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Novel Patient-Reported Outcome Measures for the Assessment of Patient Satisfaction and Health-Related Quality of Life Following Postmastectomy Breast Reconstruction

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  • Breast Surgery
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Abstract

Background

Patient-reported outcome measures (PROMs) have become an integral part of the evaluation of reconstruction surgery outcomes. However, there are limitations in current PROMs when it comes to the assessment of well-being during inpatient stay, patient perception of health, relationship with partner, and vitality (i.e., mood and ability to work and pursue hobbies, carry out daily tasks, and sleep) following breast reconstructive surgery. The aim was to develop a novel set of measures to compare patient satisfaction and health-related quality of life following different types of postmastectomy breast reconstruction.

Methods

A novel questionnaire was created and refined through cognitive interviews with patients and expert feedback. A field test study was conducted, including patients who had undergone delayed postmastectomy breast reconstruction with implant, autologous tissue, or combination of implant and autologous tissue. Based on the results, confirmatory factor analysis and examination of reliability of the questionnaire were conducted. Results of patient responses were analyzed using Chi-square test, Kruskal–Wallis test, and Mann–Whitney U test.

Results

Confirmatory factor analysis showed good model fit, and Cronbach’s alpha indicated high internal consistency of the questionnaire. Besides that, patients with combination reconstruction reported significantly lower vitality than patients with implant and autologous reconstruction (p = 0.048).

Conclusions

This novel questionnaire expands the current knowledge base of postmastectomy breast reconstruction PROMs. Results of the field test study showed that combination reconstruction was associated with lower patient vitality than other reconstruction types.

Level of Evidence IV

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

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Acknowledgements

The authors would like to thank Professor Jill A. Helms (Division of Plastic and Reconstructive Surgery, Stanford University) for her guidance during preparation of this manuscript.

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Authors and Affiliations

  1. Department of Plastic Surgery, 3rd Faculty of Medicine and University Hospital Kralovske Vinohrady, Charles University in Prague, Srobarova 50, 10034, Prague 10, Czech Republic

    Pavla Ticha, Michele Bujda & Andrej Sukop

  2. Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford University School of Medicine, 1651 Page Mill Road, Palo Alto, CA, 94304, USA

    Pavla Ticha & Meagan Wu

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Correspondence to Andrej Sukop.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The protocol has been approved by the Ethics Commission, Third Faculty of Medicine, Charles University in Prague. Ethics approval for this retrospective study was obtained from the Ethics Commission of the Third Faculty of Medicine, Charles University in Prague. Ethical standards maintained by this ethics committee conform to the Declaration of Helsinki.

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Ticha, P., Wu, M., Bujda, M. et al. Novel Patient-Reported Outcome Measures for the Assessment of Patient Satisfaction and Health-Related Quality of Life Following Postmastectomy Breast Reconstruction. Aesth Plast Surg 46, 1588–1599 (2022). https://doi.org/10.1007/s00266-022-02985-6

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