Skip to main content
Top
Published in: International Urogynecology Journal 7/2009

01-07-2009 | Original Article

Qualifying a quantitative approach to women’s expectations of continence surgery

Authors: Sushma Srikrishna, Dudley Robinson, Linda Cardozo

Published in: International Urogynecology Journal | Issue 7/2009

Login to get access

Abstract

Introduction and hypothesis

The objective of this study is to explore expectations and goals of women undergoing continence surgery using a combined quantitative and qualitative approach.

Methods

Women with urinary incontinence, recruited from the waiting list, were assessed with a structured clinical interview, and these data were transcribed and analysed thematically (grounded theory). The Kings Health Questionnaire (KHQ) was used to determine incontinence impact on patient’s life.

Results

Incontinence was objectively quantified using videocystourethrography. KHQ quantitative analysis suggested that the main domains affected were incontinence impact on life and physical limitations. However, qualitative analysis based on the interview found women were most affected by incontinence impact on physical or social limitation, sexual function, emotions and body image.

Conclusion

Whilst disease-specific QoL questionnaires allow broad comparisons to be made assessing patient bother; they lack sensitivity to assess individual symptoms. A qualitative approach may individualise patient care and improve patient satisfaction and overall outcome.
Literature
1.
go back to reference Abrams P, Cardozo L, Fall M, Griffiths D, Rosier P, Ulmsten U et al (2002) The standardisation of terminology of lower urinary tract function. Report from the standardisation committee of the International Continence Society. Neurourol Urodynam; 21:167–178CrossRef Abrams P, Cardozo L, Fall M, Griffiths D, Rosier P, Ulmsten U et al (2002) The standardisation of terminology of lower urinary tract function. Report from the standardisation committee of the International Continence Society. Neurourol Urodynam; 21:167–178CrossRef
2.
go back to reference Kelleher CJ, Cardozo LD, Khullar V, Salvatore S (1997) A new questionnaire to assess the quality of life of urinary incontinent women. Br J Obstet Gynaecol 104:1374–1379PubMed Kelleher CJ, Cardozo LD, Khullar V, Salvatore S (1997) A new questionnaire to assess the quality of life of urinary incontinent women. Br J Obstet Gynaecol 104:1374–1379PubMed
3.
go back to reference Hannestad YS, Rortveit G, Sandvik H, Hunskar S (2000) A community-based epidemiological survey of female urinary incontinence: The Norwegian EPINCONT Study. J Clin Epidem; 53:1150–1157CrossRef Hannestad YS, Rortveit G, Sandvik H, Hunskar S (2000) A community-based epidemiological survey of female urinary incontinence: The Norwegian EPINCONT Study. J Clin Epidem; 53:1150–1157CrossRef
4.
go back to reference Robinson D, Anders K, Cardozo L, Bidmead J (2007) Outcome measures in Urogynaecology: the clinician’s perspective. Int Urogynaecol J Pelvic Floor Dysfunct; 18:273–279CrossRef Robinson D, Anders K, Cardozo L, Bidmead J (2007) Outcome measures in Urogynaecology: the clinician’s perspective. Int Urogynaecol J Pelvic Floor Dysfunct; 18:273–279CrossRef
5.
