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Patients without preoperative education class have higher expectations of outcome
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Researchers from New York found that more than one-third of patients who underwent unilateral total hip arthroplasty had discordantly higher expectations of their outcomes than their surgeon.
Hassan Ghomrawi, PhD, and colleagues found that of 249 patients who took a validated Hospital for Special Surgery hip replacement expectations survey, 34.5% had discordantly high expectations of their outcome compared to their surgeon.
“The preoperative educational class was important to align patient expectations with those of the surgeon,” Ghomrawi stated in his presentation. “This study also identified patient subgroups and potentially modifiable patient factors, such as the perception of complications that could be addressed in further education to reduce discordance.”
The survey included 18 items on aspects of recovery, including psychological well being, walking, pain relief and the ability to complete recreational activities. Surgeons were blinded to patient responses and also took the same preoperative survey, Ghomrawi said.
Researchers noted that a college education, WOMAC stiffness score and perception of no complications were factors more likely to influence higher expectations in patients. Patients who were sicker, who attended an education course on expectations and who filled out the expectation preoperatively instead of postoperatively had much lower odds of discordantly high expectations, Ghomrawi said.
Reference:
Ghomrawi H, Mancuso C, Della Valle AMG, et al. Predictors of discordance in expectations of total hip arthroplasty between patients and surgeons. Paper #217. Presented at the American Academy of Orthopaedic Surgeons 2012 Annual Meeting. Feb. 7-11. San Francisco.
Disclosure: Ghomrawi has no relevant financial disclosures.
