.
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Strimas, Rachel, Michelle M. Dionne, Stephanie E. Cassin, Susan Wnuk, Marlene Taube-Schiff, and Sanjeev Sockalingam. "Psychopathology in severely obese women from a Canadian bariatric setting." Ethnicity and Inequalities in Health and Social Care 7, no. 2 (June 10, 2014): 72–85. http://dx.doi.org/10.1108/eihsc-10-2013-0033.
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Purpose – Evidence suggests high rates of psychiatric disorders in bariatric surgery candidates (e.g. Mitchell et al., 2012), although no rigorous studies have examined the prevalence in a Canadian sample. Improved understanding of the prevalence of psychopathology among female patients is an important area of study, as females comprise approximately 80 percent of surgical candidates (Martin et al., 2010; Padwal, 2005). The purpose of this paper is to assess the prevalence of Axis I disorders and associations with quality of life in a Canadian sample of female bariatric surgery candidates. Design/methodology/approach – Female patients (n=257) were assessed using a structured psychodiagnostic interview and completed a health-related quality of life questionnaire. Findings – Results indicated that 57.2 percent of patients met DSM-IV-TR criteria for a lifetime psychiatric disorder and 18.3 percent met criteria for a current psychiatric disorder. Major depressive disorder was the most common lifetime psychiatric disorder (35.0 percent) and binge eating disorder was the most prevalent current psychiatric disorder (6.6 percent). Patients scored significantly lower than Canadian population norms on all domains of the SF-36 (all p's<0.001). Patients with a current Axis I disorder also reported significantly worse functioning on four mental health domains and one physical health domain (p's<0.01) compared to patients without a current Axis I disorder. Originality/value – Results confirm high rates of psychiatric disorders in Canadian female bariatric surgery candidates and provide evidence for associated functional health impairment. Further study is needed to elucidate how pre-operative psychopathology may impact female patients’ post-operative outcomes.
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Close, Kristin L., and Floor T. E. Christie-de Jong. "Lasting impact: a qualitative study of perspectives on surgery by adult recipients of free mission-based surgical care in Benin." BMJ Open 9, no. 11 (November 2019): e028235. http://dx.doi.org/10.1136/bmjopen-2018-028235.
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ObjectivesThis study aimed to explore how adult patients who received free mission-based elective surgery experienced surgery and its outcomes, in order to provide recommendations for improved service delivery, measurement of impact and future quality initiatives for the humanitarian organisation Mercy Ships and other mission-based surgical platforms.SettingData were collected in June 2017 in Cotonou, Benin, where the participants had previously received free mission-based elective surgery aboard the Africa Mercy, a non-governmental hospital ship.ParticipantsSixteen patients (seven male, nine female, age range 22–71, mean age 43.25) who had previously received surgical care aboard the Africa Mercy hospital ship between September 2016 and May 2017 participated in the study.MethodsUsing a qualitative design, 16 individual semistructured interviews were conducted with the assistance of two interpreters. Participants were recruited using purposive sampling from the Mercy Ships patient database. Interview data were coded and organised into themes and subthemes using thematic content analysis in an interpretivist approach.FindingsAnalysis of interview data revealed three main themes: barriers to surgery, experiences with Mercy Ships and changes in perspectives of surgery after their experiences. Key findings included barriers to local surgical provision such as cost, a noteworthy amount of fear and distrust of local surgical teams, exceptional positive experiences with the care at Mercy Ships, and impactful surgery, resulting in high levels of trust in foreign surgical teams.ConclusionsWhile foreign surgical teams are meeting an immediate need for surgical care, the potential enduring legacy is one of trusting only foreigners for surgery. Patients are a critical component to a well-functioning surgical system, and mission-based surgical providers must formulate strategies to mitigate this legacy while strengthening the local surgical system.
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Khalafallah, Adham, Shirley Fung, Sharon Kozachik, Benita Valappil, Hussam Abou Al Shaar, Eric Wang, Georgios Zenonos, et al. "QOLP-15. QUALITATIVE STUDY OF DIFFERENTIAL QUALITY OF LIFE (QOL) IN SUPRASELLAR MENINGIOMA PATIENTS TREATED VIA ENDOSCOPIC ENDONASAL APPROACH VERSUS OPEN CRANIOTOMY." Neuro-Oncology 22, Supplement_2 (November 2020): ii178. http://dx.doi.org/10.1093/neuonc/noaa215.740.
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Abstract BACKGROUND The optimal surgical treatment of suprasellar meningiomas remains controversial. While successful surgery has historically been measured by extent of tumor resection (EOR), surgeons must also balance tumor- and patient-specific characteristics with quality of life (QoL) outcomes when considering either an open craniotomy or endoscopic endonasal approach (EEA). METHODS We conducted 28 in-depth individual interviews with patients diagnosed with suprasellar meningioma and treated via EEA (n=14) or craniotomy (n=14). We used a structured interview script and the transcribed interviews were independently coded by two researchers. Consensus was used to identify themes and domains of interest. RESULTS The overall sample (80% between 40-69 years old, 70% female, and 82% white) was largely similar between craniotomy and EEA cohorts. Tumor volumes were not different between both cohorts (p=0.2), with a combined average of 4.4 cm3 (standard error ± 0.7). Suprasellar meningiomas caused a wide range of symptoms with 21 concepts elicited. The most frequently endorsed concepts were “Vision” (n=22), “Headaches” (n=11), “Fatigue” (n=11), “Cognitive Symptoms” (n=10), “Pituitary Dysfunction – including Trouble Sleeping and Frequent Urination” (n=9), “Sinus Problems” (n=7), and “Personality Changes” (5). Both surgical approaches demonstrated improvements in vision (69.2% EEA, 66.7% craniotomy) and headaches (100% EEA, 80% craniotomy). Compared to EEA, craniotomy yielded a longer list of complications (3 vs.14) and surgery-specific symptoms (9 vs.16). More craniotomy patients reported having negative emotions (5 vs.1), new depression and anxiety (6 vs.1), financial difficulties (3 vs.1), and reduced desire/ability to pursue fun activities (12 vs.7) after surgery relative to EEA counterparts. CONCLUSION Suprasellar meningiomas can be debilitating with significantly impact on patients’ health and QoL. Our findings demonstrate differential effects upon patients’ post-operative QoL associated with type of surgery. Our findings support the need for measuring patient-centered, disease-specific QoL outcomes in patients undergoing craniotomy versus EEA for suprasellar meningioma resection.
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Zener, Rebecca, and Mark Bernstein. "Gender, Patient Comfort and the Neurosurgical Operating Room." Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques 38, no. 1 (January 2011): 65–71. http://dx.doi.org/10.1017/s0317167100011094.
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Abstract:Background:Neurosurgical patients may be unaware of components of their intra-operative care. The relationship between patient gender and comfort level in the neurosurgical operating room (OR) has not been previously studied. Our objective was to gain insight into patients' perspective of the OR environment, including staffing and observers, the role of medical students, catheterization, exposure, and verbiage, using a qualitative needs assessment.Methods:Face-to-face semi-structured interviews were conducted with 20 patients (14 female, six male) who had a neurosurgical operation under general anesthetic within the previous two years. The majority underwent craniotomy for benign tumours. Interviews were transcribed and subjected to modified thematic analysis.Results:Nine themes emerged: 1) perception of the intra-operative environment varies between men and women; 2) lacking awareness about observers is anxiety-provoking for women; 3) being unaware of the hands-on involvement of students is a concern for all patients; 4) disclosure of implantation of foreign and permanent materials into patients is important; 5) catheterization is anxiety provoking for women; 6) pre-operative menstruation screening may minimize embarrassment for women; 7) patients perceive extraneous conversation as a distraction for surgeons; 8) patients trust their surgeon; 9) a relationship exists between interviewer gender and patient comfort in the interview.Conclusion:Although most male and female patients are unaware of OR activities, they are generally not fearful since they trust their surgeon. Women appear to have greater information needs. Patients' information needs must be met without provoking anxiety and yet preserving their personal sense of modesty in the intra-operative environment.
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Schumacher, Jessica R., David Zahrieh, Selina Chow, John Taylor, Rachel Wills, Bret M. Hanlon, Paul J. Rathouz, Jennifer L. Tucholka, and Heather B. Neuman. "Increasing socioeconomically disadvantaged patients’ engagement in breast cancer surgery decision-making through a shared decision-making intervention (A231701CD): protocol for a cluster randomised clinical trial." BMJ Open 12, no. 11 (November 2022): e063895. http://dx.doi.org/10.1136/bmjopen-2022-063895.
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IntroductionSocioeconomic disparities for breast cancer surgical care exist. Although the aetiology of the observed socioeconomic disparities is likely multifactorial, patient engagement during the surgical consult is critical. Shared decision-making may reduce health disparities by addressing barriers to patient engagement in decision-making that disproportionately impact socioeconomically disadvantaged patients. In this trial, we test the impact of a decision aid on increasing socioeconomically disadvantaged patients’ engagement in breast cancer surgery decision-making.Methods and analysisThis multisite randomised trial is conducted through 10 surgical clinics within the National Cancer Institute Community Oncology Research Program (NCORP). We plan a stepped-wedge design with clinics randomised to the time of transition from usual care to the decision aid arm. Study participants are female patients, aged ≥18 years, with newly diagnosed stage 0–III breast cancer who are planning breast surgery. Data collection includes a baseline surgeon survey, baseline patient survey, audio-recording of the surgeon–patient consultation, a follow-up patient survey and medical record data review. Interviews and focus groups are conducted with a subset of patients, surgeons and clinic stakeholders. The effectiveness of the decision aid at increasing patient engagement (primary outcome) is evaluated using generalised linear mixed-effects models. The extent to which the effect of the decision aid intervention on patient engagement is mediated through the mitigation of barriers is tested in joint linear structural equation models. Qualitative interviews explore how barriers impact engagement, especially for socioeconomically disadvantaged women.Ethics and disseminationThis protocol has been approved by the National Cancer Institute Central Institutional Review Board, and Certificate of Confidentiality has been obtained. We plan to disseminate the findings through journal publications and national meetings, including the NCORP network. Our findings will advance the science of medical decision-making with the potential to reduce socioeconomic health disparities.Trial registration numberClinicalTrials.gov Registry (NCT03766009).
