Abdominal wall hernia and mental health: patients lived experiences and implications for patient care

Abstract

Background Abdominal wall hernia (AWH) affects mental health and mental health questions are frequently included within Patient-Reported Outcome Measures (PROMS) for this patient population. However, these questions have not been informed by the subjective lived experiences of mental health in AWH patients. This study is the first to qualitatively examine how AWH affects patients’ mental health. Methods Fifteen patients were interviewed from a purposive sample of AWH patients until no new themes emerged. Interviews explored patient thoughts and experiences of AWH and mental health. Data were examined using Interpretative Phenomenological Analysis (IPA). Results Three key themes pertaining to mental health were identified: “psychological and emotional distress”, “identity disruption” and “coping mechanisms and support systems”. Conclusion Our findings illustrate that AWH is a pathology that can have a significant detrimental impact on people’s mental health. This impact has implications for patient care and can be treated and managed through better psychological support. This support may positively affect AWH patient’s experience and outcomes in terms of quality of life. This paper provides recommendations for improved AWH patient care in regard to mental health. Supplementary Information The online version contains supplementary material available at 10.1007/s10029-022-02699-3.

Quality of Life With a Hernia—A Novel Patient Led Study

“…Only through using validated disease specific QoL tools, which ask questions that are important to patients, can outcomes for different treatment modalities be properly assessed. The literature review by Smith ( 2 ) identified six abdominal wall hernia specific QoL tools, each being used to assess different populations, none are universally accepted ( 1 ). The measurements covered within these abdominal wall specific QoL tools are summarised by the authors in Table 2 .…”

“…Through understanding how a hernia affects the patient’s QoL, the surgeon can assess the impact that any potential surgery may have on them. Although hernia specific QoL tools exist, none are universally accepted ( 1 ), and most have been developed without patient input ( 2 ). Within hernia research, generic QoL tools are often used, however as not disease specific these may not capture key aspects important to patients with hernias ( 1 ).…”

The Role of Quality Improvement Projects in a Complex Abdominal Wall Service

“…As such, patients requiring AWR are often overlooked in socialist healthcare systems, given the non-life-threatening nature of their condition. Despite their relatively benign status, complex hernias carry a heavy QoL burden [5], including repercussions on mental health, disruption of daily activities of living, and recurrent bowel obstruction [6,7]. Consequently, AWR patients often display a higher rate of comorbidities [8], thus further complicating their care while the root cause of their issue remains unaddressed.…”