Optimizing Satisfaction With Care In Breast Reconstruction
Wess A. Cohen, M.D.1, Tiffany N.S. Ballard, M.D.2, Jennifer B. Hamill, MPH2, Hyungjin M. Kim, ScD3, Xiaoxue Chen, BS3, Randy S. Roth, PhD4, Stefan J. Cano, PhD5, Edwin G. Wilkins, M.D. MS2, Andrea L. Pusic, M.D. MHS1.
1Division of Plastic and Reconstructive Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY, USA, 2Section of Plastic and Reconstructive Surgery, University of Michigan Health System, Ann Arbor, MI, USA, 3Department of Biostatistics, University of Michigan, Ann Arbor, MI, USA, 4Department of Physical Medicine and Rehabilitation, University of Michigan Health System, Ann Arbor, MI, USA, 5Clinical Neurology Research Group, Plymouth University Peninsula Schools of Medicine and Dentistry, Plymouth, United Kingdom.
Previous research suggests that patient dissatisfaction in breast reconstruction may stem from unrecognized expectations and a lack of information. While information delivery is essential to providing quality care, surgeons may be unaware of how successful they and members of their team convey useful information. Additionally, certain patient groups may experience greater difficulty comprehending the information as presented. The objective of this study was to evaluate patients' perception of their interactions with the reconstructive surgeon and medical team, focusing on the preoperative education process.
As part of the Mastectomy Reconstruction Outcomes Consortium Study, 2,093 patients met the inclusion criteria and were eligible for analysis having completed the BREAST-Q Process of Care (POC) scales preoperatively (Satisfaction with information, surgeon, medical team, and office staff). 1,562 patients completed the scale at three months postoperatively and were included in the analysis.
Patients scored lowest on ‘Satisfaction with Information’ (mean = 72.8) compared to all other POC scales (means: 89.5 - 95.5). Patients who underwent immediate reconstruction were less satisfied with their plastic surgeon compared to those with delayed reconstruction. The racial category, “other” (Asians, Pacific Islanders, Hawaiians, American Indians), was the least satisfied group across all POC scales.
Patients undergoing breast reconstruction perceive a significant gap in their knowledge of breast reconstruction and express strong preferences for better information. Immediate reconstruction patients and minority ethnic groups may require additional resources and attention. These findings highlight the need for better systems to inform patients about the reconstructive options and expected results.
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