A qualitative analysis of patients’ reasons for choosing neobladder or ileal conduit after cystectomy for bladder cancer

Abstract

A qualitative analysis of patients reasons for choosing neobladder or ileal conduit after cystectomy for bladder cancer.

Factors related to patient choice of bladder reconstruction following radical cystectomy

“…9 Beyond this key 'survival' issue, the main reasons why participants chose IC was the perception that it offered a quicker, less surgically involved, and safer means to recovery after cancer treatment. 9 These participants also expressed more concerns relating to the degree of work needed to maintain NB, relative to IC. These participants also tended to have what might be termed 'outwardly directed' values, especially concerning others, their relationships with others, and the environment.…”

“…3 No consistent health-related quality of life (HR-QoL) superiority is noted for IC or NB [4][5][6][7] -there is good HR-QoL for most patients, irrespective of their type of urinary diversion. 5,8,9 Contemporary thinking suggests that the key issues to consider, when advising on reconstruction, are the precise aspects of QoL impacted by each procedure. Decisionmaking processes regarding whether patients should opt for IC or NB should take into account patient views about these aspects of their preoperative health status and lifestyle.…”

“…10 That is, rather than basing treatment decisions on reports of superior QoL, decisions are best when tailored to individual patient's needs and preoperative lifestyles and values. 9,11,12 Unfortunately, there is little information regarding patient views in this context. Studies have suggested patients choosing IC tend to report poorer body image satisfaction and less active lifestyles; whereas, those choosing NB report increased concerns with urinary leakage.…”

“…Studies have suggested patients choosing IC tend to report poorer body image satisfaction and less active lifestyles; whereas, those choosing NB report increased concerns with urinary leakage. 13 One qualitative study 9 identified that procedure and lifestyle factors were secondary to survival considerations, and that most patients adapted to reconstruction. However, beyond this, patients tended to choose IC because of perceived simplicity of this operation, or the fear of urinary incontinence, and extra 'work' for the patient involved in having NB; and chose NB because of perceptions of normality and less restricted activities.…”

Personal experiences disclosed by parents of children with Autism Spectrum Disorder: A YouTube analysis

“…typically comes from a specifically-focused question, and the interviewer-interviewee interactions can often be shaded by the needs of the question-focused data collection process (Roulston, 20916), which often reinforces existing theoretical models of the problem (Hepworth & McVittie, 2016; see Osborne, Dixon, Edwards, Begum, Younis, Lucas, & Reed, 2016, for an example in another health-related area). No study, to date, has attempted to capture parents freely expressed views on what they feel are the most important aspects of their experience.…”