Patient-Reported Outcomes Following Ventral Hernia Repair: Designing a Qualitative Assessment Tool

Abstract

Background

Current hernia patient-reported outcome (PRO) measures were developed without patient input, greatly impairing their content validity.

Objective

The purpose of this study was to develop a conceptual model for PRO measures for ventral hernia (VH) patients.

Methods

Fifteen semi-structured, concept elicitation interviews and two focus groups employing nominal group technique were conducted with VH patients. Patients were recruited between November 2015 and July 2016 over the telephone from a five-surgeon patient cohort at our institution. Iterative thematic analysis identified domains. Reliability and validation were achieved using inter-rater reliability checks and triangulation.

Results

Seven framework domains were established: (1) expectations; (2) self and others; (3) surgeon and surgical team; (4) sensation; (5) function; (6) appearance; and (7) overall satisfaction. Overall patient satisfaction was associated with two themes: (1) provider–patient relationship; and (2) patient assessment of post-repair improvement.

Conclusions

VH patients experience a profoundly broad range of reactions to VH repair. A patient-informed PRO instrument that addresses the spectrum of patient-identified outcomes can guide practice, optimizing care targeting VH patients' needs.

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