Patient Satisfaction With Mohs Surgery for Melanoma In Situ

International Journal for Quality in Health Care, 2000

Letter to the Editor Predictors of satisfaction with surgical treatment To the Editor: We read the article 'Predictors of satisfaction that the disease itself may produce dissatisfaction, and that discontent may be projected onto the doctors [39]. If we with surgical treatment' of Tore Sorlie et al [1] with great interest. The authors are right when they say that patient separate mental health from physical health, the principal influence on the level of satisfaction would be mental health satisfaction appears to be influenced by multiple factors. Indeed, numerous demographic and socioeconomic factors, [44-46]. Lenert et al, for example, proposed that depressed patients systematically undervalue the beneficial effects of such as age, gender, race, social and educational level [2,3], are considered to affect the degree of satisfaction. the care received [47]. Further factors that have been indicated as predictors of satisfaction include confidence in the health In general, older patients tend to demand less and to be more satisfied with the services received [4-12]. The findings system, a source of regular support and satisfaction with life in general [48]. of Baker [13], who conducted surveys on the satisfaction of outpatients, are an exception. Baker found that those patients The relationship between physical health and satisfaction with medical attention varies according to whether an in-experiencing less satisfaction were male or older. With respect to gender, Lledó et al [14] found that female patients facing dividual's physical health is self-evaluated or whether it is medically evaluated using symptoms of pain. In a study of cataract surgery displayed higher expectations than their male counterparts. While Hall & Dernan did not find gender to patients suffering from systemic lupus erythematosus, Da Costa et al found that those who had self-evaluated their be associated with a patient's satisfaction with medical attention [4], they did find a correlation between satisfaction physical health as diminished displayed greater satisfaction than those who were evaluated by physicians [15]. In-and lower levels of education. Furthermore, Da Costa et al [15] found that educational level was the main socio-terestingly, the factor that was most associated with satisfaction in the former group was the perception of good demographic factor associated with satisfaction. They proposed that less educated patients-in contrast to patients social support [15]. Scholte op Reimer et al discovered that for patients who had suffered a stroke, satisfaction was having received a higher education-were not familiar with the diverse aspects of medical care, and thus applied less associated with emotional stress and expectations, rather than with degree of illness [49]. However, in the investigation by demanding criteria when judging the attention they received. In addition to treatment outcome [16,17], other factors to Sorlie et al [1], neither age nor preoperative expectations influenced satisfaction. With regard to age, the authors men-consider are those related specifically to the doctor, such as a positive patient-doctor relationship [18,19], personal tioned that the group that declined to participate was older, which might explain the results. Nevertheless, the two groups attention [20], good communication [21-24], health education [24-27], courtesy [25] and skills and technical ability [28-33]. [58.4 [ ± 16.5] and 59.3 [ ± 17.4]] did not differ statistically. The fact that the preoperative expectations did not in-A physician's specialty could also have some influence on the degree of satisfaction; an obstetrician, for example, is fluence the degree of satisfaction contradicts the findings of other authors [10,50-56], who define satisfaction as the usually associated with a happy event. This is less likely, however, in the case of a general surgeon [34]. With respect positive difference between the quality perceived upon discharge and previous expectations. to the physician's gender, the literature suggests that female doctors usually obtain better patient satisfaction as compared Opinions about a service or product can be affected by three components: previous experience, information pre-with male doctors [35]. Furthermore, one must also take into consideration or-viously received and affective perceptions. Patients who have been readmitted to a hospital are generally more satisfied ganizational factors such as availability [17,18,22,29,30,32], waiting times [16,26], the type of hospital [36] and its physical than those who have been admitted for the first time [29,36, 57,58]. This may be an indirect indicator of the existence of environment [37]. With respect to the type of hospital, Fleming [36] demonstrated that university hospitals were preconceived ideas or expectations, which would have been formed partly by the effect of the previous experience. Further evaluated more negatively despite their reputation for academic excellence and state-of-the art technology. evidence of the existence of expectations arises when sociocultural differences among people with different values are The patients' state of health may also influence their degree of satisfaction. According to Hall et al [38,39] as well as other studied [3]. Certainly, evaluating the effect that expectations have on ones satisfaction is a much more complex task. investigators [40-43], patients who were ill were less satisfied with their medical attention than healthy ones. Hall suggested Expectations are cognitive. The jump from expectations to

