Carpal tunnel syndrome patients prefer to share decision-making with their physicians

August 8, 2011 in Other

Patients receiving treatment for carpal tunnel syndrome (CTS) prefer to play a more collaborative role when it comes to making decisions about their medical or surgical care, according to the findings of an August 3rd issue of the Journal of Bone and Joint Surgery (JBJS).

"While other studies have shown patients with potentially life-threatening conditions such as cancer tend to prefer a more passive role when it comes to , this study demonstrates that in carpal , which raises issues of quality of life rather than those related to a life-threatening condition, the majority of patients preferred to share decision making with their physicians," said study author and Hyun Sik Gong, MD, PhD.

Study Details and Findings

In this study, 78 patients who underwent carpal tunnel release for CTS were requested to indicate their preferred level of involvement preoperatively and to assess their actual levels of involvement postoperatively, using a scale containing five levels ranging from fully active to fully passive.

According to the study results, patients were more likely to assume an active role in the decision-making process if they:

  • had undergone one or more previous surgical procedures;
  • had a ; or
  • had additional to help defray treatment costs.

"It is likely that the experience of a previous operation clarified uncertainties or conflicts regarding surgery, and that the presence of a caregiver allowed patients greater freedom during decision-making," Dr. Gong noted.

Dr. Gong said that previous studies have described three primary approaches to medical decision-making:

  • The paternalistic model, in which physicians make decisions on the basis of what they believe to be in the patients' best interest, and minimal information is conveyed from the physician to the patient;
  • The consumerist model, in which doctors provide the information that patients require to make their own decisions;
  • And the shared decision-making, or collaborative, model, in which the physician and patient make the decision together and exchange medical and other information related to the patient's health. Dr. Gong added that previous studies have shown that this type of decision making leads to greater patient satisfaction in medical or surgical treatment.

"This study shows the majority of patients wanted to share decision-making with their physicians, and patients should feel comfortable asking questions and expressing their preferences regarding care. Patient-centered care emphasizes the incorporation of individual styles of decision making to provide a more patient-centered consultation," Dr. Gong added.

In a 'patient-centered' approach, patients' cultural traditions, personal preferences and values, family situations, social circumstances and lifestyles are considered in the decision-making process.

Patient-centered care presumes active involvement of patients and their families in health care and in decision-making about individual options for treatment, and is identified as one of important factors constituting high-quality health care, Dr. Gong continued.

Although the current study did not determine which type of role, if any, resulted in better surgical outcomes, Dr. Gong said a subsequent study is being conducted evaluating surgical outcomes and patients' preferred levels of involvement.

"Symptoms and signs of CTS are widely recognized, but the natural history is still unclear," Dr. Gong said. "There are several treatment options available for CTS, but a discussion between a patient and his or her physician, based upon what activities patients need to pursue will help them achieve their mutual goal of getting back to activities, together. Therefore, the need for patient involvement in CTS is different from the treatment for other orthopaedic conditions such as fractures or bone tumors, where the decision can be more straightforward or depend on the physician's decision."

Patients considering treatment of carpal tunnel syndrome or any orthopaedic injury should feel comfortable with their provider's level of involvement and not be afraid to ask questions or speak up, Dr. Gong noted.

Provided by American Academy of Orthopaedic Surgeons search and more info website

not rated yet  

Rank not rated yet
Relevant PhysicsForums posts

More news stories

Flesh-eating disease victim gets prosthetic hands

(AP)—A woman who lost both hands, her left leg and right foot after contracting a flesh-eating disease has been fitted with prosthetic hands.

Other created 14 hours ago | popularity not rated yet | comments 0

Illinois Senate approves medical marijuana bill

(AP)—Medical marijuana use in Illinois is now in Gov. Pat Quinn's hands after the state Senate approved legislation.

Other created May 17, 2013 | popularity 5 / 5 (1) | comments 0

Nigerian court jails two over killer teething drug

A Nigerian court on Friday sentenced two officials from a pharmaceutical company to seven years in prison over the sale of an adulterated teething drug which killed 84 babies in 2008.

Other created May 17, 2013 | popularity not rated yet | comments 0

Many patients would switch doc to cut health care costs

(HealthDay)—Many Americans feel that keeping out-of-pocket health care costs is more important than staying with the same primary care physician.

Other created May 17, 2013 | popularity not rated yet | comments 0

Cultural attitudes impede organ donations in China

(AP)—China is phasing out its reliance on executed prisoners for donated organs, but an architect of the country's transplant system said Friday that ingrained cultural attitudes are impeding the rise of ...

Other created May 17, 2013 | popularity not rated yet | comments 0


New research identifies risks, interventions for children's GI health

An increasing number of U.S. children are experiencing gastrointestinal issues that require interventions to resolve, according to research presented at Digestive Disease Week (DDW).

US psychiatry gets makeover in new manual

The latest makeover to a massive psychiatric tome honored by some, reviled by others and even called the "Bible" of mental disorders is being released Saturday with a host of new changes.

New case of SARS-like virus in Saudi: ministry

A new case of the deadly coronavirus has been detected in Saudi Arabia where 15 people have already died after contracting it, the health ministry announced on Saturday on its Internet website.

AIDS science at 30: 'Cure' now part of lexicon

Big names in medicine are set to give an upbeat assessment of the war on AIDS on Tuesday, 30 years after French researchers identified the virus that causes the disease.

For combat veterans suffering from post-traumatic stress disorder, 'fear circuitry' in the brain never rests

Chronic trauma can inflict lasting damage to brain regions associated with fear and anxiety. Previous imaging studies of people with post-traumatic stress disorder, or PTSD, have shown that these brain regions can over-or ...

New colonoscope provides ground-breaking view of colon

A ground-breaking advance in colonoscopy technology signals the future of colorectal care, according to research presented today at Digestive Disease Week(DDW). Additional research focuses on optimizing the minimal withdrawal ...