Pain intensity in total hip arthroplasty patients: how communication influences satisfaction

Abstract

Introduction: An important global measure of health care quality is patient satisfaction. Patient satisfaction partially determines hospital reimbursement for procedures such as total hip arthroplasty (THA). Press Ganey (PG) survey responses assess patient satisfaction, and impact reimbursement. Current efforts to maximise repayment for THA include reducing postoperative pain. The “Pain Management” survey domain is considered a significant factor in patient ratings, but other studies have highlighted staff communication domains as determinants of satisfaction. Therefore, the purpose of this study is to compare PG survey responses to inpatient pain intensity. Methods: We queried the PG database for all patients who underwent a THA between November 2012 and January 2015. This yielded a total of 302 patients. Descriptive statistics were performed to analyse patient-level demographics. A multivariate regression model was constructed utilising pain intensity as the dependent variable. Results: Patients rating of “Communication with Doctors” ( B = –25.534; p < 0.001) and “Communication about Medicines” ( B = –31.49; p = < 0.001) domains were representative of patient pain intensity. No other factors demonstrated a significant relationship to pain intensity. Conclusions: Patient satisfaction continues to be important in care quality. Surrogate markers, such as the PG survey, can guide institutions looking to improve care. Our study revealed scores for “Communication with Doctors” and “Communication about Medicines” best represented true pain intensity levels for THA recipients during the postoperative period. The “Pain Management” domain did not display a relationship to pain intensity. The current method of measuring patient satisfaction should be reassessed to better represent patient responses and outcomes.

Reducing Postoperative Opioid-prescribing Following Posterior Lumbar Fusion Does Not Significantly Change Patient Satisfaction

“…The results of this study demonstrated high patient satisfaction despite marked reduction in postoperative opioid-prescribing, which is consistent with previously published literature in the field of total joint arthroplasty. [37][38][39] This is an important finding because the misconception that opioids improve patient satisfaction through better pain control can lead to unnecessary, and potentially harmful overprescribing of opioids.…”

Acetabular Component and Liner Selection for the Prevention of Dislocation After Primary Total Hip Arthroplasty

“…Neurocognitive disorders 13,60 Chronic lung disease 13 Depression or anxiety 13 Dynamic anatomy: spinal pathology, including previous fusion, which may limit spinal mobility 14,26,60,61 Static anatomy: large anterior inferior iliac spine and greater trochanter morphology that may increase the risk of osseous impingement 62,63 Alcohol use disorder 64,65 Abductor mechanism deficiency 17,66 Previous hip surgery 67 Hip dysplasia 68 Osteonecrosis 13 Capsular laxity 60 Higher American Society of Anesthesiologists score 57,60 Fig. 1 Demonstration of basic sagittal radiographic measurements including sacral slope (SS), pelvic tilt (PT), and pelvic incidence (PI).…”

The Impact of Living Arrangements on the Prevalence of Falls after Total Joint Arthroplasty: A Comparison between Institutionalized and General Geriatric Population

“…The growing need for TJA, illustrated by the estimated increases of 171% for THA and 185% for TKA until 2030 [ 21 , 22 ], warrants the investigation of conditions associated with postoperative falls in this category of patients. Until now, several risk factors have been identified, such as persistent disability and pain after TJA [ 23 , 24 , 25 ], deficient limb proprioception [ 25 ], depression, a history of preoperative falls [ 26 ], female gender [ 27 ], older age [ 28 ], medication (bisphosphonates and drugs used for psychiatric diseases) [ 29 , 30 ] and age-related neuromuscular alteration [ 28 ].…”