Satisfaction with care after total hip or knee replacement predicts self-perceived health status after surgery

Abstract

BackgroundInpatient satisfaction with care is a standard indicator of the quality of care delivered during hospitalization. Total hip and knee replacement (THR/TKR) for osteoarthritis (OA) are among the most successful orthopaedic interventions having a positive impact on health-related quality of life (HRQoL). The aim was to evaluate the effect of satisfaction shortly after hospital discharge on 1-month, 6-month and 1-year Medical Outcomes Study 36-item Short Form (SF-36) scores for OA patients after THR and TKR, controlling for patient characteristics, clinical presentation and preoperative SF-36 scores.MethodsA multicenter prospective cohort study recruited 231 patients with OA scheduled to receive THR or TKR. Satisfaction was assessed by the Patients Judgment of Hospital Quality (PJHQ) questionnaire and HRQoL by the SF-36 questionnaire. Linear models for repeated measures assessed the relation between satisfaction (scores were dichotomized) and postoperative SF-36 scores.ResultsOf 231 participants, 189 were followed up 12 months after discharge (mean age 69 SD = 8; 42.6% male). The mean length of hospital stay was 13.5 (SD = 4) days. After adjustment for preoperative SF-36 scores, sociodemographic and clinical patient characteristics, satisfied patients (PJHQ score > 70) had higher SF-36 scores 1 year after surgery than did less-satisfied patients. Admission, medical care, and nursing and daily care scores mainly predicted bodily pain, mental health, social functioning, vitality and general health scores of the SF-36.ConclusionBesides being a quality-of-care indicator, immediate postoperative patient satisfaction with care may bring a new insight into clinical practice, as a predictor of self-perceived health status after surgery.

The percutaneous stabilisation of the sacroiliac joint with hollow modular anchorage screws: a prospective outcome study

“…Patients with sacroiliac joint disease present with considerable pain and morbidity, with preoperative SF-36 scores falling way below that for both knee and hip arthritis in patients requiring arthroplasty surgery [13,14]. Pain scores reported are also considerably worse than in patients with knee and hip arthritis [14]. The improvements in SF-36 forms and visual analogue pain scores following surgery fair well in comparison with hip and knee arthroplasty.…”

“…For this reason, we have seen much larger improvements in the pelvic specific scoring questionnaires as compared to the general SF-36 forms. Patients with sacroiliac joint disease present with considerable pain and morbidity, with preoperative SF-36 scores falling way below that for both knee and hip arthritis in patients requiring arthroplasty surgery [13,14]. Pain scores reported are also considerably worse than in patients with knee and hip arthritis [14].…”

Importance of patient satisfaction with care in predicting osteoarthritis-specific health-related quality of life one year after total joint arthroplasty

“…In a cohort of 189 patients, those satisfied with their medical and nursing care (by the PJHQ) had higher generic HRQoL scores (on the SF-36) 1 year after total hip and total knee replacement (THR/TKR) than those not satisfied [7]. Finding a similar relation with use of an OA-specific HRQoL instrument as well as a different measure of satisfaction with care that explores a similar construct formulated in closed domains would suggest consistency of this relationship.…”

“…Many studies have reported substantial improvement in postoperative HRQoL scores, with a plateau at 3 and 6 months after surgery [6][7][8][9][10][11][12][13]. Patients waiting for joint replacement show consistently worse HRQoL scores than population controls [14].…”

Assessment and management of chronic pain in patients with stable total hip arthroplasty

“…In addition, these patients with good self-perceived health status preoperatively also have high postoperative HRQoL. However, patients reporting poor preoperative HRQoL showed no improvement in HRQoL after surgery [12].…”