scholarly journals A Patient Satisfaction Survey Investigating Pre- and Post-Operative Information Provision in Lower Limb Surgery

2020 ◽  
Author(s):  
Maxwell Stanley Renna ◽  
Andrew Metcalfe ◽  
David Ellard ◽  
David Davies
Keyword(s):  
Patient Satisfaction ◽  
Lower Limb ◽  
Cruciate Ligament ◽  
Recovery Period ◽  
Information Provision ◽  
Free Text ◽  
Healthcare Provision ◽  
Major Trauma Centre ◽  
Lower Limb Surgery ◽  
The Impact

Abstract BackgroundPlanned lower limb surgery is common, with over 90,000 hip replacements, 95,000 knee replacements and 15,000 anterior cruciate ligament reconstructions performed in the UK each year. Patient satisfaction an important element of healthcare provision that is usually measured by functional outcomes but influenced by many other factors. Few studies have assessed patients’ views on the information given to them pertaining surgery and patients are infrequently consulted when designing leaflets and information packs which can lead to confusion during the recovery period and poor long-term outcomes. We aimed to assess if patients were satisfied with the information they received around their operations and identify potential improvements.MethodsSet in a major trauma centre in the West Midlands, a multiple choice and free-text answer survey was administered to patients who used the orthopaedic service over the course of one month. Surveys were designed in Qualtrics and administered face-to-face on paper. Thematic content analysis was performed. ResultsEighty patients completed the survey, of which 88.8% of patients were satisfied with the information they received. Discussions with surgeons were the most useful resource and 53% of patients requested more internet resources. Post-operative patients were statistically more likely to be dissatisfied with information provision. Over 20% of patients requested more information on post-op pain and recovery timelines. ConclusionsAlthough patients were satisfied in general, areas for change were identified. Suggested improvements take the form of webpages, a mobile platform or forum for asking healthcare professionals questions. Extra resources could contain educational videos, patient experiences and an interactive recovery timeline. These suggestions may enable NHS Trusts to “get into the digital age”, however, more research on patient satisfaction around information provision and the impact it has on recovery and decision making is needed.

scholarly journals A patient satisfaction survey investigating pre- and post-operative information provision in lower limb surgery

2020 ◽  
Author(s):  
Maxwell Stanley Renna ◽  
Andrew Metcalfe ◽  
David Ellard ◽  
David Davies
Keyword(s):  
Patient Satisfaction ◽  
Lower Limb ◽  
Cruciate Ligament ◽  
Recovery Period ◽  
Information Provision ◽  
Free Text ◽  
Healthcare Provision ◽  
Major Trauma Centre ◽  
Lower Limb Surgery ◽  
The Impact

Abstract Background Planned lower limb surgery is common, with over 90,000 hip replacements, 95,000 knee replacements and 15,000 anterior cruciate ligament reconstructions performed in the UK each year. These procedures are primarily indicated to treat osteoarthritis, sporting injuries and trauma. Patient satisfaction is an important element of healthcare provision, which is usually measured by functional outcomes but influenced by other factors. Few studies have assessed patients’ views on the information given to them pertaining surgery and patients are infrequently consulted when designing leaflets and information packs, which can lead to confusion during the recovery period and poor long-term outcomes. Furthermore, previous studies have not directly asked patients what resources they would prefer, or which format would suit them best. This project aimed to assess if patients were satisfied with the information they received around their operations and to identify potential improvements.Methods Set in a National Health Service (NHS) run major trauma centre in the West Midlands, a multiple choice and free-text answer survey was administered to patients who used the orthopaedic service over the course of one month. Surveys were designed in Qualtrics and administered face-to-face on paper. Thematic content analysis was performed on the results. Results Eighty patients completed the survey, of which 88.8% of patients were satisfied with the information they received. Discussions with surgeons were the most useful resource and 53% of patients requested more internet resources. Post-operative patients were statistically more likely to be dissatisfied with information provision than pre-operative patients. Over 20% of study population requested more information on post-operative pain and recovery timelines. Conclusions Although patients were satisfied in general, areas for change were identified. Suggested resources take the form of webpages and mobile platforms. These resources could contain educational videos, patient experience blogs or interactive recovery timelines, to be of benefit to patients. These suggestions may enable NHS Trusts to “get into the digital age”, however, more research on patient satisfaction around information provision and the impact it has on recovery and decision making is needed.

scholarly journals A patient satisfaction survey investigating pre- and post-operative information provision in lower limb surgery

