Study examines patient modesty concerns and a novel approach to solving them


For as long as most of us can probably remember, it’s been standard practice to remove all street clothes, including underwear, before surgery. Patients are then asked to wear a loose-fitting gown into surgery with an open back that allows a surgeon easy access to all surgical regions. The removal of street clothes is one of the ways hospitals and surgery centers help reduce infection risk during procedures.

However, this long-time practice has created anxiety in some patients who would prefer to wear their underwear into surgery for privacy and dignity. Some even forego care. In a British Journal of Anesthesia-published study, gown use induced preoperative anxiety in 45.2% of inpatients and 38.3% of outpatients. In another study at Samara State University, anxiety around potential exposure even had an adverse effect on outcomes.

Arizona study seeks solutions


This spring, the MORE Foundation, in cooperation with The CORE Institute, will conduct a study involving 200 orthopedic surgery patients to gather more perspective on the subject of patient modesty and to test a potential solution: surgical underpants that are manufactured to medical equipment grade hygiene and quality standards.

“Some of the reasons for this anxiety can be gender bias — a female patient, for example, with a male surgeon. Some of it might be religious in nature, or the belief you should only expose yourself to your spouse or to parents. We know this is important for a growing number of people, and we want to learn more and explore a possible solution,” said Marc Jacofsky, Ph.D., the study’s lead investigator and Executive Director for Research and Education at the MORE Foundation.

Dr. Marc Jacofsky says the research is randomized and single-blinded, so patients won’t know ahead of time if they will be offered the underpants or not. The study will evaluate responses from pre- and post-surgery patient surveys about the topic of patient modesty in general, as well as the impact of the coverings offered on the entire surgery experience.

“We may be surprised by the number of people who actually want the garment when it’s offered to them,” Dr. Marc Jacofsky added. “Some may turn it down, too.”

Patient advocacy


Dr. Jacofsky said that while the issue of patient modesty might not be top of mind for everyone, the growing discussion warrants research. The subject has spurred patient advocacy organizations into action.

“Because we have the partnership with The CORE Institute Specialty Hospital, where it’s a very controlled environment, it’s easy for us to run a study like this,” he added. “This used to be a very top-down ‘surgeon says’ issue, but as people push back from that norm and feel more empowered, we want to explore the best alternatives and not be resistant to change.”

-Article by Brian Sodoma


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