Hospital for Special Surgery (HSS) investigators have developed reportedly the first-ever patient questionnaire to measure the physical and emotional impact of brachial plexus injury (BPI), and to assess patients’ expectations and treatment outcomes.
“A brachial plexus injury has a profound impact on quality of life,” says Carol A. Mancuso, MD, a senior scientist at HSS and lead investigator. “Patients are usually young adults who sustained trauma, such as from a motor vehicle accident or sports injury.”
“The sudden nature of the injury can lead to a realm of psychological challenges, such as emotional distress, loss of independence, and depression, that can overwhelm patients and potentially hamper recovery,” says Mancuso, who specializes in developing surveys and questionnaires at HSS, noting she developed the questionnaire to thoroughly understand the injury’s impact on patients.
“Capturing these psychological elements is necessary to thoroughly understand disability and recovery from this complex condition,” per a media release from Hospital for Special Surgery.
Mancuso developed the questionnaire, published in the Journal of Bone & Joint Surgery, based on patient input, with preoperative and postoperative versions. Patients with BPI who were undergoing or had already undergone surgical reconstruction were enrolled during routine office visits at HSS.
The study had three phases. Phase 1 included interviews with patients using open-ended questions addressing the impact of BPI and improvement expected before surgery (preoperative patients) or received (postoperative patients). Phase 2 involved assembling a draft questionnaire and administering it twice to establish test-retest reliability. Phase 3 involved selecting final items, developing a scoring system, and assessing validity. Patient scores using the questionnaire were assessed in comparison with scores of the Disabilities of the Arm, Shoulder and Hand (DASH) and RAND-36 measures.
The HSS preoperative and postoperative surveys both include questions rating the severity of BPI symptoms; assess difficulty with activities of daily living, such as getting dressed; address psychological issues, such as depression; and ask how the injury has affected school or work. The preoperative questionnaire also assesses how much improvement patients expect from treatment, while the postoperative version asks how much improvement patients believe they received from surgery or another treatment, the release explains.
The questionnaire has the potential to improve patient care, Mancuso suggests. “First, it provides a template from which patients can discuss the spectrum of physical and emotional effects of BPI with their surgical team. This, in turn, offers providers the opportunity to comprehensively address patients’ needs directly or through a referral,” she states. “Second, the questionnaire fosters discussion of realistic outcome expectations, which are necessary to maintain motivation and ensure long-term participation in rehabilitation. This also enables patients to make appropriate plans for school or work activities.”
In addition, the survey could play a role in assessing outcomes of highly specialized nerve reconstruction surgery to repair brachial plexus injury, she adds. “The questionnaire provides a valid and standardized method for clinicians and researchers to document and compare patient-reported outcomes from specific or novel surgical interventions.”
[Source(s): Hospital for Special Surgery, Newswise]