Differences between patients' and physicians' evaluations of outcome after total hip arthroplasty
Differences between patients' and physicians' evaluations of outcome after total hip arthroplasty
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DOI：
10.2106/00004623-199606000-00005
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发表时间：
1996-06-01
影响因子：
5.3
通讯作者：
Finerman, GA
中科院分区：
文献类型：
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作者：
Lieberman, JR;Dorey, F;Finerman, GA
本研究的目的是比较147例全髋关节置换术患者和医生对手术结果的评价。患者和医生独立地评价疼痛和总体满意度，使用10.0厘米视觉模拟量表评价手术结果，他们还回答了一份问卷，其中他们评估了一般健康状况、功能能力和疼痛。平均（和标准差）疼痛模拟评级（0.0厘米表示没有疼痛，10.0厘米表示剧烈疼痛）患者评估为1.7 ± 2.6厘米，医生评估为1.1 ± 1.8厘米（p < 0.001，配对t检验），总体满意度的平均模拟评分患者评估的平均直径（0.0 cm表示差，10.0 cm表示优）为8.6 ± 2.1 cm，医生评估的平均直径为8.8 ± 1.7 cm（p = 0.07，配对t检验），当患者将低评分分配给特定区域时，患者和医生的评分之间存在显著差异。对于将疼痛评定为超过4.0厘米的30名患者，根据患者，平均模拟评分为6.8 +/- 2.1厘米，而根据医生的说法，它是3.6 +/- 2.7厘米（p < 0.001，线性回归），根据将该参数评定为小于7.0 cm的19名患者，总体满意度的平均模拟评级为3.8 +/- 2.0 cm，而根据医生的平均评分为6.5 ± 2.8厘米（p < 0.001，线性回归），当患者很少或没有疼痛并且对结果满意时，患者和医生对全髋关节置换术结果的评价相似。然而，随着患者疼痛评分的增加和整体满意度评分的下降，这种差异也在增加。这项研究强调了患者和医生对全髋关节置换术结果的评价之间的差异。当患者对结果不满意时，这种差异会增加。使用患者自填问卷以及传统的医生评估可能会对全髋关节置换术的结果进行更全面的评估。
The purpose of this study was to compare patients' and physicians' evaluations of the results of 147 total hip arthroplasties, The patients and physicians independently evaluated pain and over-all satisfaction,vith the outcome of the procedure using a 10.0-centimeter visual-analog scale, They also answered a questionnaire with which they assessed general health, functional ability, and pain,The mean (and standard deviation) analog rating for pain (with 0.0 centimeters indicating no pain and 10.0 centimeters, severe pain) was 1.7 +/- 2.6 centimeters as assessed by the patients and 1.1 +/- 1.8 centimeters as assessed by the physicians (p < 0.001, paired t test), The mean analog rating for over-all satisfaction (with 0.0 centimeters indicating poor and 10.0 centimeters, excellent) was 8.6 +/- 2.1 centimeters as assessed by the patients and 8.8 +/- 1.7 centimeters as assessed by the physicians (p = 0.07, paired t test), There was a marked disparity between the patients' and the physicians' scores when the patients assigned a low score to a particular area, For the thirty patients who rated the pain as more than 4.0 centimeters, the mean analog rating was 6.8 +/- 2.1 centimeters according to the patients, while it was 3.6 +/- 2.7 centimeters according to the physicians (p < 0.001, linear regression), The mean analog rating for over-all satisfaction according to the nineteen patients who rated this parameter as less than 7.0 centimeters was 3.8 +/- 2.0 centimeters, while the mean rating according to the physicians was 6.5 +/- 2.8 centimeters (p < 0.001, linear regression), The patients' and physicians' evaluations were similar regarding the results of the total hip arthroplasty when the patients had little or no pain and were satisfied with the result. However, the disparity increased as the patients' ratings for pain increased and their ratings for over-all satisfaction decreased.This study highlights a discrepancy between patients' and physicians' evaluations of the results of total hip arthroplasty. This discrepancy increased when the patient was not satisfied with the outcome, The use of patients' self-administered questionnaires as well as traditional physician-generated assessments may provide a more complete evaluation of the results of total hip arthroplasty.