1Orthopaedic Hand and Upper Extremity Service, Yawkey Center, Massachusetts General Hospital, Boston, USA
2Chief Orthopaedic Hand Service, Yawkey Center, Massachusetts General Hospital, 55 Fruit Street, Boston, USA
3Abzug M. Joshua, Julie Adams, Gallo Fabio Arbelaez, T. Aspard, George W. Balfour, Brent H. Bamberger, Jose Camilo Barreto Romero, Michael Baskies, Arnnold W. Batson, Taizoon Baxamusa, Ramón De Bedout, Steven Beldner, Prosper Benhaim, Leon Benson, Jorge G. Boretto, Martin Boyer, Gregory Byrd Dee, Ryan P. Calfee, Cecilia Gladys Caro Zambrano, Charles Cassidy, Louis III Catalano, Karel Chivers, Ralph M. Costanzo, Phani Dantuluri, Gregory DeSilva, Seth Dodds, John P. Evans, Luis Felipe Náquira Escobar, C.H. Fernandes, Thomas J. Fischer, Jochen Fischer, Renato M. Fricker, Gary K. Frykman, Aida E. Garcia, Glenn R. Gaston, Fernando José Giovanni Di, Charles A. Goldfarb, Michael W. Grafe, H.W. Grunwald, Warren C. Hammert, Randy Hauck, Ricardo German Hernandez, Eric Hofmeister, Richard L. Hutchison, Asif Ilyas, Jonathan Isaacs, Sidney M. Jacoby, Peter Jebson, Christopher M. Jones, Michael Jones, Sanjeev Kakar, David M. Kalainov, Kaplan D. Thomas, Saul Kaplan, Leonid Katolik, Stephen A. Kennedy, Michael W. Kessler, Hervey L. Kimball, G.A. Kraan, Paul A. Martineau, John McAuliffe, Steven J. McCabe, Desirae M. McKee, Greg Merrell, Charles Metzger, Michael Nancollas, David L. Nelson, Ralf Nyszkiewicz, Jose A. Ortiz, Patrick W. Owens, Jason M. Palmer, Lior Paz, Gary M. Pess, Daniel Polatsch, J. Frank Raia, Marc J. Richard, Marco Rizzo, Rozental, David Ruchelsman, Oleg M. Semenkin, Javier Francisco Sierra Aguilar, Todd Siff, Samir Sodha, Catherine Spath, Sander Spruijt, Thomas G. Stackhouse, Carrie Swigart, Robert M. Szabo, John Taras, Jason D. Tavakolian, Andrew L. Terrono, Thomas F. Varecka, Abhijeet L. Wahegaonkar, Christopher J. Walsh, Frank L. Walter, Lawrence Weiss, Brian P.D Wills, Chris Wilson, Christopher J. Wilson, Jennifer Wolf Moriatis, Megan M. Wood, Colby Young.
Background: As part of the process of developing a decision aid for carpal tunnel syndrome (CTS) according to the Ottawa Decision Support Framework, we were interested in the level of ‘decisional conflict’ of hand surgeons and patients with CTS. This study addresses the null hypothesis that there is no difference between surgeon and patient decisional conflict with respect to test and treatment options for CTS. Secondary analyses assess the impact of patient and physician demographics and the strength of the patient-physician relationship on decisional conflict.
Methods: One-hundred-twenty-three observers of the Science of Variation Group (SOVG) and 84 patients with carpal tunnel syndrome completed a survey regarding the Decisional Conflict Scale. Patients also filled out the Pain Self-efficacy Questionnaire (PSEQ) and the Patient Doctor Relationship Questionnaire (PDRQ-9).
Results: On average, patients had significantly greater decision conflict and scored higher on most subscales of the decisional conflict scale than hand surgeons.Factors associated with greater decision conflict were specific hand surgeon, less self-efficacy (confidence that one can achieve one’s goals in spite of pain), and higher PDRQ (relationship between patient and doctor). Surgeons from Europe have--on average--significantly more decision conflict than surgeons in the United States of America.
Conclusions: Patients with CTS have more decision conflict than hand surgeons. Decision aids might help narrow this gap in decisional conflict.
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