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1.
J Endourol ; 38(1): 23-29, 2024 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-37937698

RESUMEN

Introduction: After the introduction of same-day discharge (SDD) pathways for various surgeries, these pathways have demonstrated comparable complication rates and a reduced overall cost of care. Outpatient robot-assisted radical prostatectomy (RARP) is introduced in high-volume centers; however, patients' perspectives on the SDD RARP protocol are not well understood. Materials and Methods: A questionnaire consisting of 24 questions, including the Likert Decisional Regret Scale, was distributed to patients who underwent RARP at our center. The overall decision regret score was calculated as described in the literature. We used 15 as a cutoff point for differentiating between high- and low-regret rates. Median and interquartile range were determined for non-normally distributed variables, while mean ± standard deviation was calculated for continuous data. Results: Of the 72 patients who completed the questionnaire, 65.7% (n = 44) of patients felt no regret about their decision of choosing the SDD RARP protocol and 90.3% (n = 65) of men stated that they would have made the same decision. At the same time, 97.1% (n = 68) of patients would also recommend this procedure to others. The median decisional regret score of the cohort (n = 67) was 0 (0-10). Fifty-four of 67 (80.6%) patients were in the low-regret score group, while 13 (19.4%) were in the high-regret group. Patients in the high-regret group were more likely to have low household income (<$30,000 a year) and they experienced postoperative pain more frequently compared with patients in the lower regret group (7.7% vs 1.9%, p = 0.626, and 61.5% vs 38.9%, p = 0.212, respectively). Conclusions: Most patients expressed low regret about choosing the SDD pathway for RARP, underscoring the importance of thorough explanation of the procedure and discharge process to enhance patient experience. However, a subset of patients did express regret, possibly due to an interplay of patient- and procedure-related factors.


Asunto(s)
Procedimientos Quirúrgicos Robotizados , Robótica , Masculino , Humanos , Alta del Paciente , Procedimientos Quirúrgicos Robotizados/métodos , Prostatectomía/métodos , Emociones , Resultado del Tratamiento
2.
Clin Obes ; 14(2): e12633, 2024 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-38124342

RESUMEN

It is assumed that the individuals who undergo bariatric surgery will experience significant improvements in their health and overall well-being. However, it is yet to be examined whether these individuals may also experience subsequent decision regret. The level of regret regarding the choice to undergo bariatric surgery was assessed 1 year after bariatric surgery using the Decision Regret Scale (DRS). Associations of regret with patient characteristics, complications, weight loss and quality of life (BODY-Q) were investigated using linear regression analyses. In total, 115 patients completed the DRS (92% underwent Roux-en-Y gastric bypass Roux-en-Y gastric bypass and 8% underwent sleeve gastrectomy (SG)). Two out of 115 patients indicated absolute regret about their decision to undergo bariatric surgery because of insufficient weight loss and complications. The median decision regret score was zero (range 0-80). Most patients experienced no decision regret (50.4%), followed by mild regret (34.8%) and moderate to strong regret (14.8%). Higher levels of regret were associated with having osteo-articular disorders, gastro-oesophageal reflux disease or a history of psychiatric disorders at baseline. Patients with mild regret demonstrated significantly more weight loss and better psychological function. Major surgical complications were not associated with increased decision regret. Only two out of 115 patients (1.7%) indicated absolute regret about their decision to undergo bariatric surgery, and 15% reported moderate-to-strong regret according to the results of the DRS. These findings should be considered when providing pre-operative counselling and could assist patients in their decision-making process.


Asunto(s)
Cirugía Bariátrica , Derivación Gástrica , Laparoscopía , Obesidad Mórbida , Humanos , Obesidad Mórbida/cirugía , Calidad de Vida , Laparoscopía/métodos , Cirugía Bariátrica/efectos adversos , Cirugía Bariátrica/métodos , Derivación Gástrica/métodos , Emociones , Gastrectomía/efectos adversos , Gastrectomía/métodos , Pérdida de Peso , Estudios Retrospectivos , Resultado del Tratamiento
3.
J Otolaryngol Head Neck Surg ; 52(1): 33, 2023 Apr 25.
Artículo en Inglés | MEDLINE | ID: mdl-37098608

RESUMEN

BACKGROUND: In-office vocal fold injections (VFI) are an effective treatment for glottic insufficiency. The primary objective of this study was to assess if patients reported decisional regret after VFI. Secondary objectives included determining if variables were associated with lower decisional regret. METHODS: Case-control study of patients who underwent in-office VFIs for glottic insufficiency from August 2017 to December 2019 at a tertiary laryngology clinic. Participants completed the validated Decision Regret Scale (DRS). Demographic data, clinician's perceptual analysis with GRBAS (Grade, Roughness, Breathiness, Asthenia, Strain), and patient's self-reported Voice Handicap Index-10 (VHI-10) were analyzed. Nonparametric tests as well as univariate and multiple logistics regression were performed. RESULTS: Of patients eligible, 75% (136/182) completed the DRS (mean age 65.4 years (SD 13.9), 58.1% male). Eighty-three (61.0%) reported no decisional regret, thirty-three (24.3%) reported mild decisional regret, and twenty (14.7%) reported moderate to strong decisional regret. Improvement in most recent VHI-10 (Kendall correlation coefficient tau = 0.156, p = 0.029), Grade of voice (tau = 0.236, p value = 0.002) and Breathiness of voice (tau = 0.150, p = 0.044) were associated with lower DRS. Multivariate logistics regression results showed that the change in Grade of voice (OR 9.9, p < 0.01), Roughness (OR 0.2, p < 0.01) and Breathiness (OR 0.2, p < 0.03) were significantly associated with DRS. CONCLUSION: The majority of patients had no or mild decisional regret after in-office VFI for glottic insufficiency. Both patients who reported less vocal handicap after VFI and clinician-noted improvements in perceptual evaluation of voice after VFI were associated with significantly lower decisional regret.


