Patient expectations and decisional regret in the management of ventral hernias

Cameron A. Casson, Bradley S. Kushner, Timothy R. Holden, Arnab Majumder, Jeffrey A. Blatnik, Sara E. Holden

Research output: Contribution to journalArticlepeer-review

Abstract

Introduction: Older adult patients have many factors to contemplate when considering elective ventral hernia repair. In this study, we aimed to understand whether our novel shared decision-making (SDM) aid helped reduce this population’s decisional regret when choosing hernia management strategy. Methods: Patients ≥ 60 years of age presenting for ventral hernia evaluation were randomized to two groups. The experimental group had their visit guided by our novel SDM aid. All patients took a survey prior to consultation outlining their treatment expectations. All patients were called within 6 months to complete the Decision Regret Scale, which measures remorse after a healthcare decision. Results: Seventy-two patients (36 control, 36 experimental) completed final follow-up. On initial expectations evaluation, 53 patients (74%) reported wanting surgical repair and 58 patients (81%) reported expecting surgical repair. Ultimately, 18 patients in the control group and 17 patients in the experimental group did not undergo surgery. The use of the SDM aid did not affect if patients chose observation (OR 0.44, p = 0.24) or result in a lower decision regret score (9.86 vs 9.31, p = 0.89). Surgery was associated with a lower decision regret score (3.38 vs 16.14; p = 0.001). Of those who did not undergo repair, patients initially wanting or expecting surgery had higher decision regret scores (22.83 vs 3.33, p < 0.001; 20.40 vs 5.50, p = 0.009). Nonoperative patients who chose observation had less regret than those needing medical optimization (9.50 vs 25.00, p = 0.04). There were no differences in decision regret scores based on initial wants or expectations for those who had surgical repair. Conclusion: Decisional regret following ventral hernia management is associated with patients’ expectations prior to initial surgical consultation. The use of a decisional aid did not lower decision regret scores. These findings emphasize the need for upfront expectation setting and longitudinal programs to help patients reach their treatment goals.

Original languageEnglish
Article numbere256
Pages (from-to)522-529
Number of pages8
JournalSurgical endoscopy
Volume39
Issue number1
DOIs
StatePublished - Jan 2025

Keywords

  • Decision regret
  • Geriatric
  • Shared decision-making
  • Ventral hernia

Fingerprint

Dive into the research topics of 'Patient expectations and decisional regret in the management of ventral hernias'. Together they form a unique fingerprint.

Cite this