患者对日间膝关节镜手术的回忆。

Madan S, Kulkarni S, Friedrichs I, Barrett D S

Department of Orthopaedics, Southampton University Hospital, UK.

Bull Hosp Jt Dis. 2001;60(2):76-9.

A prospective study of 103 consecutive patients who underwent day case knee arthroscopy was performed. The purpose was to evaluate the information delivery system, patient comprehension, and issues of informed consent pertaining to day case arthroscopy procedures. There were 34 females and 69 males in the study group and their mean age was 38.6 years (range: 14.4 to 74.9 years). The diagnosis, procedure, and aftercare were explained to the patients in the outpatients clinic by a trained nurse and by the operating surgeon just prior to the operation. The nurse before the operation gave the patients an information booklet. Postoperatively the patients were informed about the findings and diagnosis prior to their discharge from the day care facility. Patients were requested to complete a questionnaire. Three weeks later they were given the same questionnaire, prior to consultation, in the outpatient clinic. These two forms were compared with the operative findings and diagnosis documented in the copy, of the questionnaire completed by the surgeon as well as the case notes. Most patients (38.8%; 40 patients) had no recollection; 3.9% (4 patients) had partial recollection at their consultation three weeks later; 19.4% (20 patients) found that the arthroscopic photograph was not helpful in making them understand the procedure; and 9.7% (10 patients) found the information booklet to be unhelpful. Further, 23.3% (24 patients) said that it would not help if the booklet were sent to them prior to the operation. The recollection rate was also correlated to their position on the operating list, to ascertain the effect of the anesthetic. There was a 65.9% (58 patients) recollection rate in those patients who were on the first half of the list and there was only a 33.33% recollection rate in those patients who were last or second to the last [p = 0.0225]. We recommend regular evaluation and improvement in the communication and information delivery system provided to patients.

对103例连续接受日间膝关节镜检查的患者进行了一项前瞻性研究。目的是评估与日间关节镜检查程序相关的信息传递系统、患者理解情况以及知情同意问题。研究组中有34名女性和69名男性，他们的平均年龄为38.6岁（范围：14.4至74.9岁）。在门诊，由一名经过培训的护士以及主刀医生在手术前向患者解释诊断、手术过程和术后护理。手术前护士给患者一本信息手册。术后在患者从日间护理机构出院前告知他们检查结果和诊断。要求患者填写一份问卷。三周后，在门诊咨询前再次给他们相同的问卷。将这两份问卷与外科医生填写的问卷副本以及病历中记录的手术结果和诊断进行比较。大多数患者（38.8%；40例）没有记忆；3.9%（4例）在三周后的咨询时有部分记忆；19.4%（20例）发现关节镜照片无助于他们理解手术过程；9.7%（10例）认为信息手册没有帮助。此外，23.3%（24例）表示术前将手册寄给他们也没有帮助。记忆率还与他们在手术名单上的位置相关，以确定麻醉的影响。排在名单前半部分的患者记忆率为65.9%（58例），而排在最后或倒数第二的患者记忆率仅为33.33%[p = 0.022（此处原文应为0.0225，疑似有误）5]。我们建议定期评估并改进向患者提供的沟通和信息传递系统。