A survey on the short to medium-term satisfaction of neurological patients treated by functional surgery for the correction of limb deformities

Abstract

Objectives

Functional surgery (FS) is often used to correct congenital or acquired deformities in neurological patients. Along with functional results, short- and medium-term patient satisfaction should always be considered a key goal of surgery and rehabilitation. The aim of this study is to assess the short to medium-term satisfaction of patients who underwent FS and its correlation with perceived improvements.

Methods

Invitation to an anonymous online survey was sent via e-mail to all neurological adult patients or caregivers of children who underwent lower or upper limb FS over the 2018–2020 period. The survey investigated patients’ satisfaction with the surgery and the variation in pain, ADLs, level of independence, body image, self-esteem, social interaction skills, participation in social events, leisure activities and sports, and use of orthoses or walking aids. Descriptive data analysis was performed. Correlations were assessed using Kendall’s tau.

Results

122 out of 324 adults and 53 out of 163 children’s caregivers filled out the questionnaire, with a response rate approaching 40%. Eighty-three percent of adult respondents and 87% of the children’s caregivers were satisfied or very satisfied in the short and medium terms and reported their expectations had been met. Satisfaction was significantly correlated (p < 0.01) with improvements in functional abilities, social participation, self-esteem, and pain reduction. Half of the adults and 40% of children stopped using their orthoses or replaced them with lighter ones. Dissatisfaction and worsened conditions were reported by <10% of the respondents.

Conclusion

According to patients and caregivers, FS was satisfactory in the short and medium terms, following improvements in all the ICF domains for most patients.

PLAIN LANGUAGE SUMMARY

In this study, we studied the satisfaction of patients with neurological diseases and their caregivers about two years after having undergone surgery to correct lower and/or upper limb deformities. We mailed a specifically designed survey to adult patients and caregivers of children who had surgery at our hospital. The questionnaire asked about how satisfied they were with the surgery and if they felt any improvements in different domains: meeting previous expectations, pain level, daily activities, being autonomous, body image, self-esteem, social interaction, participation in social events, leisure activities, and the use of orthoses or walking aids. About 40% of the patients we contacted filled out the questionnaire. Most of them said they were happy with the results obtained and felt their pre-surgical expectations had been met. Satisfaction was associated with improvements in functional abilities, social participation, self-esteem, and lessening of pain. Many patients also stopped using orthoses or switched to lighter ones. Only a few people said they were not happy or felt worse after the surgery. These findings highlight the positive impact of surgery on patient well-being and motor abilities.

Keywords:

• Stroke
• cerebral palsy
• surgery
• patient satisfaction
• surveys and questionnaires

Transparency

Declaration of funding

This research was entirely funded by the Sol et Salus Hospital, Torre Pedrera di Rimini, Italy.

Declaration of financial/other relationships

The authors certify that there is no conflict of interest with any financial organization regarding the material discussed in the manuscript. Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Author contributions

Authors PZ, DM, and AM have given substantial contributions to the conception or the design of the manuscript, authors MG, GB, CR, FM, PP to data acquisition, authors AM, DM, MCB, CD, LP, MG, GB, CR, PP to data analysis and interpretation. All authors have participated in drafting the manuscript, authors PZ, DM, AM, MCV, and JB revised it critically. All authors read and approved the final version of the manuscript. All authors contributed equally to the manuscript and read and approved the final version of the manuscript.

Data availability statement 

The data associated with the paper are publicly available at the https://doi.org/10.6084/m9.figshare.25522900.v2.