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Satisfaction des soins et qualité de vie après une arthroplastie totale de hanche ou de genou pour arthrose

Abstract : Context. The increasing use of Patient-Reported Outcomes (PROs) in practice assessment and epidemiologic research fields shows that we pay more and more attention to the patient's opinion. From the point of view of patients with chronic disease, two concepts are meaningfu l: the self-perceived health related Quality of Life (QoL) measures and the self-perceived qualitv of care with satisfaction indices. Objective. The general objective was to investigate of relations between pre- and post-Total Hip or Knee Replacement (THRITKR) QoL and immediate postoperative satisfaction with care. Method. Patients in the AMISAT cohort, a multicentre prospective study, were enrolled at preoperative surgery consultation and were prospectively followed up to 1 year after discharge Çom hospital. Overall, 234 patients were included and 189 were followed up at 1 year. We successively assessed (1) the effect of order of presentation of a generic (SF36) and a specific OsteoArthritis Knee and Hip QoL (OAKHQOL) instrument in terms of the response quality and the level of QoL, (2) the impact of clinical presentation and preoperative QoL on the patient satisfaction with care, and (3) the relation between immediate postoperative satisfaction with care and postoperative QoL measured at 1, 6 and 12 months fier discharge. Results. Our results show that the order of presentation of a generic and a specific QoL questionnaire about OA only marginally influences the quality of responses and the level of QoL measured. The usual recommendation to administer the generic questionnaire first, which allows for comparing patients across diseases, is valid apd applicable in OA. The study of preoperative QoL, health care satisfaction and postoperative QoL relations showed, first, that the level of inpatient satisfaction after total hip or knee replacement was independent of initial clinical presentation and not very sensitive to preoperative Qo, and then, that the patients satisfied with medical care, nursing and daily care and admission domains have higher QoL after surgery than less satisfied patients, whatever the preoperative QoL. Conclusions. Showing that health care satisfaction is independent of patient preoperative characteristics, our results suggest that satisfaction reflects heterogeneity of patient care. We bring also an argument in favour of an innovative use of inpatient satisfaction measures. Besides being a quality-of-care indicator, immediate postoperative satisfaction with care appears a good predictor of self-perceived health status fier surgery. This concept should be investigated in patients hospitalized for other chronic diseases.
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Submitted on : Thursday, March 29, 2018 - 10:49:07 AM
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Cédric Baumann. Satisfaction des soins et qualité de vie après une arthroplastie totale de hanche ou de genou pour arthrose. Médecine humaine et pathologie. Université Henri Poincaré - Nancy 1, 2006. Français. ⟨NNT : 2006NAN10236⟩. ⟨tel-01746991⟩



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