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Kara-Júnior, Newton, Edméa Rita Temporini, and Newton Kara-José. "Cataract surgery: expectations of patients assisted during a community project in São Paulo, state of São Paulo, Brazil." Revista do Hospital das Clínicas 56, no. 6 (December 2001): 163–68. http://dx.doi.org/10.1590/s0041-87812001000600001.
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OBJECTIVE: To identify social characteristics and expectations of individuals seen during a community project for the treatment of senile cataracts. Expected results from their eye surgery and its consequences to their quality of life were studied as well. METHODOLOGY: Cataract patients (visual acuity equal to or lower than 0.2 in the more superior eye) aged 50 years or over, were surveyed by means of interviews held during their visit at the Cataract Project in São Paulo city, State of São Paulo, Brazil, in 1999. RESULTS: The sample was composed of 331 subjects of low socioeconomic level ranging in age from 50 to 97 years (average = 71.8 years). Expectation of total recovery from the cataract condition by means of surgery was declared by 80.0% of the respondents, with no significant differences between male and female subjects (P < 0.1723). Hope to resume manual activities was expressed by 59.8%. CONCLUSION: A predominance of expectations of resuming normal activity and achieving a better quality of life after cataract surgery were identified.
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Moro-López-Menchero, Paloma, Cristina García-Bravo, César Fernández-de-las-Peñas, Javier Güeita-Rodríguez, Carmen Jiménez-Antona, and Domingo Palacios-Ceña. "Understanding the Non-Surgical Treatment Experience of Female Patients with Carpal Tunnel Syndrome: A Qualitative Study." International Journal of Environmental Research and Public Health 19, no. 19 (September 28, 2022): 12349. http://dx.doi.org/10.3390/ijerph191912349.
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Carpal tunnel syndrome (CTS) is a peripheral neuropathy of the upper extremity, characterized by pain, loss of strength, and decreased fine motor function. This study describes the experiences of women with CTS who received non-surgical treatments. A qualitative phenomenological study was undertaken. Purposive sampling was used. Women with clinical and electromyographic diagnoses of CTS were included. Eighteen in-depth interviews were conducted among women with CTS, and field notes were kept. The Giorgi’s approach was used for qualitative analysis of the data collected. Five themes emerged: (a) Seeking help and waiting for a diagnosis, (b) trying non-surgical therapeutic options, (c) avoiding invasive options, (d) treatment expectations, and (e) relationships with clinicians. The women described how diagnoses were delayed because women delay seeking help and referrals to medical specialists. Women avoid surgical options and prefer to opt for more conservative approaches, such as splinting or physical therapy. The main reason for avoiding surgical treatment is the fear of limitations and that surgery will not fully eliminate the symptoms. Conflicts may arise in the relationship with the clinician, and they demand to be able to participate in the decision-making process.
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Thalaivirithan, Balakrishnan Margabandu, Maithreyi Sethu, Dinesh Karuvakkurichi Ramachandran, Mahadevan Kandasamy, and Jaganmohan Janardhanam. "Application of embryonic equivalents in male-to-female sex reassignment surgery." Indian Journal of Plastic Surgery 51, no. 02 (May 2018): 155–66. http://dx.doi.org/10.4103/ijps.ijps_62_18.
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ABSTRACT Introduction: The feeling of incongruence between phenotypic sex and psychological recognition of self-gender is termed gender dysphoria. Transsexualism is the most extreme form of this disorder. Aims and Objectives: The aims and objectives of the study are to evaluate the esthetic and functional outcome of embryonic equivalents-based male-to-female sex reassignment surgery in transwomen using the institutional scoring system. Materials and Methods: Thirty transwomen who had undergone male-to-female embryonic equivalents-based sex reassignment surgery (MFEEbSRS) from October 2012 to March 2016 were retrospectively studied. The outcome was evaluated by two independent plastic surgeons, based on interview with the individuals, visual assessment, and measurements. Surgical Technique: Clitoris was created from reduced glans on dorsal penile pedicle mounted on the crura of the conjoined corpora cavernosa. De-gloved unfurled proximal penile skin formed the introitus, hood for clitoris and labia minora. Neo-external urethral meatus was fashioned from the distal portion of the bulbar urethra. Distal de-gloved inverted penile tube flap was used for the creation of neovagina. Reduced scrotal flaps formed the labia majora. Observation and Results: The maximum length of neovagina in the study was 12 cm, and the average length was 9.8 cm. Based on our institutional scoring system for the assessment of esthetic and functional outcome, we got excellent results in all transwomen. Conclusion: The esthetic and functional outcome in all the patients was good. All patients were relieved of their primordial feminine tension and satisfied with the surgery. Their personality, lifestyle, and self-esteem improved remarkably following surgery.
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Salas, Maribel, Michele Julian, Leonidas Drogaris, Zahidul Islam, Mackenzie Henderson, Annette Stemhagen, Natalie O'Donnell, and Nora Tu. "Evaluation of patient and healthcare provider (HCP) knowledge, attitudes, and behavior for safety and use of pexidartinib." Journal of Clinical Oncology 38, no. 15_suppl (May 20, 2020): e23580-e23580. http://dx.doi.org/10.1200/jco.2020.38.15_suppl.e23580.
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e23580 Background: Pexidartinib, a kinase inhibitor, is approved for treatment of adult patients with symptomatic tenosynovial giant cell tumor (TGCT) associated with severe morbidity or functional limitations and not amenable to improvement with surgery. Due to risk of serious and potentially fatal liver injury, pexidartinib is available via a Risk Evaluation and Mitigation Strategy (REMS) Program. A requirement of the REMS is to conduct a qualitative evaluation of stakeholder Knowledge, Attitudes, and Behavior (KAB) of risks via surveys. The objective of the qualitative evaluation is to review key risk message questions with respect to understanding, relevance, clarity and provide recommendations on alternative language, phrasing, and structure. Methods: Anonymized, one-on-one 45–60-min phone interviews with patients and HCPs were conducted by UBC. Patients ≥18 y, diagnosed with TGCT (prioritized) or metastasis/sarcoma of the connective tissue, with different levels of education and fluent reading/speaking English were included. To participate, HCPs were required to treat patients with TGCT (prioritized) or metastasis/sarcoma of the connective tissue, treat patients ≥75% of their time, and clearly read/speak English. Participants were required to complete an Interview Release Form (IRF) and confirm access to a computer/tablet. Participants had little/no familiarity with pexidartinib materials. All interviews followed a standard process, used a pre-scripted guide on general instructions, confidentiality, safety event reporting, rapport building and assessment of health literacy (patients only). Feedback regarding understanding, relevance, and clarity were used to recommend potential alternate language/phrasing. To receive compensation participants were required to execute/return the IRF. Results: Twelve patients were interviewed, majority 67% had TGCT; mean age 52 y; 58% female; 42% reported some college/associates degree. 12 HCPs were interviewed, 67% treated patients with TGCT; 100% male; mean years practicing 22; all spent 75% or more time seeing patients; primary specialty Orthopedics. Areas of confusion/misunderstanding were reported, and questions were then revised. Patient findings: complexity and wordiness; HCP findings: repetition/difficulty reading, and some terminology was not self-explanatory. Conclusions: Feedback from HCPs and patients was received to improve the key risk messages of the KAB. Qualitative research is recommended to improve comprehension and data quality collected.
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Ferraro, Samantha L., David N. Williams, and Michael B. Millis. "A qualitative study of the impact of a periacetabular osteotomy on patients’ lives." Bone & Joint Journal 104-B, no. 7 (July 1, 2022): 781–85. http://dx.doi.org/10.1302/0301-620x.104b7.bjj-2021-1775.r1.
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Aims The aim of this study was to understand the experience of mature patients who undergo a periacetabular osteotomy (PAO), a major hip-preserving surgical procedure that treats symptomatic hip dysplasia by realigning the acetabulum. Our aim was to improve our understanding of how the operation affected the lives of patients and their families, with a long-term goal of improving their experience. Methods We used a phenomenological approach with in-depth, semi-structured interviews to investigate the experience of seven female patients, aged between 25 and 40 years, who underwent a PAO. A modified homogeneity sampling approach coupled with criterion sampling was used. Inclusion criteria involved having at least one child at home and being in a committed relationship with a spouse or partner. Results Analysis of interview transcripts revealed five major themes: feelings of frustration before having a treatment plan; fear of the operation; the importance of understanding the procedure in order to feel in control of their care; feelings of helplessness, dependence, and depression during recovery; and the need for support during recovery. Conclusion Our findings suggest that both the physical and psychosocial burdens of undergoing a PAO are great, with a major impact on the patient and their family. Many important issues lie outside the scope of what healthcare teams currently address. Cite this article: Bone Joint J 2022;104-B(7):781–785.
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Bakr, Shirin, Sirwan Ali, and Saadia Khudhr. "Anxiety among patients undergoing major general surgery." Zanco Journal of Medical Sciences 14, no. 3 (December 1, 2010): 7–11. http://dx.doi.org/10.15218/zjms.2010.028.
