Bosma, E. (2012) RELATION BETWEEN AESTHETICS AND PATIENT’S SATISFATION : A RETROSPECTIVE COHORT STUDY. thesis, Medicine.
Full text available on request.Abstract
Introduction: The purpose of a BR changed during the past decades. Whereas morbidity and mortality used to be the primary outcomes in breast cancer surgery, now aesthetic results, quality of life and satisfaction are the most important goals. It is not yet known if satisfaction of the patient is related to the aesthetic results of a BR. In this retrospective cohort study we studied the relation between the satisfaction score of the patient and the aesthetic score. We used the satisfaction scores obtained in a previous study concerning the same cohort. This satisfaction scores were obtained using the Breast-Q, a self-report questionnaire designed and validated to measure quality of life and satisfaction in women with a BR. We also determined whether autologous, primary and bilateral BRs give better aesthetic scores than alloplastic, secondary and unilateral BRs. Finally, we examined whether finished BRs give a better aesthetic score than unfinished BRs. Materials and Methods: We used photographs taken at the moment of completing the Breast-Q, which we called ‘first series’. We also used photographs of the finished BR, when women had additional treatments, which we called ‘second series’. An independent panel, consisting of plastic surgeons, an oncological surgeon, breast nurses and laypersons assessed the aesthetic scores from photographs. For the aesthetic assessment of the photographs we used the Strasser Grading System, this is a subscale scoring system that is developed to evaluates aesthetic surgical results. We tested the primary question whether there is a relation between the Strasser score and the Breast-Q score using a Kruskall-Wallis test. We used a Mann-Whitney U test to determine whether autologous, primary and bilateral BRs give better Strasser scores than alloplastic, secondary and unilateral BRs. Finally we used a t-test to compare the Strasser score of the first series with the second series. Results: From the 94 included women we obtained 91 photographs of women for the first series of photographs and 26 photographs of women for the second series of photographs. We determined a relation between the patient’s satisfaction and the aesthetic score, a higher Breast-Q score corresponds with a better Strasser score (p= 0,002 for ‘Satisfaction with Breasts’ and p=0,039 for ‘Satisfaction with Outcome’). Primary BRs give better Strasser scores than secondary BRs (p=0,004) and bilateral BRs seem to give better Strasser scores than unilateral (p=0,061). Finished BRs seem to give better aesthetic scores than unfinished BRs. (p=0,072). Discussion: With these new insights we can provide better information to the patient. Retrospective obtainment of data is a limitation of this study. Uncertainty exists if the Strasser Grading System is a reliable and valid instrument to score aesthetics. Future studies should ideally be prospective, should obtain patient’s satisfactions scores and aesthetic scores on similar predetermined moments and should develop and use a valid and reliable scoring system for aesthetic evaluation of BRs. Conclusion: With this retrospective study we show that there is a relationship between the patient’s satisfaction score and the aesthetic score of a BR. We also showed that primary BRs give better aesthetic results than secondary BRs and bilateral BRs seem to give better aesthetic results than unilateral. Finally we determined that finished BRs seem to give better aesthetic results than unfinished BRs.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Supervisors: and Dreise, M.M. research nurse and Eltahir, Y. plastic surgeon and Werker, Prof. dr. P.M.N. plastic surgeon |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 10:45 |
| Last Modified: | 25 Jun 2020 10:45 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/664 |
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