The Patients' VOICE on Carotid Surgery; Insights From Focus Group Discussions.

Abstract

IntroductionOutcomes of carotid surgery are commonly evaluated using clinical parameters such as mortality and stroke, and these are mostly based on doctors' and scientific perspectives. Patient-centered health care aims to value the evaluation from the patients' perspective, mostly using Patient-Reported Outcomes (PROs). The aim of this study was to gain insights into outcomes that patients undergoing carotid surgery consider important (PROs) and to verify these outcomes by patients themselves.Methods and OutcomesThese protocol-based, exploratory semi-structured, focus group discussions (FGDs) were conducted in a single-center teaching hospital. Included patients were symptomatic and underwent an eversion technique between June 2024 and March 2025. FGDs were conducted, 3-12 weeks after surgery, by a medical psychologist. Patients completed the Shared Decision-Making Questionnaire-9 (SDM-Q-9) and the Short Form-36 Health Survey (SF-36) preoperatively; the SF-36 was repeated three months after surgery. The physician who informed the patient about treatment options completed the corresponding SDM-Q-9 for clinicians.ResultsA total of 24 patients were enrolled across five FGDs, of whom two withdrew consent. The consecutive sample (n = 22) included 4 women and 18 men (mean age of 77.7 years (SD ± 6.5)). Patients reported trusting their healthcare providers but expressed a desire for more information regarding hospital stay, prescribed medication, and overall recovery. Regarding health status, physical function showed a statistically significant difference (p = .04,95%CI0.55-29.86) between preoperative mean score (80.1) and postoperative (66.2). We found no differences (p = .45) between the mean scores of the patients and doctors regarding the ranking in SDM-Q-9.ConclusionThis study showed that FGDs helped to better understand the patients' perspective and experience regarding outcomes in the carotid surgery care-chain. The findings of the FGDs are highly valuable for optimizing local care pathways and patient information materials, while identifying new domains (such as fatigue) for future multicenter validation.