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Background and objective: It has been recognized for more than 40 years that patients experience different levels of anxiety when faced with impending surgery. The degree to which each patient manifests anxiety is related to many factors; this study aims to assess the level of anxiety among patients undergoing major general surgery and to identify the effect of gender on preoperative anxiety. Methods: A sample of 300 patients who were admitted from 5th April 2009 to the 10th November 2009; in general surgery units of teaching hospitals ( Rezgari & Hawler ) in Erbil city were interviewed to assess their level of anxiety before surgery. The instrument used for this purpose was a questionnaire that included socio-demographic information and the State-Trait Anxiety Inventory (STAI) of Spilberger. Results: Most of the patients showed moderate to severe anxiety level; (moderate=50% and severe=38.3%) others showed mild anxiety level (11.7%). A statistically significant relationship was seen between preoperative anxiety and gender; female patients showed high levels of anxiety (severe anxiety=46.9%) while male patients showed less severe anxiety level (severe anxiety=28.6%). Conclusion: According to the results of the study patients undergoing major general surgery need to be assessed regarding level of anxiety before surgery. This anxiety should be reduced through appropriate interventions, especially in women who have been found to experience high levels of anxiety.
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JUNIOR, WILSON CINTRA, MIGUEL LUIZ ANTONIO MODOLIN, RODRIGO ITOCAZO ROCHA, and ROLF GEMPERLI. "Augmentation mastopexy after bariatric surgery: evaluation of patient satisfaction and surgical results." Revista do Colégio Brasileiro de Cirurgiões 43, no. 3 (June 2016): 160–64. http://dx.doi.org/10.1590/0100-69912016003005.
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ABSTRACT Objective: to evaluate patient satisfaction and surgical results obtained after mastopexy with breast implant inclusion. Methods: we conducted a prospective study of 20 consecutive female patients with a mean age of 39.9 years, submitted to augmentation mastopexy. We applied semi-directed psychological interviews pre and postoperatively. The answers to the evaluations were tabulated, categorized, and allowed patient satisfaction analysis. We evaluated surgical results through photographic analysis of three independent plastic surgeons, in the pre and postoperative periods, when scores were attributed to the following items: breasts shape, breasts volume, breasts symmetry, nipple-areolar complex position, and scar quality and extent. Results: nineteen patients (95%) referred satisfaction with the surgical results attained (p<0,001). The mean sum of the scores attributed by the three surgeons to each patient varied between 4.7 and 10, with an overall mean of 7.28. The results were considered good or great for 65% of the sample and poor for 8.4%. Conclusion: there was a 95% satisfaction rate among patients with the results obtained through augmentation mastopexy. The photographic analysis of the results obtained a mean score of 7.28, considered as a good result, albeit the weak correlation among evaluators.
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RIBEIRO, Graziela Aparecida Nogueira de Almeida, Helenice Brizolla GIAMPIETRO, Lídia Barbieri BELARMINO, and Wilson SALGADO-JÚNIOR. "PSYCHOLOGICAL PROFILE OF PATIENTS ELIGIBLE FOR BARIATRIC SURGERY." ABCD. Arquivos Brasileiros de Cirurgia Digestiva (São Paulo) 29, suppl 1 (2016): 27–30. http://dx.doi.org/10.1590/0102-6720201600s10008.
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Abstract Background: The psychologist who works in bariatric surgery has a role to receive, evaluate, prepare and educate the patient who will undergo the surgical procedure. Psychological evaluation becomes important in so far as allows us to obtain data on personal and familiar history and allow tracing of possible psychopathology. Aim: To collect data on psychological evaluations of patients in a bariatric surgery service of a public hospital in order to describe the psychological profile of patients in this service. Method: Data were collected from 827 patients between 2001 and 2015, using data from an interview, Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI) and Binge Eating Scale (BES). Results: The mean age of patients before surgery was 39 years+/- 10, the mean BMI was 51 kg/m²+7, and most patients (81%) were female. The average score on the BDI was 14.8+8 and women had significantly higher scores than men. On the BAI the average score was 11+8 and on the ECAP was 14+8, both with no difference between groups. Conclusions: Psychosocial characteristics of the patients points to the significant presence of indicators of depression, with low levels of anxiety and binge eating.
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Grant, Sabrina, Ashley W. Blom, Ian Craddock, Micheal Whitehouse, and Rachael Gooberman-Hill. "Home health monitoring around the time of surgery: qualitative study of patients’ experiences before and after joint replacement." BMJ Open 9, no. 12 (December 2019): e032205. http://dx.doi.org/10.1136/bmjopen-2019-032205.
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ObjectivesHip and knee replacements are common major elective surgical interventions with over 200 000 performed annually in the UK. Not all patients achieve optimal outcomes or experience problems or delays in recovery. The number of patients needing these operations is set to increase, and routine clinical monitoring is time-consuming and resource-consuming for patients and healthcare providers; therefore, innovative evaluation of surgical outcomes is needed. The aim of this qualitative study was to capture the patient experience of living with a novel home monitoring sensing system during the period around joint replacement.SettingOne secondary care hospital in the South West, UK.Participants13 patients (8 female, 63–89 years) undergoing total hip or knee replacement enrolled into the study.DesignQualitative study with thematic analysis. The system remained in situ for up to 12 weeks after their surgery and comprised a group of low-powered sensors monitoring the environment (temperature, light and humidity) and activity of people within the home. Patients were interviewed at two timepoints: before and after surgery. Interviews explored views about living with the technology, its acceptability, as well as attitudes towards health technology.ResultsThree main themes emerged: installation of home-sensing technology on the journey to surgery, the home space and defining unobtrusiveness and pivotal role of social support networks.ConclusionsPatients who agreed to the technology found living with it acceptable. A home-sensing system that monitors the environment and activity of the people in the home could provide an innovative way of assessing patients’ surgical outcomes. At a time characterised by reduced mobility, functional limitations and increased pain, patients in this study relied on informal and formal supportive networks to help maintain the system through the busy trajectory of the perioperative period.
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S., M.D, Alnefaie, Alqashqari K., Almalki A., Baabbad A., Alrabie A., and Almalki N. "The Association between Soy Food and Breast Cancer; a Multicenter Cross-Sectional Study at Taif City, Saudi Arabia." International Journal of Innovative Research in Medical Science 6, no. 12 (December 1, 2021): 854–61. http://dx.doi.org/10.23958/ijirms/vol06-i12/1279.
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Background: Breast cancer (BC) has a high incidence rate among females (3 to 8 per 1000) and is one of the most common causes of cancer-related death. Diet is considered one of the risk factors in BC. Phytoestrogens are chemical components similar to estrogen in structure. An isoflavone is a major group of phytoestrogens, and it is found in food like soy products. Aim: Our study investigates the association between soy food intake, BC development and mammogram density among women in Taif City, Saudi Arabia. Methods: A descriptive cross-sectional study was conducted in three hospitals in Taif City, Saudi Arabia. The data was gathered using a questionnaire created by the authors. Phone interviews were conducted with female patients who visited breast/general surgery clinics from January to July 2020. Results: A total of 194 patients participated in this study. We observed that only two female patients (1.03%) had a history of high soya intake, and both developed BC (p = 0.011). One-third (33.5%) showed scattered areas of fibro-glandular densities in a mammogram. Conclusion: We found that a large amount of soy food intake was significantly associated with a higher risk of BC. There is no relationship between mammogram density and age based on soya intake. More prospective studies with larger sample sizes in different cities of Saudi Arabia are needed to confirm this association.
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Moreira, Clayton Alencar, Silvestre Savino Neto, and Silvia Ferreira Nunes. "What I as a Patient/Family need to know about Bariatric and Metabolic Surgery: A Booklet for Lay People." International Journal of Advanced Engineering Research and Science 9, no. 9 (2022): 095–109. http://dx.doi.org/10.22161/ijaers.99.10.
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Introduction: obesity and its comorbidities have an increasing prevalence each year, with a surgical treatment established for many years. Objective: to transform the preoperative, trans and postoperative aspects of bariatric and metabolic surgery in obese patients into accessible, clear and assertive information. Methods: This is an excerpt from a descriptive, observational and cross-sectional master's dissertation carried out in a hospital in the state of Pará.The information was collected through the institution's medical records, in addition to interviews with obese patients and close family members who presented the indications for bariatric and metabolic surgery. The study complied with the Research Standards involving Human Beings of the Ministry of Health and the National Health Council. Results and discussion: after analyzing the exclusion criteria, 98 patients and family members were included, who responded adequately to the questionnaire. Most were young adults, female, brown, with higher education and married. Soon after, an educational booklet was prepared for patients and their families. The research focused on selecting random bariatric surgery patients, being strategic in the information construction process. Conclusion: The tool as a booklet has very simple and intelligible didactics and can reach a very large percentage of patients, becoming of great value in the future of bariatric surgery, demystifying many topics that are still obscure for the vast majority of patients and their families.
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Niimi, Keiko, Ayataka Fujimoto, Yoshinobu Kano, Yoshiro Otsuki, Hideo Enoki, and Tohru Okanishi. "Speech Analysis Using Artificial Intelligence as a Peri-Operative Evaluation: A Case Report of a Patient with Temporal Lobe Epilepsy Secondary to Tuberous Sclerosis Complex Who Underwent Epilepsy Surgery." Brain Sciences 11, no. 5 (April 29, 2021): 568. http://dx.doi.org/10.3390/brainsci11050568.
