A prospective study of the association of patient expectations with changes in health-related quality of life outcomes, following total joint replacement
1 Research Unit. Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Basurto University Hospital, Jado, 4th Floor. Avda. Montevideo 18, 48013 Bilbao, Spain
2 Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Hospital Universitario Virgen de las Nieves, Avda. de las Fuerzas Armadas, 2, Granada, Spain
3 Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Planning and Evaluation Service, Canary Islands Health Service, C/ Pérez de Rozas, n°5, 4th Floor, 38004 Santa Cruz de Tenerife, Spain
4 Research Unit. Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Txagorritxu University Hospital, C/ Jose Atxotegi, s/n, 01006 Vitoria-Gasteiz, Spain
5 Research Unit. Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Donostia University Hospital, Paseo Dr. Beguiristain s/n. 20014. San Sebastián, Donostia-San Sebastian, Spain
BMC Musculoskeletal Disorders 2014, 15:248 doi:10.1186/1471-2474-15-248Published: 23 July 2014
Patient expectations regarding surgery may be related to outcomes in total joint replacement (TJR). The aim of this study was to determine the association of patient expectations with health related quality of life (HRQoL) outcomes measured by Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and Short Form 12 (SF-12) and satisfaction with current symptoms measured on a 4-point Likert scale, one year after surgery, adjusting for Body Mass Index (BMI), age, gender, joint, education, previous intervention and baseline scores.
Consecutive patients preparing for TJR of the knee or hip due to primary osteoarthritis (OA) in 15 hospitals in Spain were recruited for the study. Patients completed questionnaires before surgery and 12 months afterwards: five questions about expectations before surgery; an item to measure satisfaction; two HRQoL instruments—WOMAC and SF-12; as well as questions about sociodemographic information. To determine the association of patient expectations at baseline, with changes in HRQoL 12 months after surgery and with satisfaction, general linear models and logistic regression analysis were performed.
A total of 892 patients took part in the study. Patients who had higher pain relief or ability to walk expectations improved more in HRQoL at 12 months. Moreover, patients with high daily activity expectations were more satisfied.
Patients with higher baseline expectations for TJR, improved more in HRQoL at one year and had more likelihood to be satisfied than patients with lower expectations, adjusted for BMI, age, gender, joint, education, previous intervention and HRQoL baseline scores.