CC BY-NC-ND 4.0 · Joints 2017; 05(03): 133-137
DOI: 10.1055/s-0037-1605585
Original Article
Georg Thieme Verlag KG Stuttgart · New York

Expectations of Shoulder Surgery Are Not Altered by Surgeon Counseling of the Patient

Cassandra Lawrence
1   Department of Orthopaedic Surgery, Thomas Jefferson University, Sidney Kimmel Medical College, Philadelphia, Pennsylvania, United States
,
Benjamin M. Zmistowski
2   Department of Orthopaedic Surgery, Rothman Institute, Thomas Jefferson University, Philadelphia, Pennsylvania, United States
,
Mark Lazarus
2   Department of Orthopaedic Surgery, Rothman Institute, Thomas Jefferson University, Philadelphia, Pennsylvania, United States
,
Joseph Abboud
2   Department of Orthopaedic Surgery, Rothman Institute, Thomas Jefferson University, Philadelphia, Pennsylvania, United States
,
Gerald Williams
2   Department of Orthopaedic Surgery, Rothman Institute, Thomas Jefferson University, Philadelphia, Pennsylvania, United States
,
Surena Namdari
2   Department of Orthopaedic Surgery, Rothman Institute, Thomas Jefferson University, Philadelphia, Pennsylvania, United States
› Institutsangaben
Weitere Informationen

Publikationsverlauf

Publikationsdatum:
11. August 2017 (online)

Abstract

Purpose The primary objective of this study was to evaluate if the current mechanisms of preoperative counseling influence patients' expectations of shoulder surgery.

Methods Patients were asked to complete the Hospital for Special Surgery's (HSS) Shoulder Surgery Expectations Survey. The first survey was completed before the first appointment with one of four fellowship-trained shoulder surgeons. The second survey was completed after patients consented for surgery. Our analysis also included patient demographics and surgical factors.

Results A total of 41 patients completed the HSS Shoulder Surgery Expectations Survey before and after their first appointment with the surgeon during which they consented to shoulder surgery. Before seeing the surgeon, the mean HSS Shoulder Surgery Expectations score was 72.5. After seeing the surgeon and being consented for surgery, the mean HSS Shoulder Surgery Expectations score was 74.8. The mean change in HSS Shoulder Surgery Expectations score (+2.3) was not statistically significant (p value = 0.242). We did not find any significant correlations between patients' expectations and demographics or surgical factors. Total HSS Shoulder Surgery Expectations scores and change in scores were not statistically different between the four surgeons (p = 0.146).

Conclusion Patient expectations were not substantially altered after preoperative counseling. Further investigation is necessary to investigate factors correlated with expectations, the implication of unaltered expectations on the postoperative outcome, and methods for improving the preoperative counseling process.

Level of Evidence Level II, prospective cohort study.

Note

This study was performed at the Rothman Institute, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, United States. Institutional review board approval number is #12D.233.