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Background: Improved conversational fluency is sometimes identified postoperatively in patients with epilepsy, but improvements can be difficult to assess using tests such as the intelligence quotient (IQ) test. Evaluation of pre- and postoperative differences might be considered subjective at present because of the lack of objective criteria. Artificial intelligence (AI) could possibly be used to make the evaluations more objective. The aim of this case report is thus to analyze the speech of a young female patient with epilepsy before and after surgery. Method: The speech of a nine-year-old girl with epilepsy secondary to tuberous sclerosis complex is recorded during interviews one month before and two months after surgery. The recorded speech is then manually transcribed and annotated, and subsequently automatically analyzed using AI software. IQ testing is also conducted on both occasions. The patient remains seizure-free for at least 13 months postoperatively. Results: There are decreases in total interview time and subjective case markers per second, whereas there are increases in morphemes and objective case markers per second. Postoperatively, IQ scores improve, except for the Perceptual Reasoning Index. Conclusions: AI analysis is able to identify differences in speech before and after epilepsy surgery upon an epilepsy patient with tuberous sclerosis complex.
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Teng Phuah, Kit, Kelly Kai Seng Wong, and Jenn Ling TingJL. "Propensity to Undergo Cosmetic Surgery and Services in Seoul." International Journal of Community Development and Management Studies 3 (2019): 001–16. http://dx.doi.org/10.31355/37.
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NOTE: THIS ARTICLE WAS PUBLISHED WITH THE INFORMING SCIENCE INSTITUTE. Aim/Purpose................................................................................................................................................................................................. The focus of this study is to find the relationship between the components in Theory of Reasoned Action (TRA) such as attitude, subjective norms (Media), subjective norm (celebrity), psychological attribute (self-esteem) and psychological attributes (social status) which influence Seoul Korea female intention to undergo cosmetic surgery in Seoul, Korea. Background................................................................................................................................................................................................... South Korea was ranked third in the world of cosmetic surgery in 2015. The Korean cosmetic surgery market is a promising market with 24% market share of the total world market. The market data about female willingness to undergo cosmetic surgery strongly suggests that marketers who work in the beauty and health industries associated with cosmetic surgery should pay attention to Seoul Korean women who are in the age group under 40 years old as the potential target market. In Korea, cosmetic surgery is frequently mentioned in normal conversation as a general topic and it is naturally settled as a culture. Methodology................................................................................................................................................................................................... The Seoul Korean female behavior with respect to use of cosmetic surgery is approximately determined by factors underlying the consumer’s behavioral intent. Thus, the theory of Reasoned Action (TRA) is used in this study because it attempts to explain consumer intentions and has a strong power of prediction of utility for a wide range of human behavioral attributes such as attitude, subjective norms (Media), subjective norm (celebrity), psychological attribute (self-esteem) and psychological attributes. A survey was conducted in Seoul, Korea where 400 female were interviewed by self-administrated questionnaire. Descriptive analysis, exploratory factor analysis and multiple regressions were used to examine the factors that influence Seoul Korean female intention to engage in cosmetic surgery. Contribution................................................................................................................................................................................................... This research provides an insight to the health and beauty industry, marketers, decision makers and academics on the factors that influence Seoul Korea female intention to engage with cosmetic surgery. Findings According to the research findings, Seoul Korean female attitude towards cosmetic surgery are generally positive, or favorable intention. That is to say, they usually think that the most effective way to improve their appearance and social status is to undergo cosmetic surgery. The study results (both qualitative and quantitative) support the proposition that the variables such as the media and the celebrities play important role in influencing females to do surgery. The results also provide important information to formulate and design strategies for the development and effective conduct of advertisements and promotions of cosmetic surgery. Lastly, other potential influencing factors were psychological attributes which are self-esteem and social status. Recommendations for Practitioners............................................................................................................................................................. It is suggested that psychologists can try to find the clinical roles in helping the cosmetic surgery patients by identifying patients who may not adjust well psychologically or psycho-socially after surgery. Psychologists can examine the issues related to cosmetic surgery due to the increasing popularity and the link between appearance, body image, eating disorders, sexual functioning and social phobia. Recommendations for Researchers............................................................................................................................................................... To help to fill in the research gaps, it is recommended to examine on how cosmetic surgery makes patients feel, how cosmetic surgery affects those around the recipients and what the effect of cosmetic surgery would be on children and teenagers. Impact on Society The increasing number of cosmetic surgery is having a dramatic impact on the Korean society. In Korea, the number of cosmetic procedures has nearly doubled in the past few years. Distorted perception of self-image, over dependence on the social media is enormous and cannot be overstated had also caused the dramatic rise of cosmetic surgery. The impact of social media has resulted in the rising demand for injectable facial fillers, liposuction, breast implants, buttock augmentation and Botox among younger generation. Future Research.............................................................................................................................................................................................. It is suggested to conduct further research involving Korean females who have undergone cosmetic surgery. The extended research should attempt to determine the level of satisfaction towards non-core and post cosmetic surgery services. That is, after sales services, the skills and knowledge of the doctor, the clinic environment and other attributes that further define the total or augmented product.
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Keiner, Doerthe, Michael R. Gaab, Henry W. S. Schroeder, and Joachim Oertel. "LONG-TERM FOLLOW-UP OF DUAL-PORTAL ENDOSCOPIC RELEASE OF THE TRANSVERSE LIGAMENT IN CARPAL TUNNEL SYNDROME." Neurosurgery 64, no. 1 (January 1, 2009): 131–38. http://dx.doi.org/10.1227/01.neu.0000335784.90217.9d.
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Abstract OBJECTIVE The long-term efficacy of dual-portal endoscopic release of the transverse ligament in carpal tunnel syndrome is still being debated. In this study, the authors present 94 endoscopic carpal tunnel surgery cases with long-term follow-up data. METHODS The study includes 72 patients aged 17 to 86 years (mean age, 53.4 years); bilateral surgery was performed in 22 of these patients. Seventy-two hands of female patients and 22 hands of male patients were included. All procedures were performed with a dual-portal set according to the Chow technique. All patients were examined 2 to 3 months after surgery. The long-term follow-up evaluation was based on telephone interviews 5 to 12 years (mean, 8.2 years) after surgery. RESULTS From a cohort of 214 cases that were treated surgically between 1995 and 2002, 94 cases (44%) could be evaluated for long-term follow-up. Four of these patients had to be excluded from long-term follow-up because of a switch to an open technique and early open revision (3–6 months after the first surgery), owing to persistent symptoms. A good to optimal postoperative outcome with improvement of neurological signs and subjective patient satisfaction was observed in 84 (93.3%) of the remaining 90 cases. There were no recurrences. CONCLUSION The study shows that dual-portal endoscopic release of the transverse ligament in carpal tunnel syndrome is a valuable technique that produces very good long-term results and high patient satisfaction and does not result in a significant recurrence rate.
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Hasan, Nawal A., Afnan Freije, Abdulmenem Abualsel, Hani Al-Saati, and Simone Perna. "Effect of Bariatric Surgery on Weight Loss, Nutritional Deficiencies, Postoperative Complications and Adherence to Dietary and Lifestyle Recommendations: A retrospective cohort study from Bahrain." Sultan Qaboos University Medical Journal [SQUMJ] 20, no. 3 (October 5, 2020): 344. http://dx.doi.org/10.18295/squmj.2020.20.03.015.
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Objectives: This study aimed to investigate the effect of bariatric surgery on degree of weight loss, as well as the prevalence of nutritional deficiencies, postoperative complications and adherence to dietary and lifestyle recommendations in a cohort of patients from Bahrain. Methods: This retrospective cohort study took place between March and September 2018 at two hospitals in Bahrain. All adult patients who had undergone bariatric surgery between 2012–2017 were included. Sociodemographic and clinical information was collected from the patients’ medical records and during phone interviews. Results: A total of 341 patients participated in the study. The mean age was 39.82 ± 9.95 years and 67.7% were female. There was a significant relationship between postoperative body mass index and both the type of surgery and time since surgery (P = 0.025 and 0.008, respectively). While type of surgery had no significant effect on percent of excess weight loss (EWL) or percent of total weight loss (TWL), time since surgery significantly affected both of these weight loss measures (P = 0.006 and 0.001, respectively). Biochemical tests revealed haemoglobin, mean corpuscular volume, 25-hydroxy vitamin D, ferritin and iron deficiencies. Commonly reported complications included hair loss (59.5%), flatulence/abdominal pain (39.3%), dry skin (34.3%) and gastroesophageal reflux disease (33.1%). The level of adherence to dietary and lifestyle recommendations was high to moderate. Conclusion: Bariatric surgery was effective in accelerating EWL and TWL; however, it also resulted in complications such as nutritional deficiencies and gastrointestinal side-effects.Keywords: Bariatric Surgery; Obesity Management; Weight Loss; Gastric Bypass; Biliopancreatic Diversion; Avitaminosis; Iron-Deficiency Anemia; Bahrain.
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SILVA, Paola Turchiello da, Luciana Dapieve PATIAS, Glauco da Costa ALVAREZ, Vanessa Ramos KIRSTEN, Elisângela COLPO, and Cristina Machado Bragança de MORAES. "PROFILE OF PATIENTS WHO SEEK THE BARIATRIC SURGERY." ABCD. Arquivos Brasileiros de Cirurgia Digestiva (São Paulo) 28, no. 4 (December 2015): 270–73. http://dx.doi.org/10.1590/s0102-6720201500040013.
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Background: Nowadays obesity is a chronic disease considered one of the greatest problems in public healthy. Showing to be effective in a short and long term, the bariatric surgery has emerged as an optional treatment for morbid obesity. Aim: Identify the profile of patients seeking bariatric surgery. Methods: Were interviewed 100 patients in preoperative nutritional monitoring of bariatric surgery. The study was conducted by applying a questionnaire prepared according to the research objectives. Results: From the individuals that were seeking bariatric surgery, 78% were female, 62% were married and 69% reported physical activity. The average age of those surveyed was 37±10.83 years and mean body mass index (BMI) was 43.51± 6.25 kg/m². The comorbidity more prevalent in this group was high blood pressure (51%). In previous treatments for weight reduction, 92% have already done hypocaloric diet followed by anorectic drug (83%). The success of these treatments was reported by 92% of patients; however, the weight lost was recovered in less than one year of 75%. Patients with diabetes mellitus and dyslipidemia had higher BMI values. The patients with comorbidities showed lower levels of BMI. Conclusion: The profile of patients who sought surgical treatment for their obesity were predominantly women with a family background of obesity and obesity-related comorbidities, especially hypertension and diabetes mellitus.