European Spine Journal, 2013

Purpose The majority of studies of surgical outcome focus on measures of function and pain. Increasingly, however, the desire to include domains such as patients' satisfaction and expectations had led to the development of simple measures and their inclusion into clinical studies. The purpose of this study was to determine patients' preoperative expectations of and post-operative satisfaction with the outcome of their spinal surgery. Methods As part of the FASTER randomised controlled trial, patients were asked pre-operatively to quantify their expected improvement in pain and health status at 6 weeks, 6 and 12 months following surgery using 100 mm visual analogue scales (VAS), and to indicate their confidence in achieving this result and also the importance of this recovery to them. Patients were then asked to rate their satisfaction with the improvement achieved at each postoperative review using 100 mm VAS.

Plastic and Reconstructive Surgery - Global Open, 2019

BACKGROUND Over 5 million basal and squamous cell skin cancers are diagnosed in the United States each year. 1,2 Seventy to 80% of these cancers occur in the head and neck region, for which surgical excision is the standard of treatment. 3 Diagnosis and treatment can be stressful for patients and families, affecting psychosocial well-being, social interactions, and other aspects of health-related quality of life. 4,5 In addition, treatment of facial skin cancers can result in scars or physical disfigurement, which are particularly distressing. 6 Patients are concerned about changes in their facial appearance following reconstruction and desire meaningful data to help them better understand expected outcomes. 4,5,7 As patient satisfaction and quality of life are among the most important outcomes in plastic and reconstructive surgery, 5,8 understanding patient perceptions of aesthetic postoperative outcomes is critical. 9-11 Patient-reported outcome measures (PROMs) are questionnaires developed with direct input from patients.

Journal of Cutaneous Medicine and Surgery, 2018

The purpose of the present review was to describe evidence-based indications for Mohs micrographic surgery (MMS) in patients with a diagnosis of skin cancer. Relevant studies were identified from a systematic MEDLINE, EMBASE, and Cochrane Database of Systematic Reviews search of studies published from 1970 to 2017. Randomized controlled trials (RCTs), prospective and retrospective comparative studies with greater than 30 patients, and single-arm retrospective studies with multivariate analyses were included. A total of 2 RCTs, 3 prospective studies, and 16 retrospective studies (14 comparative and 2 single-arm) were included. Data on recurrence rate, cure rate, complications, cosmesis, and quality of life were extracted. Surgery (with postoperative or intraoperative marginal assessment) or radiation for those who are ineligible for surgery should remain the standard of care for patients with skin cancer given the lack of high-quality, comparative evidence. MMS is recommended for tho...

Plastic and …, 2003

Plastic and Reconstructive Surgery - Global Open, 2019

A primary measurement of success in facial plastic surgery is patient satisfaction. 1-10 As plastic surgeons operating on the face are rarely curing disease, it could be argued that patient satisfaction is the most important outcome. A mismatch between the surgeon's and the patient's expectations can result in dissatisfaction despite the outcome meeting a technical standard of excellence. 6,7 Another challenge is that objective medical or surgical measures may not correlate with report of symptom relief. 11,12 Opinions also differ with regard to varying patient factors

Surgical Endoscopy

Background Little is known concerning what may influence surgeon satisfaction with a surgical procedure and its associations with intraoperative factors. The objective was to explore the relationships between surgeons' self-assessed satisfaction with performed radical prostatectomies and intraoperative factors such as technical difficulties and intraoperative complications as reported by the surgeon subsequent to the operation. Methods We utilized prospectively collected data from the controlled LAPPRO trial where 4003 patients with prostate cancer underwent open (ORP) or robot-assisted laparoscopic (RALP) radical prostatectomy. Patients were included from fourteen centers in Sweden during 2008-2011. Surgeon satisfaction was assessed by questionnaires at the end of each operation. Intraoperative factors included time for the surgical procedure as well as difficulties and complications in various steps of the operation. To model surgeon satisfaction, a mixed effect logistic regression was used. Results were presented as odds ratios (OR) with 95% confidence intervals (CI). Results The surgeons were satisfied in 2905 (81%) and dissatisfied in 702 (19%) of the surgical procedures. Surgeon satisfaction was not statistically associated with type of surgical technique (ORP vs. RALP) (OR 1.36, CI 0.76; 2.43). Intraoperative factors such as technical difficulties or complications, for example, suturing of the anastomosis was negatively associated with surgeon satisfaction (OR 0.24, CI 0.19; 0.30). Conclusions Our data indicate that technical difficulties and/or intraoperative complications were associated with a surgeon's level of satisfaction with an operation.

