Predictors of goal achievement in patients undergoing hysterectomy

Abstract

Objective: The primary objective of our study was to identify predictors of goal achievement in patients undergoing simple hysterectomy for benign indications. We also sought to describe the goals of patients in this population.

Study design: This was a prospective cohort study of patients undergoing hysterectomy for benign indications performed at a single academic institution. We documented patient-reported goals of treatment prior to undergoing hysterectomy in 57 patients, and assessed goal achievement and other patient-centered outcomes three months after surgery in 47 of the patients (82.5%). We compared patients who met all of their goals to those who did not, and used multivariate regression to identify predictors of goal achievement. We also characterized the general profile of goals for patients undergoing hysterectomy.

Results: We identified the primary surgical diagnosis of abnormal uterine bleeding (OR 6.5, 1.7-30.1, p = 0.006), as well as an increased feeling of being prepared for postoperative discharge (OR 11.9, 2.1-104.4, p = 0.005), to be independent predictors of patient goal achievement. Goal achievement was correlated with other patient-centered outcomes, including a higher sense of satisfaction and greater patient global impression of improvement. Goals related to symptoms were more commonly stated and more commonly achieved than functional goals.

Conclusion: Goal achievement in patients undergoing hysterectomy depends on the preoperative diagnosis and the patient's feeling of preparedness for postoperative discharge. Goal achievement should be considered as a useful patient-centered outcome. Patients undergoing hysterectomy have a unique profile of goals which should be considered and addressed in preoperative counseling.

Keywords: Abnormal uterine bleeding; Goal achievement; Hysterectomy; Patient counseling; Patient expectations; Satisfaction; Surgical goals.