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Evaluation of indications for and outcomes of elective surgery.

https://arctichealth.org/en/permalink/ahliterature188492
Source
CMAJ. 2002 Sep 3;167(5):461-6
Publication Type
Article
Date
Sep-3-2002
Author
Charles J Wright
G Keith Chambers
Yoel Robens-Paradise
Author Affiliation
Centre for Clinical Epidemiology and Evaluation, Vancouver Hospital and Health Sciences Centre, BC. cwright@vanhosp.bc.ca
Source
CMAJ. 2002 Sep 3;167(5):461-6
Date
Sep-3-2002
Language
English
Publication Type
Article
Keywords
Adult
Aged
Arthroplasty, Replacement, Hip - psychology
Attitude of Health Personnel
British Columbia
Cataract Extraction - psychology
Cholecystectomy - psychology
Diskectomy - psychology
Feasibility Studies
Female
Health status
Humans
Hysterectomy - psychology
Male
Middle Aged
Patient satisfaction
Prostatectomy - psychology
Quality of Life
Questionnaires
Surgical Procedures, Elective - psychology
Treatment Outcome
Abstract
Wide small-area variations in the rates of elective surgical procedures and lack of systematic outcome measurement have raised questions about the appropriateness of such surgery. Our objective was to determine the feasibility of routine evaluation of indications for and outcomes of elective surgery.
Participants consisted of 138 surgeons and 5313 patients who underwent 1 or more of 6 specific surgical procedures (for a total of 6274 operations). Surgical indications were evaluated according to published guidelines. Patients' self-reported health-related quality of life (HRQOL) before and at appropriate intervals after surgery was measured with standard, validated generic and disease-specific instruments. Patient-specific results were routinely sent to the surgeons, from whom feedback was requested.
Surgeons provided information on the indications for surgery for 44% to 95% of the 6 procedures, and the indications matched the guidelines in 73% to 99% of cases. Completed HRQOL questionnaires were returned by 58% of the patients. Postoperative HRQOL scores were markedly improved in most patients, but in 2% to 26% of the various procedures, there was either no change or a deterioration in HRQOL. In most of the procedure groups a small proportion of patients had relatively minor symptoms and disability preoperatively, but in the cataract surgery group this proportion was large. Opinion among the participating surgeons was divided as to the potential value of this method of evaluation. The cost of the outcome evaluation program was about $12/patient.
Evaluation of indications for and outcomes of elective surgery could be implemented systematically at reasonable cost and could be included in an accountability framework for health services. Most surgeons were not enthusiastic about this kind of evaluation.
Notes
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Comment In: CMAJ. 2003 Feb 18;168(4):398; author reply 398-40012591776
Comment In: CMAJ. 2003 Feb 18;168(4):397; author reply 398-40012591774
Comment In: CMAJ. 2003 Feb 18;168(4):397-8; author reply 398-40012591773
PubMed ID
12240811 View in PubMed
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Factors related to self-rated health and life satisfaction one year after radical prostatectomy for localised prostate cancer: a cross-sectional survey.

