Patient-assessed outcomes in Swedish and Egyptian men undergoing radical cystectomy and orthotopic bladder substitution--a prospective comparative study.
OBJECTIVE
To compare two patient populations with assumed cultural differences undergoing radical cystectomy and orthotopic bladder substitution to determine whether these translate into differences in the answers to self-report instruments.


METHODS
The questionnaires Functional Assessment of Cancer Therapy-Bladder Cancer (FACT-BL), consisting of a general version (FACT-G) and a bladder cancer specific module, and Hospital Anxiety and Depression Scale (HADS) were used preoperatively and 3 and 12 months postoperatively to assess patient well-being, urologic symptoms, depression, and anxiety in 29 and 32 Swedish and Egyptian male patients, respectively.


RESULTS
Significant differences were found between the two groups. Higher FACT-G scores (ie, better outcomes) were obtained in the Swedish patients, both preoperatively and 3 months postoperatively, but not after 12 months. Differences were also seen in the urogenital assessment provided by the FACT-BL module. HADS revealed more depression among the Egyptian patients throughout the study period. Also, anxiety was more common preoperatively and 3 months postoperatively in the Egyptian patients, but not after 12 months.


CONCLUSIONS
Swedish men scored better than Egyptian men on the FACT-BL and HADS, although the latter improved with time after surgery. These results show that patient-assessed outcomes differ in patients from different sociocultural backgrounds. This should be recognized when analyzing results from comparative studies. Also, the use of culture-fair instruments is important when assessing patients with different sociocultural backgrounds.
D000328:Adult; D000368:Aged; D001007:Anxiety / Q000209:etiology; D001294:Attitude to Health; D015653:Cystectomy / Q000009:adverse effects / Q000523:psychology; D003863:Depression / Q000209:etiology; D004534:Egypt; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D013548:Sweden; D001749:Urinary Bladder Neoplasms / Q000523:psychology / Q000601:surgery*; D014547:Urinary Diversion / Q000009:adverse effects / Q000523:psychology; D014555:Urination Disorders / Q000209:etiology