European Archives of Oto-Rhino-Laryngology, 2012

Thyroidectomy has few complications, as a result, many patients are concerned about the prominence of their scar. Performing thyroid surgery through excessively small incisions in order to maximise cosmesis may increase the likelihood of complications. This study investigates the relationship between conventional approach thyroidectomy scar length and patient satisfaction. A validation of self-measurement of neck circumference and thyroidectomy scar was carried out with the measurements taken by patients compared with those taken by an investigator. One hundred consecutive patients who had undergone conventional thyroidectomy and total thyroidectomy within 24 months were invited to measure their scars and neck circumference, and to score their satisfaction on a Likert scale of 1-10. Spearman's correlation was calculated for the relationship between absolute and relative scar length, and patient satisfaction. Thirty-four patients entered the preliminary study and 80 patients entered the main study (80% response rate). Measurements by patients and investigators were closely associated: Spearman's Rank correlation coeYcient for neck circumference and for scar length were = 0.9, p < 0.0001 and = 0.93, p < 0.0001 respectively. No signiWcant correlation was evident between scar length and patient satisfaction ( = 0.068, p = 0.55), or between relative scar length ratio and patient satisfaction ( = ¡0.045, p = 0.69). Mean scar length was 6.96 cm [standard deviation (SD) 2.70], and mean satisfaction score 8.62 (SD 2.04). Thyroidectomy scar length appears to have no association with patient satisfaction. Thyroid surgery should, therefore, not be performed through unnecessarily small incisions for purely aesthetic reasons.

2020

There is little understanding of patients' experiences and perceptions with satisfaction by health professionals such as medical and dental clinicians. Furthermore, patient satisfaction is not well understood. The objective of this article is to better understand patients' satisfaction with their medical and dental care. The methods of the current article are based on a narrative review of the literature strategy. Patient satisfaction's multidimensional nature has been established since the perceived reasons for satisfaction varied widely among patients. Many aspects of the treatment influence participant satisfaction at different stages of the intervention's process. An improved understanding of the basis for managing patients' expectations with information reiteratively and efficiently may ultimately reduce patients' potential for negative feelings toward the medical and dental treatment experience. The consumerist method may misrepresent the concept of satisfaction in health service.

Journal of Clinical Anesthesia, 2009

Study Objective: To evaluate patient satisfaction at discharge and 30 days after day surgery, and to identify predictive factors of patient satisfaction. Design: Observational, prospective study. Setting: Day surgery unit of a university hospital. Patients: 251 consecutive patients, aged 43 ± 15 years (56.6% women), scheduled for day surgery. Interventions: Patients were asked to answer a questionnaire. Measurements: Patients' level of satisfaction was recorded in relation to different variables, using questions of demographics, logistics, and those relating to surgery. Main Results: Over 95% of patients were satisfied with their care at both interviews; 74.5% of patients were completely satisfied at the discharge time; and only 62.4% had the same opinion 30 days after the surgery (P b 0.01). Postoperative pain control [odds ratio (OR) = 1.6], waiting time for surgery (OR = 1.4), and patient changing room conditions (OR = 1.3) were the most important factors influencing patient satisfaction at the time of discharge. Clinical outcome (OR = 3.2), clinical information (OR = 1.6), and postoperative pain control (OR = 1.3) were the main factors affecting patient satisfaction 30 days after surgery. Conclusions: Overall satisfaction following day surgery was at least 95% at discharge and at 30 days. However, complete satisfaction was present only in 75% at discharge and decreased to 62% at 30 days. Clinical outcome was strongly related to patient satisfaction at 30 days after surgery. Factors directly controlled by anesthesiologists such as postoperative pain and information provided, also had a significant impact on patient satisfaction.

