What are the concerns and goals of women attending a urogynaecology clinic? Content analysis of free-text data from an electronic pelvic floor assessment questionnaire (ePAQ-PF)
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Introduction and hypothesis
Understanding patients’ concerns and goals is essential for providing individualised care in urogynaecology. The study objectives were to undertake a content analysis of free-text concerns and goals recorded by patients using an electronic pelvic-floor questionnaire (ePAQ-PF) and measure how these related to self-reported symptom and health-related quality-of-life (HRQOL) data also recorded using ePAQ-PF.
A total of 1996 consenting patients completed ePAQ-PF. Content analysis was undertaken of free-text responses to the item: ‘Considering the issues that currently concern you the most, what do you hope to achieve from any help, advice or treatment?’ Key content themes were identified by the lead researcher, and three researchers read and coded all recorded responses. Student’s t test was used to compare ePAQ-PF domain scores for patients reporting concerns in the relevant domain with those who did not.
In total, 63% of participants who completed the questionnaire, recorded at least one free-text item. Content analysis identified 1560 individual concerns coding into the 19 ePAQ-PF domains. Symptom scores were significantly higher for patients reporting free-text concerns in 18 domains (p < 0.05). Additional concerns relating specifically to body image were recorded by 11% of patients. Key areas of importance emerging for personal goals included cure/improvement, better understanding, incontinence pad use, sexual function and surgery.
Free-text reporting in ePAQ-PF is utilised by patients and facilitates self-expression and discussion of issues impacting on HRQOL. The significant relationship between recorded free-text concerns and ePAQ-PF domain scores suggests convergent validity for the instrument. Development and psychometric testing of a domain to assess body image is proposed.
KeywordsPatient-reported outcome measures Prolapse Incontinence Body image
Compliance with ethical standards
Conflicts of interest
Mr. Stephen Radley is a director and shareholder of ePAQ Systems Limited, an NHS spin-out technology company (www.epaq.co.uk). The other authors declare they have no conflicts of interest. Mr. Radley did not collect or analyse the data for this study. The other authors have no financial or commercial interests in ePAQ Systems, Ltd.
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