Niche-related outcomes after caesarean section and quality of life: a focus group study and review of literature

Abstract Background A niche in the uterus, present in 60% of women after caesarean section (CS), is associated with several gynaecological symptoms and possibly with subfertility. Studies that focus on quality of life (QoL) in relation to a niche are lacking. Purpose To identify niche-related outcomes that influence QoL and to compare patient-reported outcomes with outcomes studied in the literature. Methods Two focus group discussions (FGDs, N = 8 and 5) were conducted in Amsterdam UMC—location VUmc. Participants were Dutch patients with a large niche, with (planned) surgical treatment for their symptoms. Niche-related symptoms and impact on functioning or participation were fixed topics. The transcripts of the FGDs were coded into outcomes, themes and domains of QoL according to the WHOQOL model. Additionally, participants created a top five important outcomes. Next, we performed a systematic review (SR) on niche-related outcomes and compared the FGDs with niche-related outcomes from the SR. Results In four domains (physical health, psychological domain, social relationships and environment), fifteen themes were reported in the FGDs. Abnormal uterine bleeding (AUB), subfertility, sexual activity, abdominal pain and self-esteem were themes prioritised by participants. In the literature, gynaecological symptoms and reproductive outcomes were predominantly studied. Sexuality and self-esteem were prioritised in the FGDs but hardly or never studied in the literature. Conclusion We found a broad range of niche-related outcomes influencing QoL. Apart from symptoms evaluated in the literature such as AUB, abdominal pain and subfertility, clinicians and researchers should be more aware of sexual activity and self-esteem in this population.

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Quality of life, distress and self-esteem: A focus group study of people with chronic bronchitis

British Journal of Health Psychology ◽

10.1348/135910703322370842 ◽

2003 ◽

Vol 8 (3) ◽

pp. 251-270 ◽

Cited By ~ 59

Author(s):

Paula Nicolson ◽

Pippa Anderson

Keyword(s):

Quality Of Life ◽

Focus Group ◽

Chronic Bronchitis ◽

Self Esteem ◽

Focus Group Study

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Quality of life themes in Canadian adults and street youth who are homeless or hard-to-house: A multi-site focus group study

Health and Quality of Life Outcomes ◽

10.1186/1477-7525-10-93 ◽

2012 ◽

Vol 10 (1) ◽

pp. 93 ◽

Cited By ~ 14

Author(s):

Anita Palepu ◽

Anita M Hubley ◽

Lara B Russell ◽

Anne M Gadermann ◽

Mary Chinni

Keyword(s):

Quality Of Life ◽

Focus Group ◽

Street Youth ◽

Focus Group Study

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Patients’ perspective of the impact of COPD on quality of life: a focus group study for patients with COPD

International Journal of Clinical Pharmacy ◽

10.1007/s11096-018-0614-z ◽

2018 ◽

Vol 40 (3) ◽

pp. 573-579 ◽

Cited By ~ 3

Author(s):

Anan Jarab ◽

Eman Alefishat ◽

Tareq Mukattash ◽

Karem Alzoubi ◽

Sharrel Pinto

Keyword(s):

Quality Of Life ◽

Focus Group ◽

Focus Group Study ◽

The Impact ◽

Patients Perspective

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Patient-reported impact of hirsutism on health-related quality of life, mood and self-esteem in patients with polycystic ovary syndrome

Journal of the American Academy of Dermatology ◽

10.1016/j.jaad.2016.02.263 ◽

2016 ◽

Vol 74 (5) ◽

pp. AB66

Keyword(s):

Quality Of Life ◽

Polycystic Ovary Syndrome ◽

Polycystic Ovary ◽

Self Esteem ◽

Health Related Quality ◽

Ovary Syndrome ◽

Patient Reported ◽

Related Quality ◽

Health Related

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OP28 Patient Involvement at AQuAS: Experiences And Reflections For Future

International Journal of Technology Assessment in Health Care ◽

10.1017/s0266462319000990 ◽

2019 ◽

Vol 35 (S1) ◽

pp. 6-6

Author(s):

Lina Masana ◽

Emmanuel Gimenez Garcia ◽

Mireia Espallargues

Keyword(s):

Quality Of Life ◽

Focus Group ◽

Cataract Surgery ◽

Patient Involvement ◽

Assessment Tool ◽

Economic Evaluations ◽

Self Assessment ◽

Maxillofacial Reconstruction ◽

Patient Reported

IntroductionAQuAS is gradually incorporating patient involvement in health technology assessment (HTA). We present two experiences conducted during 2018 and the different methods and approaches used. The aim is to reflect on learnings from those experiences to improve ways for increasing patient involvement with HTA at AQuAS.MethodsWe conducted two experiences using different quantitative and qualitative techniques (mix-methods approach). The first, a focus group discussion regarding the use of 3D-technologies for maxillofacial reconstruction with a selection of hospital patients that received maxillofacial reconstruction, which included the use of a quality-of-life retrospective self-assessment tool. The second, a sequence of email correspondence regarding cataract surgery technology (femtosecond laser-assisted cataract surgery (FLACS), in the context of an EUnetHTA Joint Assessment) with a patients’ association representative, to learn their opinion regarding the use of laser technology.ResultsMain learnings were: (1) patients and associations have different levels of knowledge and expertise to consider when planning an HTA; (2) sharing experience and knowledge among peers (i.e. focus group) proved to have a positive impact on patients and worked as a resource for some to improve knowledge on their condition; (3) critiques were received regarding a specific Patient Reported Experience template for HTA patient involvement (iv) quality of life retrospective self-assessment tool provided unexpected positive and negative results.ConclusionsRecent patient involvement in HTA at AQuAS proved to be useful to complement HTA reports. We believe that patients’ experiences and opinions can help decision-making regarding the use, disinvestment or incorporation of health technologies, contribute to the improvement of tools and survey accuracy and improve doctor-patient communication. Their involvement might be beneficial for them to gain more knowledge, share experiences, reflect on their health situation and improve communication with the professionals that treat them. Future patient-involvement in HTA is needed, e.g. considering the social perspective in economic evaluations or including patients in recommendation consensus panels.

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