Rosenberger Patricia H, Jokl Peter, Cameron Ann, Ickovics Jeannette R
Department of Epidemiology and Public Health, Yale University School of Medicine, New Haven, Connecticut, USA.
Arthroscopy. 2005 May;21(5):562-9. doi: 10.1016/j.arthro.2005.02.022.
The present study was performed to determine the extent to which physicians and patients rate preoperative and postoperative knee pain and function differently, and to determine whether physicians or patients more accurately predict postoperative knee pain and function.
Longitudinal, prospective study.
Ninety-eight patients requiring either anterior cruciate ligament reconstruction surgery or meniscectomy and related surgery were interviewed 1 week before surgery, as well as 3 and 24 weeks postoperatively. Patients and their physicians completed ratings on knee pain and function at each time point. In addition, at their preoperative visit, patients and physicians completed ratings predicting their postoperative pain and functional status.
Physicians rated patients as having less pain and greater knee function preoperatively and at 24 weeks postoperatively. Patients had more significant differences between predicted and actual ratings.
Physicians tended to underestimate knee pain and overestimate knee function compared with patients. However, physicians better predicted postoperative knee pain and function ratings than did patients. These findings suggest that physician-patient discussions about preoperative expectations and postoperative reality might be an important part of clinical care.
Level II, Prospective Longitudinal Study.
进行本研究以确定医生和患者对术前及术后膝关节疼痛和功能的评分差异程度，并确定医生或患者谁能更准确地预测术后膝关节疼痛和功能。
纵向前瞻性研究。
对98例需要进行前交叉韧带重建手术或半月板切除术及相关手术的患者，在术前1周以及术后3周和24周进行访谈。患者及其医生在每个时间点完成对膝关节疼痛和功能的评分。此外，在术前就诊时，患者和医生完成对术后疼痛和功能状态的预测评分。
医生评定患者在术前和术后24周时疼痛较轻且膝关节功能较好。患者在预测评分和实际评分之间存在更显著的差异。
与患者相比，医生往往低估膝关节疼痛并高估膝关节功能。然而，医生比患者能更好地预测术后膝关节疼痛和功能评分。这些发现表明，医生与患者之间关于术前期望和术后实际情况的讨论可能是临床护理的重要组成部分。
二级，前瞻性纵向研究。