go back to reference Mattiasson A, Djurhuus J, Fonda D, Gunnar L, Nordling J, Stoher M (1998) Standardisation of outcome studies in patients with lower urinary tract dysfunction: A report on general principles from the standardisation committee of the International Continence Society. Neurourol Urodynam 17:249CrossRef Mattiasson A, Djurhuus J, Fonda D, Gunnar L, Nordling J, Stoher M (1998) Standardisation of outcome studies in patients with lower urinary tract dysfunction: A report on general principles from the standardisation committee of the International Continence Society. Neurourol Urodynam 17:249CrossRef
6.
go back to reference Lose G, Fantl A, Victor A, Walter S, Wells T, Wyman J, Mattiasson A (1998) Outcome measures for research in adult women with symptoms of lower urinary tract dysfunction. Neurourol Urodynam 17:255CrossRef Lose G, Fantl A, Victor A, Walter S, Wells T, Wyman J, Mattiasson A (1998) Outcome measures for research in adult women with symptoms of lower urinary tract dysfunction. Neurourol Urodynam 17:255CrossRef
7.
go back to reference Renganathan A, Cartwright R, Cardozo L, Srikrishna S, Robinson D, Vella M (2008) Redefining surgical cure: Role of composite endpoints. Int Urogynaecol J Pelvic Floor Dysfunct 19:S14 Renganathan A, Cartwright R, Cardozo L, Srikrishna S, Robinson D, Vella M (2008) Redefining surgical cure: Role of composite endpoints. Int Urogynaecol J Pelvic Floor Dysfunct 19:S14
8.
go back to reference Kelleher CJ, Pleil AM, Reese PR, Burgess SM, Brodish PH (2004) How much is enough and who says so? Br J Obstet Gynaecol 111:605–612 Kelleher CJ, Pleil AM, Reese PR, Burgess SM, Brodish PH (2004) How much is enough and who says so? Br J Obstet Gynaecol 111:605–612
9.
go back to reference Hullfish KL, Bovbjerg VE, Gibson J, Steers WD (2002) Patient centered goals for pelvic floor dysfunction surgery: what is success and is it achieved? Am J Obstet Gynaecol 187:88–92CrossRef Hullfish KL, Bovbjerg VE, Gibson J, Steers WD (2002) Patient centered goals for pelvic floor dysfunction surgery: what is success and is it achieved? Am J Obstet Gynaecol 187:88–92CrossRef
10.
go back to reference Hullfish KL, Bovbjerg VE, Steers WD (2004) Patient centered goals for pelvic floor dysfunction surgery: long-term follow up. Am J Obstet Gynaecol 191:201–205CrossRef Hullfish KL, Bovbjerg VE, Steers WD (2004) Patient centered goals for pelvic floor dysfunction surgery: long-term follow up. Am J Obstet Gynaecol 191:201–205CrossRef
11.
go back to reference Versi E, Cardozo L, Anand D, Cooper D (1991) Symptoms analysis for the diagnosis of genuine stress incontinence. Br J Obstet Gynaecol 98:815–819PubMed Versi E, Cardozo L, Anand D, Cooper D (1991) Symptoms analysis for the diagnosis of genuine stress incontinence. Br J Obstet Gynaecol 98:815–819PubMed
12.
go back to reference Arksey H, Knight P (1999) Interviewing for social scientists: An introductory. resource with examples. Sage, London Arksey H, Knight P (1999) Interviewing for social scientists: An introductory. resource with examples. Sage, London
13.
go back to reference Patton MQ (1987) How to use qualitative methods in evaluation. Sage, London, pp 108–43 Patton MQ (1987) How to use qualitative methods in evaluation. Sage, London, pp 108–43
14.
go back to reference Glaser BG, Strauss AL (1967) The discovery of grounded theory: strategies for qualitative research. Aldine, Chicago Glaser BG, Strauss AL (1967) The discovery of grounded theory: strategies for qualitative research. Aldine, Chicago
15.
go back to reference Glaser BG (1978) Theoretical Sensitivity. Sociology Press, Mill Valley Glaser BG (1978) Theoretical Sensitivity. Sociology Press, Mill Valley
16.
