AP-HP, Hôpital R. Poincaré, Service de Médecine Physique et Réadaptation, Garches, France.
PLoS One. 2012;7(1):e30195. doi: 10.1371/journal.pone.0030195. Epub 2012 Jan 17.
Analysis of discrepancies between patient and surgeon expectations before total hip arthroplasty (THA) should enable a better understanding of motives of dissatisfaction about surgery, but this question has been seldom studied. Our objectives were to compare surgeons' and patients' expectations before THA, and to study factors which affected surgeon-patient agreement.
132 adults (mean age 62.8+/-13.7 years, 52% men) on waiting list for THA in three tertiary care centres and their 16 surgeons were interviewed to assess their expectations using the Hospital for Special Surgery Total Hip Replacement Expectations Survey (range 0-100). Patients' and surgeons' answers were compared, for the total score and for the score of each item. Univariate analyses tested the effect of patients' characteristics on surgeons' and patients' expectations separately, and on surgeon-patient differences.
Surgeon and patient expectations' mean scores were high (respectively 90.9+/-11.1 and 90.0+/-11.6 over 100). Surgeons' and patients' expectations showed no systematic difference, but there was little agreement on Bland and Altman graph and correlation coefficient was low. Patients had higher expectations than surgeons for sports. Patients rated their expectations according to trust in physician and mental quality of life, surgeons considered disability. More disabled patients and patients from a low-income professional category were often "more optimistic" than their surgeons.
Surgeons and patients often do not agree on what to expect from THA. More disabled patients expect better outcomes than their surgeons.
分析全髋关节置换术（THA）前患者和外科医生期望之间的差异，以便更好地了解对手术不满意的动机，但这一问题很少被研究。我们的目的是比较 THA 前外科医生和患者的期望，并研究影响医患一致的因素。
在三个三级护理中心，对等待 THA 的 132 名成年人（平均年龄 62.8±13.7 岁，52%为男性）及其 16 名外科医生进行了访谈，使用特种外科医院全髋关节置换期望调查（范围 0-100）评估他们的期望。比较了患者和外科医生的总评分和每个项目的评分。单变量分析分别测试了患者特征对外科医生和患者期望的影响，以及对外科医生和患者差异的影响。
外科医生和患者期望的平均得分较高（分别为 100 分中的 90.9±11.1 和 90.0±11.6）。外科医生和患者的期望没有系统差异，但 Bland 和 Altman 图上的一致性很小，相关系数较低。外科医生和患者对运动的期望不同。患者根据对医生的信任和精神生活质量来评估自己的期望，而外科医生则考虑残疾。残疾程度较高的患者和来自低收入职业类别的患者往往比他们的外科医生“更乐观”。
外科医生和患者对 THA 的期望往往不一致。残疾程度较高的患者比外科医生期望更好的结果。
