Takayanagi K, Kimura K; AcademyHealth. Meeting (2003 : Nashville, Tenn.).

Abstr AcademyHealth Meet. 2003; 20: abstract no. 333.

Nippon Medical School, Health Services Administration, 1-1-5,Bunkyo-ku, Sendagi, Tokyo, 113-8602 Tel. 81-3-3822-2131 Fax 81-3-3822-8144

RESEARCH OBJECTIVE: Antegrade enema through a cecostomy created by a button device (CCBD) was proven to contribute to the improvement of QOL of the patients with incontinence and severe constipation in the USA previously. This study identifies the Japanese patients' preference and acceptance of CCBD. An analysis is performed for the decision making process in Japanese patients in trading off between the stable life with difficult defecation after spinal injury and the challenging life with possible easier defecation by CCBD. STUDY DESIGN: Documented survey is done for the patients with spinal injury. The preference of CCBD after explanation of a benefit obtained by an antegrade enema is questioned. Verbal questionnare survey is done for the special group to know the preference and acceptance of CCBD. POPULATION STUDIED: Documented questionnare survey was mailed between October 30 to November 30, 2002 to 3900 people who had hada spinal cord injury. A verbal questionnare survey was done for the selected patient, who documented to have severe defecation problems. PRINCIPAL FINDINGS: Out of the 973 responders, 832( 85.6%) was male and 136(14% )was female. The average age was 56.8 years old. Duration of the difficulty was 16 years. 342(35.2% )of the responders preferred operation, 324(34.6% )did not prefer, 158(16.9%) presented with a variety of reasons and 124(13.3?) did no reply. Defecation problems included long duration, sweating, fatigue, abdominal pain, incontinence etc. There was a relation between the defecation problems and the operation preference, however little relation between the defecation problems and the actually acceptance of CCBD. CONCLUSIONS: The gear of healthcare in Japan is still in the life saving approach. Surgery for improving QOL is not accepted by the Japanese healthcare system with financial support. It will take a long time before CCBD is widely accepted by the Japanese patients, because their attitude toward a new operative procedure is generally conservative and health insurance does not cover the new procedure. IMPLICATIONS FOR POLICY, DELIVERY OR PRACTICE: Health insurance coverage seems the hidden agenda to popularization of the new technique.

Publication Types:

• Meeting Abstracts

Keywords:

• Autonomic Nervous System Diseases
• Cecostomy
• Constipation
• Data Collection
• Defecation
• Digestive System Surgical Procedures
• Enema
• Enterostomy
• Female
• Humans
• Japan
• Male
• Patient Satisfaction
• Questionnaires
• Spinal Cord Injuries
• Urinary Diversion
• Urinary Incontinence
• surgery
• hsrmtgs

Other ID:

• GWHSR0003634

UI: 102275313

From Meeting Abstracts