https://orcid.org/0000-0002-6909-5111
Abstract
Purpose
To identify the expectations of men with LUTS referred to a urologist and to study the association between those expectations and satisfaction with the care provided.
Methods
In this prospective cohort study, adult men with LUTS completed a questionnaire before their first outpatient appointment, and again at 6 and 12 weeks. The questionnaires included IPSS and OABq-SF, and self-constructed questions on patient expectations, outcome of expectations and satisfaction.
Results
Data from 182 participants showed positive expectations about the urologist performing examinations, providing explanations and finding the underlying cause, but mostly neutral expectations for treatment plans and outcomes. Positive treatment expectations were associated with positive expectations about outcomes after physiotherapy, drug treatment and surgery. Higher symptom scores and age were associated with higher expectations about drug treatment. Expectations were subjectively and objectively fulfilled for 66.4% and 27.3%, respectively. Symptom improvement (decrease in IPSS scores) was significantly more in men with objectively fulfilled expectations than in men with no unfulfilled expectations. No significant difference was present between men with subjectively fulfilled expectations and men with unfulfilled expectations. However, satisfaction was significantly higher for patients with subjectively fulfilled expectations at 6 and 12 weeks compared with those who had unfulfilled expectations.
Conclusion
Most men referred to a urologist with LUTS do express clear expectations about treatment in secondary care. Patients with higher expectations for treatment outcomes are more likely to expect to receive that treatment. Satisfaction with the care of a urologist is also higher when patients self-report that they receive the treatment they expected.
Informed Consent
All participants signed a written informed consent.
Research Involving Human Participants and/or Animals
The requirements of the Medical Research Involving Human Subjects Act (WMO, Dutch Law) did not apply to this study, meaning that ethical approval was not needed (in Dutch: “NIET WMO-plichtige studie”, or “Verklaring geen bezwaar”.). This was confirmed by the medical ethics committee of Isala (number 170,319, March 20th 2017 and October 3rd 2017). This study was performed in accordance with the principles stated in the Declaration of Helsinki. All participants provided written informed consent. The requirements of the Medical Research Involving Human Subjects Act (WMO) did not apply to this study, as confirmed by our institution’s medical ethics review board.
Acknowledgments
This study was conducted with an unrestricted grant from the University Medical Centre Groningen, healthy ageing pilots (number CDO16.0008/282). We thank Dr Robert Sykes for providing editorial services. The abstract of this paper was presented at the 2018 Annual meeting of the International Continence Society as a poster presentation. The poster’s abstract has not been published in any journal.
Author Contributions
Pim Brandenbarg: Execution of the study, especially acquisition of data, analysis and interpretation; drafting of the manuscript; agreed on the journal to which the manuscript has been submitted; reviewed and agreed all versions of the manuscript; agreed to take responsibility and be accountable for the contents of the article. Puk Rooijers: Execution of the study, especially acquisition of data, analysis and interpretation; drafting of the manuscript; agreed on the journal to which the manuscript has been submitted; reviewed and agreed all versions of the manuscript; agreed to take responsibility and be accountable for the contents of the article. Martijn Steffens: Conception of the study, study design, interpretation; critically reviewed the article; agreed on the journal to which the manuscript has been submitted; reviewed and agreed all versions of the manuscript; agreed to take responsibility and be accountable for the contents of the article. Michael van Balken: Data acquisition, interpretation; critically reviewed the article; agreed on the journal to which the manuscript has been submitted; reviewed and agreed all versions of the manuscript; agreed to take responsibility and be accountable for the contents of the article. Henk-Jan Mulder: Data acquisition, interpretation; critically reviewed the article; agreed on the journal to which the manuscript has been submitted; reviewed and agreed all versions of the manuscript; agreed to take responsibility and be accountable for the contents of the article. Marco Blanker: Conception of study, study design, analysis and interpretation; writing of the article; agreed on the journal to which the manuscript has been submitted; reviewed and agreed all versions of the manuscript; agreed to take responsibility and be accountable for the contents of the article.
Disclosure
All authors declare that they have no conflicts of interest.