Patient Expectations of Quality of Life Following Lumbar Spinal Surgery

Saban, Karen L.; Penckofer, Sue

doi:10.1097/01376517-200706000-00009

Cited by 55 publications

(60 citation statements)

References 22 publications

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“…Furthermore, the predictive power of psychological variables is also supported by our finding that patients planning to receive early post-operative rehabilitation with a biopsychosocial approach are predicted to have less prospective functional disability levels than patients receiving traditional post-operative exercise therapy. Previous studies that have included pre-surgical outcome expectations in multivariate models have found its predictive significance when testing pain, functional and HRQOL-related outcomes [5,20,29,33,39,48]. Our results showed that patient's expectations of future back pain-related outcome was the most important predictor of prospective HRQOL, but was not predictive of pain or functional related outcomes.…”

Section: Discussionmentioning

confidence: 46%

Leg pain and psychological variables predict outcome 2–3 years after lumbar fusion surgery

2011

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Prediction studies testing a thorough range of psychological variables in addition to demographic, workrelated and clinical variables are lacking in lumbar fusion surgery research. This prospective cohort study aimed at examining predictions of functional disability, back pain and health-related quality of life (HRQOL) 2-3 years after lumbar fusion by regressing nonlinear relations in a multivariate predictive model of pre-surgical variables. Before and 2-3 years after lumbar fusion surgery, patients completed measures investigating demographics, work-related variables, clinical variables, functional self-efficacy, outcome expectancy, fear of movement/(re)injury, mental health and pain coping. Categorical regression with optimal scaling transformation, elastic net regularization and bootstrapping were used to investigate predictor variables and address predictive model validity. The most parsimonious and stable subset of pre-surgical predictor variables explained 41.6, 36.0 and 25.6% of the variance in functional disability, back pain intensity and HRQOL 2-3 years after lumbar fusion. Pre-surgical control over pain significantly predicted functional disability and HRQOL. Pre-surgical catastrophizing and leg pain intensity significantly predicted functional disability and back pain while the pre-surgical straight leg raise significantly predicted back pain. Postoperative psychomotor therapy also significantly predicted functional disability while pre-surgical outcome expectations significantly predicted HRQOL. For the median dichotomised classification of functional disability, back pain intensity and HRQOL levels 2-3 years post-surgery, the discriminative ability of the prediction models was of good quality. The results demonstrate the importance of pre-surgical psychological factors, leg pain intensity, straight leg raise and postoperative psychomotor therapy in the predictions of functional disability, back pain and HRQOL-related outcomes.

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Section: Discussionmentioning

confidence: 46%

Leg pain and psychological variables predict outcome 2–3 years after lumbar fusion surgery

2011

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“…Additionally, the recent inclusion of an expectations domain in the New Knee Society Score further promises to expand opportunities for the investigation of this variable in patients undergoing TKA [48,59]. However, although it has been recognized that patient expectations can be assessed using dimensions of values (states considered to be more or less important) or probabilities (states considered to be more or less likely) [26,54], all of the validated instruments reported to date are limited to a single one of these two domains.…”

Section: Discussionmentioning

confidence: 99%

“…We limited eligibility to studies that assessed patient expectations using either a probabilistic (ie, likelihood of a given outcome) or value-based (ie, importance attached to a given outcome) definition, which are the most commonly used descriptions in the context of medical care [26,54]. In contradistinction, any assessment methods that exclusively investigated beliefs (premises held to be true by an individual), needs (outcomes perceived as necessary, irrespective of likelihood), or desires (outcomes or situations wanted by the respondent irrespective of perceived likelihood of attainment) were not included.…”

Section: Eligibility Criteriamentioning

confidence: 99%

“…For instance, patient expectations may vary depending on when in the course of care they are measured (before surgery, postoperatively, or at full recovery), by different diagnoses (such as malignant versus nonmalignant processes), and by anatomic location or patient age (eg, anterior cruciate ligament surgery in teens or THA in octogenarians). Second, as described by Saban and Penckofer [54] and Kravitz [26], expectations may be defined in at least two dimensions. They can be probabilistic reflecting the perceived likelihood of a particular outcome or event or value-based based on the importance attached to a particular outcome or event.…”