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Nygaard, Christiana, Lucas Schreiner, Thiago Morsch, Rodrigo Saadi, Marina Figueiredo, and Alexandre Padoin. "Urinary Incontinence and Quality of Life in Female Patients with Obesity." Revista Brasileira de Ginecologia e Obstetrícia / RBGO Gynecology and Obstetrics 40, no. 09 (September 2018): 534–39. http://dx.doi.org/10.1055/s-0038-1670626.
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Objective To analyze the prevalence of urinary incontinence (UI) in female patients with an indication for bariatric surgery, to investigate the potential risk factors and the impact on quality of life. Methods A cross-sectional study with female patients with obesity. The evaluation consisted of a structured interview, a specific study form and quality of life questionnaires. The Poisson regression was performed to identify independent risk factors related to UI. Results A total of 221 patients were enrolled; 118 of the study participants (53.4%) reported UI episodes. Mixed UI (MUI), stress UI (SUI) only, and urgency UI (UUI) only were reported by 52.5% (62), 33.9% (40) , and 13.5% (16) of these patients respectively. The prevalence of UI was increased by 47% among the women who had given birth vaginally and by 34% of the women who had entered menopause. Vaginal delivery and menopause were identified as independent risk factors related to UI. The mean International Consultation on Incontinence Questionnaire - Short Form (ICIQ-SF) score was 9.36 ± 4.9. The severity of symptoms was considered moderate in 53.3% (63) of the patients with UI. Conclusion Urinary incontinence impacts quality of life negatively, and the prevalence of UI is high among obese patients. In the present study, vaginal delivery and menopause were independently associated with UI.
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Gallagher, Robyn, and Sharon McKinley. "Stressors and Anxiety in Patients Undergoing Coronary Artery Bypass Surgery." American Journal of Critical Care 16, no. 3 (May 1, 2007): 248–57. http://dx.doi.org/10.4037/ajcc2007.16.3.248.
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Background Patients undergoing coronary artery bypass surgery who have increased anxiety levels have poorer outcomes than patients with lower levels, yet few studies have identified the concerns associated with this anxiety. Objective To describe the concerns of patients undergoing coronary artery bypass surgery and to identify concerns that were associated with higher levels of anxiety. Method Patients (n = 172) were interviewed to determine their concerns and anxiety levels before surgery, before discharge, and 10 days after discharge. Multiple regression was used to determine the predictors of anxiety. Results Although individual concerns changed over time, anxiety levels did not change from before to after surgery, remaining low to moderate. Being female and having more concerns about waiting for the surgery, being in pain/discomfort, and resuming lifestyle were predictors of increased anxiety before surgery. Predictors of increased anxiety while hospitalized after the surgery included taking anxiolytic or antidepressant medications, higher anxiety levels before surgery, concerns about personal things being inaccessible, and difficulty sleeping. Patients with higher anxiety levels after discharge were older, more anxious before surgery, and had concerns about being in pain/discomfort. Conclusion Patients waiting for coronary artery bypass surgery should be routinely assessed for anxiety before the procedure, and interventions to prevent or reduce anxiety should be provided. Interventions must be multifactorial, including information and support for pain management and realistic information about surgery schedules and resuming lifestyle after the surgery. Women and older patients may need to be targeted for intervention.
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Pereira, Adriana Pelegrini dos Santos, Claudia Bernardi Cesarino, Marielza Regina Ismael Martins, Maria Helena Pinto, and João Gomes Netinho. "Associations among socio-demographic and clinical factors and the quality of life of ostomized patients." Revista Latino-Americana de Enfermagem 20, no. 1 (February 2012): 93–100. http://dx.doi.org/10.1590/s0104-11692012000100013.
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This study identifies the socio-demographic and clinical factors of patients with irreversible colostomy secondary to colorectal cancer and correlates them with quality of life (QOL). It is a cross-sectional study. Socio-demographic and clinical data were collected through interviews and the WHOQOL-bref to assess QOL. The sample comprised 60 patients. Most of the patients were male, elderly individuals, half were married and half did not have a sexual partner, with complete primary education, receiving up to two times the minimum wage, carried a stoma for three months on average, were instructed they would carry a stoma, but did not have their stoma marked prior to surgery. The average QOL score was 75.500, while the psychological, social and physical domains were the most affected. No statistically significant differences were found in QOL in relation to the following socio-demographic and clinical factors: female gender, low income, no sexual partners, and lack of instruction. The patients with an intestinal stoma presented a satisfactory QOL.
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Geary, Rebecca S., Ipek Gurol-Urganci, Jil B. Mamza, Rebecca Lynch, Dina El-Hamamsy, Andrew Wilson, Simon Cohn, Douglas Tincello, and Jan van der Meulen. "Variation in availability and use of surgical care for female urinary incontinence: a mixed-methods study." Health Services and Delivery Research 9, no. 7 (March 2021): 1–94. http://dx.doi.org/10.3310/hsdr09070.
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Background Urinary incontinence affects between 25% and 45% of women. The availability and quality of services is variable and inequitable, but our understanding of the drivers is incomplete. Objectives The objectives of the study were to model patient, specialist clinician, primary and secondary care, and geographical factors associated with referral and surgery for urinary incontinence, and to explore women’s experiences of urinary incontinence and expectations of treatments. Design This was a mixed-methods study. Setting The setting was NHS England. Participants Data were collected from all women with a urinary incontinence diagnosis in primary care data, and all women undergoing mid-urethral mesh tape surgery for stress urinary incontinence were included. Interviews were also carried out with 28 women from four urogynaecology clinics who were deciding whether or not to have surgery, and surveys were completed by 245 members of the Royal College of Obstetricians and Gynaecologists with a specialist interest in urinary incontinence. Data sources The sources were patient-level data from Hospital Episode Statistics, the Clinical Practice Research Datalink and the Office for National Statistics mortality data linked to Hospital Episode Statistics. Interviews were conducted with women. An online vignette survey was conducted with members of the Royal College of Obstetricians and Gynaecologists. Main outcome measures The main outcome measures were the rates of referral from primary to secondary care and surgery after referral, the rates of stress urinary incontinence surgery by geographical area, the risk of mid-urethral mesh tape removal and reoperation after mid-urethral mesh tape insertion. Results Almost half (45.8%) of women with a new urinary incontinence diagnosis in primary care were referred to a urinary incontinence specialist: 59.5% of these referrals were within 30 days of diagnosis. In total, 14.2% of women referred to a specialist underwent a urinary incontinence procedure (94.5% of women underwent a stress urinary incontinence procedure and 5.5% underwent an urgency urinary incontinence procedure) during a follow-up period of up to 10 years. Not all women were equally likely to be referred or receive surgery. Both referral and surgery were less likely for older women, those who were obese and those from minority ethnic backgrounds. The stress urinary incontinence surgery rate was 40 procedures per 100,000 women per year, with substantial geographical variation. Among women undergoing mid-urethral mesh tape insertion for stress urinary incontinence, the 9-year mesh tape removal rate was 3.3%. Women’s decision-making about urinary incontinence surgery centred on perceptions of their urinary incontinence severity and the seriousness/risk of surgery. Women judged urinary incontinence severity in relation to their daily lives and other women’s experiences, rather than frequency or quantity of leakage, as is often recorded and used by clinicians. Five groups of UK gynaecologists could be distinguished who differed mainly in their average inclination to recommend surgery to hypothetical urinary incontinence patients. The gynaecologists’ recommendations were also influenced by urinary incontinence subtype and the patient’s history of previous surgery. Limitations The primary and secondary care data lacked information on the severity of urinary incontinence. Conclusions There was substantial variation in rates of referrals, surgery, and mesh tape removals, both geographically and between women of different ages and women from different ethnic backgrounds. The variation persisted after adjustment for factors that were likely to affect women’s preferences. Growing safety concerns over mid-urethral mesh tape surgery for stress urinary incontinence during the period from which the data are drawn are likely to have introduced more uncertainty to women’s and clinicians’ treatment decision-making. Future work Future work should capture outcomes relevant to women, including ongoing urinary incontinence and pain that is reported by women themselves, both before and after mesh and non-mesh procedures, as well as following conservative treatments. Future research should examine long-term patient-reported outcomes of treatment, including for women who do not seek further health care or surgery, and the extent to which urinary incontinence severity explains observed variation in referrals and surgery. Funding This project was funded by the National Institute for Health Research (NIHR) Health Services and Delivery Research programme and will be published in full in Health Services and Delivery Research; Vol. 9, No. 7. See the NIHR Journals Library website for further project information.
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Hornby, ST, FD McDermott, M. Coleman, Z. Ahmed, J. Bunni, D. Bunting, M. Elshaer, et al. "Female Gender and Diabetes Mellitus Increase the Risk of Recurrence after Laparoscopic Incisional Hernia Repair." Annals of The Royal College of Surgeons of England 97, no. 2 (March 2015): 115–19. http://dx.doi.org/10.1308/003588414x14055925058751.
