Patient expectations of podiatric surgery in the United Kingdom

Abstract

BackgroundPatient expectations can be difficult to conceptualise and are liable to change with time, health and environmental factors. Patient expectation is known to influence satisfaction, however little is known about the expectations of patients attending for podiatric surgery. This paper will explore the expectations of a large cohort of patients undergoing elective foot surgery.MethodsThe UK based podiatric audit of surgery and clinical outcome measurement (PASCOM) audit system was applied to a consecutive cohort of patients undergoing elective podiatric surgery in Doncaster, South Yorkshire between 2004 and 2010. Data was collected relating to the surgical episode and patient expectations. A patient questionnaire was administered at 6 months post intervention.ResultsA total of 2910 unique surgical admissions were completed and satisfaction questionnaires were returned by 1869 patients. A total of 1430 patients answered question 1 which relates to patient expectations. Pain relief was the most frequent expectation with 1191 counts (52.3%), while footwear and mobility accounted for 16.6% and 16.4% respectively. Cosmesis counts occurred less commonly; 12.2%. 709 patients (49.6%) stated only a single expectation, 599 patients (41.9%) stated two expectations, 114 patients (8%) stated three expectations and 7 patients (0.5%) stated 4 expectations. Pain relief was the dominant expectation accounting for 515 counts (72.6%) of patients who provided only one response.ConclusionsThis paper demonstrates the expectations of a large cohort of podiatric surgery patients. For the most part patients expect pain relief, improved mobility and improved shoe fitting, while a small number of patients also expect a cosmetic improvement. Further research is required to determine the relationship between patient expectation and health related quality of life, and to determine whether podiatric surgery is successful in addressing the expectations of patients.

Patient Factors Associated With Higher Expectations From Foot and Ankle Surgery

“…Previous studies addressed only individual diagnoses 21,24 or developed nonquantifiable means of assessing expectations. 19,23 Younger et al 24 compared expectations and satisfaction between patients undergoing total ankle replacement (TAR) and ankle fusion. Patients undergoing TAR had significantly higher preoperative expectations than those undergoing fusion.…”

Foot Width Changes Following Hallux Valgus Surgery

“…Authors showed that while the degree of deformity correction did not improve QoL, achieving free choice of shoe wear had a positive effect on the QoL outcome. Conversely, Wilkinson et al, 27 studying patient expectations of foot surgery in the United Kingdom, reported that cosmesis was a relatively uncommon expectation and reported in only 12% of patients. Furthermore, when specifically addressing the issue of improved appearance in terms of achieving a narrower foot following hallux valgus surgery, Tai et al 24 reported that among females, this ranked only as the 10th criteria in order of importance in patients' expectations.…”

An analysis of Euroqol EQ‐5D and Manchester Oxford Foot Questionnaire scores six months following podiatric surgery

“…Patients attending for podiatric surgery typically expect pain relief, followed by improved mobility and shoe fitting [30,36]. …”