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

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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.

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Acknowledgements

We would like to thank the Penn Data Store for their assistance in assembling the information used in this study. Thank you to Rachel Russell from the Mixed Methods Research Lab at our institution for her support with data collection.

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Authors and Affiliations

  1. Division of Plastic Surgery, Department of Surgery, Penn Presbyterian Medical Center, University of Pennsylvania, Perelman School of Medicine, 2nd Floor Wright-Saunders Building, 51 N. 39th Street, Philadelphia, PA, 19104, USA

    Martin J. Carney, Jason M. Weissler, Michael A. Lanni, Andrew R. Bauder, Fabiola Enriquez, Robyn Broach & John P. Fischer

  2. Mixed Methods Research Lab, University of Pennsylvania, Philadelphia, PA, USA

    Kate E. Golden, Brigid Cakouros & Frances K. Barg

  3. Department of Family Medicine and Community Health, University of Pennsylvania, Philadelphia, PA, USA

    Frances K. Barg

  4. Division of General Internal Medicine, University of Pennsylvania, Philadelphia, PA, USA

    Marilyn M. Schapira

Authors
  1. Martin J. Carney
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  2. Kate E. Golden
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  3. Jason M. Weissler
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  4. Michael A. Lanni
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  5. Andrew R. Bauder
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  6. Brigid Cakouros
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  7. Fabiola Enriquez
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  8. Robyn Broach
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  9. Frances K. Barg
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  10. Marilyn M. Schapira
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  11. John P. Fischer
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Contributions

MC, KG, JW, ML, AB, BC, FE, RB, FB, MS, and JF: substantial contributions to conception and design, review and interpretation of references, drafting the article critically for important intellectual content, final approval of the version to be published, and agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. All authors have given approval of the version to be published.

Corresponding author

Correspondence to John P. Fischer.

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Funding

This research received Grant funding from the Edwin and Fannie Gray Hall Center for Human Appearance (CHA).

Conflict of interest

MC, KG, JW, ML, AB, BC, FE, RB, FB, and MS declare no conflict of interest. JF declares a Grant from Edwin and Fannie Gray Hall Center for Human Appearance during the conduct of this study. He is also a paid speaker and consultant for Bard Davol, Integra Lifesciences, and Misonix.

Ethical approval

This study was approved by the Institutional Review Board at the University of Pennsylvania in the USA for all portions of consenting, surveying, and data analysis (protocol #823282).

Informed consent

All participants in the study were consented in an informed manner as dictated and approved by the Institutional Review Board at the University of Pennsylvania. Patients were given the option to opt out at any point in the study.

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Carney, M.J., Golden, K.E., Weissler, J.M. et al. Patient-Reported Outcomes Following Ventral Hernia Repair: Designing a Qualitative Assessment Tool. Patient 11, 225–234 (2018). https://doi.org/10.1007/s40271-017-0275-3

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