title: Patient-selected goals: a new perspective on surgical outcome.
abstract: 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.
authors.affiliation: Division of Female Pelvic Medicine and Reconstructive Surgery, Loyola University Medical Center, Maywood, IL, USA.
authors.forename: Eman A
authors.initials: EA
authors.lastname: Elkadry
authors.forename: Kimberly S
authors.initials: KS
authors.lastname: Kenton
authors.forename: Mary P
authors.initials: MP
authors.lastname: FitzGerald
authors.forename: Susan
authors.initials: S
authors.lastname: Shott
authors.forename: Linda
authors.initials: L
authors.lastname: Brubaker
mesh_terms: 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