Department of Orthopaedics, Division of Spine, University of British Columbia, Vancouver, British Columbia, Canada.
Spine (Phila Pa 1976). 2010 Sep 1;35(19):1807-11. doi: 10.1097/BRS.0b013e3181c15b5d.
Surgeon completed questionnaire.
To determine information provided by spine surgeons to patients, part of a 4-part study determining the impact of patient expectations on outcome following spinal trauma.
An important goal of treatment is patient satisfaction, which may be influenced by patient expectations. Impact of patient expectations on outcome has been demonstrated in various elective orthopedic populations. It is anticipated that there will be similar, if not greater, impact on outcome in a trauma setting.
A questionnaire was developed, in a case-based format, to determine the information provided by spine surgeons to their patients. There were 3 questionnaires, each consisting of 5 cases and grouped by cervical spine trauma, thoracolumbar spine trauma, and spinal cord injury. These questionnaires were distributed to members of the Spine Trauma Study Group and our division. Statistical analysis consisted of a single-factor random effects model. In this analysis, the degree of variability was quantified as the ratio of surgeon induced variance over total variance for the questions.
Questionnaires were distributed to 54 surgeons and 31 responses received (57%). There was substantial variability in responses ranging from a ratio of 9% [95% confidence interval (CI): 0-26] for the regaining range of motion 1 year following cervical spine trauma domain to a ratio of 84% (95% CI: 69-92) for the early postoperative spasticity following spinal cord injury domain.
This study demonstrated substantial variability in the information provided by spine surgeons to spine trauma patients and the need to improve the quality of information provided, allowing patient expectations to be more appropriate, potentially maximizing their outcome. Further areas for study include, assessment of the best available evidence on which to base information provided to spinal trauma patients, determination of what information spinal trauma patients view as relevant and the effect appropriate expectations have on outcome.
外科医生完成问卷调查。
确定脊柱外科医生向患者提供的信息，这是一项 4 部分研究的一部分，旨在确定患者期望对脊柱创伤后结果的影响。
治疗的一个重要目标是患者满意度，这可能受到患者期望的影响。在各种择期骨科人群中，已经证明了患者期望对结果的影响。预计在创伤环境中，这种影响即使没有更大，也会相似。
以案例为基础的格式制定了一份问卷，以确定脊柱外科医生向其患者提供的信息。有 3 份问卷，每份问卷由 5 个案例组成，分为颈椎创伤、胸腰椎创伤和脊髓损伤。这些问卷分发给脊柱创伤研究小组和我们部门的成员。统计分析包括单因素随机效应模型。在这种分析中，外科医生引起的方差与问题的总方差之比被量化为方差的程度。
向 54 名外科医生分发了问卷，收到 31 份回复（57%）。答复存在很大差异，从颈椎创伤领域 1 年后恢复活动范围的比例为 9%（95%置信区间[CI]：0-26）到脊髓损伤领域术后早期痉挛的比例为 84%（95% CI：69-92）。
这项研究表明，脊柱外科医生向脊柱创伤患者提供的信息存在很大差异，需要提高信息提供的质量，使患者期望更加合理，从而最大限度地提高他们的结果。进一步的研究领域包括，评估提供给脊柱创伤患者的最佳现有证据，确定脊柱创伤患者认为哪些信息相关，以及适当的期望对结果的影响。
