Development of an instrument evaluating the impact of surgeon-patient relationship in patients on sick leave

Dubert, T.; Girault, Cédric; Kilink, Alexandre; Rozenblat, M.; Lebellec, Y; Vataire, Anne-Lise; Vilasco, Myriam; Katz, Grégory

doi:10.1080/20016689.2017.1345586

Cited by 3 publications

(4 citation statements)

References 40 publications

(30 reference statements)

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“…Although the QPASREL was initially developed to evaluate the association between a better PSR and the return to work, 6 , 7 the comprehensive question set of the QPASREL was found to be also effective for assessing PSR and PPR in the context of RTS. This score measures critical aspects of the patient-practitioner relationship such as communication (items 1, 2, 3, 7), availability/time management (items 4, 10), interprofessional collaboration (items 3, 6), and empathy (items 9, 11).…”

Section: Discussionmentioning

confidence: 99%

“…Recent studies have established the potential impact of the PSR and PPR on functional outcomes, particularly regarding musculoskeletal disorders. 10 The Quality of Patient-Surgeon Relationship (QPASREL) instrument is a questionnaire developed in 2017 by Dubert et al 6 to assess the impact of the PSR on recovery and return to work after surgery. The QPASREL comprises 11 items, each rated from 1 to 4, resulting in a global score that can range from 11 to 44, and it covers aspects including a surgeon's communication, availability, understanding, empathy, and encouragement to discuss concerns.…”

mentioning

confidence: 99%

“…This questionnaire has been shown to have good psychometric properties, including reliability and validity. 6 In 2019, Dubert et al 7 demonstrated that a positive PSR as measured by the QPASREL was associated with shortened sick leave after surgery for upper limb injuries or musculoskeletal disorders. This can result in reduced time off from work and reduced lost productivity for both patients and payers.…”

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confidence: 99%

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Association of Patient-Surgeon and Patient–Physical Therapist Relationships With Return to Sports After ACL Reconstruction: The Untested Dimension in Outcome Assessments

Moussa,

Lefèvre,

Valentin

et al. 2024

Orthopaedic Journal of Sports Medicine

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Background: The Quality of Patient-Surgeon Relationship (QPASREL) is an 11-item questionnaire developed and validated to assess the relationship between practitioners and patients on recovery and return to work after surgery. Purpose: To evaluate the association of patient-surgeon relationship (PSR) and patient-physical therapist relationship (PPR), as measured by QPASREL, with a patient's return to sports (RTS) after anterior cruciate ligament reconstruction (ACLR). Study Design: Case-control study; Level of evidence, 3. Methods: This study targeted patients who underwent primary ACLR at a specialized sports surgery referral center between January and May 2021. Patients who had revision surgery, multiligamentous knee injury, and sedentary status were excluded from the study. Patients were grouped based on ability to RTS at the preinjury level 1 year postoperatively (RTS group and no-RTS group). The primary outcome was rate of RTS at 1 year postoperatively, and the primary dependent variables were the quality of PSR and PPR as measured by QPASREL scores at 6-month intervals. Secondary outcomes were the correlation and discriminative capacity of the QPASREL compared with the Anterior Cruciate Ligament–Return to Sport After Injury (ACL-RSI) scores (collected at 6-month intervals). Results: The study included 243 patients. Patients in the RTS group exhibited a higher mean PPR QPASREL score (36.6 ± 5.1) compared with no-RTS patients (34.8 ± 5.2; P = .01) as well as a higher mean PSR score (35.7 ± 5.1) compared with no-RTS patients (33.8 ± 5.9; P = .01). Multivariate analysis showed that every 5-point increase in the QPASREL scores for PPR and PSR resulted in a 39% (odds ratio [OR] = 1.39; P = 0.014) and 35% (OR = 1.35, P = 0.021) increased odds of RTS, respectively. A weak yet positive correlation was found between QPASREL and ACL-RSI. The predictive capacity of the QPASREL (area under the curve [AUC] = 0.60 for PPR and 0.61 for PSR), although significant, was less powerful compared with that of the ACL-RSI (AUC = 0.73). Conclusion: The quality of the PPR and PSR, as measured by QPASREL scores, demonstrated a significant association with RTS rates at 1 year after ACLR. A weak yet positive correlation was found between QPASREL and ACL-RSI.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

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confidence: 99%

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Association of Patient-Surgeon and Patient–Physical Therapist Relationships With Return to Sports After ACL Reconstruction: The Untested Dimension in Outcome Assessments

