Evaluation of preoperative expectations and patient satisfaction after carpal tunnel release.

Full Abstract

PURPOSE: We tested the hypothesis that preoperative expectations affect postoperative satisfaction and arm-specific, self-reported health status after elective carpal tunnel release. METHODS: Forty-nine patients having elective carpal tunnel release completed questionnaires evaluating self-rated upper extremity-specific disability using the Disabilities of the Arm Shoulder and Hand (DASH) questionnaire, expectations regarding surgery (Preop Expectations Score), personal importance of upper-extremity function, measures of general optimism, the Life Orientation Test (LOT), as well as health-specific optimism, and the Multidimensional Health Locus of Control scale. Six months after surgery, patients completed a 10-point Likert scale to assess satisfaction, the DASH, and measures determining (1) fulfillment of expectations (Postop Met Expectations Score) and (2) relief of specific systems (Postop Help Score). RESULTS: The DASH scores decreased significantly from an average of 37 points before surgery to an average of 15 points 6 months after carpal tunnel release (p<.001), and patients rated their satisfaction (mean +/- standard deviation) as 8 +/- 3. Preoperative expectations did not correlate with patient satisfaction or postoperative DASH scores. Multivariable analyses determined that patient satisfaction was best predicted by fulfillment of expectations (Postop Help Score alone, accounting for 41% of the variance in scores) and postoperative DASH scores were predicted by a combination of Postop Met Expectations Score and the LOT score (accounting for 31% of the variance in scores). CONCLUSIONS: As measured in this study, the strongest predictor of satisfaction after carpal tunnel release was relief of symptoms, and the strongest predictors of postoperative disability were met expectations and optimism; however, the majority of the variance in postoperative satisfaction remains unexplained. TYPE OF STUDY/LEVEL OF EVIDENCE: Prognostic III.

Author information

Author/s: Kadzielski, John (J); Malhotra, Leah R (LR); Zurakowski, David (D); Lee, Sang-Gil P (SG); Jupiter, Jesse B (JB); Ring, David (D);

Affiliation: Department of Orthopaedic Surgery, Hand and Upper Extremity Service, Massachusetts General Hospital, Boston, MA 02114-2696, USA.

Journal and publication information

Publication Type: Journal Article; Research Support, Non-U.S. Gov't

Journal: The Journal of hand surgery (J Hand Surg Am), published in United States. (Language: eng)

Reference: 2008-Dec; vol 33 (issue 10) : pp 1783-8

Dates: Created 2008/12/16; Completed 2009/03/31; Revised 2009/06/08;

PMID: 19084178, status: MEDLINE (last retrieval date: 6/8/2009, IMS Date: 08 Jun 2009 00:00:00)

Sourced from the National Library of Medicine. Abstract text and other information may be subject to copyright.

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MeSH headings (categories)

This article was linked to the MESH Headings shown below.

Aspirations (Psychology)
Carpal Tunnel Syndrome - psychology; surgery
Disability Evaluation
Female
Follow-Up Studies
Health Status
Humans
Male

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