Asunto(s)
Laringe , Pliegues Vocales , Humanos , Masculino , Anciano , Femenino , Estudios de Casos y Controles , Inyecciones , Resultado del Tratamiento , Estudios Retrospectivos
4.
Front Psychol ; 13: 945669, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-36186382

RESUMEN

The Decision Regret Scale (DRS) was assessed for its psychometric qualities in measuring decision regret in ordinary life scenarios. Although the scale has typically been used with patients and in the context of medical decision-making in earlier studies, this contribution shows that the instrument may have a variety of uses, retaining excellent metric properties even in non-medical contexts. The tool showed good fits with both the CFA and the gender Measurement Invariance. A non-probabilistic selection of 2,534 Italian university students was conducted. The internal consistency measures were found to be completely appropriate. Correlations with the General Decision-Making Style (GDMS) and Scale of Regulatory Modes were used to check for convergent validity (SRM). Convergence analysis showed that participants with higher regret scores were those who favored a rational decision-making style, while lower regret scores correlated with avoidant and spontaneous styles. With regard to the regulatory modes, the relationship between regret and locomotion was positive. Overall, the directions of association point to an interesting predictive measure of a person's decision-making and self-regulatory orientation through the evaluation of regret using the DRS. The excellent psychometric properties found foreshadow a reliable use in various contexts where knowledge of post-decisional attitude becomes important: school, university, professional orientation, marketing studies, relationship choices, as well as for use in research.

5.
Colorectal Dis ; 23(6): 1474-1479, 2021 06.
Artículo en Inglés | MEDLINE | ID: mdl-33386682

RESUMEN

AIM: A defunctioning stoma may be an option for a small group of patients with chronic constipation who have exhausted all forms of conservative management and remain symptomatic. We investigated this group in terms of stoma-related complications and whether they regretted the intervention. METHODS: Patients presenting to Sheffield Teaching Hospitals Pelvic Floor Unit over a 7-year period with chronic constipation unresponsive to conservative management and who had undergone a loop ileostomy for management were interviewed using the decision regret scale. Details about subsequent stoma-related surgery were recorded. RESULTS: Thirty-seven of 38 female patients identified (median age 49 years, range 24-86) completed the decision regret scale. Median follow-up was 34 months (range 7-74). About half (49%) had no regret and a further 27% had minimal regret about the decision for a stoma. Fifty-five per cent of patients had further operations related to the stoma, some undergoing up to five operations. CONCLUSION: A small group of patients with intractable constipation may benefit from a loop ileostomy but are likely to need subsequent surgery to the stoma. Despite this most patients who have had a stoma do not regret the decision.


Asunto(s)
Ileostomía , Estomas Quirúrgicos , Adulto , Anciano , Anciano de 80 o más Años , Colostomía , Tratamiento Conservador , Estreñimiento/etiología , Estreñimiento/cirugía , Femenino , Humanos , Persona de Mediana Edad , Complicaciones Posoperatorias , Adulto Joven
6.
J Patient Rep Outcomes ; 3(1): 43, 2019 Jul 17.
Artículo en Inglés | MEDLINE | ID: mdl-31317289

RESUMEN

BACKGROUND: To ensure that patients continue treatment, it is essential that the patient is satisfied with the decision-making process of the treatment. One way to address this is to assess the healthcare quality using the concept of regret, which can measure "Being convinced in decision-making." This study aimed to elucidate patient factors affecting regret using the Japanese version of the Decision Regret Scale (DRS). METHODS: A questionnaire survey was conducted with 197 patients with uterine myoma, ovarian tumors, and endometriosis. We then examined the relationship between the Japanese DRS, the Japanese SF-8 as a health-related quality of life (QOL), and patient factors using latent class analysis and path analysis through a multi-group comparison. RESULTS: The final sample comprised 102 patients. Patients were classified into the following two groups based on the latent class analysis of patient characteristics: many patients who were married and had children and a few patients who were unmarried and had no children (class 1), and many patients who were unmarried and had no children and a few patients who were married and had children (class 2). The path analysis through the group comparison of the two classes revealed that subjective symptoms, preferences, and surgical procedure (laparotomy or laparoscopic surgery) had a direct impact on regret. The magnitude of the influence factors for Class 1 and Class 2 Regret was different. The indirect effect on regret was through mental component summary. CONCLUSION: Our results suggest that it is necessary to present treatment methods with consideration to patients' backgrounds and to obtain informed consent from patients.

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