USF-LVHN SELECT
Patient selected goals and satisfaction after bilateral subthalamic nucleus deep brain stimulation in Parkinson's disease.
Publication/Presentation Date
6-1-2020
Abstract
Assessing patient goals is crucial in understanding patient centered outcomes and satisfaction. However, patient goals may change throughout treatment. Our objective is to identify the changes in patient-selected goals of Parkinson's disease (PD) patients undergoing bilateral subthalamic nucleus deep brain stimulation (STN-DBS) and examine the relationship among patient-selected goal achievement, standard DBS outcome measures, and overall patient satisfaction. Seventy-five patients undergoing bilateral STN-DBS listed three patient-selected goals before surgery. After six months, patients were asked to restate the three goals and to rate the degree of goal achievement and the overall satisfaction of surgery. The three most frequently selected goals were "dyskinesia", "gait disorder", and "medication off duration". After six months, 80.0% of patients could not accurately recall their pre-DBS goals. "Dyskinesia" was the most consistently selected goal, more patients selected "tremor" and "less medication" at post-DBS compared to pre-DBS, and less patients selected "gait disorder" at post-DBS compared to pre-DBS. 74.7% of patients reported overall satisfaction by stating they were "very much" or "much better after surgery". Patient satisfaction significantly correlated with goal achievement (r = 0.640; p < 0.001). Interestingly, change in UPDRS motor scores did not correlate with patient satisfaction (r = 0.100; p = 0.395). Although recalled goals do not accurately represent the pre-surgical goals, the achievement score for recalled goals significantly correlated with patient satisfaction. Patient goals change due to many reasons. Therefore, follow-up patient counseling to discuss goals and outcomes is important in improving patient satisfaction after STN-DBS.
Volume
76
First Page
148
Last Page
153
ISSN
1532-2653
Published In/Presented At
Nam, S. K., Yoo, D., Lee, W. W., Jang, M., Kim, H. J., Kim, Y. E., Park, H. R., Ehm, G., Yang, H. J., Yun, J. Y., Shin, C., Kim, H. J., & Jeon, B. (2020). Patient selected goals and satisfaction after bilateral subthalamic nucleus deep brain stimulation in Parkinson's disease. Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia, 76, 148–153. https://doi.org/10.1016/j.jocn.2020.04.005
Disciplines
Medical Education | Medicine and Health Sciences
PubMedID
32312629
Department(s)
USF-LVHN SELECT Program, USF-LVHN SELECT Program Students
Document Type
Article