Scientific articleThe Effect of Patient Involvement in Surgical Decision Making for Carpal Tunnel Release on Patient-Reported Outcome
Section snippets
Subjects
We obtained an approval for this study from our institutional review board. We prospectively recruited patients with CTS who underwent surgery by a single hand surgeon at our urban tertiary referral hospital between the period April 2010 and September 2011 and who were followed-up for more than 6 months. We excluded those with worker's compensation issues and those with associated conditions, such as cervical radiculopathy and cubital tunnel syndrome, or comorbidities such as diabetes mellitus,
Preferred and experienced roles in decision making
The patients expressed a wide range of preferred roles in decision making before surgery and also indicated diverse roles that they experienced during the actual decision-making process (Table 2).
Forty patients (47%) had the same level of involvement in decision making as they had preferred before surgery. Twenty-nine patients (34%) experienced a more active role than they had preferred before surgery, and 16 patients (19%) experienced a more passive role than they had preferred before surgery (
Discussion
In this study, we aimed to determine whether a particular preference or experience in surgical decision making was associated with patients' subjective outcomes for CTR. We found that patient-reported outcomes were not significantly different between patients with different preferences for involvement in decision making for surgery or between those with different experiences in actual decision making. However, we found that those who experienced the same level of involvement as they had
References (38)
- et al.
Shared decision-making in the medical encounter: what does it mean? (or it takes at least two to tango)
Soc Sci Med
(1997) - et al.
Decision-making in the physician-patient encounter: revisiting the shared treatment decision-making model
Soc Sci Med
(1999) Patients using the Internet to obtain health information: how this affects the patient-health professional relationship
Patient Educ Couns
(2006)- et al.
Information needs and decisional preferences among women with ovarian cancer
Gynecol Oncol
(2000) - et al.
Information and patient participation in screening for prostate cancer
Patient Educ Couns
(1999) - et al.
Treatment decisions in palliative cancer care: patients' preferences for involvement and doctors' knowledge about it
Eur J Cancer
(1997) - et al.
Comparison of longitudinal open incision and two-incision techniques for carpal tunnel release
J Hand Surg Am
(2010) - et al.
Reducing neurologic and vascular complications of endoscopic carpal tunnel release using a modified chow technique
Arthroscopy
(2007) - et al.
Effective communication skills are the key to good cancer care
Eur J Cancer
(1999) - et al.
Incidence of clinically diagnosed and surgically treated carpal tunnel syndrome in Korea
J Hand Surg Am
(2010)
Minimal clinically important differences of 3 patient-rated outcomes instruments
J Hand Surg Am
Patients' use of the Internet for medical information
J Gen Intern Med
Patient-centered medicine. A professional evolution
JAMA
Emerging ideas: shared decision making in patients with osteoarthritis of the hip and knee
Clin Orthop Relat Res
The importance of patient preference in the decision to screen for prostate cancer. Prostate Patient Outcomes Research Team
J Gen Intern Med
Patients' preferred and retrospectively perceived levels of involvement during decision-making regarding carpal tunnel release
J Bone Joint Surg Am
Do people want to be autonomous patients? Preferred roles in treatment decision-making in several patient populations
Health Expect
Information needs and decisional preferences in women with breast cancer
JAMA
Patient preferences for medical decision making: who really wants to participate?
Med Care
Cited by (19)
The association between patient-reported outcomes (PROs) and patient participation in chronic care: A scoping review
2022, Patient Education and CounselingCitation Excerpt :Findings in this section are based on: Discussions/commentaries (4), Cochrane review (1), systematic review (1), individual interviews (1), cross-sectional survey (1), survey (1) and panel survey (1). Results reflected that patients vary in their interest in taking an active role in the decision-making process [64,94,95], although the majority of patients prefer to share treatment responsibility [95]. Therefore, PRO-based follow-up might be most suiting in patient cases in which there is a preference for an active patient role [64].
The Influence of Cost Information on Treatment Choice: A Mixed-Methods Study
2020, Journal of Hand SurgeryWhich Decisions For Management of Carpal Tunnel Syndrome and Distal Radius Fractures Should Be Shared?
2020, Journal of Hand SurgeryParental role in decision-making for pediatric surgery: Perceptions of involvement in consultations for tonsillectomy
2020, Patient Education and CounselingCitation Excerpt :This is instructive considering the extent to which a universal application of shared decision-making is often perceived as optimal in current medical practice. Indeed, a body of research has suggested that patients want to be involved in decision-making [8,11,16,23,26,31,37,47,48,70–76]. However, we note that >25% of parents in our sample preferred limited involvement in decision-making.
The quality and readability of internet information regarding clavicle fractures
2016, Journal of Orthopaedic ScienceCitation Excerpt :The informed patient is more prepared to participate in a discussion about treatment options. Recent publications have demonstrated that when patients share in the decision making process they experience better subjective outcomes [10]. We chose clavicle fracture as our study topic, because (1) there have been recent conflicting Therapeutic Level I evidence regarding the optimal treatment for displaced midshaft clavicular fractures [11–13], and (2) clavicle fractures are often treated on a non-urgent, semi-elective basis.
Physician Empathy as a Driver of Hand Surgery Patient Satisfaction
2015, Journal of Hand SurgeryCitation Excerpt :Third, the results might have been different if we enrolled patients presenting with a single condition or a group of similar conditions, although inclusion of patients with the usual spectrum of illnesses in our office could also be considered a strength. Fourth, we did not collect patients’ expectation data preoperatively and on the desired level of involvement in care, which may influence satisfaction with the provider.14,47 Moreover, we did not collect data on whether patients were accompanied during the visit, which may influence the patient–physician interaction.48
No benefits in any form have been received or will be received related directly or indirectly to the subject of this article.