The relationship between perceptions of shared decision‐making and patient‐reported outcomes in a cross‐sectional cohort of haemorrhoidectomy patients

Merali, Khalil; Karimuddin, Ahmer; Crump, Trafford; Brown, Carl; Phang, Terry; Raval, Manoj J.; Liu, Guiping; Sutherland, Jason M.

doi:10.1111/codi.16039

Cited by 5 publications

(3 citation statements)

References 38 publications

(45 reference statements)

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“…The clinical results were excellent. These equipment could reduce operation time, blood loss, and postoperative pain (26). However, due to the limitation of the medical insurance policy, to reduce the medical cost to meet the demand of Diagnosis-Related Groups (DRGs), we only used the normal high-frequency elytrotomy to stop bleeding during hemorrhoidectomy in all the cases in our study.…”

Section: Discussionmentioning

confidence: 99%

Psychological states could affect postsurgical pain after hemorrhoidectomy: A prospective cohort study

Wang

Wu²,

Cao³

et al. 2023

Front. Surg.

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BackgroundOpen hemorrhoidectomy is one of the standard procedures for grade IV hemorrhoids. Postsurgical pain is a common problem for patients. We aim to prospectively evaluate potential factors affecting postoperative pain among hemorrhoidectomy patients.MethodsAn observational study was conducted on 360 patients who had undergone Milligan-Morgan open hemorrhoidectomy. Details of the surgery and baseline information were recorded. Preoperative anxiety and depression were analyzed via the self-rating anxiety scale 20 (SAS-20) and self-rating depression scales 20 (SDS-20), respectively. Postoperative pain score was performed daily after surgery until the patient was discharged. The numerical pain score was evaluated by the visual analogue scale (VAS). The association between preoperative psychological states (anxiety or depression) and postoperative pain was analyzed using a generalized additive mixed model.ResultsA total of 340 patients eventually provided complete data and were included in our study. The average age was 43.3 ± 14.4 years, and 62.1% of patients were women. In total, 14.9% of patients had presurgical anxiety and 47.1% had presurgical depression. Postsurgical pain reached a peak point 1–2 days after surgery and went down to a very low level around 4–5 days after surgery. More excision of hemorrhoids could lead to more pain experience after surgery. Presurgical depression was associated with postsurgical pain. Patients who had presurgical depression had higher pain scores after surgery (2.3 ± 1.9 vs. 3.3 ± 1.9, p = 0.025).ConclusionPreoperative depression and the amount of excisional hemorrhoids are positively related to postsurgical pain.

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Section: Discussionmentioning

confidence: 99%

Psychological states could affect postsurgical pain after hemorrhoidectomy: A prospective cohort study

Wang

Wu²,

Cao³

et al. 2023

Front. Surg.

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“…Observational studies are predominantly in the fields of orthopaedics, plastics surgery (eg, breast reconstruction) and general surgery. [9][10][11][12][13][14][15][16] Outcomes reported are predominantly on the practice and perception of SDM: In the surgical sphere, SDM is associated with higher patient satisfaction, but clinician and patient perceptions of if it has occurred do not always align; patients with lower socioeconomic status and depression often have worse perceptions of their SDM process. Randomised controlled trials are few and heterogeneous.…”

Section: Open Accessmentioning

confidence: 99%

“…The year 2022 saw a large increase in published trials (predominantly based out of North America, Canada and the Netherlands) but the heterogeneity of interventions and outcomes reported remains large. Observational studies are predominantly in the fields of orthopaedics, plastics surgery (eg, breast reconstruction) and general surgery 9–16. Outcomes reported are predominantly on the practice and perception of SDM: In the surgical sphere, SDM is associated with higher patient satisfaction, but clinician and patient perceptions of if it has occurred do not always align; patients with lower socioeconomic status and depression often have worse perceptions of their SDM process.…”

Section: Introductionmentioning

confidence: 99%

Protocol paper for SMART OPS: Shared decision-making Multidisciplinary Approach – a Randomised controlled Trial in the Older adult Population considering Surgery

et al. 2023

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IntroductionThe Australian population presenting with surgical pathology is becoming older, frailer and more comorbid. Shared decision-making is rapidly becoming the gold standard of care for patients considering high-risk surgery to ensure that appropriate, value-based healthcare decisions are made. Positive benefits around patient perception of decision-making in the immediacy of the decision are described in the literature. However, short-term and long-term holistic patient-centred outcomes and cost implications for the health service require further examination to better understand the full impact of shared decision-making in this population.MethodsWe propose a novel multidisciplinary shared decision-making model of care in the perioperative period for patients considering high-risk surgery in the fields of general, vascular and head and neck surgery. We assess it in a two arm prospective randomised controlled trial. Patients are randomised to either ‘standard’ perioperative care, or to a multidisciplinary (surgeon, anaesthetist and end-of-life care nurse practitioner or social worker) shared decision-making consultation. The primary outcome is decisional conflict prior to any surgical procedure occurring. Secondary outcomes include the patient’s treatment choice, how decisional conflict changes longitudinally over the subsequent year, patient-centred outcomes including life impact and quality of life metrics, as well as morbidity and mortality. Additionally, we will report on healthcare resource use including subsequent admissions or representations to a healthcare facility up to 1 year.Ethics and disseminationThis study has been approved by the Hunter New England Human Research Ethics Committee (2019/ETH13349). Study findings will be presented at local and national conferences and within scientific research journals.Trial registration numberACTRN12619001543178.

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A comparison of patient-reported outcomes among Canadian women having hysterectomies

et al. 2022

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The relationship between perceptions of shared decision‐making and patient‐reported outcomes in a cross‐sectional cohort of haemorrhoidectomy patients

Cited by 5 publications

References 38 publications

Psychological states could affect postsurgical pain after hemorrhoidectomy: A prospective cohort study

Psychological states could affect postsurgical pain after hemorrhoidectomy: A prospective cohort study

Protocol paper for SMART OPS: Shared decision-making Multidisciplinary Approach – a Randomised controlled Trial in the Older adult Population considering Surgery

A comparison of patient-reported outcomes among Canadian women having hysterectomies

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