Abstract：
BACKGROUND: Patient expectations for orthopedic surgeries, and elective shoulder surgery in particular, have been shown to be important for patient outcomes and satisfaction. Current surveys assessing patient expectations lack clinical applicability and allow patients to list multiple expectations at the highest level of importance. The purpose of this study was to develop and evaluate the use of a novel, rank-based survey assessing the relative importance of patient expectations for shoulder surgery.
METHODS: The Preoperative Rank of Expectations for Shoulder Surgery (PRESS) survey was developed by polling 100 patients regarding their expectations for surgery. The PRESS survey consisted of eight common expectations for elective shoulder surgery by importance and a 0-100% scale of expected pain relief and range of motion improvement. After initial development of the PRESS survey, it was administered preoperatively to 316 patients undergoing surgery for shoulder arthritis, rotator cuff tear, subacromial pain syndrome, or glenohumeral instability between August 2020 and April 2021. Patients also completed preoperative outcome measures such as ASES, PROMIS PF, and PROMIS PI surveys. PROM surveys were administered six months postoperatively.
RESULTS: Improvement in range of motion was the expectation most often ranked first for the entire study group (18%), arthritis subgroup (23%), and rotator cuff tear subgroup (19%). Subacromial pain syndrome patients most often ranked improving ability to complete ADL\'s and relieving daytime pain first (19%). Shoulder instability patients most often ranked improving ability to participate in sports first (31%). Patients that ranked improving range of motion or sports highly had better PROMs. Those who ranked relieving pain highly had worse PROMs. Patients with high (>90%) expectations of pain relief had better PROMIS PI scores. Patients with high pain relief expectations in the arthritis and subacromial pain syndrome groups had better PROMs, while patients with instability were less satisfied.
CONCLUSIONS: The novel PRESS survey assesses patient expectations for shoulder surgery in a new, more clinically applicable rank-based format. The responses provided by patients provide actionable information to clinicians and are related to postoperative outcomes. Therefore the PRESS survey represents a useful tool for guiding discussions between patients and surgeons, as well as aiding in overall patient-centered clinical decision making.
METHODS: The Preoperative Rank of Expectations for Shoulder Surgery (PRESS) survey was developed by polling 100 patients regarding their expectations for surgery. The PRESS survey consisted of eight common expectations for elective shoulder surgery by importance and a 0-100% scale of expected pain relief and range of motion improvement. After initial development of the PRESS survey, it was administered preoperatively to 316 patients undergoing surgery for shoulder arthritis, rotator cuff tear, subacromial pain syndrome, or glenohumeral instability between August 2020 and April 2021. Patients also completed preoperative outcome measures such as ASES, PROMIS PF, and PROMIS PI surveys. PROM surveys were administered six months postoperatively.
RESULTS: Improvement in range of motion was the expectation most often ranked first for the entire study group (18%), arthritis subgroup (23%), and rotator cuff tear subgroup (19%). Subacromial pain syndrome patients most often ranked improving ability to complete ADL\'s and relieving daytime pain first (19%). Shoulder instability patients most often ranked improving ability to participate in sports first (31%). Patients that ranked improving range of motion or sports highly had better PROMs. Those who ranked relieving pain highly had worse PROMs. Patients with high (>90%) expectations of pain relief had better PROMIS PI scores. Patients with high pain relief expectations in the arthritis and subacromial pain syndrome groups had better PROMs, while patients with instability were less satisfied.
CONCLUSIONS: The novel PRESS survey assesses patient expectations for shoulder surgery in a new, more clinically applicable rank-based format. The responses provided by patients provide actionable information to clinicians and are related to postoperative outcomes. Therefore the PRESS survey represents a useful tool for guiding discussions between patients and surgeons, as well as aiding in overall patient-centered clinical decision making.
摘要：
背景：患者对骨科手术的期望，特别是选择性的肩部手术，已被证明对患者的预后和满意度很重要。当前评估患者期望的调查缺乏临床适用性，并且允许患者以最高的重要性列出多个期望。这项研究的目的是开发和评估小说的使用，基于等级的调查评估患者对肩部手术的期望的相对重要性。
方法：术前肩关节手术期望排名（PRESS）调查是通过对100名患者的手术期望进行调查而制定的。PRESS调查包括对择期肩部手术的八个常见期望，其重要性以及0-100％的预期疼痛缓解和运动改善范围。在PRESS调查的初步发展之后，术前对316名接受肩关节炎手术的患者进行了治疗，肩袖撕裂,肩峰下疼痛综合征,或2020年8月至2021年4月之间的肱骨不稳定。患者还完成了术前结果测量，如ASES，PROMISPF,和PROMISPI调查。PROM调查在术后六个月进行。
结果：运动范围的改善是整个研究组最常排名第一的期望（18％），关节炎亚组（23%），和肩袖撕裂亚组（19％）。肩峰下疼痛综合征患者最常排名第一（19%），提高完成ADL和缓解日间疼痛的能力。肩关节不稳定患者最常排名第一（31％）。对疼痛缓解期望较高(>90%)的患者具有较好的PROMISPI评分。关节炎和肩峰下疼痛综合征组中疼痛缓解期望较高的患者有更好的PROM，而不稳定患者满意度较低。
结论：新的PRESS调查评估了患者对肩部手术的期望，更适用于临床的基于等级的格式。患者提供的反应为临床医生提供了可操作的信息，并与术后结果相关。因此，PRESS调查是指导患者和外科医生之间讨论的有用工具，以及帮助整体以患者为中心的临床决策。
方法：术前肩关节手术期望排名（PRESS）调查是通过对100名患者的手术期望进行调查而制定的。PRESS调查包括对择期肩部手术的八个常见期望，其重要性以及0-100％的预期疼痛缓解和运动改善范围。在PRESS调查的初步发展之后，术前对316名接受肩关节炎手术的患者进行了治疗，肩袖撕裂,肩峰下疼痛综合征,或2020年8月至2021年4月之间的肱骨不稳定。患者还完成了术前结果测量，如ASES，PROMISPF,和PROMISPI调查。PROM调查在术后六个月进行。
结果：运动范围的改善是整个研究组最常排名第一的期望（18％），关节炎亚组（23%），和肩袖撕裂亚组（19％）。肩峰下疼痛综合征患者最常排名第一（19%），提高完成ADL和缓解日间疼痛的能力。肩关节不稳定患者最常排名第一（31％）。对疼痛缓解期望较高(>90%)的患者具有较好的PROMISPI评分。关节炎和肩峰下疼痛综合征组中疼痛缓解期望较高的患者有更好的PROM，而不稳定患者满意度较低。
结论：新的PRESS调查评估了患者对肩部手术的期望，更适用于临床的基于等级的格式。患者提供的反应为临床医生提供了可操作的信息，并与术后结果相关。因此，PRESS调查是指导患者和外科医生之间讨论的有用工具，以及帮助整体以患者为中心的临床决策。
