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Preoperative Expectations in Hand Surgery Patients.

Patrick M J Sajak1, Samir Kaveeshwar1, Ali Aneizi1

  • 1Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, Maryland, United States.

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Summary

Patients with higher education and less baseline pain report greater expectations for hand surgery outcomes. Understanding these patient factors can improve preoperative counseling and expectation management.

Keywords:
expectationshand surgeryorthopaedic surgerypatient-reported outcomesupper extremity

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Area of Science:

  • Orthopaedic Surgery
  • Patient-Reported Outcomes
  • Health Psychology

Background:

  • Patient preoperative expectations correlate with postoperative satisfaction.
  • Limited research exists on factors influencing high preoperative expectations in hand surgery patients.

Purpose of the Study:

  • To analyze preoperative expectation scores in hand surgery patients.
  • To identify patient characteristics associated with higher preoperative expectations.

Main Methods:

  • Analysis of 418 elective hand surgery patients (≥15 years) from an orthopaedic registry (June 2015-December 2018).
  • Utilized Patient-Reported Outcome Measurement Information System (PROMIS) domains and Musculoskeletal Outcomes Data Evaluation and Management System (MSOR-DEMS) expectations questionnaire.
  • Employed bivariate and multivariable analyses to identify predictors of higher expectations.

Main Results:

  • Overall high patient expectations (≥80.0) for hand surgery.
  • Higher expectations associated with females, college graduates, better baseline health, and fewer prior hand surgeries (p < 0.05).
  • Multivariable analysis confirmed college education (p=0.023) and less pain (p=0.008) as predictors of higher expectations.

Conclusions:

  • More educated patients with less baseline pain and better health status exhibit higher hand surgery expectations.
  • Findings can guide hand surgeons in preoperative counseling and expectation management.