CHANGE IN PATIENT SELF-EVALUATION OF PAIN, FUNCTION AND SATISFACTION BEFORE AND AFTER CLINICAL VISIT

Abstract

Introduction: Self-administered questionnaires are commonly used to evaluate functional and satisfaction results of different treatments applied. The objective of the study is to analyze the effect of the doctor-patient interview in the self-evaluation of the patient of the pain, level of function and satisfaction in different shoulder procedures.

Material and Method: 95 consecutive patients were recruited. There were 70 females and 25 males. Mean age of 64,18 yo (20–88). There were 28 fracture cases, 37 cuff disorders, 6 instabilities and 21 gleno-humeral arthritis. 46 patients had received surgery while 49 did not. 24 patients were excluded because of wrong complementation of the questionnaire. All the patients were asked to fill 3 analogical scales (level of shoulder pain, level of shoulder function and satisfaction with the procedure) before and after the clinical visit. Non parametric values studied through U-Mann-Whitney.

Results: Analyzing the whole series there were significant differences between the pain experienced in the shoulder before and after the visit (p=0,039). There were marginally significant differences between the level of function of the shoulder experienced before and after visit (p=0,061), and there were no differences in satisfaction with the procedure (p=0,462). If the cohort of patients that had received surgery is analyzed apart, there are significant differences in pain perception (p=0,05) and also in function perception (p=0,046) but no differences were noted with satisfaction even though patients tend to perceive more satisfaction after visit. Females significantly considered less pain after visit than males (p=0,034) and no differences were noted because of age, diagnosis or time elapsed since surgery.

Conclusions: Globally, patients with shoulder disorders significantly consider to have less pain perception after clinical visit. Patients that had received surgery because of the shoulder disorder significantly perceive less pain and better shoulder function after visit. Satisfaction with the procedure tends to improve after visit but that is not significant.

Even a simple analogical scale has a 25% drop-outs because of wrong complementation.

When planning patient self-evaluation of pain and function the effect of the clinical visit has to be considered in order to avoid masking results.