LONDON -
More than half of people who undergoes implantation of a knee prosthesis od'anca delude themselves that the operation will produce better results than expected by our doctors. This is the result of a study conducted by researchers at the Hospital for Special Surgery in New York and presented during the annual meeting of the American Academy of Orthopedic Surgeons meeting in New Orleans from 9 to March 13.
RESEARCH - Researchers have submitted 42 surgeons and their patients, many with a detailed test in which they investigated and what each other were expected from the intervention in terms of psychological well-being, pain reduction and recovery capacity to carry out normal daily activities: eg walking, standing or sitting, playing sports, going to work. The doctors have proved realistic and well aware of the benefits and limitations of surgery: on a scale from 1 to 100 provided that the average patient would have recovered to 75. More likely to consider remedial action instead of the patients (84). The study, according to the research group, is among the first to examine the discrepancies between the expectations of those doctors and patients about the results of an intervention opens the field of prostheses and the need for a deeper reflection on the communication before surgery.
Neither too much nor too little - "We've seen a lot of variability between the expectations of doctors and the patients," said one of the authors of the study, Alejandro Gonzalez Della Valle. "In an ideal world, should be similar." "If patients have unrealistic expectations that are not corrected before the operation nor satisfied with the speech - said the research - the patient may prove to be dissatisfied with the final result. " Nor is it enough to avoid making promises, "eliminating" hopes, "If the patient has low expectations - he added - are likely to not engage sufficiently in the early stages of post-operative rehabilitation. With the result that could have a recovery feature even lower than expected. "
MPARARE WHAT I EXPECT - What solution, then? According to the team must refine the strategy that the American hospital, which has for years topped the charts for its departments of Orthopaedics and Rheumatology, practice for years to precede any surgical operation on the actual courses in which patients receive information on what can realistically expect after the operation. "The key message for surgeons is that a cheap educational intervention as a course information can be used to align the expectations of doctors and patients before surgery. This may ultimately result in an increase in the perception of the results, "said Della Valle. "For patients, however, is essential to understand from the outset what they can expect in terms of pain relief and functional recovery."
THE STRENGTH OF THE REASONS - Beyond the immediate results, the study may have long-term development. The NIH (National Institutes of Health), the U.S. government agency appointed to support the research, funded a research study for the next five years: "Hope - the coordinator said Hassan Ghomrawi - is able to study the relationship between the discrepancy between the aspettattive and several "outcomes" as the situation at the time of discharge or follow-up of features aa six months and two years. " In practice, the researchers suggest, the loss of motivation following the disappointment of expectations might influence recovery after surgery. "We're trying to figure out what unmet expectations can have an impact on clinical grounds. And after we use this information to improve dialogue doctor / patient and review the content of our courses to align expectations, "concluded Ghomrawi.
Anthony Michienzi - Corriere della Sera April 26, 2010
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