James Whiteside, MD, Stephanie Singleton, BA, Kris Strohbehn, MD, E. Ann Gormley, MD, Paul D. Hanissian, MD, Christine McDonough, MS, and Marlene Goldman, ScD. Dartmouth-Hitchcock Medical Center, Lebanon, NH
Purpose: To determine patients' acceptance of a computer-based tool to administer validated surveys in pelvic pain or pelvic floor function. Methods: Eighty-six women completed 125 computer-based assessments of either pelvic pain or pelvic floor function between December 2006 and June 2007. The women were queried regarding satisfaction and acceptance of a computer-based technology that administers basic medical history questions and, using branching logic, validated pelvic pain, sexual function, or pelvic floor function surveys. Technology acceptance is assessed at completion of the medical questions and surveys according to five acceptance domains. Did the surveys help: (1) Identify problem(s), (2) communicate problem(s) to the provider, (3) understand the reason for visiting the provider, (4) understand treatment options, and (5) improve care of future patients? Pain is assessed using the McGill Pain Scale. Sexual function is assessed with the Female Sexual Function Index or Prolapse, Incontinence, Sexual Questionnaire. Pelvic floor function is assessed with the Incontinence Severity Index, Pelvic Floor Distress Inventory, Pelvic Floor Impact Questionnaire, and Fecal Incontinence Severity Index. Overall quality of life is measured with the SF-12. The medical questions and surveys were administered both at initial visitation before medical provider consultation and at follow-up after therapeutic intervention. Chi-square analysis was used to assess differences between survey group type and acceptance responses. Correlation analyses were done to assess relationships between demographic variables, survey scores and acceptance responses with significance regarded p ≤ 0.05. Results: Mean patient age was 49 +/- 16.9 (range 17 -87). 73% of women had less than college education, 28% had a college education and 9% of women had graduate level education. Seventy-four percent of participants had home Internet access with 70% of these having high-speed access. The figure displays the percent positive response among women at their initial and follow-up visits for five acceptance domains. Overall satisfaction with the types of questions asked was correlated with the identify, understand, treat and care acceptance domains. McGill Pain score was correlated with the understand domain. Lower scores for specific SF-12 domains were correlated with some of the acceptance domains; however, only a trend toward significance was seen in the SF-12 composite scores. Conclusion: Women find value in the use of computer-based surveys of pelvic floor function or pelvic pain.