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Maxwell Stanley Renna ◽  
Andrew Metcalfe ◽  
David Ellard ◽  
David Davies
Keyword(s):  
Patient Satisfaction ◽  
Lower Limb ◽  
Cruciate Ligament ◽  
Recovery Period ◽  
Information Provision ◽  
Free Text ◽  
Healthcare Provision ◽  
Major Trauma Centre ◽  
Lower Limb Surgery ◽  
The Impact

Abstract Background Planned lower limb surgery is common, with over 90,000 hip replacements, 95,000 knee replacements and 15,000 anterior cruciate ligament reconstructions performed in the UK each year. These procedures are primarily indicated to treat osteoarthritis, sporting injuries and trauma. Patient satisfaction is an important element of healthcare provision, which is usually measured by functional outcomes but influenced by other factors. Few studies have assessed patients’ views on the information given to them pertaining surgery and patients are infrequently consulted when designing leaflets and information packs, which can lead to confusion during the recovery period and poor long-term outcomes. Furthermore, previous studies have not directly asked patients what resources they would prefer, or which format would suit them best. This project aimed to assess if patients were satisfied with the information they received around their operations and to identify potential improvements. Methods Set in a National Health Service (NHS) run major trauma centre in the West Midlands, a multiple choice and free-text answer survey was administered to patients who used the orthopaedic service over the course of 1 month. Surveys were designed in Qualtrics and administered face-to-face on paper. Thematic content analysis was performed on the results. Results Eighty patients completed the survey, of which 88.8% of patients were satisfied with the information they received. Discussions with surgeons were the most useful resource and 53% of patients requested more internet resources. Post-operative patients were statistically more likely to be dissatisfied with information provision than pre-operative patients. Over 20% of the study population requested more information on post-operative pain and recovery timelines. Conclusions Although patients were satisfied in general, areas for change were identified. Suggested resources took the form of webpages and mobile platforms. These resources could contain educational videos, patient experience blogs or interactive recovery timelines, to be of benefit to patients. These suggestions may enable NHS Trusts to “get into the digital age”, however, more research on patient satisfaction around information provision and the impact it has on recovery and decision making is needed.

scholarly journals The impact of ‘unofficial trauma’ on a Major Trauma Centre: A service evaluation of accident and emergency department trauma team activations

Trauma ◽  
2020 ◽  
Vol 22 (4) ◽  
pp. 278-284
Author(s):  
Alex Wright ◽  
Simon J Mercer ◽  
Ben Morton
Keyword(s):  
Road Traffic ◽  
Statistical Tests ◽  
Penetrating Trauma ◽  
Trauma Centre ◽  
Research Network ◽  
Shop Floor ◽  
Trauma Patients ◽  
Healthcare Provision ◽  
Major Trauma Centre ◽  
The Impact

Introduction Trauma remains a leading cause of death worldwide. In the UK, data for trauma patients are prospectively collected locally and collated by the Trauma Audit and Research Network. This study assesses and describes the subgroup of patients who triggered a trauma call but who subsequently did not meet criteria for Trauma Audit and Research Network. Methods A single centre, retrospective observational study of trauma calls between 1 June 2012 and 31 August 2018 was performed, determining which trauma calls had been submitted to Trauma Audit and Research Network by cross referencing with the submission database. Data were tested for normality (Shapiro–Wilk test) and appropriate statistical tests employed to determine differences between inclusion and non-inclusion groups. For categorical data, we used Chi-squared tests to examine for differences. Results There were 6529 trauma calls and over half (3837 (58.8%)) were not registered on Trauma Audit and Research Network. Patients excluded were significantly younger (mean 42.4 years SD 19.2) than those who met inclusion criteria (mean 50.3 years, SD 21.8), p < 0.001 and were significantly more likely to suffer from penetrating trauma (18.6% versus 8.2%, p < 0.001), the majority (77.8%, 553/713) caused by stabbings. Patients excluded were less likely to be involved in a road traffic accident (31.1% versus 35.3%, p < 0.001), less likely to have fallen downstairs (15.2% versus 18.7%, p < 0.001) and less likely to have fallen from a height > 2 m (8.1% versus 12.7%, p < 0.001). Discussion Patients who trigger a trauma call but who subsequently do not meet the criteria for Trauma Audit and Research Network inclusion place a significant burden on healthcare provision. To our knowledge this is the first investigation to specifically explore this group of at-risk patients. To enable medical planners a more accurate view of activity on the ‘shop floor’, particularly in reference to knife crime injuries we ask the question as to whether a separate database should now be held of trauma calls?

