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Preoperative anxiety and desire for information among scoliosis deformity surgical patients
Proceedings of the BASS 2015 Bath Meeting / The Spine Journal 15 (2015) 50S–85S maintaining spine motion in patients with degenerative spine deformity and symptomatic sagittal imbalance. CONFLICTS OF INTEREST: None. FUNDING SOURCES: None. http://dx.doi.org/10.1016/j.spinee.2014.12.132
The quality and access to information among scoliosis surgical patients pre-operatively Ismael Salam, Maryam Kazeem, Gayle D’Souza, Alex Gibson; The Royal National Orthopaedic Hospital BACKGROUND CONTEXT: The provision of preoperative information is important in minimising levels of pre and post-operative anxiety, decrease clinical symptoms and manage expectations. PURPOSE: Explore scoliosis surgical patient’s access to information and the quality of information given by surgeons and preoperative assessment nursing staff. STUDY DESIGN/SETTING: Retrospective observational study. PATIENT SAMPLE: Convenient sample. OUTCOME MEASURES: Questionnaire scaling quality of information and access to information outlets. METHODS: A sample of 46 patients admitted to the RNOH between February-July 2014 for scoliosis correction surgery. The piloted questionnaire was completed by patients pre-operatively. Access to information was explored and we scaled the quality of information given, concerning different aspects of planned surgery on a scale of 1; ’excellent’ to 5; ’bad’. RESULTS: The mean age was 20 years (13-69); with 76% females. 50% of patients were provided website details by their surgeons pre-operatively. 67% of patients accessed information from websites while 46%and 24% of patients gained information from YouTube videos and GP respectively. 80% of female patients accessed websites compared to 55% in males. Generally the quality of information given by surgeons was better than same type of information given by nursing staff; with slightly less quality of information provided on anaesthesia and recovery by both surgeons (mean score52) and nurses (mean score52.5) (P50.05). CONCLUSIONS: Generally the quality of information regarding scoliosis was good but improving information provision by nursing staff is required. We need to deliver more information regarding anaesthesia and recovery. We could develop video material as part of information pack and wider project like ‘‘Spinal Scoliosis School’’ to address patient education. CONFLICTS OF INTEREST: None. FUNDING SOURCES: None. http://dx.doi.org/10.1016/j.spinee.2014.12.133
The quality of spinal surgery consent forms: do we tell our patients all risks and benefits associated with their surgery? Salam Ismael, Alex Gibson; The Royal National Orthopaedic Hospital (RNOH) BACKGROUND CONTEXT: Informed consent is an essential part of surgical practice. Patients who undergoing surgery need to be fully informed of the risk and benefits associated with their surgery. PURPOSE: Objective was to evaluate the practice of informed consent in patients undergoing spinal surgery in the royal national orthopaedic hospital(RNOH). STUDY DESIGN/SETTING: Retrospective Observational Study. PATIENT SAMPLE: Convenient sample. OUTCOME MEASURES: Complying with International Spinal Surgery information Sheet (ISSiS) (risks and complications of surgery).