https://arctichealth.org/en/permalink/ahliterature310658
Source
Scand J Caring Sci. 2019 Sep; 33(3):688-697
Publication Type
Comparative Study
Journal Article
Date
Sep-2019
Author
Anna-Maija Talvitie
Hanna Ojala
Teuvo Tammela
Anna-Maija Koivisto
Ilkka Pietilä
Author Affiliation
Faculty of Social Sciences, Tampere University, Tampere, Finland.
Source
Scand J Caring Sci. 2019 Sep; 33(3):688-697
Date
Sep-2019
Language
English
Publication Type
Comparative Study
Journal Article
Keywords
Aged
Cross-Sectional Studies
Finland
Humans
Male
Patient Satisfaction - statistics & numerical data
Personal Satisfaction
Prostatectomy - psychology
Prostatic Neoplasms - psychology - surgery
Quality of Life - psychology
Surveys and Questionnaires
Abstract
Localised prostate cancer affects patient's quality of life in many ways. The aim of this study was to explore factors related to self-rated health and life satisfaction for patients treated for prostate cancer, and to compare the results of these generic quality-of-life measures to the prostate cancer-specific quality-of-life measure (UCLA Prostate Cancer Index), which focuses on physical functioning.
This cross-sectional survey was carried out among 183 men who underwent radical prostatectomy in 2012-2015 at a university hospital in Finland and were seen 1 year postsurgery. Approval from an ethics committee and written consents from participants were received. A questionnaire was used to evaluate patients' perceived quality of life. Logistic regression model, Spearman's correlation, Kruskal-Wallis test and Mann-Whitney U-test were used to analyse factors related to quality of life.
Of the 183 men in the study, 63% rated their health status as good, and 70% were satisfied with their lives after prostatectomy. Older age and better urinary function were the only factors that explained both better self-rated health and better satisfaction with life. The patients seemed not to interpret problems with sexual function as health-related problems. In our sample, sexual dysfunction was relatively severe, but patients considered them to be less harmful than urinary or bowel symptoms. Interestingly, 24% of the men with low sexual function did not find that dysfunction bothersome.
Objectively measured physical functioning is not necessarily in line with patients' experienced satisfaction with life and their self-ratings of health. More longitudinal and qualitative research is needed about the meanings that patients attach to physical treatment side effects and the extent to which they can adapt to them over time. With a bigger sample and longer follow-up time, it would be possible to identify men who particularly benefited from pretreatment counselling.
PubMed ID
30866074 View in PubMed
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[International Prostate Symptom Scale. Evaluation of the usefulness of a French version].

https://arctichealth.org/en/permalink/ahliterature197072
Source
Can Fam Physician. 2000 Sep;46:1772-6
Publication Type
Article
Date
Sep-2000
Author
J. Moisan
J P Grégoire
M G Labrecque
Y. Fradet
Author Affiliation
Faculté de pharmacie de l'Université Laval, Qué. Jocalyne.Moisan@pha.ulaval.ca
Source
Can Fam Physician. 2000 Sep;46:1772-6
Date
Sep-2000
Language
French
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Bias (epidemiology)
Follow-Up Studies
Humans
Male
Middle Aged
Prostatectomy - psychology
Prostatic Hyperplasia - physiopathology - psychology - surgery
Quality of Life
Quebec
Questionnaires - standards
Reproducibility of Results
Translating
Abstract
To evaluate the usefulness of a French-language version of the International Prostate Symptom Scale (I-PSS) by measuring, on this scale and on the quality of life index, the scores of patients with benign prostatic hyperplasia before and after prostate surgery.
The questionnaire was completed by 14 men, mostly between 60 and 80 years old, 24 hours before surgery and 1 month and 3 months after surgery.
The French-language scale worked well. Scores changed from 19.1 before surgery to 7.5 3 months after surgery for prostate symptoms and from 8.5 to 4.5 for quality of life.
This version of the questionnaire is a valid tool for evaluating prostate symptoms reported by French-speaking people.
Notes
Cites: J Urol. 1984 Sep;132(3):474-96206240
Cites: Prostate. 1990;16(1):39-481689482
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Cites: Br J Urol. 1994 Nov;74(5):542-507530115
Cites: Scand J Urol Nephrol. 1996 Feb;30(1):45-98727865
Cites: J Urol. 1992 Nov;148(5):1549-57; discussion 15641279218
PubMed ID
11013796 View in PubMed
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Patient evaluation of a discharge program following a radical prostatectomy.

