Delivering an effective outpatient service in gynaecology: an assessment of patient preference
ABSTRACT Objectives To assess whether patients would prefer to undergo outpatient or day-case hysteroscopy for the investigation of abnormal uterine bleeding.Design An anonymous questionnaire.Setting A general gynaecology clinic in a large UK teaching hospital.Subjects 250 consecutive patients attending the gynaecology clinic.Main outcome measures These were patient preference for either outpatient or day-case hysteroscopy, and the reasons for the decisions.Results The questionnaire was completed by189 patients (76% response rate). Of these 52% chose outpatient hysteroscopy, 26% chose day-case hysteroscopy, 17% wanted to let the doctor decide and 5% needed more information. We found that women in employment and those who had previously undergone review were significantly more likely to opt for outpatient hysteroscopy. The most common reason for preferring outpatient hysteroscopy was that the entire process was quick, whereas the main reason for NOT favouring it was the potential for discomfort. The main appeal of day-case hysteroscopy for patients was that no pain would be felt during the procedure; the most common reason for disliking day-case hysteroscopy was the possible wait for up to 3 hours in the day-case unit before hysteroscopy was performed.Conclusions When given the choice, women prefer to undergo outpatient rather than daycase hysteroscopy for the investigation of abnormal uterine bleeding. From the patient's perspective, the most common reasons for preferring outpatient hysteroscopy are (in order of priority): the speed of the entire process; the uninterrupted sequence of counselling, investigation and information regarding results, and the shorter wait in hospital before the hysteroscopy is performed.
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ABSTRACT: Laparoscopy is the most common mode of surgery for female tubal sterilisation. Hysteroscopic sterilisation is a new method which can be performed in the outpatient setting under local anaesthetic. We carried out a prospective cohort trial to determine whether women would actually favour hysteroscopic sterilisation over laparoscopic sterilisation. Data analysis in a cohort of 96 women showed that 77% would prefer laparoscopic sterilisation over the hysteroscopic procedure (23%), despite the advantages of an outpatient setting. Age, obstetric history, employment and marital status, access to transport and previous anaesthetic did not significantly influence the choice made.BJOG An International Journal of Obstetrics & Gynaecology 04/2005; 112(3):360-2. · 3.76 Impact Factor
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ABSTRACT: This study was conducted to assess whether women would prefer to undergo saline infusion sonography (SIS) or office hysteroscopy for the investigation of the uterine cavity. In a randomised controlled trial, 100 patients underwent SIS or office hysteroscopy for assessing patients' pain scores. After the investigation, 92 of them were asked to fill out an anonymous questionnaire addressing their preference regarding the method of evaluation and treatment of the uterine cavity. A control group, consisting of 50 women who never underwent SIS or office hysteroscopy, was also asked to complete an identical questionnaire. The questionnaire was completed by 113 women (83.7%). Twenty-four (21.2%) women would opt for SIS, whereas 52 (46.0%) would opt for office hysteroscopy, and 37 (32.7%) had no preference. If therapy would be necessary, 48.7% of the women would opt for an outpatient treatment, whereas 33.0% of the women would prefer treatment under general anaesthesia. Despite the fact that SIS is less painful, the majority of the women prefer office hysteroscopy. Additionally, therapy in an outpatient setting is preferred to a day case setting.Gynecological Surgery 02/2011; 8(1):65-70.
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ABSTRACT: To determine women's preference towards Thermachoice being performed either awake in the outpatient setting or under general anaesthetic (GA) as a day case. Questionnaire. Setting Large teaching hospital. One hundred women. The questionnaire was developed from prior research on factors associated with preference for procedures performed in the outpatient versus day case setting. (1) Describe women's preference towards outpatient versus day case Thermachoice and other menorrhagia treatments. (2) Identify variations in preference by demographic characteristics and prior experience of anaesthesia. Results There was an exact split in preference with 50% preferring Thermachoice as an outpatient and 50% as a day case. The mean age of women preferring outpatient Thermachoice was significantly higher (41.5 years) than those preferring day case (33.5 years) (P < 0.005). Women with children and a higher qualification were more likely to opt for outpatient Thermachoice. A previous bad experience of GA was associated with preference for outpatient Thermachoice. Spending less time in hospital, attending for one visit, feeling well straight after treatment and choosing the treatment setting were important factors to the majority of women. Most women (70%) who opted for Thermachoice as a menorrhagia treatment would prefer to have it performed in the outpatient setting. If the Department of Heath is to target services towards women's choice, there is a need to increase the provision of outpatient menorrhagia treatments, such as Thermachoice, to more women in the UK.BJOG An International Journal of Obstetrics & Gynaecology 01/2008; 115(1):31-7. · 3.76 Impact Factor