Discordance between the patient's and surgeon's perception of complications following hernia surgery

被引:31
作者
Fränneby U. [1 ]
Gunnarsson U. [2 ]
Wollert S. [3 ]
Sandblom G. [2 ]
机构
[1] Dept. of Surgery, Södersjukhuset, Stockholm
[2] Dept. of Surgery, Akademiska Sjukhuset
[3] Dept. of Surgery, Samariterhemmet, Uppsala
关键词
Complications; Hernia; Reliability; Validation; Validity;
D O I
10.1007/s10029-004-0310-x
中图分类号
学科分类号
摘要
Background: The study was undertaken in order to assess the degree of concordance between the patient's and surgeon's perceptions of adverse events after groin hernia surgery. Methods: 206 patients who underwent elective surgery for groin hernia at Samariterhemmet, Uppsala, Sweden in 2003 were invited to a follow-up visit after 3-6 weeks. At this visit the patient was instructed to answer a questionnaire including 12 questions concerning postoperative complications. A postoperative history was taken and a clinical examination performed by a surgeon who was not present at the operation and did not know the outcome of the questionnaire. All complications noted by the physician were recorded for corresponding questions in the questionnaire. Results: 174 (84.5%) patients attended the follow up, 161 men and 13 women. A total of 190 complications were revealed by the questionnaire, 32 of which had caused the patient to seek help from the health-care system. There were 131 complications registered as a result of the follow-up clinical examinations and history. Kappa levels ranged from 0.11 for urinary complications to 0.56 for constipation. Conclusion: In general, the concordance was poor. These results emphasise the importance of providing detailed information about the usual postoperative course prior to the operation. Whereas the surgeon, from a professional point of view, has a better idea about what should be expected in the postoperative period and how any complications should be categorised, only the patient has a complete picture of the symptoms and adverse events. This makes it impossible to reach complete agreement between the patient's and surgeon's perceptions of complications, even under the most ideal circumstances. © Springer-Verlag 2005.
引用
收藏
页码:145 / 149
页数:4
相关论文
共 21 条
[1]  
Nilsson E., Haapaniemi S., Gruber G., Sandblom G., Methods of repair and risk for reoperation in Swedish hernia surgery from 1992 to 1996, Brit. J. Surg., 85, pp. 1686-1691, (1998)
[2]  
Sandblom G., Gruber G., Kald A., Nilsson E., Audit and recurrence rates after hernia surgery, Eur. J. Surg., 166, pp. 154-158, (2000)
[3]  
Nilsson E., Haapaniemi S., Hernia registers and specialization, Surg. Clin. North Am., 78, pp. 1141-1155, (1998)
[4]  
Haapaniemi S., Nilsson E., Recurrence and pain three years after groin hernia repair. Validation of postal questionnaire and selective physical examination as a method of follow-up, Eur. J. Surg., 168, pp. 22-28, (2002)
[5]  
Sandblom G., Haapaniemi S., Nilsson E., Femoral hernias: A register analysis of 588 repairs, Hernia, 3, pp. 131-134, (1999)
[6]  
Gunnarsson U., Quality assurance in surgical oncology - Colorectal cancer as an example, Eur. J. Surg. Oncol., 29, pp. 89-94, (2003)
[7]  
Gunnarsson U., Heuman R., Patient experience ratings in surgery for recurrent hernia, Hernia, 3, pp. 69-73, (1999)
[8]  
Armitage P., Berry G., Further analysis of categorical data Armitage, Statistical Methods in Medical Research, pp. 443-447, (1994)
[9]  
Durieux P., Bissery A., Dubois S., Gasquet I., Coste J., Comparison of health care professionals' self-assessments of standards of care and patients' opinions on the care they received in hospital: Observational study, Qual. Saf. Health Care, 13, pp. 198-202, (2004)
[10]  
Lawrence K., McWhinnie D., Goodwin A., Doll H., Gordon A., Gray A., Britton J., Collin J., Randomized controlled trial of laparoscopic versus open repair of inguinal hernia: Early results, Brit. Med. J., 311, pp. 981-985, (1995)