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

Research output: Contribution to journalArticle

Hsin Ying Lin, Harutomo Hasegawa, Nilesh Mundil, Michael Samuel, Keyoumars Ashkan

Original languageEnglish
JournalWorld Neurosurgery
Early online date4 Oct 2018
DOIs
Accepted/In press24 Sep 2018
E-pub ahead of print4 Oct 2018

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Abstract

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.

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