Surgery versus observation for nephrolithiasis: experiences and health-related quality of life metrics from decision-making

You have accessJournal of UrologyStone Disease: Epidemiology & Evaluation I (PD14)1 Sep 2021PD14-04 SURGERY VERSUS OBSERVATION FOR NEPHROLITHIASIS: EXPERIENCES AND HEALTH-RELATED QUALITY OF LIFE METRICS FROM DECISION-MAKING Connor Forbes, Kemberlee Bonnet, Tracy Bryant, Kerri Cavanaugh, David G. Schlundt, and Ryan S. Hsi Connor ForbesConnor Forbes More articles by this author , Kemberlee BonnetKemberlee Bonnet More articles by this author , Tracy BryantTracy Bryant More articles by this author , Kerri CavanaughKerri Cavanaugh More articles by this author , David G. SchlundtDavid G. Schlundt More articles by this author , and Ryan S. HsiRyan S. Hsi More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000001990.04AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The experience for patients who make a selection between observation or surgery for renal calculi has not been well established. We compared the experiences of patients who had the option for either observation or surgery for upper tract urinary calculi using qualitative interviews, the Wisconsin Quality of Life questionnaire (WISQOL), and the Cambridge Renal Stone Patient Reported Outcome Measure (CReSP). METHODS: Adult patients with upper tract urinary calculi for whom observation or intervention were options made a selection for clinical course of action after counselling by their urologist (RH). WISQOL and CReSP questionnaires were completed at baseline and at 1-2 months as well if surgery was selected. Patients were interviewed by trained qualitative interviewers at baseline and at 2 months. Quality of life and patient experience was compared between surgery and observation groups, as well as for before and after surgery. RESULTS: Thirty patients were enrolled and 25 participants completed at least one interview. 15 patients opted for surgery and 10 patients chose observation. Major themes in patient experiences were related to context, health care episodes, patient responses, and perceived outcomes. WISQOL and CReSP scores were comparable between groups at baseline. WISQOL and CReSP were moderately concordant at baseline (R=0.71 for surgery, 0.69 for observation). Both WISQOL and CReSP improved after surgery compared to before surgery (WISQOL 58 to 83, higher is better, p=0.008; CReSP 31 to 23, lower is better, p=0.009). During interviews, patients with lower WISQOL emotional domain scores expressed a more negative outlook and more uncertainty. A qualitative framework was developed to categorize expressed themes (Figure 1). CONCLUSIONS: Patients who chose surgery for kidney stones reported improvements in quality of life after treatment via WISQOL and CReSP. An understanding of patient experiences provides insight into the shared decision-making process. Source of Funding: The project described was supported by a grant from the Vanderbilt Center for Effective Health Communication. It was also supported by CTSA award No. UL1TR000445 from the National Center for Advancing Translational Sciences. Its contents are solely the responsibility of the authors and do not necessarily represent official views of the National Center for Advancing Translational Sciences or the National Institutes of Health © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e216-e217 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Connor Forbes More articles by this author Kemberlee Bonnet More articles by this author Tracy Bryant More articles by this author Kerri Cavanaugh More articles by this author David G. Schlundt More articles by this author Ryan S. Hsi More articles by this author Expand All Advertisement Loading ...