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Biomedical subjects

S Derrett

Publications and source records attributed to S Derrett.

4 recordsLinked to original sources

Prospective evaluation of the effects of prostatectomy on symptoms and quality of life.

AIMS: To evaluate prospectively urinary symptoms and quality of life before and after prostate surgery, among men who had been on a waiting list for elective transurethral prostate resection (TURP). METHODS: Face-to-face interviews with 47 men before and after prostate surgery using the urinary symptom specific American Urological Association Urinary Symptom Index (AUA-7), the Short Form 36 Health Survey (SF-36), and questions relating to the effects of urinary symptoms on men's lives and acceptable waiting times for surgery. RESULTS: The mean AUA-7 score before surgery for all participants was 22.2 (range 5-34) and after surgery improved to a mean of 7.3 (range 1-28). Men with severe urinary symptoms before surgery experienced the greatest improvement in symptoms after surgery, compared with the mild/moderate symptom group. Significant improvements occurred in three of the eight SF-36 dimensions following surgery. Acceptable waiting times for surgery differed according to the severity of mens' urinary symptoms. CONCLUSIONS: Efforts to develop methods for prioritisation of access to surgery are supported. Men with mild or moderate symptoms may reasonably delay surgery, with the expectation that, if they develop more severe symptoms, surgery will be helpful. Because of the risks as well as the benefits of prostate surgery, the use of illustrative vignettes may be useful for clinicians advising patients.

Activities of Daily Living↗

Waiting for elective surgery: effects on health-related quality of life.

OBJECTIVE: To describe the experiences of people required to wait for admission to a New Zealand regional hospital to receive elective surgery. DESIGN: Cross-sectional. SETTING: Eligible people were invited to participate in a face-to-face interview with one of us in their own home or in a private office at the University of Otago. STUDY PARTICIPANTS: The study population comprised all people on the waiting list for prostatectomy or hip or knee joint replacement. Of those who were eligible and contacted, 89% of men (n=102) on the prostatectomy waiting list and 92%. of people (n = 47) on the hip/knee joint replacement waiting list were interviewed. Main outcome measures. Participants completed the SF-36 health survey to measure general health-related quality of life and condition-specific instruments to measure the severity of each participant's condition. Participants were also asked questions concerning acceptable waiting times. RESULTS: The majority of participants reported severe symptoms and significantly poorer health-related quality of life on most dimensions than a general sample of the New Zealand population. Neither general quality of life nor condition-specific health appeared to worsen with the duration of wait, but this may have been an effect of the study design. People with more severe symptoms desire surgery more quickly than people with less severe symptoms. The lengthy wait for surgery experienced by many participants represents a burden in terms of living with the unrelieved severe symptoms and poor health-related quality of life.

Cross-Sectional Studies↗

Solving the surgical waiting list problem? New Zealand's 'booking system'.

This article discusses the development and implementation of New Zealand's booking system for publicly funded non-urgent surgical and medical procedures. The 'booking system' emerged out of New Zealand's core services debate and the government's desire to remove waiting lists. It was targeted for implementation by mid-1998. However, the booking system remains in an unsatisfactory state and a variety of problems have plagued its introduction. These include a lack of national consistency in the priority access criteria, failure to pilot the system and a shortfall in the levels of funding available to treat the numbers of patients whose priority criteria 'scores' deem them clinically eligible for surgery. The article discusses endeavours to address these problems. In conclusion, based on the New Zealand experience, the article provides lessons for policy-makers interested in introducing surgical booking systems.

Appointments and Schedules↗