预期与现实对比:在最少的侵入性腰椎手术中探索决策后悔
Michael Jeffko1, Aiyush Bansal2, Kenneth T Nguyen2,3
1School of Medicine, University of Washington, Seattle, Washington, USA.
Neurosurgery
|February 4, 2026
概括
患者的期望显著影响了经过微创腰部减压后的满意度. 不匹配的期望,特别是关于缓解疼痛的期望,与决策后悔 (DR) 有很强的相关性.
科学领域:
- 脊柱外科手术的结果
- 患者报告的结果
- 共享的决策方式
背景情况:
- 在选择性脊柱护理中,未满足的患者期望可能会降低满意度并增加决策遗憾 (DR).
- 最少侵入性腰部减压 (MILR) 需要了解患者对最佳结果的期望.
- 本研究调查了MILR患者的期望-实际差异和DR之间的联系.
研究的目的:
- 评估患者期望-实际差异和MILR后的DR之间的相关性.
- 在这个人群中确定与DR相关的其他患者报告的结果.
- 为改善患者满意度提供术前咨询策略的信息.
主要方法:
- 对接受选择性MILR的成年人进行前性队列研究.
- 患者完成了手术前和术后调查 (MODEMS),评估预期和结果.
- 决策后悔量表 (DRS) 和预期结果不匹配被使用单变量线性回归分析.
主要成果:
- 在所有领域中,DR与更大的预期结果不匹配密切相关.
- 疼痛缓解,日常活动,运动,睡眠,返回工作和残疾预防方面的不匹配预测了更高的遗憾.
- 人口和临床因素与遗憾无关;MODEMS不匹配是最一致的预测因素.
结论:
- 在MILR后的决策后悔与期望与实际差异有很大关系.
- 缓解疼痛,活动水平和运动是未满足期望和后续遗憾的关键驱动因素.
- 改进预期评估工具对于减少遗憾和提高患者报告结果至关重要.
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