Citation

Kadakia RJ, Tsahakis JM, Issar NM, Archer KR, Jahangir AA, Sethi MK, Obremskey WT, Mir HR. J. Orthop. Trauma 2013; 27(8): 467-471.

Affiliation

Vanderbilt Orthopaedic Institute Center for Health Policy.

Copyright

(Copyright © 2013, Lippincott Williams and Wilkins)

DOI

10.1097/BOT.0b013e3182793338

PMID

23114414

Abstract

OBJECTIVES:: To evaluate the level of comprehension in an orthopaedic trauma patient population regarding injury, surgery, and postoperative instructions, and to determine if educational background is associated with inadequate comprehension. DESIGN:: Prospective observational cohort. SETTING:: Academic Level 1 trauma center. PATIENTS:: From April to June 2011, 248 orthopaedic trauma patients with an operatively fixed isolated fracture were eligible for inclusion. 146 eligible questionnaires were collected (58.9% response rate). INTERVENTION:: Patients were administered a questionnaire during their first postoperative visit prior to being seen by a physician. The questionnaire included demographic information, and questions regarding: (1) which bone was fractured; (2) the type of implanted fixation; (3) weight-bearing status; (4) expected recovery time; and (5) need for DVT prophylaxis. Multivariable logistic regression analyses were used to examine the association between educational level and questions regarding surgical procedure and discharge instructions. RESULTS:: The overall mean score of all patients on the patient comprehension portion was 2.54±1.27 correct responses out of 5. Only 47.9% of patients knew the bone they fractured, and 18.5% knew their expected healing time. 66.4% knew the type of implanted fixation, and 45.2% knew their weight-bearing status. 74.0% of patients knew their DVT prophylaxis medication(s). The mean score for patients in Group ≤ HS (≤ high school education) was 2.26, while the mean score for patients in Group > HS (> high school education) was 3.00 (p=0.0009). Patients in Group > HS were 2.54 times more likely to know the bone they fractured (p=0.01), 3.82 times more likely to know the recovery time (p=0.004), and 2.79 times more likely to know their DVT prophylaxis medication(s) than patients in Group ≤ HS. CONCLUSION:: Orthopaedic trauma patients demonstrated limited comprehension of their injuries, surgeries, and postoperative instructions. Patients with lower educational levels did significantly worse on the questionnaire than those with higher educational levels. The study's results highlight a lack of comprehension within this patient population, and suggest that an increased focus on patient communication by orthopaedic providers may be necessary.

Language: en