Do patients scheduled for inguinal hernia repair express a preference for the repair technique? What questions do they frequently ask?

aimThis study aimed to evaluate whether patients scheduled for elective inguinal hernia repair express a preference for the surgical technique prior to surgery, and to investigate the relationship of this preference with perceived quality of information, the decision-making process, preoperative anxiety level, and information needs.

methodsIn this cross-sectional, observational, multicenter study, a total of 140 adult patients were included from three centers (one public and two private hospitals) (public: n = 70; private: n = 70). Data were collected using a preoperative patient questionnaire. The decision-making process was assessed using the Sure of Myself, Understand Information, Risk-Benefit Ratio, and Encouragement (SURE) scale, while anxiety and information needs were measured using the Amsterdam Preoperative Anxiety and Information Scale (APAIS). Perceived quality of information and factors influencing surgical technique preference were evaluated using Likert scales. A surgical technique preference score and a perceived information score were calculated as composite indices. The primary outcome was whether the patient reported a preference regarding the surgical technique prior to surgery.

resultsOf the 140 patients, 86 (61.4%) reported a preference for the surgical technique; this rate was 72.9% (51/70) in private hospitals and 50.0% (35/70) in public hospitals (p = 0.040). Preference scores and perceived information scores were significantly higher in private hospitals (p < 0.001). Shared decision-making was more common in private hospitals, whereas surgeon-directed decision-making predominated in public hospitals (p = 0.012). The most influential factors affecting preference were expectations of postoperative pain and the risk of recurrence. When preoperative concerns were analyzed, patients in private hospitals more frequently inquired about postoperative comfort and functional recovery, whereas patients in public hospitals more often questioned whether the mesh (prosthetic material) could be harmful to the body.

conclusionA substantial proportion of patients scheduled for elective inguinal hernia repair actively participate in the preoperative decision-making process and express a preference for the surgical technique. This preference is particularly associated with concerns about recurrence risk and postoperative pain, and patients' preoperative information needs differ according to the type of healthcare institution.