ePoster #1215 - ISHA Annual Scientific Meeting 2016

Patient Comprehension Of Hip Arthroscopy: An Investigation Of Health Literacy

Gregory R Waryasz, MD, Providence, RI UNITED STATES
Joseph A Gil, MD, Providence, RI UNITED STATES
Jonathan Richard Schiller, MD, Providence, RI UNITED STATES

Rhode Island Hospital/Brown University Warren Alpert Medical School Department of Orthopaedic Surgery, Providence, RI, UNITED STATES

FDA Status Not Applicable

Summary: Although we made significant pre-operative oral and written efforts to help patients achieve an elementary level of health literacy regarding their forthcoming hip arthroscopy, we found many continued to lack a baseline level of acceptable comprehension regarding numerous pertinent components of perioperative care and outcome.

Abstract:
Introduction Health literacy is a set of individual abilities that allow patients to assimilate information, which helps them comprehend their medical condition and any interventions available for the management of their condition. The purpose of this investigation was to determine the percentage of patients who— after undergoing the process of informed consent and being provided a postoperative instruction document—were then able to reach an elementary understanding of the pathology and requisite care associated with hip arthroscopy. Methods: Any patient who elected to have a hip arthroscopy was prospectively recruited to participate in the study. Patients who did not identify as fluent in English were excluded. All patients were told they would be asked to complete a questionnaire about their surgery and post-operative instructions. Enrolled patients were informed about the care and potential postoperative complications associated with their particular procedure during the informed consent process at the preoperative visit. All answers to each question of the questionnaire they would later receive were verbally given to each patient during this visit, and they were also given a post-operative instruction sheet that contained written answers to all these questions as well. At the first post-operative visit and prior to seeing the physician, all patients were then asked to complete a multiple choice questionnaire. The questionnaire was subsequently reviewed by the clinician with each patient at the end of this postoperative visit to clarify any misunderstandings about post-operative care and expectations. Results: Seventeen patients (4 males, 13 females) have been prospectively enrolled. 100% reported they had read the postoperative instructions document prior to or after surgery, and 76 % (n=13) reported their preferred form of media for the postoperative instructions was a written handout versus a video (n=0) or on-line instructional alternative (n=4). Seven patients (41%) were 18 to 30 years old and 10 (59%) were between 31 to 65 years old. The average number of correct answers was 5.8 ± 2.2 (95% CI, 4.7 to 6.8). Only 41% (n=7), 6% (n=1) and 29% (n=5) of patients, responded correctly to the questions ‘When can I resume driving a car?’, ‘When do I expect to have fully recovered from the hip arthroscopy?’, and “What are signs of surgical site infection? Chills and night sweats?" respectively. Fischer exact test analysis revealed no significant difference between patients with a high school versus higher level of education (p=0.36), males versus females (p=0.097), or age 18 to 30 versus over 30 years (p=0.18). Conclusion: Although we made significant pre-operative oral and written efforts to help patients achieve an elementary level of health literacy regarding their forthcoming hip arthroscopy, we found many continued to lack a baseline level of acceptable comprehension regarding numerous pertinent components of perioperative care and outcome. Because these data are concerning, we plan to next implement and test an alternative video aide to assess whether alternative forms of communication will increase comprehension and retention of hip arthroscopy patients.