A Comparison of Health-Related Quality of Life of Women Awaiting Pelvic Organ Prolapse Surgery versus Hip or Knee Replacement

Leong, Yvonne; Kotani, Sayoko; Best, Carolyn; Diamond, Phaedra; Lovatsis, Danny; Drutz, Harold P.

doi:10.1016/j.jogc.2017.01.005

Cited by 4 publications

(9 citation statements)

References 11 publications

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“…This finding is consistent with several studies that have assessed the impact of waiting for elective surgery on patient well-being as well as the well-established improvement in QOL that occurs after hysterectomy [10,12,19]. In a prospective, cross-sectional study of women's health-related QOL, Leong et al [11] found women experienced poor emotional role functioning and negative impacts on mental health while awaiting surgery for pelvic organ prolapse. In a study that examined QOL among women who underwent hysterectomy, improvements were noted in symptom severity and 8 QOL domains (concern, activities, energy/mood, control, self-consciousness, and sexual function) at 1-year compared with baseline [20].…”

Section: Discussionsupporting

confidence: 87%

“… 10 , 12 , 19 In a prospective, cross-sectional study of women's health-related QOL, Leong et al found women experienced poor emotional role functioning and had negative impacts on mental health while awaiting surgery for pelvic organ prolapse. 11 In a study that examined QOL among women who underwent hysterectomy, improvements were noted in symptom severity, and 8 QOL domains (concern, activities, energy/mood, control, self-consciousness, and sexual function) at 1-year compared to baseline. 20 Taken together, these findings suggest that increased surgical wait times prior to hysterectomy for benign indications may adversely impact patient well-being and should be minimized, always taking into account patient safety and optimizing any comorbid medical conditions where appropriate.…”

Section: Discussionmentioning

confidence: 99%

“…In women awaiting prolapse surgery and other non-gynecologic surgery, there is some evidence that patients waiting for elective surgery for benign conditions can also experience negative outcomes including increased discomfort, decreased quality of life and increased anxiety. 10 , 11 , 12 However, the impact of surgical wait time in women undergoing hysterectomy for benign indications has not previously been examined. Understanding how surgical wait times affect patients and the healthcare system can provide targets to improve quality of care and reduce healthcare costs.…”

Section: Introductionmentioning

confidence: 99%

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Impact of Surgical Wait Time to Hysterectomy for Benign Gynecologic Disease

Traylor

Koelper

Kim

et al. 2021

Journal of Minimally Invasive Gynecology

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To determine the impact of surgical wait time on healthcare use and surgical outcomes for patients undergoing hysterectomy for benign gynecologic indications. Design: Retrospective cohort study. Setting: Urban, academic tertiary care center. Patients: Patients who underwent hysterectomy for benign disease between 2012 and 2018. Interventions: None. Measurements and Main Results: Patients were categorized into 2 groups, dichotomized by surgical wait times >30 days or ≤30 days. Healthcare use was measured by the number of discrete patient interactions with the healthcare system through phone calls, secure electronic messaging, and office and emergency room visits. Univariate and multivariable logistic regression models were performed to assess the association between surgical wait time and healthcare use and perioperative outcomes while controlling for confounders. A total of 277 patients were included in our analysis: 106 (38.3%) had surgical wait times >30 days (median 47 days, range 24−68 days), and 171 (67.1%) had surgical wait times ≤30 days (median 19 days; range 12−26 days). The groups did not differ by age, insurance status, substance use, or comorbid conditions. Patients in the group with surgical wait times >30 days were more likely to have increased healthcare use (69 of 106, 65% vs 43 of 171, 25%; odds ratio 5.55; 95% confidence interval, 3.27−9.41). There were no differences in intraoperative complications (9 of 106, 8% vs 19 of 171, 11%; p = .482) or postoperative complications (28 of 106, 26% vs 32 of 171, 19%; p = .13) between the groups; however, after controlling for potential confounders, patients with surgical wait times >30 days were 3.22 times more likely to be readmitted than patients with surgical wait times ≤30 days (95% confidence interval, 1.27−8.19). Conclusion: A surgical wait time >30 days in patients undergoing a hysterectomy for benign disease is associated with increased healthcare use in the interim. Although patients who experience longer surgical wait times do not experience worse surgical outcomes, they may be at higher risk for readmission after surgery. Targeted interventions to optimize perioperative coordination of care for patients undergoing a hysterectomy for benign disease, especially those within vulnerable populations, are needed to improve quality of care, decrease any redundant or inefficient healthcare use, and reduce any unnecessary delays.

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Section: Discussionsupporting

confidence: 87%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Impact of Surgical Wait Time to Hysterectomy for Benign Gynecologic Disease

Traylor

Koelper

Kim

et al. 2021

Journal of Minimally Invasive Gynecology

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“…39 In another study, the mental health component was similarly impacted among women undergoing pelvic prolapse surgery, or hip or knee replacement (41.5 vs 44.6, P = .09). 38 Three studies showed that social function (mean 75.9, SD 22.7; r = 0.319, P = .0012; P = .05) and mental health (mean 46.2, SD 10.6; r = 0.3832, P = .001; P = .01) quality of life components were particularly affected. 57,67,69 One study showed that quality of life deteriorated over time (mean change −0.04, 95% CI −0.08 to −0.01, P = .02).…”

Section: Impact Of Waiting On Mental Healthmentioning

confidence: 99%

“…specialist visit, diagnosis, decision, treatment), which was said to be frustrating, demoralizing and traumatizing, but alleviated by communication from physicians with good interpersonal skills 37,39,40,50,66,74,75. Among 11 studies of surgical procedures (3 mixed, 3 bariatric, 3 orthopedic, 1 sinus, 1 thyroid), waiting caused anxiety and depression and reduced quality of life due to restricted activities, concern about worsening health and uncertainty about procedure date 34,38,41,43,[45][46][47]58,59,65,68.…”

mentioning

confidence: 99%

The psychological burden of waiting for procedures and patient‐centred strategies that could support the mental health of wait‐listed patients and caregivers during the COVID‐19 pandemic: A scoping review

Gagliardi

Yip

Irish

et al. 2021

Health Expectations

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Background Waiting for procedures delayed by COVID‐19 may cause anxiety and related adverse consequences. Objective To synthesize research on the mental health impact of waiting and patient‐centred mitigation strategies that could be applied in the COVID‐19 context. Methods Using a scoping review approach, we searched 9 databases for studies on waiting lists and mental health and reported study characteristics, impacts and intervention attributes and outcomes. Results We included 51 studies that focussed on organ transplant (60.8%), surgery (21.6%) or cancer management (13.7%). Most patients and caregivers reported anxiety, depression and poor quality of life, which deteriorated with increasing wait time. The impact of waiting on mental health was greater among women and new immigrants, and those of younger age, lower socio‐economic status, or with less‐positive coping ability. Six studies evaluated educational strategies to develop coping skills: 2 reduced depression (2 did not), 1 reduced anxiety (2 did not) and 2 improved quality of life (2 did not). In contrast, patients desired acknowledgement of concerns, peer support, and periodic communication about wait‐list position, prioritization criteria and anticipated procedure date. Conclusions Findings revealed patient‐centred strategies to alleviate the mental health impact of waiting for procedures. Ongoing research should explore how to optimize the impact of those strategies for diverse patients and caregivers, particularly in the COVID‐19 context. Patient or Public Contribution Six patients and four caregivers waiting for COVID‐19‐delayed procedures helped to establish eligibility criteria, plan data extraction and review a draft and final report.

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