Patient Expectations about Communication in the Perioperative Setting of Elective Knee Surgery – a Questionnaire-based Cross-sectional Study

Sebastian G. Walter; Florian Naal; Franco M. Impellizzeri; Berthold Moser; Frank A. Schildberg; Tomas Drobny; Stefan Preiss; Gian M. Salzmann

doi:10.1055/a-0998-8234

Zeitschrift für Orthopädie und Unfallchirurgie, Table of Contents

Z Orthop Unfall 2020; 158(05): 490-496
DOI: 10.1055/a-0998-8234

Original Article

Patient Expectations about Communication in the Perioperative Setting of Elective Knee Surgery – a Questionnaire-based Cross-sectional Study

Ergebnisse eines Erwartungsfragebogens für Patienten mit Fokus auf perioperativen Rahmenbedingungen und Kommunikation am Beispiel der elektiven Knieoperation – eine Querschnittsstudie

Sebastian G. Walter

¹Clinic for Orthopedics and Trauma Surgery, University Hospital Bonn, Bonn, Germany

²Department of Lower Extremity Orthopaedics, Musculoskeletal Centre, Schulthess Clinic, Zurich, Switzerland

,

Florian Naal

²Department of Lower Extremity Orthopaedics, Musculoskeletal Centre, Schulthess Clinic, Zurich, Switzerland

,

Franco M. Impellizzeri

²Department of Lower Extremity Orthopaedics, Musculoskeletal Centre, Schulthess Clinic, Zurich, Switzerland

,

Berthold Moser

³Department of Anaesthesiology, Klinik Gut AG, Nordbunden, Switzerland

,

Frank A. Schildberg

¹Clinic for Orthopedics and Trauma Surgery, University Hospital Bonn, Bonn, Germany

,

Tomas Drobny

²Department of Lower Extremity Orthopaedics, Musculoskeletal Centre, Schulthess Clinic, Zurich, Switzerland

,

Stefan Preiss

²Department of Lower Extremity Orthopaedics, Musculoskeletal Centre, Schulthess Clinic, Zurich, Switzerland

,

Gian M. Salzmann

²Department of Lower Extremity Orthopaedics, Musculoskeletal Centre, Schulthess Clinic, Zurich, Switzerland

⁴Department of Orthopedics and Trauma Surgery, University Medical Center Freiburg, Freiburg, Germany

⁵Gelenkzentrum Rhein-Main, Wiesbaden, Germany

› Author Affiliations

Abstract

Background Patient expectations are an issue which is attracting increased interest in outcome research for knee surgery procedures. So far, research into patient expectations has mainly focused on the procedure and postoperative functional improvements. The purpose of this study was to identify patient expectations in the perioperative setting.

Material and Methods This was a single-center prospective study. A 17-item questionnaire (ordinal answer scale) about patientsʼ perioperative expectations was developed and completed by patients undergoing elective joint-preserving knee surgery. The study covered a period of 3 months and included all patients consecutively undergoing knee surgery. Subgroup analysis was performed for gender, age and type of insurance.

Results 111 consecutive patients completed the questionnaire on admission. Significant preferences for one answer option were found for 13 out of 17 items. Patients considered it “unimportant” whether or not the physician wore a white coat during the consultation and “very important” that the first medical consultation after the patient was discharged from hospital was with the surgeon who had performed their operation. A concise explanation of the surgical procedure using images, talking to the surgeon the day before surgery and immediately after surgery, having their wound personally inspected by the surgeon, and, finally, the availability of the surgeon by phone were regarded as “important”. There were no differences in patient responses between the different subgroups.

Conclusion Patients expect a high personal commitment and availability of the surgeon during the entire perioperative setting, starting from the first consultation and continuing during follow-up examinations.

Zusammenfassung

Hintergrund Patientenerwartungen sind in der Ergebnisforschung für Knieoperationen von zunehmendem Interesse. Bisher konzentrierte sich die Forschung der Erwartungshaltung hauptsächlich auf Operationen und postoperative Funktionsverbesserungen. Der Zweck dieser Studie bestand darin, die Patientenerwartungen an die perioperativen Rahmenbedingungen zu ermitteln.

Material und Methoden Prospektive Single-Center-Studie. Ein 17-Punkte-Fragebogen (ordinale Antwortskala) zur perioperativen Patientenerwartung wurde entwickelt und nach entsprechender Bearbeitung durch Patienten, welche sich einer elektiven gelenkerhaltenden Knieoperation unterzogen, ausgewertet. Die Analyse dauerte 3 Monate und umfasste alle Patienten, welche sich in dieser Zeit einer Operation unterzogen. Es wurden Subgruppenanalysen nach Geschlecht, Alter und Art der Versicherung durchgeführt.

Ergebnisse 111 aufeinanderfolgende Patienten füllten den Fragebogen nach der Aufnahme aus. Bei 13 von 17 Elementen wurden signifikante Präferenzen für eine Antwortoption gefunden. Die Patienten hielten es für „unwichtig“, dass der Arzt einen weißen Kittel zur Beratung trug und „sehr wichtig“ war, dass die erste ärztliche Beratung nach der Entlassung aus dem Krankenhaus vom Chirurgen persönlich durchgeführt wurde. Die Erklärung des Operationsvorgangs anhand von Bildern, ein Gespräch mit dem Chirurgen am Tag vor der Operation und direkt nach der Operation, die persönliche Wundkontrolle durch den Chirurgen und schließlich die telefonische Verfügbarkeit des Chirurgen wurden als „wichtig“ angesehen. Beim Vergleich der verschiedenen Untergruppen gab es keine Unterschiede im Antwortverhalten.

Schlussfolgerung Die Patienten erwarten ein hohes persönliches Engagement und eine hohe Verfügbarkeit des Chirurgen im gesamten perioperativen Umfeld – von der ersten Konsultation bis zur Nachuntersuchung.

Key words

patient expectations - knee surgery - patient feedback - perioperative environment - relationships in healthcare

Schlüsselwörter

Patientenerwartungen - Knieoperation - Patientenfeedback - perioperative Umgebung - Beziehungen im Gesundheitswesen

Full Text

References

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