Health Literacy and Recall of Postoperative Instructions in Patients Undergoing the Lapidus Procedure

Garfinkel, Jonathan H.; Hummel, Amelia; Day, Jonathan; Roney, Andrew; Jones, Mackenzie T.; Rosenbaum, Andrew J.; Ellis, Scott J.

doi:10.1177/2473011420940221

Cited by 3 publications

(1 citation statement)

References 18 publications

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“…In addition, independent of how well patients are informed preoperatively, they may not remember or retain this information. 6 Complications may worsen overall outcome as well as dampen the fulfillment of expectations a patient may have had going into surgery. Understanding how complications affect the fulfillment of expectations and other outcomes after surgery will allow surgeons to more effectively communicate these risks to patients before surgery and may also help guide communication once they occur.…”

Section: Influence Of Complications and Revision Surgery On Fulfillment Of Expectations In Foot And Ankle Surgerymentioning

confidence: 99%

Influence of Complications and Revision Surgery on Fulfillment of Expectations in Foot and Ankle Surgery

et al. 2021

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Background: Fulfillment of patients’ expectations following foot and ankle surgery has been previously studied, and shown to be an effective modality in assessing patient-reported outcomes (PROs). Although this assessment has been shown to correlate well with patient satisfaction and other validated PROs, the impact of postoperative complications on fulfillment of expectations is unknown. The aim of this study is to therefore investigate the impact of postoperative complications on fulfillment of patients’ expectations. Methods: Preoperatively, patients completed a validated Foot and Ankle Expectations Survey consisting of 23 questions encompassing domains including pain, ambulation, daily function, exercise, and shoe wear. At 2 years postoperatively, patients answered how much improvement they received for each item cited preoperatively. A fulfillment proportion (FP) was calculated as the amount of improvement received versus the amount of improvement expected. Chart review was performed to identify patient demographics, comorbidities, pain management, and postoperative complications, which were classified as minor (infection requiring antibiotics) or major (return to operating room for revision, deep infection). FP in patients with a complication was compared to patients who did not experience a complication. In addition, the Foot and Ankle Outcomes Score (FAOS), satisfaction, and Delighted-Terrible scale (how they would feel if asked to spend the rest of their life with their current foot/ankle symptom) were collected at final follow-up. Of the 271 patients (mean age 55.4 years, 65% female), 31 (11.4%, mean age 53.6, 58% female) had a postoperative complication: 25 major (19 revisions, 6 deep infections requiring irrigation and debridement), 4 minor (4 superficial infections requiring antibiotics), and 2 major and minor (revision and superficial infection). Average time from complication to completion of fulfillment survey was 15 (±3.6) months. The groups were similar in diagnoses. Results: Complications were associated with significantly worse FP (0.69 ± 0.45 vs 0.86 ± 0.40, P = .02). Having a complication significantly correlated with worse satisfaction, Delighted-Terrible scale, and FP ( P < .001). FAOS domains were similar between groups preoperatively; postoperatively, patients without complications had significantly higher Activities of Daily Living and Quality of Life scores ( P < .05). Demographically, there was no difference in age, sex, body mass index, Charlson Comorbidity Index, depression/anxiety, or pain management between the 2 groups. Conclusion: Our data suggests that postoperative complications following foot and ankle surgery were associated with worse patient-reported fulfillment of their operative expectations even after recovery from the initial surgery and complication. This finding is independent of preoperative expectations, and correlates with patient satisfaction with their procedure. Therefore, while patient-perceived fulfillment following foot and ankle surgery is multifactorial, the incidence of a postoperative complication negatively impacts fulfillment as well as satisfaction following surgery. Level of Evidence: Level II, prospective comparative series.

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Section: Influence Of Complications and Revision Surgery On Fulfillment Of Expectations In Foot And Ankle Surgerymentioning

confidence: 99%

Influence of Complications and Revision Surgery on Fulfillment of Expectations in Foot and Ankle Surgery

et al. 2021

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Limited Health Literacy Does Not Adversely Affect Compliance with Postoperative Restrictions, 90-day ED Return, or Opioid Use Following Shoulder Arthroscopy

Smith,

Stallone,

Khokhar

et al. 2024

JSES International

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Limited Health Literacy Among Patients With Orthopedic Injuries: A Cross-sectional Survey of Patients Who Underwent Orthopedic Trauma Surgery in a County Hospital Setting

Aynaszyan,

Lonza,

Sambare

et al. 2024

Orthopedics

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Background: Patients with limited health literacy have difficulty understanding their injuries and postoperative treatment, which can negatively affect their outcomes. Materials and Methods: This cross-sectional questionnaire-based study of 103 adult patients sought to quantify patients' health literacy at a single county hospital's orthopedic trauma clinic and to examine their ability to understand injuries and treatment plans. Demographics, Newest Vital Sign (NVS) health literacy assessment, and knowledge scores were used to assess patients' comprehension of their injuries and treatment plan. Patients were grouped by NVS score (NVS <4: limited health literacy). Fisher's exact tests and t tests were used to compare demographic and comprehension scores. Multivariate logistic regression analysis was used to examine the association among low health literacy, sociodemographic variables, and knowledge scores. Results: Of the 103 patients, 75% were determined to have limited health literacy. Patients younger than 30 years were more likely to have adequate literacy (50% vs 23%, P =.01). Patients who spoke Spanish as their primary language were 8.77 times more likely to have limited health literacy with respect to sociodemographic factors (odds ratio, 8.77; 95% CI, 1.03–76.92; P =.04). Low health literacy was 3.52 and 4.14 times more likely to predict discordance in answers to specific bone fractures and the narcotics prescribed ( P =.04 and P =.02, respectively). Conclusion: Spanish-speaking patients have demonstrated limited health literacy and difficulty understanding their injuries and postoperative treatment plans compared with English-speaking patients. Patients with low health literacy are more likely to be unsure regarding which bone they fractured or their prescribed opiates. [ Orthopedics . 202x;4x(x):xx–xx.]

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Health Literacy and Recall of Postoperative Instructions in Patients Undergoing the Lapidus Procedure

Cited by 3 publications

References 18 publications

Influence of Complications and Revision Surgery on Fulfillment of Expectations in Foot and Ankle Surgery

Influence of Complications and Revision Surgery on Fulfillment of Expectations in Foot and Ankle Surgery

Limited Health Literacy Does Not Adversely Affect Compliance with Postoperative Restrictions, 90-day ED Return, or Opioid Use Following Shoulder Arthroscopy

Limited Health Literacy Among Patients With Orthopedic Injuries: A Cross-sectional Survey of Patients Who Underwent Orthopedic Trauma Surgery in a County Hospital Setting

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