Christine B Sieberg1, Juliana Manganella, Gem Manalo, Laura E Simons, M Timothy Hresko. 1. *Department of Anesthesiology, Perioperative and Pain Medicine, Division of Pain Medicine ‡Biobehavioral Pediatric Pain Lab ∥Department of Orthopaedic Surgery, Boston Children's Hospital Departments of †Psychiatry ¶Orthopaedic Surgery, Harvard Medical School, Boston, MA §Wayne State University School of Medicine, Detroit, MI.
Abstract
BACKGROUND: There is a need to better assess patient satisfaction and surgical outcomes. The purpose of the current study is to identify how preoperative expectations can impact postsurgical satisfaction among youth with adolescent idiopathic scoliosis undergoing spinal fusion surgery. METHODS: The present study includes patients with adolescent idiopathic scoliosis undergoing spinal fusion surgery enrolled in a prospective, multicentered registry examining postsurgical outcomes. The Scoliosis Research Society Questionnaire-Version 30, which assesses pain, self-image, mental health, and satisfaction with management, along with the Spinal Appearance Questionnaire, which measures surgical expectations was administered to 190 patients before surgery and 1 and 2 years postoperatively. Regression analyses with bootstrapping (with n=5000 bootstrap samples) were conducted with 99% bias-corrected confidence intervals to examine the extent to which preoperative expectations for spinal appearance mediated the relationship between presurgical mental health and pain and 2-year postsurgical satisfaction. RESULTS: Results indicate that preoperative mental health, pain, and expectations are predictive of postsurgical satisfaction. CONCLUSIONS: With the shifting health care system, physicians may want to consider patient mental health, pain, and expectations before surgery to optimize satisfaction and ultimately improve clinical care and patient outcomes. LEVEL OF EVIDENCE: Level I-prognostic study.
BACKGROUND: There is a need to better assess patient satisfaction and surgical outcomes. The purpose of the current study is to identify how preoperative expectations can impact postsurgical satisfaction among youth with adolescent idiopathic scoliosis undergoing spinal fusion surgery. METHODS: The present study includes patients with adolescent idiopathic scoliosis undergoing spinal fusion surgery enrolled in a prospective, multicentered registry examining postsurgical outcomes. The Scoliosis Research Society Questionnaire-Version 30, which assesses pain, self-image, mental health, and satisfaction with management, along with the Spinal Appearance Questionnaire, which measures surgical expectations was administered to 190 patients before surgery and 1 and 2 years postoperatively. Regression analyses with bootstrapping (with n=5000 bootstrap samples) were conducted with 99% bias-corrected confidence intervals to examine the extent to which preoperative expectations for spinal appearance mediated the relationship between presurgical mental health and pain and 2-year postsurgical satisfaction. RESULTS: Results indicate that preoperative mental health, pain, and expectations are predictive of postsurgical satisfaction. CONCLUSIONS: With the shifting health care system, physicians may want to consider patient mental health, pain, and expectations before surgery to optimize satisfaction and ultimately improve clinical care and patient outcomes. LEVEL OF EVIDENCE: Level I-prognostic study.
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