 
  • References

  • 1 Mancuso CA, Altchek DW, Craig EV. , et al. Patients' expectations of shoulder surgery. J Shoulder Elbow Surg 2002; 11 (06) 541-549
  • 2 Henn III RF, Ghomrawi H, Rutledge JR, Mazumdar M, Mancuso CA, Marx RG. Preoperative patient expectations of total shoulder arthroplasty. J Bone Joint Surg Am 2011; 93 (22) 2110-2115
  • 3 Mondloch MV, Cole DC, Frank JW. Does how you do depend on how you think you'll do? A systematic review of the evidence for a relation between patients' recovery expectations and health outcomes. CMAJ 2001; 165 (02) 174-179
  • 4 Warth RJ, Briggs KK, Dornan GJ, Horan MP, Millett PJ. Patient expectations before arthroscopic shoulder surgery: correlation with patients' reasons for seeking treatment. J Shoulder Elbow Surg 2013; 22 (12) 1676-1681
  • 5 Henn III RF, Kang L, Tashjian RZ, Green A. Patients' preoperative expectations predict the outcome of rotator cuff repair. J Bone Joint Surg Am 2007; 89 (09) 1913-1919
  • 6 Mahomed NN, Liang MH, Cook EF. , et al. The importance of patient expectations in predicting functional outcomes after total joint arthroplasty. J Rheumatol 2002; 29 (06) 1273-1279
  • 7 Rosenberger PH, Jokl P, Cameron A, Ickovics JR. Shared decision making, preoperative expectations, and postoperative reality: differences in physician and patient predictions and ratings of knee surgery outcomes. Arthroscopy 2005; 21 (05) 562-569
  • 8 Carroll LJ, Lis A, Weiser S, Torti J. How well do you expect to recover, and what does recovery mean, anyway? qualitative study of expectations after a musculoskeletal injury. Phys Ther 2016; 96 (06) 797-807
  • 9 Hageman MG, Briët JP, Bossen JK, Blok RD, Ring DC, Vranceanu AM. Do previsit expectations correlate with satisfaction of new patients presenting for evaluation with an orthopaedic surgical practice?. Clin Orthop Relat Res 2015; 473 (02) 716-721
  • 10 Bible JE, Shau DN, Kay HF, Cheng JS, Aaronson OS, Devin CJ. Are low patient satisfaction scores always due to the provider? determinants of patient satisfaction scores during spine clinic visits. Spine 2016; DOI: 10.1097/BRS.0000000000001453.
  • 11 McGaughey I. Informed consent and knee arthroscopies: an evaluation of patient understanding and satisfaction. Knee 2004; 11 (03) 237-242
  • 12 Richards RR, An KN, Bigliani LU. , et al. A standardized method for the assessment of shoulder function. J Shoulder Elbow Surg 1994; 3 (06) 347-352
  • 13 Williams GN, Gangel TJ, Arciero RA, Uhorchak JM, Taylor DC. Comparison of the Single Assessment Numeric Evaluation method and two shoulder rating scales. Outcomes measures after shoulder surgery. Am J Sports Med 1999; 27 (02) 214-221
  • 14 Lippitt S, Harryman D, Matsen F. A practical tool for evaluating function: the Simple Shoulder Test. The shoulder: a balance of mobility and stability. Rosemont, IL: American Academy of Orthopaedic Surgeons; 1993: 501-518
  • 15 Selim AJ, Rogers W, Fleishman JA. , et al. Updated U.S. population standard for the Veterans RAND 12-item Health Survey (VR-12). Qual Life Res 2009; 18 (01) 43-52
  • 16 West SG, Finch JF, Curran PJ. Structural equation models with nonnormal variables: problems and remedies. In: Hoyle RH. , ed. Structural Equation Modeling: Concepts, Issues and Applications. Newbury Park, CA: Sage; 1995: 56-75
  • 17 Hutson MM, Blaha JD. Patients' recall of preoperative instruction for informed consent for an operation. J Bone Joint Surg Am 1991; 73 (02) 160-162
  • 18 Sandberg EH, Sharma R, Sandberg WS. Deficits in retention for verbally presented medical information. Anesthesiology 2012; 117 (04) 772-779
  • 19 Hoppe DJ, Denkers M, Hoppe FM, Wong IH. The use of video before arthroscopic shoulder surgery to enhance patient recall and satisfaction: a randomized-controlled study. J Shoulder Elbow Surg 2014; 23 (06) e134-e139
  • 20 Yin B, Goldsmith L, Gambardella R. Web- based education prior to knee arthroscopy enhances informed consent and patient knowledge recall: a prospective, randomized controlled study. J Bone Joint Surg Am 2015; 97 (12) 964-971
  • 21 Cornoiu A, Beischer AD, Donnan L, Graves S, de Steiger R. Multimedia patient education to assist the informed consent process for knee arthroscopy. ANZ J Surg 2011; 81 (03) 176-180
  • 22 Kadakia RJ, Tsahakis JM, Issar NM. , et al. Health literacy in an orthopedic trauma patient population: a cross-sectional survey of patient comprehension. J Orthop Trauma 2013; 27 (08) 467-471
  • 23 Sahin N, Oztürk A, Ozkan Y, Demirhan Erdemir A. What do patients recall from informed consent given before orthopedic surgery?. Acta Orthop Traumatol Turc 2010; 44 (06) 469-475
  • 24 Paasche-Orlow MK, Parker RM, Gazmararian JA, Nielsen-Bohlman LT, Rudd RR. The prevalence of limited health literacy. J Gen Intern Med 2005; 20 (02) 175-184