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Background Laparoscopic hernia repair is used widely for the repair of incisional hernias. Few case studies have focussed on purely ‘incisional’ hernias. This multicentre series represents a collaborative effort and employed statistical analyses to provide insight into the factors predisposing to recurrence of incisional hernia after laparoscopic repair. A specific hypothesis (ie, laterality of hernias as well as proximity to the xyphoid process and pubic symphysis predisposes to recurrence) was also tested. Methods This was a retrospective study of all laparoscopic incisional hernias undertaken in six centres from 1 January 2004 to 31 December 2010. It comprised a comprehensive review of case notes and a follow-up using a structured telephone questionnaire. Patient demographics, previous medical/surgical history, surgical procedure, postoperative recovery, and perceived effect on quality of life were recorded. Repairs undertaken for primary ventral hernias were excluded. A logistic regression analysis was then fitted with recurrence as the primary outcome. Results A total of 186 cases (91 females) were identified. Median follow-up was 42 months. Telephone interviews were answered by 115/186 (62%) of subjects. Logistic regression analyses suggested that only female sex (odds ratio (OR) 3.53; 95% confidence interval (CI) 1.39–8.97) and diabetes mellitus (3.54; 1–12.56) significantly increased the risk of recurrence. Position of the defect had no statistical effect. Conclusions These data suggest an increased risk of recurrence after laparoscopic incisional hernia repair in females and subjects with diabetes mellitus. These data will help inform surgeons and patients when considering laparoscopic management of incisional hernias. We recommend a centrally hosted, prospectively maintained national/international database to carry out additional research.
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Sinclair, David R., Frances Chung, and Gabor Mezei. "Can Postoperative Nausea and Vomiting Be Predicted?" Anesthesiology 91, no. 1 (July 1, 1999): 109–18. http://dx.doi.org/10.1097/00000542-199907000-00018.
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Background Iletrospective studies fail to identify predictors of postoperative nausea and vomiting (PONV). The authors prospectively studied 17,638 consecutive outpatients who had surgery to identify predictors. Methods Data on medical conditions, anesthesia, surgery, and PONV were collected in the post-anesthesia care unit, in the ambulatory surgical unit, and in telephone interviews conducted 24 h after surgery. Multiple logistic regression with backward stepwise elimination was used to develop a predictive model An independent set of patients was used to validate the model Results Age (younger or older), sex (female or male), smoking status (nonsmokers or smokers), previous PONV, type of anesthesia (general or other), duration of anesthesia (longer or shorter), and type of surgery (plastic, orthopedic shoulder, or other) were independent predictors of PONV. A 10-yr increase in age decreased the likelihood of PONV by 13%. The risk for men was one third that for women. A 30-min increase in the duration of anesthesia increased the likelihood of PONV by 59%. General anesthesia increased the likelihood of PONV 11 times compared with other types of anesthesia. Patients with plastic and orthopedic shoulder surgery had a sixfold increase in the risk for PONV. The model predicted PONV accurately and yielded an area under the receiver operating characteristic curve of 0.785+/-0.011 using an independent validation set. Conclusions A validated mathematical model is provided to calculate the risk of PONV in outpatients having surgery. Knowing the factors that predict PONV will help anesthesiologists determine which patients will need antiemetic therapy.
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Kalani, M. Yashar S., and Joseph M. Zabramski. "Risk for symptomatic hemorrhage of cerebral cavernous malformations during pregnancy." Journal of Neurosurgery 118, no. 1 (January 2013): 50–55. http://dx.doi.org/10.3171/2012.8.jns12241.
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Object The threat of symptomatic hemorrhage from cerebral cavernous malformations (CCMs) during pregnancy remains poorly understood. The authors undertook this study to better define the risk of pregnancy-related hemorrhage in this population. Methods The records of female patients with sporadic (isolated lesions and negative family history) and familial forms of CCM, which were collected as part of the Barrow Neurological Institute CCM natural history study, were examined. Clinical data related to pregnancy, including type of delivery (vaginal or cesarean section) and any change in neurological status, were obtained from chart reviews and patient interviews. Results There were 168 pregnancies among 64 female patients with CCM (28 sporadic and 36 familial). Assuming an average of 46 weeks per pregnancy (40 weeks of gestation and 6 weeks of puerperium), patients were at risk for hemorrhage for a total of 148.6 years. Symptomatic hemorrhage (defined as new-onset or exacerbation of seizure activity or any change in neurological status) occurred during 5 pregnancies, with the most common symptom being seizures (4 cases). The overall risk for symptomatic hemorrhage was 3% per pregnancy; the risk was 1.8% per pregnancy in the sporadic group and 3.6% per pregnancy in the familial patients. There were 19 deliveries by cesarean section: 5 for obstetrical reasons, 8 for fear of possible hemorrhage, and 6 for unknown reasons. Vaginal delivery was performed without complications for the remaining 149 pregnancies. Conclusions The authors' experience suggests that the risk of symptomatic hemorrhage from a CCM during pregnancy is not increased and that a history of CCM is not a contraindication to pregnancy or vaginal delivery.
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AlWarawreh, Amjad M., Zaid H. AlTamimi, Hazem M. Khraisat, and Winfried Kretschmer. "Prevalence of Temporomandibular Disorder Symptoms among Orthognathic Patients in Southern Germany: Retrospective Study." International Journal of Dentistry 2018 (October 18, 2018): 1–4. http://dx.doi.org/10.1155/2018/4706487.
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This study investigated the prevalence of temporomandibular disorder (TMD) among patients before and after orthognathic surgery and assessed the effect of orthognathic surgery on each of the TMD symptoms (clicking, pain, crepitus, and MRI findings). A sample of 100 consecutive patients undergoing bimaxillary surgery for correction of craniofacial deformities (31 male and 69 female), with ages ranging between 17 and 58 years (mean age: 27.7 ± 9.3 years), were interviewed and examined regarding signs and symptoms of TMD. Clinical examination and X-ray and magnetic resonance imaging of the temporomandibular junction were performed at the time of surgery and 1 year thereafter. The prevalence of TMD preoperatively and postoperatively was 35% and 27%, respectively. A high frequency of relief was found in the patients with TMD symptoms (74.3%; 19 (70.3%) of patients had reduced clicking, 7 (87.5%) patients had reduced pain, 4 (100%) patients had reduced crepitus, and 4 (57.1%) patients showed changes in MRI findings), 12 patients who were asymptomatic before surgery developed clicking in TMJ after surgery, 3 developed pain, and 3 developed crepitus. TMD problems can occur in a variety of patients, including those who have facial deformities, and require orthognathic surgery. However, orthognathic surgery may not predictably treat or reduce the symptoms of TMD.
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Vincent, Corita, Pete Wegier, Vincent Chien, Allison Miyoshi Kurahashi, Shiphra Ginsburg, Hedieh Molla Ghanbari, Jesse Isaac Wolfstadt, and Peter Cram. "Qualitative Evaluation of a Novel Educational Tool to Communicate Individualized Hip Fracture Prognostic Information to Patients and Surrogates: My Hip Fracture (My-HF)." Geriatric Orthopaedic Surgery & Rehabilitation 12 (January 2021): 215145932110505. http://dx.doi.org/10.1177/21514593211050513.
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Introduction Mortality and morbidity are high for older adults after hip fracture (HF), but patients and surrogate decision makers (SDMs) are typically unaware of the poor prognosis. We developed a novel educational tool, My Hip Fracture (My-HF), to provide patients and SDMs of patients hospitalized with acute HF individualized estimates of their post-HF prognosis. We conducted initial usability testing of My-HF in a sample of patients with HF and SDMs. Materials and Methods My-HF provides information about: 1) anatomy and risk factors for HF; 2) Hip fracture treatment received; 3) individualized predicted risk of adverse events and 4) anticipated discharge trajectory. We conducted a qualitative usability study using a convenience sample of hospitalized, post-operative patients with acute HF or SDMs of patients who lacked decision-making capacity. We used semi-structured interviews to obtain feedback. Thematic analysis was used to identify themes and concepts. Results We conducted interviews with 8 patients and 9 SDMs (mean age of interviewees 70.1 years, 41% female). My-HF was generally well received. Thematic analysis identified legibility and visual appeal, comprehension, numeracy, utility and reflection as prominent themes. Most respondents found My-HF to be useful in improving their understanding of HF and as a potential mechanism for sharing information with other care team members (including family and professionals). Suggestions for improvement of legibility, presentation of the individualized prognosis information and content were identified. Discussion Patients and SDMs are generally accepting of My-HF and found it useful for communicating individualized prognostic information. Feedback identified areas for improvement for future iterations of the tool. Conclusion My-HF presents a means of addressing the gap in understanding of prognosis post-HF as a part of patient-centered care. Further evaluation will be needed to assess the impact of My-HF on patient and SDM reported outcomes as we transition from a paper to smart-phone enabled web application.
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Sato, Masakazu, Minako Koizumi, Takahiro Hino, Yu Takahashi, Natsuki Nagashima, Nao Itaoka, Chiharu Ueshima, Maki Nakata, and Yoko Hasumi. "Retained Barium in the Appendix Is Difficult to Distinguish from Surgical Remnants following Laparoscopic Surgery." Case Reports in Obstetrics and Gynecology 2018 (June 26, 2018): 1–3. http://dx.doi.org/10.1155/2018/2589080.
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Surgical materials, such as gauze, can be accidentally left inside of patients following surgery. This iatrogenic complication should be avoided and is often prevented by routine X-ray analysis after surgical abdominal procedures. We report a case of retained barium in the appendix that was difficult to distinguish from surgical remnants. A 41-year-old Japanese female was diagnosed with uterine leiomyoma and underwent laparoscopic myomectomy. The postoperative X-ray test showed a cord-like material in the lower right abdomen that was not captured in the preoperative X-ray test two months prior to the operation. Because of this difference, the area was reexamined laparoscopically. After examination, we concluded that the cord-like material in X-ray tests was in fact retained barium in the appendix. Barium can be retained in the appendix for long periods of time, and retained barium in the appendix can be captured radiographically and can mimic the appearance of surgical remnants, appearing as a cord-like material. The knowledge above combined with detailed interviews before surgery could prevent such confusion during interpretation of X-ray tests after surgery.
