The influence of optimism on functionality after total hip replacement surgery

Balck, Friedrich; Lippmann, Maike; Jeszenszky, C.; Günther, Klaus‐Peter; Kirschner, S.

doi:10.1177/1359105314566256

Cited by 14 publications

(18 citation statements)

References 42 publications

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“…An additional regression analysis on the impact of the difference between patient-reported EQ-5D VAS and EHS-based valuation on postoperative WOMAC sum indicated that high patient-reported values compared to average population values correlate positively with knee specific outcomes (Additional file 8: Table S8). If relatively high, pre-operative VAS reports by patients would be interpreted as a sign of optimism, this result would resemble improved outcomes found for optimistic patients after hip replacement [48].…”

Section: Discussionmentioning

confidence: 99%

Patient characteristics and valuation changes impact quality of life and satisfaction in total knee arthroplasty – results from a German prospective cohort study

Felix

Becker

Vogl

et al. 2019

Health Qual Life Outcomes

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BackgroundEvaluation of variations in pre- and postoperative patient reported outcomes (PRO) and the association between preoperative patient characteristics and health and satisfaction outcomes after total knee arthroplasty (TKA) may support shared decision-making in Germany. Since previous research on TKA health outcomes indicated valuation differences in longitudinal data, experienced-based population weights were used for the first time as an external valuation system to measure discrepancies between patient and average population valuation of HRQoL.MethodsBaseline data (n = 203) included sociodemographic and clinical characteristics and PROs, measured by the EQ-5D-3 L and WOMAC. Six-month follow-up data (n = 161) included medical changes since hospital discharge, PROs and satisfaction. A multivariate linear regression analysis was performed to evaluate the relationship between preoperative patient characteristics and PRO scores. Patient acceptable symptom state (PASS) was calculated to provide a satisfaction threshold. Patient-reported health-related quality of life (HRQoL) valuations were compared with average experienced-based population values to detect changes in valuation.ResultsOne hundred thirty-seven subjects met inclusion criteria. All PRO measures improved significantly. Preoperative WOMAC and EQ-5D VAS, housing situation, marital status, age and asthma were found to be predictors of postoperative outcomes. 73% of study participants valued their preoperative HRQoL higher than the general population valuation, indicating response shift. Preoperatively, patient-reported EQ-5D VAS was substantially higher than average experienced-based population values. Postoperatively, this difference declined sharply.Approximately 61% of the patients reported satisfactory postoperative health, being mainly satisfied with results if postoperative WOMAC was ≥82.49 (change ≥20.25) and postoperative EQ-5D VAS was ≥75 (change ≥6).ConclusionOn average, patients benefited from TKA. Preoperative WOMAC and EQ-5D VAS were predictors of postoperative outcomes after TKA. Particularly patients with high absolute preoperative PRO scores were more likely to remain unsatisfied. Therefore, outcome prediction can contribute to shared-decision making. Using general population valuations as a reference, this study underlined a discrepancy between population and patient valuation of HRQoL before, but not after surgery, thus indicating a potential temporary response shift before surgery.

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Section: Discussionmentioning

confidence: 99%

Patient characteristics and valuation changes impact quality of life and satisfaction in total knee arthroplasty – results from a German prospective cohort study

Felix

Becker

Vogl

et al. 2019

Health Qual Life Outcomes

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“…Following this initial review, 46 full-texts were assessed for eligibility of which 20 manuscripts were excluded for at least one of the following reasons: non-significant findings (n = 6) 1,10,48,56,58,63 , the analyses/results were not relevant to review hypotheses (n = 6) 6,9,20,35,42,90 , and the critical test statistic was not reported, could not be computed based on reported data, and could not be obtained after contact with the author (n = 3) 3,18,86 (see Figure 1). The latter criterion included studies reporting pvalue ranges (e.g.…”

Section: Study Selection and Search Criteriamentioning

confidence: 99%

Investigating the True Effect of Psychological Variables Measured Prior to Arthroplastic Surgery on Postsurgical Outcomes: A P-Curve Analysis

Niederstrasser

Cook

2021

The Journal of Pain

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“…Alternatively, we could have employed the validated Hospital for Special Surgery (HSS) Hip and Knee Replacement Expectations Survey comprising 18 items informed by the ICF-framework [72,73]. However, the German, culturally adapted version of this questionnaire had not been validated until 2016 and was not available at the time of the planning and data collection of our study [74]. Future investigations should make use of the existing validated surveys of expectations and de ne which aspect of the construct they would like to address in order to obtain more reliable, comparable and accurate results.…”

Section: Limitationsmentioning

confidence: 99%

The Virtue of Optimistic Realism- Expectation Fulfillment Predicts Patient-Rated Global Effectiveness of Total Hip Arthroplasty

Kästner

Leong²,

Petzke³

et al. 2020

Preprint

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Abstract Background: Emerging evidence highlights the importance of preoperative expectations in predicting patient-reported outcomes of orthopedic surgeries. To date, it is still a matter of controversy whether patient satisfaction can be maximized by promoting either optimistic or realistic outcome expectations before surgery. Adjusting overly optimistic outcome expectancies in favor of a more realistic outlook on the limitations of total hip arthroplasty could reduce the risk of disappointment and lead to greater satisfaction with surgery outcomes. Our prospective cohort study was aimed at comparing the relative predictive influence of baseline expectations, expectation fulfillment and symptomatic improvement on the global effectiveness of total hip arthroplasty. Methods: Ninety patients (49 female, 41 male; mean age: 63±12.87 years) fulfilled inclusion criteria and completed a comprehensive preoperative assessment comprising sociodemographic, clinical, functional and psychological phenotypes. Moreover, the strengths of preoperative expectations for improvements in eight pain-related and functional domains were recorded on a 5-point Likert-scale. At 12 months after surgery, patients were asked to rate perceived improvements in each of these domains as well as the global effectiveness of the total hip replacement on a 5-point Likert-scale. To evaluate the relative impact of preoperative expectations, symptom improvement and the fulfillment of expectations on the global effectiveness of surgery, a hierarchical multiple linear regression analysis was performed. Results: Compared with the actual improvement at 12 months follow-up, prior expectations had been overly optimistic in about 28% of patients for hip pain, in about 45% for walking ability and around 60% for back pain, physical exercise, general function, social interactions and mental well-being. An optimistic hip pain expectation and the fulfillment of expectations for walking ability and independence in everyday life were found to independently predict global effectiveness ratings. Conclusions: In line with many authors investigating the relationship between the fulfillment of expectations and satisfaction with medical interventions, we suggest that professionals should explicitly address their patients’ expectations during the preoperative education and consultation. While for hip pain, high expectations seem to be beneficial, a realistic outlook encouraging self-efficacy expectancies should be conveyed for complex functional domains.

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The influence of optimism on functionality after total hip replacement surgery

Cited by 14 publications

References 42 publications

Patient characteristics and valuation changes impact quality of life and satisfaction in total knee arthroplasty – results from a German prospective cohort study

Patient characteristics and valuation changes impact quality of life and satisfaction in total knee arthroplasty – results from a German prospective cohort study

Investigating the True Effect of Psychological Variables Measured Prior to Arthroplastic Surgery on Postsurgical Outcomes: A P-Curve Analysis

The Virtue of Optimistic Realism- Expectation Fulfillment Predicts Patient-Rated Global Effectiveness of Total Hip Arthroplasty

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