(028) Patient and Provider Perspectives on LEEP/LLETZ Treatment
Notice bibliographique
Résumé
Abstract Introduction The loop electrosurgical excision procedure (LEEP) and large loop excision of the transformation zone (LLETZ) are highly effective in the treatment of cervical dysplasia. Though recent studies have identified the potential for negative outcomes following LEEP/LLETZ, the role of the cervix in sexual responses is contentious and has not been considered in conjunction with quality of life and relationship outcomes. Accordingly, there is a limited understanding of the patient and healthcare provider perspectives on procedural outcomes and experiences. Specifically, regarding current counselling and resource practices, and how risk information is represented in provider-patient interactions. Objective To investigate the procedural experiences associated with LEEP/LLETZ from patients who have reported bothersome symptoms and from providers who routinely perform the procedure. Also, to characterize a symptom profile for this subpopulation of patients and explore factors which may influence provider decision-making and approaches to care. Methods Patients who underwent LEEP/LLETZ treatment and reported negative outcomes, and providers with experience performing LEEP/LLETZ were recruited. Patients first completed an online survey which assessed demographic background, medical history, and sexual function. Both patients and providers completed semi-structured interviews relating to LEEP/LLETZ procedural outcomes and experiences. Interview responses were transcribed (Trint), and qualitative analyses were completed using NVivo 12. Results Perspectives and experiences gathered from patient and provider interviews revealed misaligned narratives surrounding LEEP/LLETZ outcomes and treatment. Patients reported a unique symptom profile and negative outcome experiences. Patient narratives highlighted impacts on domains of sexual functioning, including altered physical sensations and orgasm response, changed vaginal discharge and loss of arousal, interest and desire. Patients voiced changes to overall quality of life, with impacts on daily living and effects on interpersonal relationships. Patients discussed preferring open-ended and directed questions to comprehensively elucidate negative outcomes. Provider narratives outlined the current process of care, emphasizing limited experiences with adverse outcomes and the use of open-ended questions during counselling. Providers described an evolving intention to accommodate for and create comfortable clinical spaces. Regarding pre-and post-operative resources, patients described seeking support from online patient groups, and providers disclosed limitations to providing resources. Conclusions Results of this study call attention to discordance in the perceptions of patients and providers regarding LEEP/LLETZ procedural outcomes and experiences. The findings support the need for developments in pre-and post-operative procedural counselling, including a shift towards provider-initiated conversations to elucidate patient concerns. They also reveal a unique symptom profile of this subpopulation of patients who experience negative outcomes post-LEEP/LLETZ, which should be recognized within clinical practice with accessible conversations and resources. Disclosure No
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,004 | 0,010 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,002 | 0,001 |
| Communication savante | 0,002 | 0,001 |
| Science ouverte | 0,000 | 0,002 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,005 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».