Using qualitative research to reduce readmissions and optimize perioperative cystectomy care.

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  • Additional Information
    • Affiliation:
      Department of Urology, University of North Carolina at Chapel Hill, Chapel Hill North Carolina
      Department of Urology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
    • Subject Terms:
    • Subject Terms:
    • Abstract:
      Background: Preventable complications and readmissions after cystectomy may be detectable via postoperative monitoring of patient-reported outcomes (PROs). However, no study has defined meaningful PROs or the use of mobile communication devices (mobile health [mHealth]) to capture them. The objectives of this study were to determine which high-priority PROs influence patients' perioperative experience, what processes influence these outcomes, how patients and caregivers differ in their experiences, and how mHealth might be used to improve outcomes.Methods: Forty-five semistructured, in-depth interviews were conducted with readmitted cystectomy patients, caregivers, and providers with an interview guide that addressed perioperative education, symptoms, function, and the potential for mHealth interventions. Among 15 patients, 10 had an interviewed partner. A thematic analysis of interviews conducted with readmitted patients, caregivers, and providers was performed to examine processes that affected perioperative care and readmission and to determine how mHealth interventions might be implemented.Results: Readmitted patients and caregivers ranged in age from 33 to 78 years and were diverse in race and stage. The providers included a diverse representation of physicians, nurses, and other specialists. Cystectomy preoperative education was overwhelming and lacked personalization, and this contributed to a fundamental lack of knowledge regarding normal and abnormal symptoms after surgery. Three connecting themes were identified: 1) cystectomy education overload, 2) a need to define normal symptoms, and 3) education with incremental learning through mHealth.Conclusions: A personalized mHealth intervention addressing themes of education overload, the definition of normality, and incremental learning could be realized through mHealth technology and provide the right information for the right patient at the right time.
    • Journal Subset:
      Biomedical; Peer Reviewed; USA
    • Instrumentation:
      Learning and Study Strategies Inventory (LASSI)
    • ISSN:
      0008-543X
    • MEDLINE Info:
      PMID: NLM31299091 NLM UID: 0374236
    • Grant Information:
      1K08HS024134-01A1//Agency for Healthcare Research and Quality/International
    • Publication Date:
      20200513
    • Publication Date:
      20201014
    • DOI:
      10.1002/cncr.32362
    • Accession Number:
      138831637
  • Citations
    • ABNT:
      SMITH, A. B. et al. Using qualitative research to reduce readmissions and optimize perioperative cystectomy care. Cancer (0008543X), [s. l.], v. 125, n. 20, p. 3545–3553, 2019. DOI 10.1002/cncr.32362. Disponível em: http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=rzh&AN=138831637. Acesso em: 29 out. 2020.
    • AMA:
      Smith AB, Mueller D, Garren B, et al. Using qualitative research to reduce readmissions and optimize perioperative cystectomy care. Cancer (0008543X). 2019;125(20):3545-3553. doi:10.1002/cncr.32362
    • APA:
      Smith, A. B., Mueller, D., Garren, B., Tan, H., Wallen, E., Woods, M., Pruthi, R., Nielsen, M., & Tan, H.-J. (2019). Using qualitative research to reduce readmissions and optimize perioperative cystectomy care. Cancer (0008543X), 125(20), 3545–3553. https://doi.org/10.1002/cncr.32362
    • Chicago/Turabian: Author-Date:
      Smith, Angela B., Dana Mueller, Brandon Garren, Hung‐Jui Tan, Eric Wallen, Michael Woods, Raj Pruthi, Matthew Nielsen, and Hung-Jui Tan. 2019. “Using Qualitative Research to Reduce Readmissions and Optimize Perioperative Cystectomy Care.” Cancer (0008543X) 125 (20): 3545–53. doi:10.1002/cncr.32362.
    • Harvard:
      Smith, A. B. et al. (2019) ‘Using qualitative research to reduce readmissions and optimize perioperative cystectomy care’, Cancer (0008543X), 125(20), pp. 3545–3553. doi: 10.1002/cncr.32362.
    • Harvard: Australian:
      Smith, AB, Mueller, D, Garren, B, Tan, H, Wallen, E, Woods, M, Pruthi, R, Nielsen, M & Tan, H-J 2019, ‘Using qualitative research to reduce readmissions and optimize perioperative cystectomy care’, Cancer (0008543X), vol. 125, no. 20, pp. 3545–3553, viewed 29 October 2020, .
    • MLA:
      Smith, Angela B., et al. “Using Qualitative Research to Reduce Readmissions and Optimize Perioperative Cystectomy Care.” Cancer (0008543X), vol. 125, no. 20, Oct. 2019, pp. 3545–3553. EBSCOhost, doi:10.1002/cncr.32362.
    • Chicago/Turabian: Humanities:
      Smith, Angela B., Dana Mueller, Brandon Garren, Hung‐Jui Tan, Eric Wallen, Michael Woods, Raj Pruthi, Matthew Nielsen, and Hung-Jui Tan. “Using Qualitative Research to Reduce Readmissions and Optimize Perioperative Cystectomy Care.” Cancer (0008543X) 125, no. 20 (October 15, 2019): 3545–53. doi:10.1002/cncr.32362.
    • Vancouver/ICMJE:
      Smith AB, Mueller D, Garren B, Tan H, Wallen E, Woods M, et al. Using qualitative research to reduce readmissions and optimize perioperative cystectomy care. Cancer (0008543X) [Internet]. 2019 Oct 15 [cited 2020 Oct 29];125(20):3545–53. Available from: http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=rzh&AN=138831637