Quality of life and patient satisfaction in outpatient thyroid surgery

Updates in Surgery - Tập 74 - Trang 317-323 - 2021
Luca Cozzaglio1, Roberta Monzani2, Andrea Zuccarelli1,3, Ferdinando Cananzi1, Federico Sicoli1, Laura Ruspi1, Vittorio Quagliuolo1
1Department of Surgical Oncology, IRCCS Humanitas Research Hospital, Milan, Italy
2Department of Anesthesiology, IRCCS Humanitas Research Hospital, Rozzano, Italy
3Department of General Surgery, Belfast Health and Social Care Trust, Northern Ireland Foundation School, NI Medical and Dental Training Agency (NIMDTA), Belfast, UK

Tóm tắt

In the last three decades surgeons have begun to perform outpatient thyroid surgery (OTS). Important outcome measures of a day-hospital procedure are the patient’s quality of life (QoL) and satisfaction, but information on these issues in the OTS setting is scanty. The aim of this pilot study was to explore how early discharge after thyroidectomy affects patients’ QoL and satisfaction. Postoperative QoL and satisfaction were assessed retrospectively by giving each patient a self-report questionnaire specifically created in our center for OTS and derived from the post-discharge surgical recovery (PSR) scale to assess physical and mental well-being. Twenty-three of 24 patients (96%), 16 women and 7 men with a median age of 48 years (range 16–72), completed the questionnaire, answering 92% of the questions. QoL based on this scale gave a median score of 81.8% (range 62–98.8%). No major or minor complications occurred in the study group. Regarding QoL eight patients (35%) reported feeling “tired all the time” and six patients (26%) reported mild pain, which in two cases resolved spontaneously. Regarding patient satisfaction two-thirds of patients judged OTS positively while the remaining one-third would not recommend it. Our study showed very good uptake by patients of a new questionnaire dedicated to OTS as a possible aid in the identification of areas for improvement of OTS management. However, to be considered a safe procedure with maximum patient compliance and satisfaction, OTS was found to require considerable effort by hospital staff and patients’ caregivers compared to inpatient thyroid surgery.

Tài liệu tham khảo

Terris DJ, Snyder S, Carneiro-Pla D, Inabnet WB III, Kandil E, Orloff L et al (2013) American thyroid association statement on outpatient thyroidectomy. Thyroid 23:1193–1202 Clark OH, Ituarte P (1998) Ambulatory thyroid surgery—unnecessary and dangerous. J Clin Endocrinol Metab 83:1100–1103 Doran H, England J, Palazzo F (2012) Questionable safety of thyroid surgery with same day discharge. Ann R Coll Surg Engl 94:543–547 Brattwall M, Stomberg MW, Rawal N, Segerdahl M, Houltz E, Jakobsson J (2010) Patient assessed health profile: a six-month quality of life questionnaire survey after day surgery. Scand J Public Health 38:574–579 Samson PS, Reyes FR, Saludares WN, Angeles RP, Francisco RA, Tagorda ER (1997) Outpatient thyroidectomy. Am J Surg 173:499–503 Mowschenson PM, Hodin RA (1995) Outpatient thyroid and parathyroid surgery: a prospective study of feasibility, safety, and costs. Surgery 118:1051–1053 Sahmkow SI, Audet N, Nadeau S, Camiré M, Beaudoin D (2012) Outpatient thyroidectomy: safety and patients’ satisfaction. J Otolaryngol Head Neck Surg 41(suppl 1):S1-12 Rattray J, Jones MC (2007) Essential elements of questionnaire design and development. J Clin Nurs 16:234–243 American Society of Anesthesiologists (1963) New classification of physical status. Anesthesiology 24:110–111 Kleinbeck SV (2000) Self-reported at-home postoperative recovery. Res Nurs Health 23:461–472 Wang JJ, Ho ST, Lee SC, Liu YC, Ho CM (2000) The use of dexamethasone for preventing postoperative nausea and vomiting in females undergoing thyroidectomy: a dose-ranging study. Anesth Analg 91:1404–1407 Steckler RM (1986) Outpatient thyroidectomy: a feasibility study. Am J Surg 152:417–419 Lee DJ, Chin CJ, Hong CJ, Perera S, Witterck IL (2018) Outpatient versus inpatient thyroidectomy: a systematic review and meta-analysis. Head Neck 40:192–202 Khadra H, Mohamed S, Hauch A, Carter J, Hu T, Kandil E (2017) Safety of same-day thyroidectomy: meta-analysis and systematic review. Gland Surg 6:292–301 Bowers MR, Swan JE, Koehler WF (1994) What attributes determine quality and satisfaction with health care delivery? Health Care Manage Rev 19:49–55 Jun M, Peterson RT, Zsidisin GA (1998) The identification and measurement of quality dimensions in health care: focus group interview results. Health Care Manage Rev 23:81–96 Sørlie T, Sexton HC, Busund R, Sørlie D (2000) Predictors of satisfaction with surgical treatment. Int J Qual Health Care 12:31–40 McLafferty R, Williams R, Lambert A, Dunnington G (2006) Surgeon communication behaviors that lead patients to not recommend the surgeon to family members or friends: analysis and impact. Surgery 140:616–624 Guyatt G, Walter S, Norman G (1987) Measuring change over time: assessing the usefulness of evaluative instruments. J Chronic Dis 40:171–178 Kluivers KB, Riphagen I, Vierhout ME, Brölmann HA, de Vet HC (2008) Systematic review on recovery specific quality-of-life instruments. Surgery 143:206–215 Terwee CB, Dekker FW, Wiersinga WM, Prummel MF, Bossuyt PMM (2003) On assessing responsiveness of health-related quality of life instruments: guidelines for instrument evaluation. Qual Life Res 12:349–362 Delbridge L (2009) Endocrine surgery—a 23 hour specialty? ANZ J Surg 79:320–322 Balentine CJ, Sippel RS (2016) Outpatient thyroidectomy: is it safe? Surg Oncol Clin N Am 25:61–75 Materazzi G, Dionigi G, Berti P, Rago R, Frustaci G, Docimo G et al (2007) One-day thyroid surgery: retrospective analysis of safety and patient satisfaction on a consecutive series of 1,571 cases over a three-year period. Eur Surg Res 39:182–188 Schmocker RK, Cherney Stafford LM, Siy AB, Leverson GE, Winslow ER (2015) Understanding the determinants of patient satisfaction with surgical care using the consumer assessment of healthcare providers and systems surgical care survey (S-CAHPS). Surgery 158:1724–1733 Mira JJ, Tomás O, Virtudes-Pérez M, Nebot C, Rodríguez-Marín J (2009) Predictors of patient satisfaction in surgery. Surgery 145:536–541 Hessman C, Fields J, Schuman E (2011) Outpatient thyroidectomy: is it a safe and reasonable option? Am J Surg 201:565–568 Pothier DD (2005) The use of drains following thyroid and parathyroid surgery: a meta-analysis. J Laringol Otol 119:669–671 Rosato L, Avenia N, Bernante P, De Palma M, Gulino G, Nasi PG et al (2004) Complications of thyroid surgery: analysis of a multicentric study on 14,934 patients operated on in Italy over 5 years. World J Surg 28:271–276 Vaiman M, Nagibin A, Olevson J (2010) Complications in primary and completed thyroidectomy. Surg Today 40:114–118 Walker JA (2007) What is the effect of preoperative information on patient satisfaction? Br J Nurs 16:27–32 Gilmartin J (2007) Contemporary day surgery: patients’ experience of discharge and recovery. J Clin Nurs 16:1109–1117