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Kraus, Moritz, Carl Neuerburg, Nicole Thomasser, Ulla Cordula Stumpf, Matthias Blaschke, Werner Plötz, Maximilian Michael Saller, Wolfgang Böcker, and Alexander Martin Keppler. "Reduced Awareness for Osteoporosis in Hip Fracture Patients Compared to Elderly Patients Undergoing Elective Hip Replacement." Medicina 58, no. 11 (October 31, 2022): 1564. http://dx.doi.org/10.3390/medicina58111564.
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Background: Osteoporotic fractures are associated with a loss of quality of life, but only few patients receive an appropriate therapy. Therefore, the present study aims to investigate the awareness of musculoskeletal patients to participate in osteoporosis assessment and to evaluate whether there are significant differences between acute care patients treated for major fractures of the hip compared to elective patients treated for hip joint replacement.; Methods: From May 2015 to December 2016 patients who were undergoing surgical treatment for proximal femur fracture or total hip replacement due to osteoarthritis and were at risk for an underlying osteoporosis (female > 60 and male > 70 years) were included in the study and asked to complete a questionnaire assessing the awareness for an underlying osteoporosis. ASA Score, FRAX Score, and demographic information have also been examined. Results: In total 268 patients (female = 194 (72.0%)/male = 74 (28%)), mean age 77.7 years (±7.7) undergoing hip surgery were included. Of these, 118 were treated for fracture-related etiology and 150 underwent total hip arthroplasty in an elective care setting. Patients were interviewed about their need for osteoporosis examination during hospitalization. Overall, 76 of 150 patients receiving elective care (50.7%) considered that an examination was necessary, whereas in proximal femur fracture patients the awareness was lower, and the disease osteoporosis was assessed as threatening by significantly fewer newly fractured patients. By comparison, patients undergoing trauma surgery had a considerably greater risk of developing another osteoporotic fracture than patients undergoing elective surgery determined by the FRAX® Score (p ≤ 0.001).; Conclusions: The patients’ motivation to endure additional osteoporosis diagnostic testing is notoriously low and needs to be increased. Patients who underwent acute care surgery for a fragility proximal femur fracture, although acutely affected by the potential consequences of underlying osteoporosis, showed lower awareness than the elective comparison population that was also on average 6.1 years younger. Although elective patients were younger and at a lower risk, they seemed to be much more willing to undergo further osteoporosis assessment. In order to better identify and care for patients at risk, interventions such as effective screening, early initiation of osteoporosis therapy in the inpatient setting and a fracture liaison service are important measures.
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Ricardo, Eliza Dalsasso, Denise Oishi, Marcelo Oliveira Dos Santos, and Renata D'Alpino D'Alpino. "Complementary and alternative medicine use among cancer patients at a private hospital in Brazil." Journal of Clinical Oncology 38, no. 15_suppl (May 20, 2020): e14144-e14144. http://dx.doi.org/10.1200/jco.2020.38.15_suppl.e14144.
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e14144 Background: Complementary and alternative medicine (CAM) use is relatively common among cancer patients. Data regarding CAM use in Brazil is scarce. We sought to define CAM use by cancer patients and investigate factors that might influence it. Methods: We conducted a cross-sectional survey of adults diagnosed with any cancer type who came to appointments at our outpatient clinic in January 2020. Chi-square tests were used to investigate the association between CAM use and age and gender Results: We interviewed 156 patients who consented to the face-to-face interview and all of them completed the questionnaires. Most patients were between 51 and 70 years-old; 56% were female and 55% had their cancer diagnosed in the last 12 months. Most cancer types were breast (17.4%), colorectal (16.7%), and lung (16.1%). More than 90% of the participants were on any active treatment. The prevalence of current CAM use was 29.6%. 58.7% of the patients did not believe CAM has anti-cancer properties, including 32.6% of patients who reported CAM use. Two-thirds of the participants have never discussed about CAM with their oncologists. Only 5.1% of the respondents would abandon conventional cancer treatment in order to use just CAM. Among CAM users, 55% referred multiple therapies use. Of those therapies, spiritual surgery was the most prevalent one. There was a significant higher proportion of females reporting CAM use (p = 0,029) as well as a higher proportion of CAM use among younger patients (p = 0,008). Conclusions: CAM use was common among our study population, especially spiritual surgery. Women and younger patients were more prone to use CAM. Although most patients would not abandon conventional treatment, many of them have never discussed about CAM with their oncologists.
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Hamm-Faber, Tanja E., Yvonne Engels, Kris C. P. Vissers, and Dylan J. H. A. Henssen. "Views of patients suffering from Failed Back Surgery Syndrome on their health and their ability to adapt to daily life and self-management: A qualitative exploration." PLOS ONE 15, no. 12 (December 7, 2020): e0243329. http://dx.doi.org/10.1371/journal.pone.0243329.
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Background The clinical outcomes of Spinal Cord Stimulation (SCS) therapy in patients with a Failed Back Surgery Syndrome (FBSS) is mostly done by standardized pain and quality of life measurements instruments and hardly account for personal feelings and needs as a basis for a patient-centred approach and shared decision making. Objectives The objective of this study is to explore perspectives on personal health and quality of life (QoL) in FBSS patients concerning their physical-, psychological and spiritual well-being prior to receiving an SCS system. Methods We performed face-to-face, semi-structured, in-depth interviews to obtain descriptive and detailed data on personal health, guided by the Web diagram of Positive Health (Huber et al.) and a topic list. The following main topics were assessed qualitatively: 1) Bodily functioning, 2) Mental function and perception 3) Spiritual dimension, 4) Quality of life, 5) Social and societal participation and 6) Daily functioning. Results Seventeen FBSS patients (eight male, nine female) were included from April–November 2019 at the department of pain medicine in the Albert Schweitzer Hospital in the Netherlands. Median age 49 years; range 28 to 67 years, and patients underwent between one and five lumbar surgical operations. The duration of their chronic pain was between four and 22 years. After analyzing the interviews, three themes emerged: 1) dealing with chronic pain, 2) the current situation regarding aspects of positive health, and 3) future perspectives on health and quality of life. These themes arose from eleven categories and a hundred ninety codes. Conclusion This qualitative study explored FBSS patients ‘views on their health and the ability to adapt to daily life having complex chronic pain, and showed that patients experienced shortcomings in daily life within the six dimensions of the Web diagram of Positive Health before the SCS implant.
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Zaman Khan, Said, Sabih Nofil, Anum Arif, Maria Mir Jan, Bismah Riaz, and Nawabzada Zeeeak Farhat Khan Sherwani. "Frequency and Risk Factors for Post Mastectomy Pain Syndrome [PMPS] in Female Breast Cancer patients." Pakistan Journal of Medical and Health Sciences 15, no. 10 (October 30, 2021): 2530–33. http://dx.doi.org/10.53350/pjmhs2115102530.
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Post mastectomy pain syndrome is one of the most common complications after axillary surgery for breast cancer. PMPS is considered a neuropathic pain and is thought to be caused by a variety of pre-operative, intraoperative and postoperative risk factors. In this study all post operative patients for breast cancer were interviewed at follow-up visits for symptoms of pain according to DN4 neuropathic pain score questionnaire and VAS scale for pain intensity. A total of 97 patients were included according to inclusion criteria. Among them 24(24.74%) patients were having PMPS and 73(77.06%) were having no PMPS. Among risk factors, ALND was found to be the most important risk factor for development of PMPS. In most patients the pain was mild in intensity according to VAS scale. And site of the pain was mostly found to be ipsilateral chest wall and axilla and majority of patients pin responded to simple NSAIDS and Arm exercises. Keywords: Breast cancer, mastectomy, pain
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Pak, R., and D. Kaidarova. "Initial Study of Sexual Function Among Cervical Cancer Survivors in Almaty, Kazakhstan." Journal of Global Oncology 4, Supplement 2 (October 1, 2018): 103s. http://dx.doi.org/10.1200/jgo.18.50400.
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Background: There were not any evaluation of sexual dysfunction of cervix cancer patients in Almaty, Kazakhstan, to date. The study of 58 CC patients is an attempt to start filling this gap and to develop recommendations for the treatment of this kind of patients. Aim: The objective of this study was to examine sexual function of cervical cancer (CC) survivors receded different treatment approaches. Methods: 58 women subjected to CC treatment of at least 1 year in the past were examined at the initial stage of the research. The examined women were split into 5 groups by treatment methods: conization of cervix, hysterectomy with removal of ovaries, hysterectomy without removal of (one or both) ovaries, chemotherapy with radiotherapy, and those passed exclusively radiotherapy. The sexual function of the examined women was evaluated through Female Sexual Function Index (FSFI) instrument consisted of 19 questions. The questions were mainly related to the main aspects like desire, arousal, lubrication, orgasm, satisfaction and pain. The data were collected by online and face-to-face interviews. Results: The median age of the 58 interviewed women was 44.5 years. 49 of the interviewees reported that they experienced desire. 79% of the interviewed women had sexual activity, among which 74% answers pointed out high lubrication condition above 2 within 0-5 possible range, 66% indicated high score of excitation, while 72% replied positively on orgasm section of the questionnaire. The highest portion of sexual active women experienced satisfaction (76%) although 33 of the interviewees felt the pain during coitus. The total FSFI score varied between 3.9 and 32.4 in the group of women who reported their sexual activity. Conclusion: This study demonstrates that lower total score of sexual function index is found in the patients passed chemotherapy with radiotherapy, or those cured exclusively with radiotherapy. In parallel, the highest score is traced in the women treated surgically. Therefore, it proves that surgery is more preferable treatment to keep higher level of sexual function in patients with cervix cancer. For the purpose of higher accuracy at the next stages of the research the inclusion of control group of women without history of cancer and with similar social, economic and demographic characteristics is needed.
