TY - JOUR
T1 - Do Patients Want to be Involved in Their Carpal Tunnel Surgery Decisions? A Multicenter Study
AU - Roe, Allison K.
AU - Eppler, Sara L.
AU - Kakar, Sanjeev
AU - Akelman, Edward
AU - Got, Christopher J.
AU - Blazar, Philip E.
AU - Ruch, David S.
AU - Richard, Marc J.
AU - Yao, Jeffrey
AU - Kamal, Robin N.
N1 - Funding Information:
This work was supported by a grant from National Institutes of Health ( NIH ) K23AR073307-01 award (to R.N.K.) and the Orthopaedic Research and Education Foundation ( OREF ) Mentored Clinician Scientist Grant. The content of this work is solely the responsibility of the authors and does not necessarily represent the official views of the NIH or OREF. No other authors have any conflicts of interest related to this research, and no benefits in any form have been received or will be received related directly or indirectly to the subject of this article.
Publisher Copyright:
© 2022 American Society for Surgery of the Hand
PY - 2022
Y1 - 2022
N2 - Purpose: Carpal tunnel syndrome requires multiple decisions during its management, including regarding preoperative studies, surgical technique, and postoperative wound management. Whether patients have varying preferences for the degree to which they share in decisions during different phases of care has not been explored. The goal of our study was to evaluate the degree to which patients want to be involved along the care pathway in the management of carpal tunnel syndrome. Methods: We performed a prospective, multicenter study of patients undergoing carpal tunnel surgery at 5 academic medical centers. Patients received a 27-item questionnaire to rate their preferred level of involvement for decisions made during 3 phases of care for carpal tunnel surgery: preoperative, intraoperative, and postoperative. Preferences for participation were quantified using the Control Preferences Scale. These questions were scored on a scale of 0 to 4, with patient-only decisions scoring 0, semiactive decisions scoring 1, equally collaborative decisions scoring 2, semipassive decisions scoring 3, and physician-only decisions scoring 4. Descriptive statistics were calculated. Results: Seventy-one patients completed the survey between November 2018 and April 2019. Overall, patients preferred semipassive decisions in all phases of care (median score, 3). Patients preferred equally collaborative decisions for preoperative decisions (median score, 2). Patients preferred a semipassive decision-making role for intraoperative and postoperative decisions (median score, 3), suggesting these did not need to be equally shared. Conclusions: Patients with carpal tunnel syndrome prefer varying degrees of involvement in the decision-making process of their care and prefer a semipassive role in intraoperative and postoperative decisions. Clinical relevance: Strategies to engage patients to varying degrees for all decisions during the management of carpal tunnel syndrome, such as decision aids for preoperative surgical decisions and educational handouts for intraoperative decisions, may facilitate aligning decisions with patient preferences for shared decision-making.
AB - Purpose: Carpal tunnel syndrome requires multiple decisions during its management, including regarding preoperative studies, surgical technique, and postoperative wound management. Whether patients have varying preferences for the degree to which they share in decisions during different phases of care has not been explored. The goal of our study was to evaluate the degree to which patients want to be involved along the care pathway in the management of carpal tunnel syndrome. Methods: We performed a prospective, multicenter study of patients undergoing carpal tunnel surgery at 5 academic medical centers. Patients received a 27-item questionnaire to rate their preferred level of involvement for decisions made during 3 phases of care for carpal tunnel surgery: preoperative, intraoperative, and postoperative. Preferences for participation were quantified using the Control Preferences Scale. These questions were scored on a scale of 0 to 4, with patient-only decisions scoring 0, semiactive decisions scoring 1, equally collaborative decisions scoring 2, semipassive decisions scoring 3, and physician-only decisions scoring 4. Descriptive statistics were calculated. Results: Seventy-one patients completed the survey between November 2018 and April 2019. Overall, patients preferred semipassive decisions in all phases of care (median score, 3). Patients preferred equally collaborative decisions for preoperative decisions (median score, 2). Patients preferred a semipassive decision-making role for intraoperative and postoperative decisions (median score, 3), suggesting these did not need to be equally shared. Conclusions: Patients with carpal tunnel syndrome prefer varying degrees of involvement in the decision-making process of their care and prefer a semipassive role in intraoperative and postoperative decisions. Clinical relevance: Strategies to engage patients to varying degrees for all decisions during the management of carpal tunnel syndrome, such as decision aids for preoperative surgical decisions and educational handouts for intraoperative decisions, may facilitate aligning decisions with patient preferences for shared decision-making.
KW - Carpal tunnel release
KW - patient involvement
KW - shared decision-making
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U2 - 10.1016/j.jhsa.2022.03.025
DO - 10.1016/j.jhsa.2022.03.025
M3 - Article
C2 - 35672175
AN - SCOPUS:85131513016
SN - 0266-7681
JO - Journal of Hand Surgery
JF - Journal of Hand Surgery
ER -