Patient Perceptions of Planned Organ Removal During Hysterectomy

Kassem Z, Zeinab Kassem, Chad M Coleman, Coleman CM, Andrew S. Bossick, Su WT, Wan-Ting Su, Roopina Sangha, Sangha R, Wegienka G, Ganesa Wegienka
Journal of patient-centered research and reviews · 2019 · vol. 6(1) , pp. 28–35 · doi:10.17294/2330-0698.1658 · PMID:31414021 · PMC6676751
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This study assessed hysterectomy patients' self-reported expectations of organ removal, revealing significant discrepancies between their perceptions and electronic medical records regarding planned procedures.

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This study assessed the accuracy of patient-reported expectations regarding organ removal during non-oncological hysterectomies by comparing preoperative surveys with electronic medical records. Among 456 participants, significant discrepancies were found between what women believed would be removed and the actual procedures documented, particularly for partial hysterectomies where only 10.4% had accurate records. The authors concluded that a considerable proportion of patients lack an accurate understanding of their planned surgical anatomy, highlighting a need for improved patient education. Relevance to endometriosis: listed as one indication for hysterectomy, though the paper's main focus is general patient perception and communication rather than specific disease pathology.

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Abstract

PURPOSE: Previous reports indicate many women may not have a firm grasp on likely outcomes of different hysterectomy procedures. This study aimed to assess women's self-reported expectations of how they think their anatomy will change after hysterectomy. METHODS: Women scheduled for hysterectomy at a tertiary care hospital, for non-oncological reasons, reported their planned procedure type and the organs they understood would be removed 2 weeks prior to surgery. Patient reports and electronic medical records were reviewed, and kappa statistics (κ) were calculated to assess agreement for all women and within subgroups. RESULTS: Most of the 456 study participants (mean age: 48.02 ± 8.29 years) were either white/Caucasian (n=238, 52.2%) or African American (n=196, 43.0%). Among the 145 participants who reported a partial hysterectomy, 130 (89.7%) women indicated that their uterus would be removed and 52 (35.9%) reported that their cervix would be removed. Of those whose response was total hysterectomy (n=228), 208 (91.2%) participants reported their uterus would be removed and 143 (62.7%) reported their cervix would be removed. Among 144 women reporting a planned partial hysterectomy, only 15 (10.4%, κ=0.05) had a partial hysterectomy recorded in the electronic medical record. Among the 228 women who reported a planned total hysterectomy, 6.1% (κ=0.05) had a different procedure. While 125 participants reported planned ovary removal, only 93 (74.4%, κ=0.55) had an oophorectomy. Similarly, 290 participants reported planned fallopian tube removal, with 276 (95.2%, κ=0.06) having a salpingectomy. CONCLUSIONS: A considerable proportion of women undergoing hysterectomy do not accurately report the organs that are planned be removed during their hysterectomy. This work demonstrates the need to improve patient understanding of their clinical care and its implications.
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Keywords

hysterectomy, patient education, patient expectations, gynecology, patient-centered outcomes

Abstract

Purpose: Previous reports indicate many women may not have a firm grasp on likely outcomes of different hysterectomy procedures. This study aimed to assess women’s self-reported expectations of how they think their anatomy will change after hysterectomy.

Methods

Women scheduled for hysterectomy at a tertiary care hospital, for non-oncological reasons, reported their planned procedure type and the organs they understood would be removed 2 weeks prior to surgery. Patient reports and electronic medical records were reviewed, and kappa statistics (κ) were calculated to assess agreement for all women and within subgroups.

Results

Most of the 456 study participants (mean age: 48.02 ± 8.29 years) were either white/Caucasian (n = 238, 52.2%) or African American (n = 196, 43.0%). Among the 145 participants who reported a partial hysterectomy, 130 (89.7%) women indicated that their uterus would be removed and 52 (35.9%) reported that their cervix would be removed. Of those whose response was total hysterectomy (n = 228), 208 (91.2%) participants reported their uterus would be removed and 143 (62.7%) reported their cervix would be removed. Among 144 women reporting a planned partial hysterectomy, only 15 (10.4%, κ = 0.05) had a partial hysterectomy recorded in the electronic medical record. Among the 228 women who reported a planned total hysterectomy, 6.1% (κ = 0.05) had a different procedure. While 125 participants reported planned ovary removal, only 93 (74.4%, κ = 0.55) had an oophorectomy. Similarly, 290 participants reported planned fallopian tube removal, with 276 (95.2%, κ = 0.06) having a salpingectomy.

Conclusions

A considerable proportion of women undergoing hysterectomy do not accurately report the organs that are planned be removed during their hysterectomy. This work demonstrates the need to improve patient understanding of their clinical care and its implications. Recommended Citation Kassem Z, Coleman CM, Bossick AS, Su WT, Sangha R, Wegienka G. Patient perceptions of planned organ removal during hysterectomy. J Patient Cent Res Rev. 2019;6:28-35. doi: 10.17294/2330-0698.1658 Included in Clinical Epidemiology Commons, Medical Anatomy Commons, Obstetrics and Gynecology Commons, Public Health Education and Promotion Commons, Surgery Commons, Women's Health Commons Submitted September 25th, 2018 Accepted November 30th, 2018

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