https://arctichealth.org/en/permalink/ahliterature176560
Source
Urol Nurs. 2004 Dec;24(6):483-9
Publication Type
Article
Date
Dec-2004
Author
B Joyce Davison
Katherine N Moore
H. MacMillan
A. Bisaillon
K. Wiens
Author Affiliation
Prostate Centre, Vancouver General Hospital, Vancouver, British Columbia, Canada.
Source
Urol Nurs. 2004 Dec;24(6):483-9
Date
Dec-2004
Language
English
Publication Type
Article
Keywords
Adult
Aged
British Columbia
Family Practice
Health Resources - utilization
Hospitals, General
Humans
Male
Middle Aged
Nurse's Role
Nursing Evaluation Research
Pamphlets
Patient Discharge - standards
Patient Education as Topic - standards
Patient satisfaction
Postoperative Care - nursing - psychology - standards
Program Evaluation
Prostatectomy - psychology
Prostatic Neoplasms - psychology - surgery
Questionnaires
Teaching Materials - standards
Urology
Abstract
The immediate postoperative period following radical retropubic prostatectomy (RP) can be stressful, especially if men perceive discharge teaching to be incomplete. In this study, using two telephone interviews, patient satisfaction with a revised teaching program on one urology unit was evaluated.
Men undergoing a RP were given an information letter about the study at the pre-admission clinic. At days 2 and 30 post discharge, they were asked to rate the value of the call, a patient education booklet, a discharge pack of incontinence supplies, and overall satisfaction with the discharge experience. They were also asked about the use of community resources after discharge (general practitioner, urologist, emergency, home care).
One hundred men participated. Overall, they were very satisfied with the discharge teaching and felt it provided them necessary information for recovery. However, 25 subjects used community resources inappropriately, due to concerns about wound care, catheter care, or urine retention.
Although men were satisfied with the information provided in discharge program, their overuse of community resources indicates additional reinforcement is needed for management in the first month after surgery.
PubMed ID
15658734 View in PubMed
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Patient experiences at diagnosis and psychological well-being in prostate cancer: A Finnish national survey.

https://arctichealth.org/en/permalink/ahliterature271032
Source
Eur J Oncol Nurs. 2015 Jun;19(3):220-9
Publication Type
Article
Date
Jun-2015
Author
Ulla-Sisko Lehto
Sanni Helander
Kimmo Taari
Arpo Aromaa
Source
Eur J Oncol Nurs. 2015 Jun;19(3):220-9
Date
Jun-2015
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Antineoplastic Agents, Hormonal - therapeutic use
Anxiety
Attitude to Health
Brachytherapy - psychology
Drug-Related Side Effects and Adverse Reactions - psychology
Finland
Humans
Male
Middle Aged
Patient satisfaction
Patients - psychology
Prostatectomy - psychology
Prostatic Neoplasms - diagnosis - psychology - therapy
Quality of Life
Abstract
Most cases of prostate cancer are diagnosed at an early stage, and men live for many years after diagnosis. Thus, their well-being and quality of life are of great importance. This study investigated patient experiences and psychological well-being in a Finnish national sample of prostate cancer patients who received various types of treatment.
In a national sample (50%) of prostate cancer patients diagnosed in Finland in 2004, information was collected on the patients' experiences at diagnosis and choice of treatment (e.g. treatment selection, patient satisfaction with care and information, psychological reactions). In 2009, participants were asked about their experiences, and psychological well-being (psychological symptoms, satisfaction with life) was measured. In total, 1239 completed questionnaires (73%) were accepted for the study. Differences between treatments and predictors of psychological well-being were investigated using descriptive statistics and regression analysis.
Half of the respondents were satisfied with the care and information they received about the cancer and side effects of treatment. Experiences and psychological well-being were most positive among patients who received brachytherapy and poorest among patients who received hormonal therapy. Patients who underwent prostatectomy or brachytherapy were most likely to have been involved in treatment selection. Negative experiences, such as learning of the diagnosis in an impersonal way and dissatisfaction with the information and care received, were predictive of poorer well-being.
Unmet supportive care and informational needs were common. Experiences and well-being varied between treatments. Patients tended to prefer prostatectomy and brachytherapy. Unmet needs, which would probably be reduced by improvements in care, appear to have a long-lasting impact on patients' psychological well-being.
PubMed ID
25547457 View in PubMed
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