Patients and Spine Surgeons' Perspectives regarding Decision-Making and Outcomes in Lumbar Surgery: An Exploratory, Qualitative Study.

IF 3.4 3区医学 Q1 HEALTH CARE SCIENCES & SERVICES

Patient-Patient Centered Outcomes Research Pub Date : 2024-11-26 DOI:10.1007/s40271-024-00719-1

Ling Jie Cheng, Nan Luo, Le Ann Chen, Jing Ying Cheng, Gabriel Ka Po Liu, Wenru Wang, Hwee Weng Dennis Hey, Vivien Xi Wu

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引用次数: 0

Abstract

Background: Decision-making in lumbar surgery for degenerative conditions is influenced by various factors, including patient expectations and empowerment. The role of patient-reported outcomes (PROs) in guiding these decisions is underexplored. This study aims to understand the perspectives of patients and spine surgeons in decision-making for lumbar surgery and explore their perspectives on the relevance and influence of pre- and post-surgery PROs.

Methods: An exploratory qualitative study was conducted between February 2022 and November 2023. A total of 15 patients with degenerative lumbar conditions and 9 spine surgeons from 5 tertiary public hospitals in Singapore were recruited. Data were analyzed using a framework analysis approach, ensuring validity through member checking, reflexive journals, and data source triangulation.

Results: Three overarching categories emerged: "expectations and outcomes," "decision empowerment," and "surgical experiences." There is a shift toward shared decision-making, highlighting the importance of patient-centric approaches. Surgical decisions are primarily influenced by PROs, particularly health-related quality of life (HRQoL) and pain relief. Patients prioritize pain relief and improvements in daily functioning, while surgeons also emphasize avoiding postoperative complications. Decision support tools, including PRO data, are essential but need better accessibility and integration within clinical settings. Positive surgical experiences are driven by clear communication, trust with surgeons, swift recovery, and no regrets post-surgery.

Conclusions: Our study emphasizes the importance of patient-centered approaches in lumbar surgery decision-making, particularly regarding pre- and post-surgery PROs. Implementing these approaches may enhance patient satisfaction and surgical outcomes, urging the surgical community to prioritize informed, empathetic decision-making to improve healthcare quality.

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患者和脊柱外科医生对腰椎手术决策和结果的看法：一项探索性定性研究。

背景：腰椎退行性病变手术的决策受到各种因素的影响，包括患者的期望和授权。患者报告结果（PROs）在这些决策中的指导作用尚未得到充分探讨。本研究旨在了解患者和脊柱外科医生在腰椎手术决策中的观点，并探讨他们对手术前后PROs的相关性和影响的看法：在2022年2月至2023年11月期间进行了一项探索性定性研究。共招募了来自新加坡 5 家三级公立医院的 15 名腰椎退行性疾病患者和 9 名脊柱外科医生。研究采用框架分析法对数据进行分析，通过成员核查、反思性日志和数据源三角测量确保数据的有效性：结果：出现了三个主要类别：结果：出现了三个主要类别："期望和结果"、"决策授权 "和 "手术经验"。共同决策的转变突出了以患者为中心的重要性。手术决策主要受PROs的影响，尤其是与健康相关的生活质量（HRQoL）和疼痛缓解。患者优先考虑减轻疼痛和改善日常功能，而外科医生也强调避免术后并发症。包括 PRO 数据在内的决策支持工具至关重要，但需要在临床环境中更好地使用和整合。积极的手术体验源于清晰的沟通、与外科医生的信任、迅速的恢复以及术后无遗憾：我们的研究强调了以患者为中心的方法在腰椎手术决策中的重要性，尤其是在手术前后的PROs方面。实施这些方法可提高患者满意度和手术效果，敦促外科界优先考虑知情、移情决策，以提高医疗质量。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Patient-Patient Centered Outcomes Research HEALTH CARE SCIENCES & SERVICES-

CiteScore

6.60

自引率

8.30%

发文量

审稿时长

>12 weeks

期刊介绍： The Patient provides a venue for scientifically rigorous, timely, and relevant research to promote the development, evaluation and implementation of therapies, technologies, and innovations that will enhance the patient experience. It is an international forum for research that advances and/or applies qualitative or quantitative methods to promote the generation, synthesis, or interpretation of evidence. The journal has specific interest in receiving original research, reviews and commentaries related to qualitative and mixed methods research, stated-preference methods, patient reported outcomes, and shared decision making. Advances in regulatory science, patient-focused drug development, patient-centered benefit-risk and health technology assessment will also be considered. Additional digital features (including animated abstracts, video abstracts, slide decks, audio slides, instructional videos, infographics, podcasts and animations) can be published with articles; these are designed to increase the visibility, readership and educational value of the journal’s content. In addition, articles published in The Patient may be accompanied by plain language summaries to assist readers who have some knowledge of, but not in-depth expertise in, the area to understand important medical advances. All manuscripts are subject to peer review by international experts.