Patients' expectations and satisfaction in subthalamic nucleus deep brain stimulation for Parkinson disease: 6-year follow-up

TY - JOUR

T1 - Patients' expectations and satisfaction in subthalamic nucleus deep brain stimulation for Parkinson disease

T2 - 6-year follow-up

AU - Lin, Hsin Ying

AU - Hasegawa, Harutomo

AU - Mundil, Nilesh

AU - Samuel, Michael

AU - Ashkan, Keyoumars

PY - 2018/10/4

Y1 - 2018/10/4

N2 - Objective Patients’ expectations are considered to play an important role in STN DBS. We explored the relationship between expectations, satisfaction and outcome 6 years after surgery. Methods 15 patients with Parkinson disease (9 males, mean age 60.5 ± 6.4 years) undergoing STN DBS completed a modified PDQ-39 questionnaire (incorporating an assessment of patients’ expected changes in addition to the standard quality of life items) preoperatively and at 6 years postoperatively. A satisfaction questionnaire accompanied the postoperative questionnaire. Results At 6 years follow-up, PDQ-39 scores were unchanged from preoperative scores except in the stigma domain which showed a significant improvement. There was no significant difference between the postoperatively rated expected PDQ-39 summary score and the postoperative actual PDQ-39 summary score. However, there was a significant difference between the preoperatively rated expected PDQ-39 summary score and the postoperative actual PDQ-39 summary score. Patients remained highly satisfied with the outcome of surgery (mean satisfaction score 83%). Satisfaction did not correlate with PDQ-39 summary scores, domain scores or fulfilment of expectations. The more satisfied patients (satisfaction ≥ 80%) changed their expectations so that their postoperatively rated expectations reflected a less favorable condition whereas no such change was seen in the less satisfied (satisfaction <80%) patients. Conclusions Patients remain highly satisfied with STN DBS 6 years after surgery although quality of life assessed by the PDQ-39 may return to baseline levels. Patients’ expectations change over time and may influence patient satisfaction. Managing expectations before and after surgery plays an essential role in STN DBS.

AB - Objective Patients’ expectations are considered to play an important role in STN DBS. We explored the relationship between expectations, satisfaction and outcome 6 years after surgery. Methods 15 patients with Parkinson disease (9 males, mean age 60.5 ± 6.4 years) undergoing STN DBS completed a modified PDQ-39 questionnaire (incorporating an assessment of patients’ expected changes in addition to the standard quality of life items) preoperatively and at 6 years postoperatively. A satisfaction questionnaire accompanied the postoperative questionnaire. Results At 6 years follow-up, PDQ-39 scores were unchanged from preoperative scores except in the stigma domain which showed a significant improvement. There was no significant difference between the postoperatively rated expected PDQ-39 summary score and the postoperative actual PDQ-39 summary score. However, there was a significant difference between the preoperatively rated expected PDQ-39 summary score and the postoperative actual PDQ-39 summary score. Patients remained highly satisfied with the outcome of surgery (mean satisfaction score 83%). Satisfaction did not correlate with PDQ-39 summary scores, domain scores or fulfilment of expectations. The more satisfied patients (satisfaction ≥ 80%) changed their expectations so that their postoperatively rated expectations reflected a less favorable condition whereas no such change was seen in the less satisfied (satisfaction <80%) patients. Conclusions Patients remain highly satisfied with STN DBS 6 years after surgery although quality of life assessed by the PDQ-39 may return to baseline levels. Patients’ expectations change over time and may influence patient satisfaction. Managing expectations before and after surgery plays an essential role in STN DBS.

KW - Deep brain stimulation

KW - expectations

KW - Parkinson disease

KW - satisfaction

KW - subthalamic nucleus

U2 - 10.1016/j.wneu.2018.09.181

DO - 10.1016/j.wneu.2018.09.181

M3 - Article

SN - 1878-8750

JO - World Neurosurgery

JF - World Neurosurgery

ER -