Determinants of Patient Satisfaction After Severe Lower-Extremity Injuries (original) (raw)
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Factors predicting patient satisfaction following major trauma
Injury, 2008
Introduction: Patient satisfaction is an intuitively important outcome measure and has been previously linked to general health status. Previous research on patient satisfaction after injury has concentrated on satisfaction with medical care. This study aims to explore possible predictors of patient satisfaction with outcome following major trauma. Methods: A cross-sectional survey involving consecutive adult patients involved in major accidental trauma from a major metropolitan trauma centre, over a 5-year period, was performed between 1 and 6 years post-injury. The outcome used was patient satisfaction with progress since the injury. Multiple logistic regression was used to develop a model of significant predictors of patient satisfaction. Results: The survey was mailed to 728 eligible patients, 56 were excluded due to death or inability to complete the survey, 93 refused to participate and 90 were not contactable. One hundred and thirty-four patients did not respond and 355 completed surveys were returned. Patient dissatisfaction was found to be significantly associated with unemployment at the time of follow up (OR, 2.38; 95% CI, 1.38-4.08; p = 0.004), having one or more chronic illnesses at the time of injury (OR, 2.57; 95% CI, 1.45-4.55; p = 0.001), being involved in a motor vehicle accident (OR, 1.83; 95% CI, 1.02-3.30; p = 0.04) and having an unsettled compensation claim (OR, 5.19; 95% CI, 2.80-9.65;
The Open Orthopaedics Journal, 2014
Background: There is a need for a generic patient-reported outcome (PRO) that is patient-centric and offers sound properties for measuring the process and state of recovery from musculoskeletal trauma. This study describes the construction and initial validation of a new tool for this purpose. Methods: A prototype tool was constructed through input of academic and clinical experts and patient representatives. After evaluation of individual items, a 9-item Satisfaction and Recovery Index (SRI) was subject to psychometric evaluation drawn from classical test theory. Subjects were recruited through online and clinical populations, from those reporting pain or disability from musculoskeletal trauma. The full sample (N = 129) completed the prototype tool and a corresponding region-specific disability measure. A subsample (N = 46) also completed the Short-Form 12 version 2 (SF12vs). Of that, a second subsample (N = 29) repeated all measures 3 months later. Results: A single factor ‘health...
International Journal of Environmental Research and Public Health, 2022
Both clinician-reported outcome measures (CROMs) measures and patient-reported outcome measures (PROMs) are applied to evaluate outcomes in rehabilitation settings. The previous data show only a low to moderate correlation between these measures. Relationships between functional performance measures (Clinician-Reported Outcome Measures, CROMs) and Patient-Reported Outcome Measures (PROMs) were analysed in rehabilitation patients with traumatic injuries of the lower limb. A cohort of 315 patients with 3 subgroups (127 hip, 101 knee and 87 ankle region) was analysed before and after 3 weeks of inpatient rehabilitation. All three groups showed significant improvements in PROMs with low to moderate effect sizes. Moderate to high effect sizes were found for CROMs. Correlation coefficients between CROMs and PROMs were low to moderate. The performance consistency between PROMs and CROMs ranged from 56.7% to 64.1%. In this cohort of rehabilitation patients with traumatic injuries, CROMs showed higher effect sizes than PROMs. When used in combination, patient-reported outcome and performance measures contribute to collecting complementary information, enabling the practitioner to make a more accurate clinical evaluation of the patient’s condition.
Functional Outcomes Following Trauma-Related Lower-Extremity Amputation
The Journal of Bone and Joint Surgery-American Volume, 2004
Background: The principal aims of this study were to examine functional outcomes following trauma-related lowerextremity amputation and to compare outcomes according to the amputation levels. We hypothesized that above-theknee amputations would result in less favorable outcomes than would through-the-knee or below-the-knee amputations. A secondary aim was to examine the factors, in addition to amputation level, that influence outcome, including the type of soft-tissue coverage, selected patient characteristics, and the technological sophistication of the prosthetic device. Methods: A cohort of 161 patients who had undergone an above-the-ankle amputation at a trauma center within three months following the injury was followed prospectively at three, six, twelve, and twenty-four months after the injury. The Sickness Impact Profile, a self-reported measure of functional status, was used as the principal measure of outcome. Secondary outcomes included pain; degree of independence in transfers, walking, and climbing stairs; selfselected walking speed; and the physician's satisfaction with the clinical, functional, and cosmetic recovery of the limb. Longitudinal multivariate regression techniques were used to determine whether outcomes differed according to the level of amputation after we controlled for covariates. Results: There was no significant difference in the scores on the Sickness Impact Profile between the patients treated with above-the-knee and those treated with below-the-knee amputation. However, patients with a below-theknee amputation performed better than did patients with an above-the-knee amputation on the timed test for walking speed (p = 0.04). Patients with a through-the-knee amputation had worse regression-adjusted Sickness Impact Profile scores (p = 0.05) and slower self-selected walking speeds (p = 0.004) than did patients with either a below-theknee or an above-the-knee amputation. Differences according to the level of amputation were most pronounced for physical function. In general, physicians were less satisfied with the clinical, cosmetic, and functional recovery of the patients with a through-the-knee amputation. Except for problems encountered with insufficient gastrocnemius coverage of the stump in many patients with a through-the-knee amputation, neither the soft-tissue coverage nor the technological sophistication of the prosthesis correlated with outcome. Conclusions: Severe disability accompanies above-the-ankle lower-extremity amputation following trauma, regardless of the level of amputation. Clinicians should critically evaluate the need for a through-the-knee amputation in patients with a traumatic injury. The results of this study also underscore the need for controlled studies that examine the relationship between the type and fit of prosthetic devices and functional outcomes.
Appraise the Health-Related Quality of Life among Trauma Patients
International Journal of Health and Rehabilitation Sciences (IJHRS), 2016
Background: Limb injures is revolve a life-changing event that can cause significant disruptions in many important areas of life. Objectives: The objective of our study was to appraise the Health Related Quality of Life (HRQOL) and psychosocial factors associated with pain and disability in patients following Upper limb (UL) and lower limb (LL) trauma patients Materials and methods: A sample of convenience 300 adult male and female patients who met the inclusion criteria was included. A short form (36) health status questionnaire was filled by a single author from each patient after one year of follow up. This part was utilized to assess the QOL among limbs traumas patients. Results: Intraclass correlation coefficients were greater than 0.7 in five of the eight domains of SF 36 except mental health, social function and general health. Chronbach's α was higher than 0.8 all the domains except in social function domain. There was no difference in Health Related Quality of Life in patients with upper and lower limb trauma. However there was significant difference in 4 domains related to physical components of SF 36 survey form between male and females. Conclusion: Both upper and lower limb trauma similarly affects the Health Related Quality of Life in all age group of patients.
Ability of Lower-Extremity Injury Severity Scores to Predict Functional Outcome After Limb Salvage
The Journal of Bone and Joint Surgery (American), 2008
Background: Lower-extremity injury severity scoring systems were developed to assist surgeons in decision-making regarding whether to amputate or perform limb salvage after high-energy trauma to the lower extremity. These scoring systems have been shown to not be good predictors of limb amputation or salvage. This study was performed to evaluate the clinical utility of the five commonly used lower-extremity injury severity scoring systems as predictors of final functional outcome.