<p>A Qualitative Assessment of Patient Satisfaction with Radical Cystectomy for Bladder Cancer at a Single Institution: How Can We Improve?</p>

Abstract

Purpose: To evaluate patient satisfaction (with emphasis on preoperative education) with radical cystectomy for bladder cancer at our institution, the University of Missouri Hospital, qualitatively in order to identify specific areas where improvements can be made. Materials and Methods: We developed a patient survey that used open-ended questions to identify positive and negative experiences that contributed to patient satisfaction. We administered the survey to radical cystectomy patients who met inclusion criteria and agreed to participate. We recorded, transcribed and qualitatively coded the responses. We identified four themes under which both positive and negative responses were placed, and constructed two diagrams to better illustrate contributors to patient experience and satisfaction. Results: We identified 25 patients who met inclusion criteria. Of those, 13 participated in the survey. Regarding overall experience, 92.3% of patients rated their care as excellent or good. Regarding preoperative education, 76.9% of patients reported they definitely or somewhat received enough information on what to expect after surgery, and 76.9% definitely received enough guidance on how to care for themselves after surgery. From qualitative coding of patient responses to open-ended questions, we identified preoperative preparation, delivery of care, caregiver availability, and patient-centered care as themes that contributed positively and negatively to patient experience. Conclusion: Although the overall patient satisfaction could be perceived as high (92.3%), qualitative analysis revealed several areas where improvements can be made to improve patient experience with radical cystectomy at our institution. As previously expected, preoperative preparation was a contributor.

Management of the patient with urostomy: Caregiver needs during the three months after discharge. A qualitative study

“…In this regard, before and after surgery, nursing and medical staff teach the patient and caregivers how to manage the new physical condition (4). The caregiver's role is of crucial importance; they will be entrusted to follow their relative's assistance at home, throughout the complete clinical and rehabilitation process (7). Unfortunately, many caregivers are not adequately prepared to cope with the physical and psychological changes of post-cystectomy life and this leads to worsen the patients' quality of life (8).…”

Information needs in patients with bladder cancer undergoing radical cystectomy – A qualitative review with thematic synthesis

“…The timing, quality and quantity of postoperative information laid the foundation for the patient's continued information and learning needs and minimized the risk of misunderstandings (Garg et al, 2018;Hockman et al, 2020;Rammant et al, 2021;Smith et al, 2019). One of the most critical elements of information sharing and teaching was that too much information was given at the same time (Rammant et al, 2021).…”

“…One of the most critical elements of information sharing and teaching was that too much information was given at the same time (Rammant et al, 2021). Important information was at risk of drowning in the large volume that was given (Hockman et al, 2020; McMullen…”

“…, 2019). The postoperative information needed to come from all of the different professional categories in the team, as the information content was adapted based on the different competencies (Hockman et al, 2020;Smith et al, 2019).…”

Updates on enhanced recovery after surgery for radical cystectomy

“… 7 Preoperative preparation and patient expectation have been shown to impact patient satisfaction across various surgical fields. 19 – 21 Implementation of cystectomy education can vary according to the resources available at an institution and range from structured educational classes to oral and written information provided at the time to preoperative counseling. 14 , 22 Data on optimal methods of preoperative education were limited in the 2013 ERAS guidelines and unsurprisingly, this continues to remain the case.…”