Lee, M.J. orcid.org/0000-0001-9971-1635, Marshall, J.H., Jones, G.L. et al. (2 more authors) (2020) The informational and decisional preferences of patients undergoing surgery for Crohn’s anal fistula: a qualitative study. Colorectal Disease, 22 (6). pp. 703-712. ISSN 1462-8910
Abstract
Aim
One in three patients with Crohn’s disease will develop a perianal fistula, but only a few achieve long-term healing. Treatment is both medical and surgical. Since there is no ‘best’ surgical procedure, patient preference is important in selecting the appropriate treatment for this condition. The aim of this study was to investigate the informational and decisional preferences of patients when surgical treatment is being considered.
Method
Patients who had undergone surgery for Crohn's anal fistula underwent face-to-face semi-structured interviews. These explored the experience of treatments for fistula, of receiving information and of participation in decision-making. Transcripts were analysed by two investigators through inductive thematic analysis. Saturation was assessed for at 12 interviews and then after each subsequent interview.
Results
Seventeen patients completed interviews, and saturation was achieved. Five themes were identified, of which two (desired information and decision-making) were relevant to this study. Other themes included experience of Crohn’s disease, experience of receiving information and procedure-specific comments. Participants wanted to have information on any risks, high-level outcomes (e.g. success), impact on day-to-day life and aftercare. Participants felt they did not always receive the information they needed to select the best treatment option. Participants felt uninvolved in treatment decisions and would have liked to trade off operations to reach their treatment goal.
Conclusion
Information provided to patients about surgical treatment of Crohn’s perianal fistula does not meet their needs. Clinicians should address aftercare, impact on quality of life and the risks and benefits of the any proposed procedure.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | © 2019 The Association of Coloproctology of Great Britain and Ireland. This is an author-produced version of a paper subsequently published in Colorectal Disease. Uploaded in accordance with the publisher's self-archiving policy. |
Keywords: | anal fistula; attitudes; Crohn’s disease; decision support techniques; health knowledge; practice |
Dates: |
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Institution: | The University of Sheffield |
Academic Units: | The University of Sheffield > Faculty of Medicine, Dentistry and Health (Sheffield) > School of Health and Related Research (Sheffield) |
Depositing User: | Symplectic Sheffield |
Date Deposited: | 18 Mar 2022 09:13 |
Last Modified: | 18 Mar 2022 09:13 |
Status: | Published |
Publisher: | Wiley |
Refereed: | Yes |
Identification Number: | 10.1111/codi.14936 |
Related URLs: | |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:184832 |