83S
METHODS: Study conducted at the spinal surgery unit at the RNOH. We reviewed convenient sample of 80 consent forms of operations performed at spinal surgery department between January and May 2014. RESULTS: 79% of consents carried by registrars while 12.5% and 8.7% consented by consultants and senior house officer respectively. Only 26% of patients received their copies of the consent form. Surprisingly, no risk of spinal cord injury and nor risk of dura tear recorded in 11% and 75% of consents respectively. The majority of cases were involving fusion; however 22.5%,39% and 35% of the forms did not include pseudoarthrosis, non-union and failure of metal work as risks respectively. 35% of the consents mentioned risk on life and pain as possible complications. 12% of consented patients risks of anaesthesia mentioned to them. Hardly any of the patients informed of the risks of haematoma, blindness or revision surgery. CONCLUSIONS: The quality of existing spinal surgery informed consents at our hospital is less than ideal. There is a great need to develop comprehensive spinal specific consent forms that include all possible risks and benefits using agreed international tools and guidelines. CONFLICTS OF INTEREST: None. FUNDING SOURCES: None. http://dx.doi.org/10.1016/j.spinee.2014.12.134
Preoperative anxiety and desire for information among scoliosis deformity surgical patients Salam Ismael, Kazeem Maryam, Gayle D’Souza, Alex Gibson; The Royal National Orthopaedic Hospital (RNOH) BACKGROUND CONTEXT: Preoperative anxiety is a common problem that affects patients undergoing surgical procedures in general and can affect their clinical outcomes, expectations and satisfaction. PURPOSE: To determine preoperative prevalence, level of anxiety and its correlation to the desire for information among Scoliosis surgical patients. STUDY DESIGN/SETTING: Prospective Observational Study. PATIENT SAMPLE: Convenient sample. OUTCOME MEASURES: Amsterdam preoperative anxiety and information scale (AAPI). METHODS: Our cohort was sample of 46 scoliosis patients admitted to the royal national orthopaedic hospital between February and July 2014 for scoliosis correction surgery. We surveyed adolescent and adult patients undergoing surgery under the care of four different spinal surgeons and asked them to answer piloted questionnaire. We measured pre-operative anxiety using (AAPI) which is validated tool independent of age and sex. Questionnaire filled by patient preoperatively. RESULTS: The mean age of our cohort was 20 years (13-69) and 76% were females. Mean anxiety score for surgery was 7 compared to 5.7 anaesthesia related (P !0.0002). Mean total anxiety score among our patients was 12 (Scale 4-20). The mean score for information desired by our patients and pre-operative pain score were 6.6(scale 2-10)-and 4.8(scale 0-10) respectively. With higher level of anxiety there is more desire for information by our patients with positive coefficient value 4.3(P value 0.01) and mainly surgery related information. The patients with high pain score preoperatively had higher anxiety score (P value ! 0.001). CONCLUSIONS: Our patients experience high levels of preoperative anxiety mainly surgical with significant regression relationship between their level of anxiety and level of information desired by the patients. Preoperative counselling clinics and more information will help in reducing preoperative anxiety. CONFLICTS OF INTEREST: None. FUNDING SOURCES: None. http://dx.doi.org/10.1016/j.spinee.2014.12.135
The quality and access to information among scoliosis surgical patients pre-operatively Ismael Salam, Maryam Kazeem, Gayle D’Souza, Alex Gibson; The Royal National Orthopaedic Hospital BACKGROUND CONTEXT: The provision of preoperative information is important in minimising levels of pre and post-operative anxiety, decrease clinical symptoms and manage expectations. PURPOSE: Explore scoliosis surgical patient’s access to information and the quality of information given by surgeons and preoperative assessment nursing staff. STUDY DESIGN/SETTING: Retrospective observational study. PATIENT SAMPLE: Convenient sample. OUTCOME MEASURES: Questionnaire scaling quality of information and access to information outlets. METHODS: A sample of 46 patients admitted to the RNOH between February-July 2014 for scoliosis correction surgery. The piloted questionnaire was completed by patients pre-operatively. Access to information was explored and we scaled the quality of information given, concerning different aspects of planned surgery on a scale of 1; ’excellent’ to 5; ’bad’. RESULTS: The mean age was 20 years (13-69); with 76% females. 50% of patients were provided website details by their surgeons pre-operatively. 67% of patients accessed information from websites while 46%and 24% of patients gained information from YouTube videos and GP respectively. 80% of female patients accessed websites compared to 55% in males. Generally the quality of information given by surgeons was better than same type of information given by nursing staff; with slightly less quality of information provided on anaesthesia and recovery by both surgeons (mean score52) and nurses (mean score52.5) (P50.05). CONCLUSIONS: Generally the quality of information regarding scoliosis was good but improving information provision by nursing staff is required. We need to deliver more information regarding anaesthesia and recovery. We could develop video material as part of information pack and wider project like ‘‘Spinal Scoliosis School’’ to address patient education. CONFLICTS OF INTEREST: None. FUNDING SOURCES: None. http://dx.doi.org/10.1016/j.spinee.2014.12.133
The quality of spinal surgery consent forms: do we tell our patients all risks and benefits associated with their surgery? Salam Ismael, Alex Gibson; The Royal National Orthopaedic Hospital (RNOH) BACKGROUND CONTEXT: Informed consent is an essential part of surgical practice. Patients who undergoing surgery need to be fully informed of the risk and benefits associated with their surgery. PURPOSE: Objective was to evaluate the practice of informed consent in patients undergoing spinal surgery in the royal national orthopaedic hospital(RNOH). STUDY DESIGN/SETTING: Retrospective Observational Study. PATIENT SAMPLE: Convenient sample. OUTCOME MEASURES: Complying with International Spinal Surgery information Sheet (ISSiS) (risks and complications of surgery).
