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腰椎间盘切除术后患者参与手术治疗决策及对治疗结果的满意度

Patient involvement in surgical treatment decisions and satisfaction with the treatment results after lumbar intervertebral discectomy.

作者信息

Rätsep Tõnu, Abel Andreas, Linnamägi Ülla

机构信息

Department of Neurology and Neurosurgery, University of Tartu, Tartu, Estonia,

出版信息

Eur Spine J. 2014 Apr;23(4):873-81. doi: 10.1007/s00586-013-3104-y. Epub 2013 Nov 19.

Abstract

PURPOSE

To evaluate involvement of patients in surgical treatment decision making (STDM) in relations to satisfaction with the results of lumbar discectomy.

METHODS

We evaluated prospectively 150 surgically treated patients with radicular pain due to lumbar disc herniation (LDH). The patients completed self-reported questionnaires about preferences for involvement and actual involvement in STDM. Global satisfaction with the results of the treatment was assessed at 1 year after the operation.

RESULTS

Most of the patients (129 patients, 86%) stated that they had been sufficiently informed about LDH to be involved in the treatment decisions, almost half of the patients (47%) preferred active or collaborative involvement and 58% of the patients reported higher actual involvement in STDM. Congruence between preferred and actual roles in decision making was 64%. Most of the patients (77%) were satisfied with the results of the operation, but satisfaction was not associated with involvement of patients in STDM.

CONCLUSION

A significant proportion of patients with LDH prefer to be actively involved in treatment decisions and experience an STDM process that matches their preferences for participation. However, individual differences in preferences for involvement in STDM are common and global satisfaction with the treatment results is not significantly related to the activity of involvement in STDM.

摘要

目的

评估患者参与手术治疗决策(STDM)与腰椎间盘切除术结果满意度之间的关系。

方法

我们前瞻性评估了150例因腰椎间盘突出症(LDH)接受手术治疗的根性疼痛患者。患者完成了关于参与意愿和实际参与STDM情况的自我报告问卷。在术后1年评估对治疗结果的总体满意度。

结果

大多数患者(129例,86%)表示他们已充分了解LDH相关信息,能够参与治疗决策;近一半患者(47%)倾向于积极参与或共同参与,58%的患者报告在STDM中的实际参与度较高。决策中偏好角色与实际角色的一致性为64%。大多数患者(77%)对手术结果满意,但满意度与患者参与STDM无关。

结论

相当一部分LDH患者倾向于积极参与治疗决策,并经历与他们参与偏好相匹配的STDM过程。然而,STDM参与偏好的个体差异很常见,对治疗结果的总体满意度与STDM参与程度无显著关联。

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Patient preferences for shared decisions: a systematic review.患者对共同决策的偏好:系统评价。
Patient Educ Couns. 2012 Jan;86(1):9-18. doi: 10.1016/j.pec.2011.02.004. Epub 2011 Apr 6.

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