Patient-selected goals: a new perspective on surgical outcome.
OBJECTIVE
This study was undertaken to study the relationship between achievement of patient goals, overall satisfaction, and objective outcome measures.


METHODS
After Institutional Review Board approval, we prospectively evaluated 78 women undergoing pelvic reconstructive surgery at Loyola University Medical Center. After informed consent for surgery, patients were asked to state their goals for surgery. In a follow-up telephone conversation, these goals were reviewed and negotiated to modify expectations. The same physician investigator contacted women 3 months after surgery to assess goal achievement, overall satisfaction, and their surgical experience. Date were analyzed with Spearman correlation and Mann-Whitney tests.


RESULTS
Of 78 women, 75% indicated that they met most of their goals, and 72% were more than 80% satisfied. Patient satisfaction was moderately correlated to goal achievement (rho=0.57, P<.001). Objective cure, defined as no urodynamic stress incontinence and stage 0 or I prolapse, was not related to satisfaction (P=.14). Dissatisfaction was highly associated with feeling "unprepared for surgery" (P<.001).


CONCLUSIONS
Objective and subjective outcomes are necessary to predict patient satisfaction.
Elkadry
Eman A
EA
Division of Female Pelvic Medicine and Reconstructive Surgery, Loyola University Medical Center, Maywood, IL, USA.
Kenton
Kimberly S
KS
FitzGerald
Mary P
MP
Shott
Susan
S
Brubaker
Linda
L
D000046:Academic Medical Centers; D000368:Aged; D001294:Attitude to Health; D002140:California; D005260:Female; D006040:Goals; D013509:Gynecologic Surgical Procedures / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D017060:Patient Satisfaction; D017773:Pelvic Floor / Q000503:physiopathology / Q000601:surgery; D011336:Probability; D011446:Prospective Studies; D011788:Quality of Life; D019651:Plastic Surgery Procedures / Q000009:adverse effects / Q000379:methods; D020127:Recovery of Function; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014550:Urinary Incontinence, Stress / Q000601:surgery; D014596:Uterine Prolapse / Q000601:surgery