scholarly journals Determinants of Post-Operative Cognitive Decline in Elderly People

2021 ◽  
pp. 1-7
Author(s):  
J. Cartailler ◽  
C. Loyer3 ◽  
E. Vanderlynden ◽  
R. Nizard ◽  
C. Rabuel ◽  
...  
Keyword(s):  
Pilot Study ◽  
Cognitive Decline ◽  
Lower Limb ◽  
Well Being ◽  
Short Term ◽  
Sociodemographic Data ◽  
Single Center Study ◽  
Significant Difference ◽  
Lower Limb Surgery ◽  
The Impact

Background: Surgery and anesthesia can result in temporary or permanent deterioration of the cognitive functions, for which causes remain unclear. Objectives: In this pilot study, we analyzed the determinants of cognitive decline following a non-emergency elective prosthesis implantation surgery for hip or knee. Design: Prospective single-center study investigating psychomotor response time and changes in MoCA scores between the day before (D-1) and 2 days after (D+2) following surgery at the Lariboisière Hospital (Paris, France). Participants: 60 patients (71.9±7.1-year-old, 72% women) were included. Measurements: Collected data consisted in sociodemographic data, treatments, comorbidities and the type of anesthesia (local, general or both). Furthermore, we evaluated pain and well-being before as well as after the surgery using point scales. Results: Post-operative (D+2) MoCA scores were significantly lower than pre-operative ones (D-1) with a median difference of 2 pts [IQR]=4pts, (p<0.001), we found no significant difference between locoregional and general anesthesia. Pre-operative benzodiazepine or anticholinergic treatments were also associated to a drop in MoCA scores (p=0.006). Finally, the use of ketamine during anesthesia (p=0.043) and the well-being (p=0.006) evaluated before intervention, were both linked to a reduced cognitive impact. Conclusion: In this pilot study, we observed a post-operative short-term cognitive decline following a lower limb surgery. We also identified pre and perioperative independent factors linked to cognitive decline following surgery. In a next stage, a larger cohort should be used to confirm the impact of these factors on cognitive decline.

scholarly journals Impact of Anterior Cruciate Ligament Status on Early Satisfaction and Clinical Outcomes Following Total Knee Arthroplasty

2020 ◽  
Vol 10 ◽  
Author(s):  
Ali Etemad-Rezaie ◽  
Tori A. Edmiston ◽  
Sean M. Kearns ◽  
Philip H. Locker ◽  
Daniel D. Bohl ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Anterior Cruciate Ligament ◽  
Patient Satisfaction ◽  
Knee Arthroplasty ◽  
Cruciate Ligament ◽  
Outcome Scores ◽  
Operative Outcome ◽  
Total Knee ◽  
Anterior Cruciate ◽  
The Impact

Introduction While total knee arthroplasty (TKA) is a successful treatment for debilitating arthritis, up to 20% of patients may be dissatisfied with their outcome. One hypothesis for dissatisfaction is the distortion of native knee kinematics following sacrifice of the anterior cruciate ligament (ACL) during TKA. The purpose of this study was to determine the impact of ACL status at the time of surgery in patients undergoing Posterior Stabilized (PS) TKA for osteoarthritis (OA). Methods A consecutive prospective series of patients undergoing TKA by a single surgeon underwent prospective intraoperative assessment of their ACL status divided into three different groups:1) intact, 2) attenuated, or 3) deficient. Demographic, preoperative, intraoperative, and postoperative data were collected for each patient by two blinded, independent observers. Outcomes included patient satisfaction and Knee Society Score for Pain (KSS) and Function (KSF), Kellgren and Lawrence (K&L), UCLA Activity Score (UCLA), Short Form-12 (SF12), EuroQol (EQ5D) and patient satisfaction. Results: Of 116 patients, 33 (28.4%) patients had an ACL deficient knee, 40 (34.5%) patients had an attenuated ACL, and 43 (37.1%) patients had an intact ACL. Those with absent ACL were significantly more likely to have a higher BMI (p=.007) and be male (p=.003). Patient with a deficient ACL had significantly lower preoperative KSF and higher K&L scores (p=.009, p=1.26 x 10-7). Attenuated and deficient groups had the greatest change in SF12PCS scores at their one-year follow-up with increases of 9.9 (±10.0) and 10.8 (±8.0), respectively (p=.037). No significant differences in overall postoperative KSS, KSF and satisfaction scores based on ACL status (p=.574 and p=.529, respectively) were found. Conclusion In a relatively large series, patient with ACL deficiency were more likely to have worse pre-operative outcome scores and similar or better post-operative outcome scores. This suggests that those with ACL insufficiency may experience more subjective improvement from TKA. ACL status can be used as an additional surgical marker to help orthopaedic surgeons identify which patients would most benefit from TKA.

