Quantitative and qualitative assessment of women's experience of a one-stop menstrual clinic in comparison with traditional gynaecology clinics

Abstract

Objective A quantitative and qualitative evaluation of the views of patients attending two types of clinics for menstrual disorders. Methods Semi-structured qualitative interview and quantitative questionnaire.Setting Five traditional general gynaecology clinics and a one-stop menstrual clinic, where investigations are performed and results given to patients on the same day.Participants Two hundred and thirty-nine women (126 from the gynaecology clinic and 113 from the menstrual clinic) were recruited into the quantitative study; 18 and 26 patients from the gynaecology and the menstrual clinic, respectively, were interviewed for the qualitative study. Main outcome measures Women's views about their care and progress towards resolution of their problem.Results Following the initial consultation, 106 (84%) of the gynaecology clinic, and 98 (87%) of the menstrual clinic patients completed the ®rst part of the questionnaire. Of those, 75 (71%) and 79 (81%) patients from the two types of clinic, respectively, completed a follow up questionnaire one year later. There were statistically signi®cant differences in all the components of the ®rst part of the questionnaire (information, continuity, waiting, organisation, and limbo) in favour of the one-stop menstrual clinic. After one year, there was a statistically signi®cant difference in one of the components, patient centeredness, but not in overall process co-ordination. The interviews showed that patients attending the menstrual clinic appreciated getting the results of their investigations on the same day. They also found the organisation of the one-stop menstrual clinic more closely suited to their needs and as a result were more likely to feel they were making progress.Conclusion Women were consistently more positive about their experience in the one-stop clinic. One-stop clinics organised to meet the needs of patients might be appropriate for other clinical conditions. The combination of quantitative and qualitative methods is an effective method of assessing patients' views of health services.

Study comparing two types of screening provision for people with von Hippel-Lindau disease

“…One Stop screening services have been shown to reduce patient anxiety for breast and gynaecological problems in the short term [17][18][19][20], but some have argued that the lack of demonstrable long-term benefit in addition to the increased cost to the NHS of same day reporting of test results means that OS screening can not be justified [19]. This study did find important benefits of OS clinics over their AH counterparts: patients received more comprehensive screening and attended their screening appointments more regularly.…”

“…In response to this, OS clinics have been introduced in a variety of clinical settings in an attempt to reduce patient anxiety and improve attendance rates [17]. A number of studies comparing women attending OS screening clinics compared to standard treatment clinics for the investigation of breast and gynaecological problems have demonstrated that anxiety is reduced over the short-term (from 24 h post screening up to 1 week) [17][18][19][20]. The possible benefit of OS Table 1 Screening protocol for vHL patients and 'at risk' family members [11] vHL manifestation Screening required…”

Investigation of abnormal uterine bleeding in perimenopausal women by hysteroscopy and endometrial biopsy

“…Outpatient hysteroscopy in our study was performed in over 30% of the patients, but this percentage is increasing gradually with newer, narrower, instruments and staff training in diagnostic and operative hysteroscopy [13,14]. Hysteroscopy can be performed on an outpatient basis or as a day case procedure with high acceptability and satisfaction from patients [15,16]. It also has the advantage of being able to treat endometrial pathology at the same time as diagnosing endometrial polyps or submucous fibroids, and endometrial ablation is an alternative to hysterectomy in many cases [17][18][19][20].…”

“…The objective of this study was to investigate, by hysteroscopy and endometrial biopsy, the causes of AUB in perimenopausal patients on sequential or continuous HRT regimens by comparing them with the causes of postmenopausal bleeding observed in another group of patients. In addition, this study emphasizes the increasing use of outpatient hysteroscopy as an effective and acceptable method for treating patients with bleeding problems [5].…”

Association between availability of transvaginal ultrasound examination in a general gynaecology clinic with fewer follow-up visits

“…It has improved our clinical management of postmenopausal bleeding, by providing information about endometrial thickness [2], evaluation of pelvic masses, by identifying their origin and nature [3,4], menstrual dysfunction, by identifying the presence, position and size of fibroids or intrauterine polyps [5], pelvic pain, by identifying the presence of ovarian pathology [6], and subfertility, by excluding hydrosalpinges and documenting polycystic ovaries [7]. These conditions are predominantly managed in general gynaecology clinics, although some of them have been managed in one-stop clinics [8,9]. These clinics allow a diagnosis to be made and a management plan to be formulated and discussed at a single visit.…”