Browsing by Author "Hamner, Jennifer"

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    Predictors of Postdischarge Surgical Recovery Following Laparoscopic Sacrocolpopexy: A Prospective Cohort Study
    (Lippincott, Williams & Wilkins, May 2020) Heit, Michael; Carpenter, Janet S.; Chen, Chen X.; Stewart, Ryan; Hamner, Jennifer; Rand, Kevin L.; Obstetrics and Gynecology, School of Medicine
    Objectives Our aim was to identify sociodemographic/clinical, surgical, and psychosocial predictors of postdischarge surgical recovery after laparoscopic sacrocolpopexy. Methods Study participants (N=171) with ≥ stage 2 pelvic organ prolapse completed a preoperative survey measuring hypothesized sociodemographic/clinical, surgical, and psychosocial recovery predictors followed by a postoperative survey at four time points (day 7, 14, 42, and 90) that included the Postdischarge Surgical Recovery (PSR)13 scale. One multivariate linear regression model was constructed for each time point to regress PSR13 scores on an a priori set of hypothesized predictors. All variables that had p values less than 0.1 were considered significant predictors of recovery because of the exploratory nature of this study and focus on model building rather than model testing. Results Predictors of recovery at one or more time points included the following: Sociodemographic/clinical predictors: older age, higher body mass index, fewer comorbidities, and greater preoperative pain predicted greater recovery. Surgical predictors: fewer perioperative complications and greater change in the leading edge of prolapse after surgery predicted greater recovery. Psychosocial predictors: less endorsement of doctors locus of control, greater endorsement of others locus of control, and less sick role investment predicted greater recovery. Conclusions Identified sociodemographic/clinical, surgical, and psychosocial predictors should provide physicians with evidence based guidance on recovery times for patients and family members. This knowledge is critical for informing future research to determine if these predictors are modifiable by changes to our narrative during the preoperative consultation visit. These efforts may reduce the postdischarge surgical recovery for patients with pelvic organ prolapse after laparoscopic sacrocolpopexy, accepting the unique demands on each individual’s time.
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    Recommended standardized anatomic terminology of the posterior female pelvis and vulva based on a structured medical literature review
    (Elsevier, 2021) Hill, Audra Jolyn; Balgobin, Sunil; Mishra, Kavita; Jeppson, Peter C.; Wheeler, Thomas, II; Mazloomdoost, Donna; Anand, Mallika; Ninivaggio, Cara; Hamner, Jennifer; Bochenska, Katarzyna; Mama, Saifuddin T.; Balk, Ethan M.; Corton, Marlene M.; Delancey, John; Obstetrics and Gynecology, School of Medicine
    Background Anatomic terminology in both written and verbal forms has been shown to be inaccurate and imprecise. Objective Here, we aimed to (1) review published anatomic terminology as it relates to the posterior female pelvis, posterior vagina, and vulva; (2) compare these terms to “Terminologia Anatomica,” the internationally standardized terminology; and (3) compile standardized anatomic terms for improved communication and understanding. Study Design From inception of the study to April 6, 2018, MEDLINE database was used to search for 40 terms relevant to the posterior female pelvis and vulvar anatomy. Furthermore, 11 investigators reviewed identified abstracts and selected those reporting on posterior female pelvic and vulvar anatomy for full-text review. In addition, 11 textbook chapters were included in the study. Definitions of all pertinent anatomic terms were extracted for review. Results Overall, 486 anatomic terms were identified describing the vulva and posterior female pelvic anatomy, including the posterior vagina. “Terminologia Anatomica” has previously accepted 186 of these terms. Based on this literature review, we proposed the adoption of 11 new standardized anatomic terms, including 6 regional terms (anal sphincter complex, anorectum, genital-crural fold, interlabial sulcus, posterior vaginal compartment, and sacrospinous-coccygeus complex), 4 structural terms (greater vestibular duct, anal cushions, nerve to the levator ani, and labial fat pad), and 1 anatomic space (deep postanal space). In addition, the currently accepted term rectovaginal fascia or septum was identified as controversial and requires further research and definition before continued acceptance or rejection in medical communication. Conclusion This study highlighted the variability in the anatomic nomenclature used in describing the posterior female pelvis and vulva. Therefore, we recommended the use of standardized terminology to improve communication and education across medical and anatomic disciplines.
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    Validating the Postdischarge Surgical Recovery Scale 13 as a Measure of Perceived Postoperative Recovery After Laparoscopic Sacrocolpopexy
    (Wolters Kluwer, 2017-03) Carpenter, Janet S.; Heit, Michael; Chen, Chen X.; Stewart, Ryan; Hamner, Jennifer; Rand, Kevin L.; School of Nursing
    Objectives No postoperative recovery measurement tools have been validated among women undergoing laparoscopic sacrocolpopexy for pelvic organ prolapse, which impedes development and testing of strategies to improve recovery. The purpose of this study was to evaluate the performance of the Postdischarge Surgical Recovery Scale (PSR) as a measure of perceived recovery in laparoscopic sacrocolpopexy patients. Methods Women (N = 120) with stage 2 or higher pelvic organ prolapse undergoing laparoscopic sacrocolpopexy completed a 15-minute postoperative survey (days 7, 14, 42, and 90 [each ± 3 days]) which included the 15-item PSR. A confirmatory factor analysis was conducted using data from 14 days postsurgery, when patients would have begun to recover, but there was likely to be substantial variability in recovery across patients. We also assessed validity and explored sensitivity to change over time and minimally important difference values. Results Confirmatory factor analysis indicated a good fitting model for a reduced version of the PSR (ie, PSR13). Regressions showed that the PSR13 prospectively predicted single-item recovery scores. The PSR13 recovery significantly improved from days 7 to 42, suggesting the PSR13 is sensitive to change. Descriptive statistics including minimally important differences are reported. The minimally important difference was estimated to be around 5 points. Conclusions The PSR13 is a psychometrically sound tool for measuring recovery over time in this population. Its short length makes it an ideal postoperative recovery measure in clinical practice or research.