Is satisfaction among orthopaedic trauma patients predicted by depression and activation levels?
Elisa J Knutsen1, Ebrahim Paryavi, Renan C Castillo
1*R Adams Cowley Shock Trauma Center, Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, MD; and †Center for Injury Research and Policy, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.
Objectives:
Among orthopaedic trauma patients, little is known regarding the relationship between patient satisfaction and patient levels of depression and "activation" (level of involvement of patient in his or her own care). Our hypothesis was that satisfaction is correlated to levels of depression and activation.
Design:
Patient questionnaires.
Setting:
Level 1 trauma center.
Patients:
One hundred twenty-four patients with at least one fracture.
Intervention:
Patients were evaluated at orthopaedic trauma clinics 6 weeks or longer after injury.
Main Outcome Measures:
Patient Satisfaction Questionnaire (PSQ), Patient Activation Measure, and Patient Health Questionnaire, a screening and evaluation tool for the presence and severity of depression. Spearman correlation coefficients assessed the relationship between activation level and depression severity with PSQ domains. Bivariate and multivariate linear regression models determined independent effects of depression and activation on general satisfaction.
Results:
Patient satisfaction was moderate to high in general (mean score, 4.17). Spearman correlation coefficients were high for patient activation and all PSQ domains (generally >0.3, P < 0.05). Correlation coefficients were weaker for depression and PSQ domains (rho range, 0.16-0.33). Final multivariate linear regression model indicated improvement in general satisfaction of 0.14 with increasing patient activation. A decrease in general satisfaction of -0.03 was noted with increasing Patient Health Questionnaire depression score.
Conclusions:
Patient satisfaction is strongly correlated with patient activation but less correlated with the presence of depression. Patient satisfaction after orthopaedic trauma might be improved by encouraging and coaching patients on how to be more involved in their own health care.
Level Of Evidence:
Prognostic Level II. See Instructions for Authors for a complete description of levels of evidence.