Moussa,

Lefèvre,

Valentin

et al. 2024

Orthopaedic Journal of Sports Medicine

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“…In another study, good patient-surgeon communication and inclusion of "return to work" discussions during postoperative consultations were associated with shorter sick leave times and faster return to work [9]. The authors proposed an 11-item questionnaire which evaluates both the surgeon-patient empathetic relationship and administrative/work-related issues [72]. A positive relationship with the surgeon and the absence of complications were associated with adherence to follow-up with bariatric surgery patients [73].…”

Section: Postoperative Period and Follow-upmentioning

confidence: 99%

Patient-Surgeon Communication: A Literature Review and Thematic Analysis

2023

J Surg

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The wave of new research on the patient-surgeon relationship over the past two decades calls for a literature review. Our aim is to provide an up-to-date overview of the nature, aspects, and impacts of this relationship. We examined 97 articles published from 2000 to 2023 using a predefined frame of reference. We assessed the articles and summarized their essential points. The results were organized according to the patient journey, from surgeon selection to conclusion of the relationship. The articles highlight significant changes in the patient-surgeon relationship over the past 20 years. Patients seek more than kindness and prestige in their surgeons. Their behaviors and needs have changed as the paternalistic model shifts to a patient-centered approach. Clear, transparent, factual information, disclosure of conflicts of interest, information evidence level, verification of patient comprehension, and use of electronic messaging for transferring surgeon's communication and on-line documentation are essential in this approach. On a personal level, the importance of empathy, honesty, composure, and patient participation has grown. Body language plays a significant role. These changes have fostered shared decision-making, informed consent and a caring environment, enhancing patient trust. Cultivating trust through transparent, honest relationships can enhance outcomes, mitigate legal issues, and speed recovery. Communication difficulties may arise and must be recognized. The patient-surgeon relationship must be nurtured over time. In conclusion, it is crucial to provide surgeons with training in relationship-building. Quantitative measures such as PROMs and PREMs are emergent tools. The role of the Internet and Artificial Intelligence remains to be explored.

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Impact of Patient-Surgeon Relationship on Patient’s Return to Work

Dubert

Girault

Rozenblat

et al. 2019

The Journal of Bone and Joint Surgery

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Background: Upper-limb injuries and musculoskeletal disorders represent a major economic burden for both patients and society, largely due to limitations in returning to work. We hypothesized that a positive patient-surgeon relationship may facilitate patients’ recovery and lead to a faster return to work. Methods: This longitudinal observational study comprised 219 patients, from 8 French hand trauma centers, who were 18 to 55 years of age and were on sick leave from work because of an injury or musculoskeletal disorder of the upper limb. In addition to instruments measuring patients’ functional scores and quality of life, the quality of the patient-surgeon relationship was assessed at enrollment using a specific questionnaire (Q-PASREL [Quality of PAtient-Surgeon RELationship]). Six months after enrollment, the return-to-work status was assessed. Logistic and Cox regression models were developed to identify predictors of return to work (yes/no) and the time off from work in days. Results: Overall, 74% of the patients who returned to work within 6 months after enrollment had a high or medium-high Q-PASREL score, whereas 64% of the patients who were still on sick leave had a low or medium-low Q-PASREL score. The odds of patients with a low or medium-low Q-PASREL score returning to work were, respectively, 95% and 71% lower than the odds of patients with a high score doing so, with a percent difference of 56% (95% confidence interval [CI] = 40% to 71%) for low versus high (odds ratio [OR] = 0.05 [95% CI = 0.02 to 0.13]) and 25% (95% CI = 6% to 44%) for medium-low versus high (OR = 0.29 [95% CI = 0.11 to 0.76]). All Q-PASREL items and scores were significantly associated with return to work. Conclusions: Patients with a lower Q-PASREL score and more severe disability were less likely to return to work within 6 months and had a longer time off from work. Efforts to improve the quality of patient-surgeon relationships may minimize the duration of sick leaves and accelerate patient recovery. Level of Evidence: Prognostic Level II. See Instructions for Authors for a complete description of levels of evidence.

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Development of an instrument evaluating the impact of surgeon-patient relationship in patients on sick leave

Cited by 3 publications

References 40 publications

Association of Patient-Surgeon and Patient–Physical Therapist Relationships With Return to Sports After ACL Reconstruction: The Untested Dimension in Outcome Assessments

Association of Patient-Surgeon and Patient–Physical Therapist Relationships With Return to Sports After ACL Reconstruction: The Untested Dimension in Outcome Assessments

Patient-Surgeon Communication: A Literature Review and Thematic Analysis

Impact of Patient-Surgeon Relationship on Patient’s Return to Work

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