Perioperative peer support and surgical preparedness in women undergoing reconstructive pelvic surgery
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Introduction and hypothesis
The benefits of peer support for pelvic floor disorders are unclear. We hypothesize that perioperative peer support might be associated with greater preoperative preparedness compared with usual care in women undergoing pelvic reconstruction.
A multicenter prospective cohort study of women undergoing pelvic reconstruction compared peer support (group or one-to-one) with usual care. The primary outcome was preparedness, measured by a Preoperative Preparedness Questionnaire at baseline and before surgery. Assuming 48% preparedness in usual care preoperatively, 44 women per group (Group, One-to-One, or Usual care) would detect a 30% difference in preparedness (alpha = 0.05, 80% power). Chi-squared or Fisher’s exact test compared categorical variables, t test and analysis of variance compared continuous variables, independent sample tests compared changes in mean or composite scores, and multiple logistic regression estimated the effect.
One hundred and sixty-eight patients were included (113 with peer support, 55 undergoing usual care). A greater proportion of women in peer support had college or higher education versus usual care (78 vs 58%, P = 0.02). After the intervention, the proportion of women feeling prepared was not different between groups (66 vs 63%, P = 0.9). However, a greater proportion in peer support reported improved preparedness from baseline compared with usual care (71 vs 44%, P = 0.001). Peer support was associated with improved preparedness on multiple regression adjusting for age, study site, education, and surgery type (OR 4.14, 95% CI 1.69, 10.14).
Peer support was associated with improved preoperative preparedness compared with usual care, but did not result in a greater proportion of women feeling prepared before surgery.
KeywordsPeer support Preoperative preparedness Decisional conflict Decision-making Decision regret Pelvic reconstructive surgery
This work was supported by an American Urogynecologic Society Pelvic Floor Disorders Research Foundation Fellow’s Research Grant. The Foundation had no involvement in the research study design, data collection or analysis, or manuscript preparation and submission.
Compliance with ethical standards
Conflicts of interest
RGR receives royalties from UpToDate; stipend and travel support from the International Urogynecology Society for being Editor in Chief of the International Urogynecology Journal; stipend and travel support from the American Board of Obstetrics and Gynecology for her work on the Board; stipend, travel, and royalties from the American College of Obstetricians and Gynecologists. GCD receives research support from Pelvalon and Viveve, in addition to travel support from the American College of Obstetricians and Gynecologists and the American Board of Obstetrics and Gynecology for her work with the College and the Board. The remaining authors report that they have no conflicts of interest.
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