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Patient reported outcomes in elective laparoscopic cholecystectomy
Malcolm H W Mak1, Woon Ling Chew2, Sameer P Junnarkar1
1Department of General Surgery, Tan Tock Seng Hospital, Singapore.
Annals of Hepato-Biliary-Pancreatic Surgery
|March 14, 2019
Summary
Patients undergoing elective laparoscopic cholecystectomy (ELC) prioritize surgeon skill, long-term quality of life, and communication over hospital stay or scar appearance. Understanding these patient-reported outcomes (PROMs) is key for patient-centered care.
Area of Science:
- Surgical Outcomes Research
- Patient-Reported Outcome Measures (PROMs)
- Healthcare Quality Improvement
Background:
- Traditional quality of care metrics like hospital stay, morbidity, and mortality may not align with patient priorities.
- Patient perspectives are crucial for developing patient-centered healthcare strategies.
- Identifying key patient-reported outcome measures (PROMs) for elective laparoscopic cholecystectomy (ELC) is essential.
Purpose of the Study:
- To identify the most valued patient-reported outcome measures (PROMs) among patients undergoing elective laparoscopic cholecystectomy (ELC).
- To understand patient priorities in surgical care beyond traditional clinical outcomes.
Main Methods:
- A prospective study utilizing a 45-item questionnaire with four-point Likert-type questions.
- Data collected from patients undergoing ELC at a tertiary institution in Singapore.
- Questionnaire items were developed based on a comprehensive literature review.
Main Results:
- Seventy-five patients participated in the study.
- Highly valued factors included surgeon's technical skill and experience, long-term quality of life (QoL), patient involvement in decision-making, surgeon communication, ward cleanliness, and nursing care standards.
- Least important factors were hospitalization leave duration, length of hospital stay, family's opinion of the hospital, and scar cosmesis. Employed patients prioritized leave duration and procedure time, while younger and female patients valued scar cosmesis more.
Conclusions:
- Patients undergoing ELC place significant importance on long-term quality of life, surgeon expertise, patient involvement, communication, and the care environment.
- Factors such as day-case surgery, medical leave duration, family hospital opinion, and scar appearance were deemed less critical by patients.
- These findings underscore the need to integrate patient-reported outcomes into healthcare delivery to enhance patient satisfaction and care quality.
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