Surgery, 2009

Background. We sought to evaluate the satisfaction of surgical patients in order to identify predictors of patient satisfaction, using a cross-sectional surgery patients' survey in 24 public hospitals in Spain and a total of 15,539 inpatients and 7,899 outpatients. Results. Seventy-seven percent of inpatients and 88.3% of outpatients were satisfied (v 2 = 509.31; P < .0001). Case-mix and hospital size were associated with satisfaction in inpatients (v 2 = 19.31; P = .013). Older inpatients tended to be more satisfied (v 2 = 80.54; P = .001), whereas; younger outpatients showed higher satisfaction levels (v 2 = 51.73; P = .004). The most influential factors on inpatient satisfaction were information at admission (odds ratio [OR], 4.05; 95% confidence interval [CI], 2.91--5.63), knowing what type of professional one was dealing with at any given time (OR, 4.01; 95% CI, 3.01--5.34), and informed consent (OR, 3.37; 95% CI, 2.41--4.71). For outpatients, the most influential factors were informed consent (OR, 7.62; 95% CI,) and information about home care after discharge (OR, 7.010; 95% CI, 3.06--15.96). Conclusion. We should consider the importance of patient information before and after treatment in the design of clinical pathways to offer better and more comprehensive care to surgical patients. (Surgery

Aesthetic Surgery Journal, 2005

Although several studies have investigated patient satisfaction and changes in body image following aesthetic plastic surgery, few have investigated more specific dimensions of body image, including dysphoric emotions that occur in specific social situations or body image quality of life. In addition, few studies have investigated changes in body image that may occur in concert with changes in more general areas of psychosocial functioning, such as depressive symptoms and self-esteem. Objective: This prospective, multi-site study investigated postoperative satisfaction and changes in psychosocial status following cosmetic surgery. Methods: One hundred patients recruited from 8 geographically diverse surgical practices completed psychometric measures of body image, depressive symptoms, and self-esteem prior to surgery. Seventy-two patients completed the 3-month postoperative assessment, 67 completed the 6-month assessment, and 63 completed the 12-month assessment. All statistical tests on changes after surgery were conducted using the sample of 72 patients who completed the 3-month assessment. A Last Observation Carried Forward analysis was used to account for patients who did not complete the subsequent follow-up assessments. In addition, they reported their postoperative satisfaction as well as self-rated attractiveness at the 3 postoperative assessment points. Results: Eighty-seven percent of patients reported satisfaction with their postoperative outcomes. Patients also reported significant improvements in their overall appearance, as well as the appearance of the feature altered by surgery, at each of the postoperative assessment points. Patients experienced significant improvements in their overall body image, their degree of dissatisfaction with the feature altered by surgery, and the frequency of negative body image emotions in specific social situations. All of these improvements were maintained 12 months after surgery. Conclusions: These results add to a growing body of literature documenting improvements in body image following cosmetic surgery.

Chest, 2005

Study objectives: To compare the quality of non-small cell lung cancer (NSCLC) surgical care with patient satisfaction. Design: Prospective study. Setting: Academic hospital departments of thoracic oncology and surgery. Patients and methods: Patients presenting with recently diagnosed NSCLC and eligible for front-line thoracic surgery were eligible. Patient satisfaction was assessed using the Questionnaire of Satisfaction of Hospitalized Patients. Quality of surgical care was evaluated using an original score built accordingly to British Thoracic Society guidelines. Univariate analysis used parametric (Pearson correlation, t test) and nonparametric tests (Mann-Whitney U test) according to test conditions. Probability of survival was estimated using the Kaplan-Meier method. Results: Seventy patients (mean age, 63.7 years) were included. Lobectomy was performed in 62 cases, and pneumonectomy was performed in 8 cases. In all, 28 patients had a postoperative complication. One-year survival rates for patients with stage I-II and stage IIIA NSCLC were 84% and 58%, respectively. Mean patient satisfaction was 78 ؎ 13/100 and 69 ؎ 13/100 for global staff and structure index, respectively (؎ SD). Mean score for quality of surgical care was 88.7/100 (range, 51 to 100). The absence of postoperative complication was significantly related to a high level of satisfaction regarding the structure (r ‫؍‬ 0.30, p < 0.05). Other features of patient satisfaction did not show a significant correlation with the quality of the preoperative selection process or the surgical procedure itself (r < 0.20). Conclusions: Considering the lack of significant correlation, the present study does not support a shortcut between quality of care and patient satisfaction. Nonetheless, patient satisfaction should be integrated into rather than substituted for the quality of health-care assessment, which also needs further development.

Dermatologic Surgery, 2013

BACKGROUND There are few data to indicate whether the type of final wound defect is associated with the type of post-Mohs repair.