Section: Introductionmentioning

confidence: 99%

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Measuring Expectations in Orthopaedic Surgery: A Systematic Review

Zywiel

Mahomed

Gandhi

et al. 2013

Clinical Orthopaedics &Amp; Related Research

105

143

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Background Advances in the surgical treatment of musculoskeletal conditions have resulted in an interest in better defining and understanding patients' expectations of these procedures, but the best ways to do this remain a topic of considerable debate. Questions/purposes (1) What validated instruments for the assessment of patient expectations of orthopaedic surgery have been used in published studies to date? (2) How were these expectation measures developed and validated? (3) What unvalidated instruments for the assessment of patient expectations have been used in published studies to date? Methods A systematic literature search was performed using the OVID Medline and EMBASE databases, in duplicate, to identify all studies that assessed patient expectations in orthopaedic surgery. Sixty-six studies were ultimately included in the present review.Results Seven validated expectation instruments were identified, all of which use patient-reported questionnaires. Five were specific to a particular procedure or affected anatomic location, whereas two were broadly applicable. Details of reliability and validity testing were available for all but one of these instruments. Forty additional unvalidated expectation assessment tools were identified. Thirteen were based on existing clinical outcome tools, and the others were study-specific, custom-developed tools. Only one of the unvalidated tools was used in more than one study. Conclusions Several validated expectation instruments have been developed for use by patients undergoing orthopaedic surgery. However, many tools have been reported without evidence of testing and validation. The wide range of untested instruments used in single studies substantially limits the interpretation and comparison of data concerning patient expectations.

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“…Many authors suggested that uncertainty of the prognosis after spinal surgery is one of the major problems (Deyo, 2007;Harvey, 2005;Saban & Penckofer, 2007). Jun, Choi, and Lim (2010) reported that elderly patients expressed the feeling of uncertainty about the prognosis of the disease after performing an ethnographic study in 20 participants.…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of Home Health Care Service for Elders after Spinal Surgery

Jun

Jung

2012

J Korean Acad Nurs

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Purpose: This study was done to evaluate effectiveness of home healthcare services (HHCS) specialized for elders who received spinal surgeries. Methods: A non-equivalent control group pre-post test quasi-experimental study was performed. HHCS was developed based on the Rice model of dynamic self-determination for self-care. For data collection, a control group (n= 23) and an experimental group (n= 23) were selected by matching age, BMI, pain, general characteristics and type of spine surgery. Measurement tools to evaluate uncertainty and knowledge were developed by the authors. The Numeric Rating Scale (NRS) and Japanese Orthopedic Association Back Pain Evaluation Questionnaire (JOABPEQ) were used to evaluate pain levels. Muscular strength in the legs was measured using a digital muscle tester and tape ruler. Questionnaires were used to evaluate disability in performing ADL and psychological distress levels. Results: The experimental group showed significant decrease in uncertainty (p= .028), increased knowledge (p= .038), and partially decreased pain (p= .003-.331). Partial muscle strength increased significantly (p= .021-.644). Disability in performing ADL and psychological distress in the experimental group decreased significantly compared to control group (p= .002, p= .004). Conclusion: Results indicate HHCS is an efficient home care nursing program for these elders. Further experimental studies with larger samples are required to confirm effects of HHCS.

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Patient Expectations of Quality of Life Following Lumbar Spinal Surgery

Cited by 55 publications

References 22 publications

Leg pain and psychological variables predict outcome 2–3 years after lumbar fusion surgery

Leg pain and psychological variables predict outcome 2–3 years after lumbar fusion surgery

Measuring Expectations in Orthopaedic Surgery: A Systematic Review

Effectiveness of Home Health Care Service for Elders after Spinal Surgery

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