or very satisfied. No multi-centred trials have been undertaken; the materials and techniques available suggest a possibility of national provision. The aim of the study was to examine current practice.
Method A web-based self-reporting questionnaire was designed to identify: • the provision of custom made nipple areola prostheses in the UK • the range of materials and techniques used, and to evaluate their popularity • the percentage of laboratory managers and prosthetists involved and their gender • variation in service provisions, patient usage, referral patterns, review policies and disciplines which may benefit from further information on the service provided by the MPT • whether the service was developing and over what period
“Alternate questionnaires were available for prosthetists and laboratory managers” The questionnaire, approved by the Council of the Institute of Maxillofacial Prosthetists & Technologists, was made available online to all members (approximately 200 members in approximately 100 units around the UK).
Results Experimental design Twenty two laboratory managers and twenty nine prosthetists responded (approximately 25% in total and by unit) which is disappointing for a professional organisation of practitioners working in this area. Service provision The service for the prosthetic nipple areola complex has been provided for an average of 8.8 years. The majority of laboratory managers who responded (54%) felt it should be a designated person who is responsible for the service, and felt it was important that the prosthetist develop a confidential relationship based on continuity of care. However, a large minority (41%) feel that it is not appropriate to allocate one prosthetist full-time to the role and that all prosthetists should be capable of treating these patients. Ninety one percent of laboratory managers who construct these prostheses also treat the patient themselves. This means, with only 18% of all laboratory managers questioned being female, 55% of prosthetists treating patients requiring NAC are male. Referrals Fifty percent of the managers stated that they receive fewer than 20 referrals per year and 5% are over 75, as shown in figure 1.
60%
The membership was informed of the location of the questionnaire by e-mail. The questionnaire was delivered online using a form linked to a MySQL database table. After completion, the form was written to the database using PHP (Hypertext Pre-processor) scripts.
50%
50%
40%
27%
30%
The questionnaire included open and closed questions, as well as scaled responses. The responses to open questions were completed in text boxes. Closed questions or scaled responses were recorded using response buttons or drop down menus. The records were exported into Microsoft Excel® for analysis. Alternate questionnaires were available for prosthetists and laboratory managers. The questionnaire for managers included questions about unit policy as well as questions about their own practice. The questions were separated as some managers may not have treated these patients.
24 AUTUMN 2011 IMPT
18%
20%
10%
0%
5%
0-20
20-50
50-75
75-100
Figure 1. Number of referrals per year.
Referrals mainly come from plastic surgeons, with the lowest percentage of referral rates coming from general practitioners, see figure 2.
THE JOURNAL OF MAXILLOFACIAL PROSTHETICS & TECHNOLOGY