Abstract
Background
As internet access improves, patient self-education continues to increase. However, patient surgical background, e-literacy, and media exposure potentially influence what information patients search online. This impacts patient concern, healthcare decisions, and subsequent patient-physician interactions. The purpose of this pilot study is to characterize hernia patients’ use and the impact of internet self-education regarding surgical mesh.
Methods
The target population included patients presenting for evaluation of hernia repair with mesh. A total of 30 patients were enrolled. Patients took surveys before and after the initial surgical consult. The surveys evaluated internet use, mesh research completed, the impact on patient opinions/decisions, and the impact of research on the patient-physician interaction.
Results
The average age of the patients was 58.7 years; sixteen had prior surgery with surgical mesh. 93% of patients were aware of surgical mesh through the media, and 60% were motivated by the media to conduct research. 90% of patients conducted research, and 67% used the internet. Patients with negative attitudes toward mesh had more media exposure in comparison to those with neutral or positive attitudes (p = 0.046), and they were more likely to have researched surgical mesh because of media influence (p = 0.033). This group had the highest rate of perceived knowledge on mesh risks and the lowest regarding benefits (p = 0.013). Patients who had prior surgery without complication had the most positive attitude toward surgical mesh (p = 0.010) and were less likely to plan to do future internet research (p = 0.041) in comparison to patients who had surgery with complications or no prior surgery.
Conclusions
Patients’ attitudes and perceived knowledge regarding surgical mesh are associated with media exposure and internet research. These attributes along with prior surgical experience impact the patient-physician relationship and shared decision-making model regarding patient care.
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Dr. Blatnik reports grants from Ethicon, personal fees from Medtronic, personal fees from BD (Formerly Bard Davol), personal fees from Intuitive Surgical, outside the submitted work. Mr. Miller and Dr. Arefanian have no conflicts of interest or financial ties to disclose.
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Miller, M.P., Arefanian, S. & Blatnik, J.A. The impact of internet-based patient self-education of surgical mesh on patient attitudes and healthcare decisions prior to hernia surgery. Surg Endosc 34, 5132–5141 (2020). https://doi.org/10.1007/s00464-019-07300-0
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DOI: https://doi.org/10.1007/s00464-019-07300-0