RESUMEN
OBJECTIVES: The aim of this study was to describe how women experience vaginal mesh complications after optimized tertiary care level treatment. METHODS: We conducted telephone interviews in 2012 with women at least 6 months after presentation to our tertiary care clinic between 2006 and 2011 for complications related to vaginal mesh and transcribed verbatim responses to 2 open-ended questions about their experiences surrounding vaginal mesh complications. We analyzed data using qualitative description with low-inference interpretation in a team-based setting followed by consensus meetings to arrive at descriptive trajectories of their experiences. RESULTS: Of 111 women, we successfully contacted 88, and 84 agreed to the interview. The mean duration from index mesh surgery to interview was 4.5 years, and the mean duration from presentation to our clinic for complications to the interview was 2.3 years. The effects of mesh complications caused both physical and emotional pain, in addition to the discomfort of the original pelvic floor dysfunction. The women's experiences followed 1 of 3 recovery trajectories. In "cascading health problems," the women experienced a spiral of health problems, anxiety, and desperation. In "settling for a new normal," the women who once considered themselves healthy now believed that they are unhealthy and worked to adjust to their degraded health status. In "returning to health," the women described a return to health. The women still symptomatic discharged from tertiary care clinic expressed hopelessness and abandonment. CONCLUSIONS: Concomitant with ongoing research to improve the safety of vaginal mesh procedures, there must be dedicated efforts to develop and study a range of therapies for holistically treating women with mesh complications.
Asunto(s)
Satisfacción del Paciente , Mallas Quirúrgicas/efectos adversos , Adulto , Anciano , Anciano de 80 o más Años , Dispareunia/etiología , Femenino , Estado de Salud , Humanos , Persona de Mediana Edad , Prolapso de Órgano Pélvico/psicología , Prolapso de Órgano Pélvico/cirugía , Dolor Pélvico/etiología , Calidad de Vida , Reoperación/psicología , Autoimagen , Cabestrillo Suburetral/efectos adversos , Resultado del Tratamiento , Incontinencia Urinaria de Esfuerzo/psicología , Incontinencia Urinaria de Esfuerzo/cirugíaRESUMEN
Nurse coaching is gaining acceptance as a legitimate, holistic enhancement to Western medicine. Thirteen research studies that looked at nurse coaching interventions in patients with various chronic conditions were reviewed and the outcomes discussed. All but 2 of these studies reported at least some statistically significant positive health outcomes.