Pd11-02 Importance of Patient-reported Outcomes in Improving Perioperative Care Among Cystectomy Patients
Year: 2018
Type: article
Abstract: INTRODUCTION AND OBJECTIVES: Readmissions following cystectomy are prevalent and costly, with as many as 1/3 of patients readmitted within 30 days.Preventable readmissions may be avoided by postoperative monitoring of patient-reported outcomes (PROs).Our objective was to determine which PROs are high priority in the postoperative cystectomy period and identify methods to improve postoperative care.METHODS: Using purposive sampling, we conducted in-depth semi-structured interviews with 45 readmitted post-cystectomy patients, caregivers and providers (n¼15/group).Using qualitative methods of thematic analysis and grounded theory, we evaluated the peri-cystectomy experience, PROs, and methods to improve postoperative care.RESULTS: Patients ranged in age (56-78 years) and stage (pTisN0 to N+), with 66% male and 87% White.Caregivers included spouses, partners, and children.Providers included surgeons, advanced practice providers, nurses, and social workers.The most common PROs described by study participants included dehydration, fever, incisional issues (erythema, drainage, opening), abdominal and flank pain.Additional symptoms included constipation, diarrhea, fatigue, loss of appetite, poor sleep, weakness, and ostomy bag leakage.With regard to cystectomy postoperative processes, 3 general themes emerged: 1) incremental learning for cystectomy education; 2) distinguishing normal from abnormal symptoms; and 3) value of symptom tracking.All groups highlighted the challenges of acquiring necessary knowledge and emphasized the need for incremental learning.Patients and caregivers also expressed confusion distinguishing normal from abnormal symptoms.Solutions for these issues included symptom tracking and the potential for a personalized intervention (e.g.mHealth) in which the timing of information delivery was individually tailored.CONCLUSIONS: Perioperative cystectomy recovery involves a number of PROs which are difficult to address at discharge alone.Identification of abnormal symptoms could potentially be improved through personalized intervention strategies, including mHealth intervention tools to track postoperative symptoms.
Source: The Journal of Urology
Language: English
Topic: Cancer survivorship and care
Subfield: Oncology
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W2795577555