Your browser doesn't support javascript.
loading
Decision Regret Related to Urinary Diversion Choice among Patients Treated with Cystectomy.
Check, Devon K; Leo, Michael C; Banegas, Matthew P; Bulkley, Joanna E; Danforth, Kim N; Gilbert, Scott M; Kwan, Marilyn L; Rosetti, Maureen O'Keeffe; McMullen, Carmit K.
Afiliação
  • Check DK; Department of Population Health Sciences, Duke University School of Medicine and Duke Cancer Institute, Durham, North Carolina.
  • Leo MC; Center for Health Research, Kaiser Permanente Northwest, Portland, Oregon.
  • Banegas MP; Center for Health Research, Kaiser Permanente Northwest, Portland, Oregon.
  • Bulkley JE; Center for Health Research, Kaiser Permanente Northwest, Portland, Oregon.
  • Danforth KN; Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, California.
  • Gilbert SM; H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida.
  • Kwan ML; Division of Research, Kaiser Permanente Northern California, Oakland, California.
  • Rosetti MO; Center for Health Research, Kaiser Permanente Northwest, Portland, Oregon.
  • McMullen CK; Center for Health Research, Kaiser Permanente Northwest, Portland, Oregon.
J Urol ; 203(1): 159-163, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31441673
ABSTRACT

PURPOSE:

Patients who undergo cystectomy due to bladder cancer can elect an ileal conduit or a neobladder for urinary diversion. Decision regret related to this choice is an important and undesirable patient reported outcome. Our objective was to compare the severity of decision regret experienced by patients with a neobladder vs an ileal conduit. MATERIALS AND

METHODS:

We analyzed data from a longitudinal cohort study of patients who underwent cystectomy from 2013 to 2015. We applied multivariable linear regression to examine associations of the urinary diversion method (neobladder vs ileal conduit) with decision regret measured with the DRS (Decision Regret Scale) 6 and 18 months after cystectomy. Covariates included demographic and clinical characteristics, health care utilization and complications after cystectomy, quality of life and factors related to the decision making process, including informed and shared decision making, and goal concordance.

RESULTS:

Of the 192 patients in our cohort 141 received an ileal conduit and 51 received a neobladder. We observed no significant difference in the DRS score in patients with a neobladder vs an ileal conduit at 6 or 18 months (b=-1.28, 95% CI -9.07-6.53, vs b=-1.55, 95% CI -12.48-9.38). However, informed decision making was negatively related to decision regret at 6 and 18 months (b=-13.08, 95% CI -17.05--9.11, and b=-8.54, 95% CI -4.26--2.63, respectively). Quality of life was negatively associated with decision regret at 18 months (b=-5.50, 95% CI -8.95--2.03).

CONCLUSIONS:

Patients treated with cystectomy who were more informed about bladder reconstruction options experienced less regret independent of the method selected. Efforts to inform and prepare patients for the bladder reconstruction decision may help prevent decision regret.
Assuntos
Texto completo: Disponível Coleções: Bases de dados internacionais Base de dados: MEDLINE Assunto principal: Derivação Urinária / Neoplasias da Bexiga Urinária / Cistectomia / Tomada de Decisões Limite: Feminino / Humanos / Masculino / Meia-Idade Idioma: Inglês Revista: J Urol Ano de publicação: 2020 Tipo de documento: Artigo

Similares

MEDLINE

...
LILACS

LIS

Texto completo: Disponível Coleções: Bases de dados internacionais Base de dados: MEDLINE Assunto principal: Derivação Urinária / Neoplasias da Bexiga Urinária / Cistectomia / Tomada de Decisões Limite: Feminino / Humanos / Masculino / Meia-Idade Idioma: Inglês Revista: J Urol Ano de publicação: 2020 Tipo de documento: Artigo
...