Patient expectation and satisfaction in revision total hip arthroplasty
Patient expectation and satisfaction in revision total hip arthroplasty
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DOI：
10.1054/arth.2002.31245
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发表时间：
2002-06-01
影响因子：
3.5
通讯作者：
Elmstedt, E
中科院分区：
文献类型：
--
作者：
Eisler, T;Svensson, O;Elmstedt, E
66 名连续翻修全髋关节置换术患者被问及他们对未来疼痛和行走能力的期望。无论背景因素如何，期望值都很高：92% 的人预计疼痛会少得多，82% 的人预计步行能力与初次关节置换术后相同或步行能力大大提高。在患者中，56% 的患者表示期望的来源与外科医生无关，7% 的患者不确定，37% 的患者表示期望源自外科医生。第一年时，Harris 髋关节评分从中位数 45 分增加到 77 分，但只有 69% 和 55% 的人表示，他们在疼痛和行走能力方面的期望在很大程度上或相当大的程度上得到了实现。满足期望的唯一预测因素是没有并发症（比值比，4.8；95% 置信区间，1.1-20.8）。患者满意度一般； 63% 的人对满意度与实现的期望之间的中等相关性（0.46-0.47）感到非常或相当满意。术前髋部状况较差的患者通常更满意（比值比，5.0；95%置信区间，1.4-17.9），最重要的原因可能是步行能力的改善（r = 0.64）。患者的不满可能源于不切实际的期望。在术前咨询时，建议外科医生讨论翻修患者的期望，特别是对未来步行能力的期望，并告知患者翻修与初次髋关节置换术之间的基本预后差异。
Sixty-six consecutive revision total hip arthroplasty patients were asked about their expectations regarding future pain and walking ability. Expectations,were high, regardless of background factors: 92% expected to have much less Pain, and 82% expected the same walking ability as after the primary arthroplasty or a much improved walking ability. Of the patients, 56% stated a non-surgeon-related origin of expectations, 7% were uncertain, and 37% said expectations derived from the surgeon. At 1 year, Harris hip score had increased from a median 45 to 77 points, but only 69% and 55% said that their expectations had been fulfilled to a very large or rather large extent regarding pain and walking ability. The only predictor of fulfilled expectations was absence of complications (odds ratio, 4.8; 95% confidence interval, 1.1-20.8). Patient satisfaction was only moderate; 63% were very or rather satisfied with a moderate correlation (0.46-0.47) between satisfaction and fulfilled expectations. Patients with a poor preoperative hip condition generally were more satisfied (odds ratio, 5.0; 95% confidence interval, 1.4-17.9), and the most important reason probably was an improved walking ability (r = 0.64). Patient dissatisfaction may originate from unrealistic expectations. At preoperative consultation, it is recommended that the surgeon discuss the revision patient's expectations, especially regarding future walking ability, and inform the patient about the fundamental prognostic differences between revision and primary hip arthroplasty.