Grants Funded

Abstract
In reconstructive and cosmetic breast surgery, patient satisfaction is the predominant determinant of surgical success. Irrespective of this, few instruments have been developed to accurately measure breast surgery outcomes from a patient perspective. The objective of this project is to develop and validate a new questionnaire that can be used to measure patient satisfaction following breast surgery. The intent is to develop a short questionnaire that can be easily incorporated into routine practice and administered before and after surgery. This questionnaire has the potential to impact strongly on national and international research endeavors. It would provide a reference point for comparison of different studies and various surgical populations. Insight into regional variations in patient satisfaction would be gained that might guide future decisions concerning standards of care. To develop this measure, we will adhere to the following specific sequence of stages recommended by quality of life experts (Fayers, 2000, Streiner, 2001): (1) to define the intended purpose of the survey and develop an exhaustive list of all issues relevant to the topic under investigation; (2) convert these issues into questions that are easily understood and pretest the questionnaire on a small patient sample; and (3) field test the questionnaire on a large heterogeneous sample of patients to select the best indicators of patient satisfaction to form the final instrument (item reduction) and determine acceptability, reliability, validity, and responsiveness. The goal is to include a large group of surgical patients to increase the applicability of the new measure in future outcome research and allow for comparability studies. The study will performed in three sites in the United States and Canada to ensure that differences in language, culture or education do not diminish the reliability or validity of the instrument. The sensitivity of the questionnaire to regional variations will also be investigated.

Biography
Dr. Pusic is a reconstructive surgeon at Memorial Sloan-Kettering Cancer Center in New York City. She performed her general surgery residency at Dalhousie University and Plastic Surgery residency at McGill University. She completed a Master’s degree in Epidemiology at Johns Hopkins University in 1997 and a research fellowship at Memorial-Sloan Kettering Cancer Center in 2001. Her research interest lies in assessing patient reported outcomes in plastic surgery patients. With grant support from the American Society of Plastic Surgeons (ASPS), she has developed a new questionnaire, the BREAST-Q, which measures satisfaction and quality of life outcomes among breast surgery patients. This questionnaire examines body image, psychological, social, sexual, and physical function as well as satisfaction with the process of care. She is also involved in research to measure patient expectations in breast reconstruction. This NIH funded study is ultimately aimed at improving patient education and promoting shared medical decision-making. Most recently, with further grant support from the ASPS, her research team is developing a new patient-reported outcome measure for facial aesthetic patients--the FACE-Q.