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Revisiting patient satisfaction following total knee arthroplasty: a longitudinal observational study

BACKGROUND: Total knee arthroplasty (TKA) is the most common joint replacement surgery in Canada. Earlier Canadian work reported 1 in 5 TKA patients expressing dissatisfaction following surgery. A better understanding of satisfaction could guide program improvement. We investigated patient satisfact...

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Autores principales: Bryan, Stirling, Goldsmith, Laurie J., Davis, Jennifer C., Hejazi, Samar, MacDonald, Valerie, McAllister, Patrick, Randall, Ellen, Suryaprakash, Nitya, Wu, Amery D., Sawatzky, Richard
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6267049/
https://www.ncbi.nlm.nih.gov/pubmed/30497445
http://dx.doi.org/10.1186/s12891-018-2340-z
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author Bryan, Stirling
Goldsmith, Laurie J.
Davis, Jennifer C.
Hejazi, Samar
MacDonald, Valerie
McAllister, Patrick
Randall, Ellen
Suryaprakash, Nitya
Wu, Amery D.
Sawatzky, Richard
author_facet Bryan, Stirling
Goldsmith, Laurie J.
Davis, Jennifer C.
Hejazi, Samar
MacDonald, Valerie
McAllister, Patrick
Randall, Ellen
Suryaprakash, Nitya
Wu, Amery D.
Sawatzky, Richard
author_sort Bryan, Stirling
collection PubMed
description BACKGROUND: Total knee arthroplasty (TKA) is the most common joint replacement surgery in Canada. Earlier Canadian work reported 1 in 5 TKA patients expressing dissatisfaction following surgery. A better understanding of satisfaction could guide program improvement. We investigated patient satisfaction post-TKA in British Columbia (BC). METHODS: A cohort of 515 adult TKA patients was recruited from across BC. Survey data were collected preoperatively and at 6 and 12 months, supplemented by administrative health data. The primary outcome measure was patient satisfaction with outcomes. Potential satisfaction drivers included demographics, patient-reported health, quality of life, social support, comorbidities, and insurance status. Multivariable growth modeling was used to predict satisfaction at 6 months and change in satisfaction (6 to 12 months). RESULTS: We found dissatisfaction rates (“very dissatisfied”, “dissatisfied” or “neutral”) of 15% (6 months) and 16% (12 months). Across all health measures, improvements were seen post-surgery. The multivariable model suggests satisfaction at 6 months is predicted by: pre-operative pain, mental health and physical health (odds ratios (ORs) 2.65, 3.25 and 3.16), and change in pain level, baseline to 6 months (OR 2.31). Also, improvements in pain, mental health and physical health from 6 to 12 months predicted improvements in satisfaction (ORs 1.24, 1.30 and 1.55). CONCLUSIONS: TKA is an effective intervention for many patients and most report high levels of satisfaction. However, if the TKA does not deliver improvements in pain and physical health, we see a less satisfied patient. In addition, dissatisfied TKA patients typically see limited improvements in mental health.
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spelling pubmed-62670492018-12-05 Revisiting patient satisfaction following total knee arthroplasty: a longitudinal observational study Bryan, Stirling Goldsmith, Laurie J. Davis, Jennifer C. Hejazi, Samar MacDonald, Valerie McAllister, Patrick Randall, Ellen Suryaprakash, Nitya Wu, Amery D. Sawatzky, Richard BMC Musculoskelet Disord Research Article BACKGROUND: Total knee arthroplasty (TKA) is the most common joint replacement surgery in Canada. Earlier Canadian work reported 1 in 5 TKA patients expressing dissatisfaction following surgery. A better understanding of satisfaction could guide program improvement. We investigated patient satisfaction post-TKA in British Columbia (BC). METHODS: A cohort of 515 adult TKA patients was recruited from across BC. Survey data were collected preoperatively and at 6 and 12 months, supplemented by administrative health data. The primary outcome measure was patient satisfaction with outcomes. Potential satisfaction drivers included demographics, patient-reported health, quality of life, social support, comorbidities, and insurance status. Multivariable growth modeling was used to predict satisfaction at 6 months and change in satisfaction (6 to 12 months). RESULTS: We found dissatisfaction rates (“very dissatisfied”, “dissatisfied” or “neutral”) of 15% (6 months) and 16% (12 months). Across all health measures, improvements were seen post-surgery. The multivariable model suggests satisfaction at 6 months is predicted by: pre-operative pain, mental health and physical health (odds ratios (ORs) 2.65, 3.25 and 3.16), and change in pain level, baseline to 6 months (OR 2.31). Also, improvements in pain, mental health and physical health from 6 to 12 months predicted improvements in satisfaction (ORs 1.24, 1.30 and 1.55). CONCLUSIONS: TKA is an effective intervention for many patients and most report high levels of satisfaction. However, if the TKA does not deliver improvements in pain and physical health, we see a less satisfied patient. In addition, dissatisfied TKA patients typically see limited improvements in mental health. BioMed Central 2018-11-30 /pmc/articles/PMC6267049/ /pubmed/30497445 http://dx.doi.org/10.1186/s12891-018-2340-z Text en © The Author(s). 2018 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Bryan, Stirling
Goldsmith, Laurie J.
Davis, Jennifer C.
Hejazi, Samar
MacDonald, Valerie
McAllister, Patrick
Randall, Ellen
Suryaprakash, Nitya
Wu, Amery D.
Sawatzky, Richard
Revisiting patient satisfaction following total knee arthroplasty: a longitudinal observational study
title Revisiting patient satisfaction following total knee arthroplasty: a longitudinal observational study
title_full Revisiting patient satisfaction following total knee arthroplasty: a longitudinal observational study
title_fullStr Revisiting patient satisfaction following total knee arthroplasty: a longitudinal observational study
title_full_unstemmed Revisiting patient satisfaction following total knee arthroplasty: a longitudinal observational study
title_short Revisiting patient satisfaction following total knee arthroplasty: a longitudinal observational study
title_sort revisiting patient satisfaction following total knee arthroplasty: a longitudinal observational study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6267049/
https://www.ncbi.nlm.nih.gov/pubmed/30497445
http://dx.doi.org/10.1186/s12891-018-2340-z
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