scholarly journals Determinants of Post-Operative Cognitive Decline in Elderly People

2020 ◽  
Author(s):  
Jerome Cartailler ◽  
Camille Loyer ◽  
E. Vanderlynden ◽  
Remy Nizard ◽  
Christophe Rabuel ◽  
...  
Keyword(s):  
Pilot Study ◽  
Cognitive Decline ◽  
Lower Limb ◽  
Well Being ◽  
Short Term ◽  
Sociodemographic Data ◽  
Single Center Study ◽  
Significant Difference ◽  
Lower Limb Surgery ◽  
The Impact

Abstract Background: Surgery and anesthesia can result in temporary or permanent deterioration of the cognitive functions, for which causes remain unclear. In this pilot study, we analyzed the determinants of cognitive decline following a non-emergency elective prosthesis implantation surgery for hip or knee.Methods: Prospective single-center study investigating psychomotor response time and changes in MoCA scores between the day before (D-1) and 2 days after (D+2) following surgery in Lariboisière Hospital (Paris, France). 60 patients (71.9±7.1-year-old, 72% women) were included. Collected data consisted in sociodemographic data, treatment, comorbidities and type of anesthesia (local, general or both). Furthermore, we evaluated pain and well-being before as well as after the surgery using point scales. Findings: Post-operative (D+2) MoCA scores were significantly lower than pre-operative ones (D-1) with a difference of 2.25+3.0pts (p=0.004), we found no significant difference between locoregional and general anesthesia. Pre-operative benzodiazepine or anticholinergic treatment were also associated to a drop in MoCA scores (p=0.023). Finally, the use of ketamine during anesthesia (p=0.034) and the well-being (p=0.023) evaluated before intervention, were both linked to a reduced cognitive impact.Discussion: In this pilot study, we observed a post-operative short-term cognitive decline following a lower limb surgery. We also identified pre and perioperative independent factors linked to cognitive decline following surgery. In a next stage, a larger cohort should be used to confirm the impact of these factors on cognitive decline.

The impact of a physician’s recommendation and gender on informed decision making: A randomized controlled study in a simulated decision situation

2020 ◽  
Author(s):  
Marie Eggeling ◽  
Anna Meinhardt ◽  
Ulrike Cress ◽  
Joachim Kimmerle ◽  
Martina Bientzle
Keyword(s):  
Decision Making ◽  
Cruciate Ligament ◽  
Treatment Options ◽  
General Information ◽  
Treatment Preference ◽  
Controlled Study ◽  
Treatment Preferences ◽  
Hypothetical Scenario ◽  
And Gender ◽  
The Impact

Objective: This study examined the influence of physicians’ recommendations and gender on the decision-making process in a preference-sensitive situation. Methods: N = 201 participants were put in a hypothetical scenario in which they suffered from a rupture of the anterior cruciate ligament (ACL). They received general information on two equally successful treatment options for this injury (surgery vs. physiotherapy) and answered questions regarding their treatment preference, certainty and satisfaction regarding their decision, and attitude toward the treatment options. Then participants watched a video that differed regarding physician’s recommendation (surgery vs. physiotherapy) and physician’s gender (female vs. male voice and picture). Afterward, they indicated again their treatment preference, certainty, satisfaction, and attitude, as well as the physician’s professional and social competence.Results: Participants changed their treatment preferences in the direction of the physician’s recommendation (P&lt;.001). Decision certainty (P&lt;.001) and satisfaction (P&lt;.001) increased more strongly if the physician’s recommendation was congruent with the participant’s prior attitude than if the recommendation was contrary to the participant’s prior attitude. Finally, participants’ attitudes toward the recommended treatment became more positive (surgery recommendation: P&lt;.001; physiotherapy recommendation: P&lt;.001). We found no influence of the physician’s gender on participants’ decisions, attitudes, or competence assessments.Conclusion: This research indicates that physicians should be careful with recommendations when aiming for shared decisions, as they might influence patients even if the patients have been made aware that they should take their personal preferences into account. This could be particularly problematic if the recommendation is not in line with the patient’s preferences.

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