| To Register SMDM Homepage | |
|
|
|
||||
Purpose: The public often underestimates patients’ mood and quality of life, and gives lower utility ratings than do patients. Colostomy patients provide a unique opportunity to further investigate this discrepancy since many have their colostomies reversed and their bowel function restored. This study examined the difference in quality of life, mood and utility ratings between current and former colostomy patients to determine if a discrepancy similar to that found between patients and the public would still exist.
Method: 330 patients who had undergone colostomy surgery within the past five years were mailed a survey including measures of subjective well-being, mood, quality of life, and a utility measure: the time tradeoff (TTO). The TTO exercise asked people to imagine that they have ten years remaining in their lives and then asked how much of that time they would give up to rid themselves of a colostomy. 95 subjects who still had colostomies completed the survey, as did 100 subjects who had had their colostomies reversed.
Results: Measures of quality of life, subjective well-being and mood were nearly identical for the two groups (all p’s > .10). However, in the TTO exercise subjects who still had colostomies were willing to give up 18 of their 120 months of life to have normal bowel function restored, while subjects who had their colostomies reversed were willing to give up 44 months on average (p < .001). In addition the former patients, as compared to the current patients, reported that “having normal bowel function” was much more important to them (p < .001). Higher values on this item predicted lower utility values (p < .001).
Conclusion: Although colostomies do not appear to significantly affect current well-being, it seems that people who no longer have their colostomies believe that the experience is much worse than the experience reported by current colostomy patients, as evidenced by their markedly lower utility ratings. This finding mirrors the typical patient/public discrepancy, but is striking in that the “public” in this case has experienced the patient condition. Rather than accurately remembering their experiences with colostomies, these former patients may have formed a theory that colostomies negatively influenced their lives more than in actuality; this is consistent with other research on a “theory driven recall bias.”
See more of Oral Concurrent Session A - Judgment and Decision Making
See more of The 26th Annual Meeting of the Society for Medical Decision Making (October 17-20, 2004)