Patient satisfaction with urodynamics: a qualitative study

Abstract

This qualitative study was undertaken to assess patients' views of the urodynamic investigation. The aim was to identify the dimensions important to patients in evaluating satisfaction with this type of procedure and ways in which care could be improved. Unstructured interviews were carried out by four trained interviewers with 21 people (17 female and 4 male) who had undergone the urodynamic investigation at various gynaecology, urology and continence outpatient clinics. The interviews were audio-taped and transcribed verbatim. The data was then coded and a thematic analysis carried out. The main theme to emerge was focused on patients' feelings about the procedure. This consisted of a combination of anxiety and embarrassment. Anxiety was because of fear of the unknown and embarrassment at the intimate nature of the procedure and lack of privacy. The interpersonal and communication skills of the health care professional were central in alleviating these negative feelings. The establishment of a friendly relationship based on equality and mutual respect and trust was important in preventing anxiety and embarrassment. A number of practical issues were identified that would contribute to improving the service for patients. It was found that nurses possessed all the attributes required to provide an effective service and recommendations were made that nurses specializing in continence care should take a more active role in urodynamic investigations.

The impact of detailed explanatory leaflets on patient satisfaction with urodynamic consultation: A double‐blind randomized controlled trial

“…The urodynamic consultation leaflet designed by the "Groupe d'information et d'éducation du patient" of the CHR La Citadelle (Ref:GT/ Agiep-/GynecoUrodynamique/Fevrier 04) was used. This leaflet was a two-page document in simple wording that explained: (1) what is urodynamic investigation; (2) what is the usefulness of urodynamics; (3) what are the different steps of urodynamic investigation (uroflowmetry, filling cystometry, static urethral pressure profilometry, and voiding cystometry) and how they are performed. Patients were also informed in that document that: (1) the investigations were about half an hour long; (2) the equipment was either sterile or single use; (3) no injection would be performed; (4) slight pain might be noted during urination in the following days; (5) rarely a urinary infection might develop and for that reason antibiotics would be prescribed at the end of the consultation.…”

“…Relevant literature and guidelines were also revised by the first author to generate potential items. [1][2][3]8,9 A series of questions, positively or negatively worded, were selected for the development of the scale. A Delphi process was used to gain consensus among the eight persons.…”

“…However, urodynamics is an invasive medical procedure and is potentially distressing and embarrassing for the patient owing to fear of the unknown, the intimate nature of the procedure, lack of privacy, anxiety, embarrassment, and fear of pain. [1][2][3] This might impact on patients' satisfaction. 1 In general practice, different interventions have been suggested to alleviate negative feelings with medical consultations such as improvement of interpersonal and communication skills.…”

“…[1][2][3] This might impact on patients' satisfaction. 1 In general practice, different interventions have been suggested to alleviate negative feelings with medical consultations such as improvement of interpersonal and communication skills. 4 Introduction of Patient Information Leaflets (PIL) has been recommended to ameliorate this problem and has become a standard practice in the United Kingdom and elsewhere.…”

“…Questionnaires are commonly used to measure patient satisfaction in medical settings. However, there are very few studies in the literature on patient satisfaction following urodynamic investiga-tions, [1][2][3]8,9 with none from Belgium, and no questionnaire that measures satisfaction with urodynamic consultation has been reported so far. Furthermore, measurement scales are specific to the country, the discipline, and the cultural environment.…”