Factors Affecting Willingness to Undergo Carpal Tunnel Release

Gong, Hyun Sik; Baek, Goo Hyun; Oh, Joo Han; Lee, Young Ho; Jeon, Soung Hoo; Chung, Moon Sang

doi:10.2106/jbjs.h.01221

Cited by 25 publications

(21 citation statements)

References 33 publications

(38 reference statements)

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“…The analysis of all patients revealed, however, that patients with more severe symptoms had less decisional conflict. This is consistent with the previous finding that the severity of subjective symptoms is the most important reason of all factors that affect the willingness to undergo carpal tunnel release [21]. …”

Section: Discussionsupporting

confidence: 93%

Use of a decision aid did not decrease decisional conflict in patients with carpal tunnel syndrome

Gong

Park

Shin

et al. 2017

BMC Musculoskelet Disord

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BackgroundAlthough a model for shared decision-making is important for patient-centered care, decisional conflict can emerge when patients participate in the decision-making. A decision aid is proposed to provide information and to involve patients more comfortably in the decision-making process. We aimed to determine whether a decision aid helps patients with carpal tunnel syndrome (CTS) experience less decisional conflict regarding their decision-making for surgery.MethodsEighty patients with CTS were randomized into two groups. The test group was given a decision aid in addition to regular information and the control group regular information only. The decision aid consisted of a 6-min videoclip that explains diagnosis and information regarding surgery for CTS with other treatment options. We evaluated patients’ decisional conflict regarding surgery, knowledge about CTS, and symptom severity as measured by the Disabilities of Arm, Shoulder, and Hand (DASH) Questionnaire.ResultsThere was no difference in the decisional conflict scale (DCS) between both groups (p = 0.76). The test group had significantly better knowledge than the control group (p = 0.04). There was no correlation between the knowledge score and the DCS (p = 0.76). However, less severe symptoms were correlated with greater decisional conflict (r = −0.29, p = 0.02).ConclusionsWe found that a decision aid does not reduce decisional conflict in patients with CTS, although it can help them be better informed. This study suggests that although a decision-aid is effective for patient education, doctor-patient communication should be more emphasized for patients with less severe symptoms, as they can have greater decisional conflict.Trial RegistrationSNUBH Registry 1510/317-003 Registered November 13, 2015Electronic supplementary materialThe online version of this article (doi:10.1186/s12891-017-1478-4) contains supplementary material, which is available to authorized users.

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Section: Discussionsupporting

confidence: 93%

Use of a decision aid did not decrease decisional conflict in patients with carpal tunnel syndrome

Gong

Park

Shin

et al. 2017

BMC Musculoskelet Disord

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“…The reason for this finding is unclear. Given the findings of Gong et al [8], which reported that a variety of concerns existed for female patients not undergoing surgery, female patients in our study may have had additional concerns regarding surgery not shared by male counterparts. However, we were unable to further investigate that possibility in the current study.…”

Section: Discussionmentioning

confidence: 63%

“…In addition to age, patient gender must also be considered when investigating nonclinical factors contributing to disease management. While some studies suggest neither age nor gender affect ultimate surgical management and outcomes [10,11], other studies demonstrated that female patients refusing surgery had concerns with issues such as transient weakness, financial burden, and scar pain associated with the procedure [8]. It is therefore important to determine if there exists any variation in rates of surgical release between male and female patients.…”

Section: Introductionmentioning

confidence: 99%

Carpal and Cubital Tunnel Syndrome: Who Gets Surgery?

Day

Makhni

Mejia

et al. 2010

Clinical Orthopaedics &Amp; Related Research

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“…Consistent with this observation, no pain or infections were reported. By contrast, in OCTR and ECTR studies, over 50% of patients report scar pain [23] and patients have cited concerns about scar pain as a reason for surgery cancellation [24]. Although the causes of scar pain are not well understood, we can hypothesize that a smaller incision will be associated with less superficial skin nerve damage and therefore less scar discomfort.…”

Section: Discussionmentioning

confidence: 99%

Percutaneous Ultrasound-Guided Carpal Tunnel Release: Study Upon Clinical Efficacy and Safety

Petrover¹,

Silvera²,

Baère

et al. 2016

Cardiovasc Intervent Radiol

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ObjectivesTo evaluate the feasibility and 6 months clinical result of sectioning of the transverse carpal ligament (TCL) and median nerve decompression after ultra-minimally invasive, ultrasound-guided percutaneous carpal tunnel release (PCTR) surgery.MethodsConsecutive patients with carpal tunnel syndrome were enrolled in this descriptive, open-label study. The procedure was performed in the interventional radiology room. Magnetic resonance imaging was performed at baseline and 1 month. The Boston Carpal Tunnel Questionnaire was administered at baseline, 1, and 6 months.Results129 patients were enrolled. Significant decreases in mean symptom severity scores (3.3 ± 0.7 at baseline, 1.7 ± 0.4 at Month 1, 1.3 ± 0.3 at Month 6) and mean functional status scores (2.6 ± 1.1 at baseline, 1.6 ± 0.4 at Month 1, 1.3 ± 0.5 at Month 6) were noted. Magnetic resonance imaging showed a complete section of all TCL and nerve decompression in 100% of patients. No complications were identified.ConclusionsUltrasound-guided PCTR was used successfully to section the TCL, decompress the median nerve, and reduce self-reported symptoms.

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Factors Affecting Willingness to Undergo Carpal Tunnel Release

Abstract: Background: Factors regarding patient willingness to undergo or avoid joint replacement have been studied; however,

Cited by 25 publications

References 33 publications

Use of a decision aid did not decrease decisional conflict in patients with carpal tunnel syndrome

Use of a decision aid did not decrease decisional conflict in patients with carpal tunnel syndrome

Carpal and Cubital Tunnel Syndrome: Who Gets Surgery?

Percutaneous Ultrasound-Guided Carpal Tunnel Release: Study Upon Clinical Efficacy and Safety

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