Determinants of satisfaction 1?year after total hip arthroplasty: the role of expectations fulfilment

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• 作者：Clémence Palazzo (10)
  Claire Jourdan (11)
  Stéphane Descamps (12)
  Rémi Nizard (13)
  Moussa Hamadouche (14)
  Philippe Anract (14)
  Stéphane Boisgard (12)
  Myriam Galvin (12)
  Philippe Ravaud (15)
  Serge Poiraudeau (10)
  
• 关键词：Total hip arthroplasty ; Expectations ; Expectations-fulfilment ; Satisfaction ; Outcome
• 刊名：BMC Musculoskeletal Disorders
• 出版年：2014
• 出版时间：December 2014
• 年：2014
• 卷：15
• 期：1
• 全文大小：288 KB
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  41. The pre-publication history for this paper can be accessed here: http://www.biomedcentral.com/1471-2474/15/53/prepub
  
• 作者单位：Clémence Palazzo (10)
  Claire Jourdan (11)
  Stéphane Descamps (12)
  Rémi Nizard (13)
  Moussa Hamadouche (14)
  Philippe Anract (14)
  Stéphane Boisgard (12)
  Myriam Galvin (12)
  Philippe Ravaud (15)
  Serge Poiraudeau (10)
  
  10. Service de rééducation et réadaptation de l’appareil locomoteur et des pathologies du rachis, AP-HP, H?pital Cochin; PRES Sorbonne Paris Cité, Université Paris Descartes; U1153, INSERM, Paris, France
  11. Service de médecine physique et réadaptation, AP-HP, H?pital Raymond Poincaré, Garches, Université Versailles St-Quentin, Guyancourt, France
  12. Service d’orthopédie, traumatologie, chirurgie plastique et reconstructive, CHU Gabriel Montpied; Université Claude Monnet, Clermont-Ferrand, France
  13. Service de chirurgie orthopédique et traumatologie, AP-HP, H?pital Lariboisière; Université Paris Diderot, Paris, France
  14. Service d’orthopédie, AP-HP, H?pital Cochin; PRES Sorbonne Paris Cité, Université Paris Descartes, Paris, France
  15. Centre d’épidémiologie clinique, AP-HP, H?pital H?tel Dieu; PRES Sorbonne Paris Cité, Université Paris Descartes, Paris, France
  
• ISSN：1471-2474

文摘

Background Between 7% and 15% of patients are dissatisfied after total hip arthroplasty (THA). To assess predictors and postoperative determinants of satisfaction and expectation fulfilment one year after (THA). Methods Before THA surgery, 132 patients from three tertiary care centres and their surgeons were interviewed to assess their expectations using the Hospital for Special Surgery Total Hip Replacement Expectations Survey (THR survey). One year after surgery, patients (n--23) were contacted by phone to complete a questionnaire on expectation fulfilment (THR survey), satisfaction, functional outcome (Womac), and health-related quality of life (SF 12). Univariate and multivariate analyses were performed. Results Preoperative predictors of satisfaction were a good mental wellbeing (adjusted OR 1.09 [1.02; 1.16], p--.01) and optimistic surgeons expectations (1.07 [1.01; 1.14], p--.02). The main postoperative determinant of satisfaction was the fulfilment of patient’s expectations (1.08 [1.04; 1.12], p-lt;-.001). Expectation fulfilment could be predicted before surgery by young age (regression coefficient ?.55 [?.88; -0.21], p--.002), good physical function (?.96 [?.82; -0.10], p--.03) and good mental wellbeing (0.56 [0.14; 0.99], p--.01). Postoperative determinants of expectation fulfilment were functional outcome (?.10 [?.79; -1.42], p <0.001) and pain relief (?4.83 [?2.38; -7.29], p-lt;-.001). Conclusion To improve patient satisfaction after THA, patients-expectations and their fulfilment need to be carefully addressed. Patients with low mental wellbeing or physical function should be identified and specifically informed on expected surgical outcome. Surgeons-expectations are predictive of satisfaction and information should aim to lower discrepancy between surgeons-and patients-expectations.