83S
METHODS: Study conducted at the spinal surgery unit at the RNOH. We reviewed convenient sample of 80 consent forms of operations performed at spinal surgery department between January and May 2014. RESULTS: 79% of consents carried by registrars while 12.5% and 8.7% consented by consultants and senior house officer respectively. Only 26% of patients received their copies of the consent form. Surprisingly, no risk of spinal cord injury and nor risk of dura tear recorded in 11% and 75% of consents respectively. The majority of cases were involving fusion; however 22.5%,39% and 35% of the forms did not include pseudoarthrosis, non-union and failure of metal work as risks respectively. 35% of the consents mentioned risk on life and pain as possible complications. 12% of consented patients risks of anaesthesia mentioned to them. Hardly any of the patients informed of the risks of haematoma, blindness or revision surgery. CONCLUSIONS: The quality of existing spinal surgery informed consents at our hospital is less than ideal. There is a great need to develop comprehensive spinal specific consent forms that include all possible risks and benefits using agreed international tools and guidelines. CONFLICTS OF INTEREST: None. FUNDING SOURCES: None. http://dx.doi.org/10.1016/j.spinee.2014.12.134
Preoperative anxiety and desire for information among scoliosis deformity surgical patients Salam Ismael, Kazeem Maryam, Gayle D’Souza, Alex Gibson; The Royal National Orthopaedic Hospital (RNOH) BACKGROUND CONTEXT: Preoperative anxiety is a common problem that affects patients undergoing surgical procedures in general and can affect their clinical outcomes, expectations and satisfaction. PURPOSE: To determine preoperative prevalence, level of anxiety and its correlation to the desire for information among Scoliosis surgical patients. STUDY DESIGN/SETTING: Prospective Observational Study. PATIENT SAMPLE: Convenient sample. OUTCOME MEASURES: Amsterdam preoperative anxiety and information scale (AAPI). METHODS: Our cohort was sample of 46 scoliosis patients admitted to the royal national orthopaedic hospital between February and July 2014 for scoliosis correction surgery. We surveyed adolescent and adult patients undergoing surgery under the care of four different spinal surgeons and asked them to answer piloted questionnaire. We measured pre-operative anxiety using (AAPI) which is validated tool independent of age and sex. Questionnaire filled by patient preoperatively. RESULTS: The mean age of our cohort was 20 years (13-69) and 76% were females. Mean anxiety score for surgery was 7 compared to 5.7 anaesthesia related (P !0.0002). Mean total anxiety score among our patients was 12 (Scale 4-20). The mean score for information desired by our patients and pre-operative pain score were 6.6(scale 2-10)-and 4.8(scale 0-10) respectively. With higher level of anxiety there is more desire for information by our patients with positive coefficient value 4.3(P value 0.01) and mainly surgery related information. The patients with high pain score preoperatively had higher anxiety score (P value ! 0.001). CONCLUSIONS: Our patients experience high levels of preoperative anxiety mainly surgical with significant regression relationship between their level of anxiety and level of information desired by the patients. Preoperative counselling clinics and more information will help in reducing preoperative anxiety. CONFLICTS OF INTEREST: None. FUNDING SOURCES: None. http://dx.doi.org/10.1016/j.spinee.2014.12.135