Patient-Reported Outcomes Following Ventral Hernia Repair: Designing a Qualitative Assessment Tool

Martin J. Carney, Kate E. Golden, Jason M. Weissler, Michael A. Lanni, Andrew R. Bauder, Brigid Cakouros, Fabiola Enriquez, Robyn Broach, Frances K. Barg, Marilyn M. Schapira and John P. Fischer ()
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Martin J. Carney: Penn Presbyterian Medical Center, University of Pennsylvania, Perelman School of Medicine
Kate E. Golden: University of Pennsylvania
Jason M. Weissler: Penn Presbyterian Medical Center, University of Pennsylvania, Perelman School of Medicine
Michael A. Lanni: Penn Presbyterian Medical Center, University of Pennsylvania, Perelman School of Medicine
Andrew R. Bauder: Penn Presbyterian Medical Center, University of Pennsylvania, Perelman School of Medicine
Brigid Cakouros: University of Pennsylvania
Fabiola Enriquez: Penn Presbyterian Medical Center, University of Pennsylvania, Perelman School of Medicine
Robyn Broach: Penn Presbyterian Medical Center, University of Pennsylvania, Perelman School of Medicine
Frances K. Barg: University of Pennsylvania
Marilyn M. Schapira: University of Pennsylvania
John P. Fischer: Penn Presbyterian Medical Center, University of Pennsylvania, Perelman School of Medicine

The Patient: Patient-Centered Outcomes Research, 2018, vol. 11, issue 2, No 9, 225-234

Abstract: Abstract Background Current hernia patient-reported outcome (PRO) measures were developed without patient input, greatly impairing their content validity. Objective The purpose of this study was to develop a conceptual model for PRO measures for ventral hernia (VH) patients. Methods Fifteen semi-structured, concept elicitation interviews and two focus groups employing nominal group technique were conducted with VH patients. Patients were recruited between November 2015 and July 2016 over the telephone from a five-surgeon patient cohort at our institution. Iterative thematic analysis identified domains. Reliability and validation were achieved using inter-rater reliability checks and triangulation. Results Seven framework domains were established: (1) expectations; (2) self and others; (3) surgeon and surgical team; (4) sensation; (5) function; (6) appearance; and (7) overall satisfaction. Overall patient satisfaction was associated with two themes: (1) provider–patient relationship; and (2) patient assessment of post-repair improvement. Conclusions VH patients experience a profoundly broad range of reactions to VH repair. A patient-informed PRO instrument that addresses the spectrum of patient-identified outcomes can guide practice, optimizing care targeting VH patients’ needs.

Date: 2018
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DOI: 10.1007/s40271-017-0275-3

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