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Acceptability and effectiveness of a multidisciplinary team approach involving counselling for mesh-removal patients

Lisa Osborne, Simon Emery, Monika Vij, Bhawana Purwar, Phil Reed Orcid Logo

Journal of Obstetrics and Gynaecology, Pages: 1 - 6

Swansea University Authors: Lisa Osborne, Simon Emery, Monika Vij, Phil Reed Orcid Logo

  • Accepted Manuscript under embargo until: 23rd December 2022

Abstract

Patients with complications following mesh removal risk a variety of symptoms, and can view medical intervention negatively. This study explored the patient-acceptability of a Multidisciplinary Team (MDT), and whether the presence of a Counsellor would be accepted and effective. Twenty consecutively...

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Published in: Journal of Obstetrics and Gynaecology
ISSN: 0144-3615 1364-6893
Published: Informa UK Limited 2021
Online Access: Check full text

URI: https://cronfa.swan.ac.uk/Record/cronfa59138
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Abstract: Patients with complications following mesh removal risk a variety of symptoms, and can view medical intervention negatively. This study explored the patient-acceptability of a Multidisciplinary Team (MDT), and whether the presence of a Counsellor would be accepted and effective. Twenty consecutively referred women, who had undergone mesh-removal but experienced complications were interviewed about their experiences, and completed the Queensland scale for pelvic floor symptoms, McGill Pain Questionnaire, and Hospital Anxiety and Depression Scales, before and after treatment. Patients had high levels of pelvic-floor symptoms, sensory and affective pain, anxiety, and depression. 70% reported a positive MDT experience; predicted by higher anxiety, and lower depression. 60% elected to receive Counselling, which commenced within one week of referral, typically lasted 1-4 sessions, and reduced pelvic-floor symptoms, affective pain, anxiety, and depression. Results suggest that the MDT approach is generally acceptable for this patient group, and that mesh-removal patients accept and benefit from input by a Counsellor.Impact statement Concerns have been raised regarding the safety of mesh insertion. Multidisciplinary Teams (MDTs) are suggested to offer a strong approach to managing many women's health conditions, but no studies have examined mesh-removal patients, making generalisation difficult to the current patient group. Furthermore, it is unknown whether an MDT approach, including a Counsellor, would be acceptable to mesh-removal patients. Patients had high levels of pelvic-floor symptoms, pain, anxiety, and depression. 70% reported the MDT experience as positive, predicted by higher anxiety, and lower depression. 60% elected to receive Counselling, which reduced pelvic-floor symptoms, affective pain, anxiety, and depression. The Counselling provided as part of the MDT approach was able to commence quickly, did not require many sessions, and reduced reported pelvic-floor symptoms, affective pain, anxiety, and depression. These findings suggest that an MDT approach involving Counselling is generally acceptable, and that mesh-removal patients accept and benefit from the input of a Counsellor, as part of their treatment.
Keywords: counselling, symptoms, Multidisciplinary Team (MDT), Mesh-removal, treatment acceptability, mesh complications
College: College of Human and Health Sciences
Start Page: 1
End Page: 6