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Patient decision-making and regret in pilonidal sinus surgery: a mixed-methods study.

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Understanding patient choices in pilonidal sinus disease (PSD) management is crucial. Patients regret decisions due to wound care burden and unexpected recovery times, highlighting the need for better pre-operative information.

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Area of Science:

  • Surgical outcomes
  • Patient decision-making
  • Health services research

Background:

  • Optimal management strategies for pilonidal sinus disease (PSD) remain poorly understood.
  • Patient decision-making processes and subsequent regret are key factors in treatment satisfaction.

Purpose of the Study:

  • To investigate the reasons behind patient treatment decisions in PSD.
  • To understand the factors contributing to decision regret after PSD surgery.

Main Methods:

  • A mixed-methods study involving longitudinal semi-structured interviews with 20 PSD patients across 13 UK hospitals.
  • Framework analysis of interview themes mapped to coping and acceptability frameworks.
  • Triangulation with survey data on shared decision-making (SDM) and decision regret (DR).

Main Results:

  • Nine out of 20 patients were not offered treatment choices, with varying impacts on SDM.
  • Key decision-making factors included prior experience and anticipated recovery.
  • High decision regret was linked to wound care burden and recovery time discrepancies, even with high SDM scores.

Conclusions:

  • Patients with PSD require enhanced information regarding wound care and recurrence risks for different surgical options.
  • Improving pre-operative patient education is essential to minimize decision regret in PSD management.