The aim of this study was to explore the concerns of men with urinary incontinence in the early weeks of recovery after radical prostatectomy for early stage prostate cancer. As part of a larger study evaluating effectiveness of intensive physiotherapy for post prostatectomy incontinence, semistructured interviews were conducted at study entry. Sixty-three men approximately 8 weeks post-surgery participated. The descriptive data were analysed for themes. Pre-operative concerns focused on dealing with the diagnosis of prostate cancer, information gathering and decision-making. Post-operatively, a frequently repeated concern was lack of knowledge about the post-surgery recovery period. Specifically, men stated they did not process much of the detailed pre-operative teaching provided by the urologists and the nurses because of the overwhelming nature of the diagnosis. As a result, at discharge, they revealed many knowledge gaps about catheter care, post-operative pain, incontinence and erectile dysfunction. Participants also perceived a lack of health care professional support. These information deficits severely affected quality of life and healthy post-operative rehabilitation. The results of the informal interviews provide a deeper understanding of the post-operative recovery experience and suggest some strategies for improving the early weeks of recovery after radical prostatectomy including telephone follow-up, additional written information and on-going support.
Results support the validity of the PCS as a measure of surgeon-rated urgency. Patients might be ranked differently with different prioritization measures.
Objectives:To determine the perceptions of health care professionals and service providers with regard to emergency department (ED) overcrowding, including definitions of overcrowding, characteristics of an overcrowded ED, and causes of overcrowding, and secondarily to solicit potential solutions to the problem. Methods: Focus groups were conducted with front-line staff, physicians and managers from 7 EDs within an integrated health region. Participants received questions before the sessions, and an experienced moderator conducted the sessions and prepared transcripts from audio tapes. Analyses included identification of key themes and the interrelationships between those themes. Results: Focus group participants defined service pressures that result in overcrowding as "anything that impedes the flow of patients through the ED, affects the quality of care delivered or results in patient frustration and stress to staff." Overcrowding, which can occur at any time of the day, was perceived to have many causes, including some seasonal factors. Two key problems were identified as causing many spin-off pressures: inefficient access to ED beds (stretchers) because of slow throughput of patients and staff shortages. Other perceived causes included the changing role and use of EDs and limited access to services such as home care, diagnostic imaging, laboratory services, social services and specialist care. Participants generally believed that the characteristics and causes of overcrowding could not be viewed independently; rather, in the search for remedies, they should be considered as interrelated variables. Conclusion: Qualitative studies of this complex issue can identify and describe complex interactions in real-world settings. The findings of such studies can lead to quantitative studies involving objective measurement.
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