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Jovanovic, Ksenija, Nevena Kalezic, Sandra Sipetic Grujicic, Vladan Zivaljevic, Milan Jovanovic, Milica Savic, Ranko Trailovic, et al. "Patients’ Fears and Perceptions Associated with Anesthesia." Medicina 58, no. 11 (November 1, 2022): 1577. http://dx.doi.org/10.3390/medicina58111577.
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Background and Objectives: It has been suggested that intense feelings of fear/anxiety and significant patient concerns may affect the perioperative course. Those findings emphasize the importance of surgical patients’ preoperative feelings. Still, current knowledge in this area is based on a limited number of studies. Thus, we think that there is a need to further explore patients’ preoperative fears, better characterize risk factors and reasons for their occurrence, and evaluate patients’ perspectives associated with anesthesia. Materials and Methods: A total of 385 patients undergoing vascular surgery were preoperatively interviewed using a questionnaire that included demographics and questions related to patients’ fears and perceptions of anesthesia. Statistical analyses included descriptive statistics, Pearson’s χ2 and McNemar tests, and multivariate ordinal logistic regression. Results: The main causes of patients’ preoperative fear were surgery (53.2%), potential complications (46.5%), and anesthesia (40%). Female sex was a predictor of surgery and anesthesia-related fear (OR = 3.07, p = 0.001; OR = 2.4, p = 0.001, respectively). Previous experience lowered the fear of current surgery (OR = 0.65, p = 0.031) and anesthesia (OR = 0.6, p = 0.017). Type of surgery, type of anesthesia, educational and socioeconomic status, and personal knowledge of an anesthesiologist affected specific anesthesia-related fears. Over 25% of patients did not know that an anesthesiologist is a physician, and only 17.7% knew where anesthesiologists work. Level of education and place of residence influenced patients’ perceptions of anesthesia. Conclusions: Anesthesia-related fears are affected by the type of surgery/anesthesia, experience with previous surgery, and personal knowledge of an anesthesiologist. Women, patients with lower education levels, and patients with poorer socioeconomic status are at higher risk of developing those fears. The perception of anesthesiologists is inadequate, and knowledge of anesthesia is poor. Promotion of patient education regarding anesthesia is needed to alleviate those fears and increase understanding of anesthesia.
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Nicklin, Emma, Isaac Phang, Susan Short, Petra Hoogendoorn, and Florien Boele. "QOL-19. RETURNING TO WORK AFTER A BRAIN TUMOUR – “I THOUGHT I WOULD BE BACK AT WORK THE NEXT WEEK, HOW WRONG I WAS!”." Neuro-Oncology 24, Supplement_7 (November 1, 2022): vii245. http://dx.doi.org/10.1093/neuonc/noac209.946.
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Abstract BACKGROUND Returning to work is important for patients' and their families’ well-being, financial circumstances and quality of life. Side-effects of brain tumour (BT) treatment or clinical deterioration from BT progression often causes temporary or permanent inability to work. Aim: To explore the occupational expectations, experiences and satisfaction of BT patients (and their caregivers) following diagnosis/treatment. METHODS Qualitative semi-structured interviews were conducted with adults diagnosed with a primary BT, in employment/self-employed before diagnosis, currently in follow-up care; and their caregivers. Purposive sampling ensured a mixed BT sample. Participants were recruited from two UK tertiary referral hospitals. Data collection and thematic analysis are ongoing and will be completed by August 2022. RESULTS To date, 17 interviews (13 patient/4 caregiver) have taken place (59% female, aged 26-73,M= 43). Early findings: 1) Managing expectations: Patients underestimated the impact of surgery and how long it would take to return to work (if they had). Many would have liked more information prior to treatment about potential side-effects (e.g., extreme fatigue). 2) Prior financial support: Most patients suffered financially, often resulting in returning to work before they felt ready. Patients wanted more information prior to treatment about financial support. 3) Ongoing communication: Employers who were emotionally and practically supportive throughout the BT trajectory were highly valued. Some interviewees believed their employers needed to receive better education about BTs. 4) Flexible working: Patients returning to work with enhanced employer support (e.g., reduced hours, working from home and lighter duties) were more satisfied. 5) Better caregiver support: Many caregivers were unsupported by their employers to take carer leave, some worked more to support the family financially. CONCLUSIONS Preliminary findings offer novel data in an under-researched area. More knowledge around the experiences, barriers and facilitators influencing patients’ return to work will allow the planning of tailored occupational support and resources.
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Jones, Leah Ffion, Ellie Ricketts, Katy Town, Claire Rugman, Donna Lecky, Kate Folkard, Anthony Nardone, Thomas Nathan Hartney, and Cliodna McNulty. "Chlamydia and HIV testing, contraception advice, and free condoms offered in general practice: a qualitative interview study of young adults’ perceptions of this initiative." British Journal of General Practice 67, no. 660 (May 22, 2017): e490-e500. http://dx.doi.org/10.3399/bjgp17x691325.
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BackgroundOpportunistic chlamydia screening is actively encouraged in English general practices. Based on recent policy changes, Public Health England piloted 3Cs and HIV in 2013–2014, integrating the offer of chlamydia testing with providing condoms, contraceptive information, and HIV testing (referred to as 3Cs and HIV) according to national guidelines.AimTo determine young adults’ opinions of receiving a broader sexual health offer of 3Cs and HIV at their GP practice.Design and settingQualitative interviews were conducted in a general practice setting in England between March and June 2013.MethodThirty interviews were conducted with nine male and 21 female patients aged 16–24 years, immediately before or after a routine practice attendance. Data were transcribed verbatim and analysed using a thematic framework.ResultsParticipants indicated that the method of testing, timing, and the way the staff member approached the topic were important aspects to patients being offered 3Cs and HIV. Participants displayed a clear preference for 3Cs and HIV to be offered at the GP practice over other sexual health service providers. Participants highlighted convenience of the practice, assurance of confidentiality, and that the sexual health discussion was appropriate and routine. Barriers identified for patients were embarrassment, unease, lack of time, religion, and patients believing that certain patients could take offence. Suggested facilitators include raising awareness, reassuring confidentiality, and ensuring the offer is made in a professional and non-judgemental way at the end of the consultation.ConclusionGeneral practice staff should facilitate patients’ preferences by ensuring that 3Cs and HIV testing services are made available at their surgery and offered to appropriate patients in a non-judgemental way.
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Eikelboom, Rachel, Anna R. Gagliardi, Rajiv Gandhi, Christine Soong, and Peter Cram. "Patient and Caregiver Understanding of Prognosis After Hip Fracture." Canadian Geriatrics Journal 21, no. 3 (September 14, 2018): 274–83. http://dx.doi.org/10.5770/cgj.21.308.
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BackgroundHip fracture (HF) is common and requires communication between patient, family, surgeons, and hospitalists. Patient and family understanding of the seriousness of HF is unclear.MethodsWe interviewed older patients (age > 65 years) hospitalized with HF at two Canadian academic hospitals, or their surrogate decision-makers (SDMs). We used qualitative methods to explore understanding of HF treatment options and prognosis. Participants estimated probability of mortality and living independently 30 days after surgery. Results were compared with estimates from the National Surgery Quality Improvement Program (NSQIP) surgical risk calculator.Results9 patients and 3 SDMs were interviewed. Mean age of 12 patients was 82.5 years (75% female). Participants were uncertain about recovery timeline and degree of functional recovery, as well as content and duration of rehabilitation. Participants’ mean estimated 30-day mortality of 6.7% did not differ significantly from estimated mortality predicted by NSQIP (7.5%; p = .88). Participants’ mean estimated probability of living independently 30 days after surgery was 90.8% (range 65–100%).ConclusionsOlder patients and SDMs lack understanding about prognosis and functional recovery even after providing informed consent for HF surgery. Clinical teams should improve communication of prognosis and recovery information to patients and surrogates.
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Sadat-Ali, Mir, Moaad Alfaraidy, Abdulaziz AlHawas, Ahmed Abdallah Al-Othman, Dakheel A. Al-Dakheel, and Badar K. Tayara. "Morbidity and mortality after fragility hip fracture in a Saudi Arabian population: Report from a single center." Journal of International Medical Research 45, no. 3 (May 8, 2017): 1175–80. http://dx.doi.org/10.1177/0300060517706283.
Full textAbstract:
Objective To determine the functional morbidity and mortality after fragility hip fracture and compare the mortality with three other common diseases. Methods Data were collected from patients admitted to King Fahd Hospital of the University, AlKhobar from January 2010 to December 2014. Demographic data included the preoperative American Society of Anesthesiologists (ASA) score as assessed by the anesthetist and the type of surgery. Personal and telephone interviews were performed, and data were entered into a database and analyzed. Results We identified 203 patients with fragility proximal femoral fractures, and the data of 189 patients (109 male, 80 female; average age, 66.90 ± 13.43 years) were available for analysis. The overall mortality rate was 26.98% (51 patients). The mortality rate was significantly higher among patients with an ASA score of 4 (36.36%) than 1 (20.45%). With respect to morbidity, only 48.23% of patients were able to return to their pre-fracture status; 32.35% of those who required assisted walking and 83.4% of those who required a wheelchair became bedridden. Conclusions Our data demonstrate that patients with fragility hip fractures have high morbidity and a mortality rate approaching 30%. Age and the ASA score significantly influence this high mortality rate.