go back to reference Robinson D, Anders K, Cardozo L, Bidmead J, Dixon A, Balmfoth J, Rufford J (2003) What do women want? Interpretation of the concept of cure. JPelv Med Surg 9(6):273–277CrossRef Robinson D, Anders K, Cardozo L, Bidmead J, Dixon A, Balmfoth J, Rufford J (2003) What do women want? Interpretation of the concept of cure. JPelv Med Surg 9(6):273–277CrossRef
17.
go back to reference Tincello DG, Alfirevic Z (2002) Important clinical outcomes in urogynaecology: views of patients, nurses and medical staff. Int Urogynaecol J 13:96CrossRef Tincello DG, Alfirevic Z (2002) Important clinical outcomes in urogynaecology: views of patients, nurses and medical staff. Int Urogynaecol J 13:96CrossRef
18.
go back to reference Elkadry EA, Kenton KS, Fitzgerald MP, Shott S, Brubaker L (2003) Patient selected goals: a new perspective on surgical outcome. Am J Obstet Gynaecol 189:1551–1557CrossRef Elkadry EA, Kenton KS, Fitzgerald MP, Shott S, Brubaker L (2003) Patient selected goals: a new perspective on surgical outcome. Am J Obstet Gynaecol 189:1551–1557CrossRef
19.
go back to reference Hullfish KL, Bovbjerg VE, Gurka MJ, Steers WD (2008) Surgical versus nonsurgical treatment of women with pelvic floor dysfunction:patient centred goals at 1 year. J Urol 179:2280–2285PubMedCrossRef Hullfish KL, Bovbjerg VE, Gurka MJ, Steers WD (2008) Surgical versus nonsurgical treatment of women with pelvic floor dysfunction:patient centred goals at 1 year. J Urol 179:2280–2285PubMedCrossRef
20.
go back to reference Mahajan ST, Elkadry EA, Kenton KS, Shott S, Brubaker L (2004) Patient selected goals: perspectives on surgical outcomes one year after surgery. Neurourol Urodyn 23:520–521 Mahajan ST, Elkadry EA, Kenton KS, Shott S, Brubaker L (2004) Patient selected goals: perspectives on surgical outcomes one year after surgery. Neurourol Urodyn 23:520–521
21.
go back to reference Mahajan ST, Elkadry EA, Kenton KS, Shott S, Brubaker L (2006) Patient centered surgical outcomes: the impact of goal achievement and urge incontinence on patient satisfaction one year after surgery. Am J Obstet Gynaecol; 194:722–728CrossRef Mahajan ST, Elkadry EA, Kenton KS, Shott S, Brubaker L (2006) Patient centered surgical outcomes: the impact of goal achievement and urge incontinence on patient satisfaction one year after surgery. Am J Obstet Gynaecol; 194:722–728CrossRef
22.
go back to reference Brubaker L, Shull B. EGGS for patient-centred outcomes (2005). Int Urogynaecol J Pelvic Floor Dysfunct.; 16: 171-173 Brubaker L, Shull B. EGGS for patient-centred outcomes (2005). Int Urogynaecol J Pelvic Floor Dysfunct.; 16: 171-173
23.
go back to reference Lowenstein L, Fitzgerald MP, Kenton K, Dooley Y, Templehof M, Mueller ER, Brubaker L (2008) Patient-selected goals: the fourth dimension in assessment of pelvic floor disorders. Int Urogynaecol J Pelvic Floor Dysfunct 19:81–84CrossRef Lowenstein L, Fitzgerald MP, Kenton K, Dooley Y, Templehof M, Mueller ER, Brubaker L (2008) Patient-selected goals: the fourth dimension in assessment of pelvic floor disorders. Int Urogynaecol J Pelvic Floor Dysfunct 19:81–84CrossRef
Metadata
Title
Qualifying a quantitative approach to women’s expectations of continence surgery
Authors
Sushma Srikrishna
Dudley Robinson
Linda Cardozo
Publication date
01-07-2009
Publisher
Springer-Verlag
Published in
International Urogynecology Journal / Issue 7/2009
Print ISSN: 0937-3462
Electronic ISSN: 1433-3023
DOI
https://doi.org/10.1007/s00192-009-0870-5

Other articles of this Issue 7/2009

International Urogynecology Journal 7/2009 Go to the issue