2.50
Hdl Handle:
http://hdl.handle.net/10755/243389
Category:
Abstract
Type:
Presentation
Title:
Are Caregivers Able to Estimate How Patients Judge Their Scars?
Author(s):
Eskes, Anne M.; Br�lmann, Fleur E.; Ubbink, Dirk T.; Vermeulen, Hester
Author Details:
Eskes, Anne M., MSc, RN, a.m.eskes@amc.nl; Br�lmann, Fleur E., MD; Ubbink, Dirk T., MD, PhD; Vermeulen, Hester, RN, PhD;
Abstract:
Background

Nowadays, incorporating patient values and opinions in the decision-making process has become a standard in delivering high-quality care. However, caregivers tend to use their own opinion regarding the pros and cons of a treatment as a proxy for the patient’s opinion. We investigated the agreement in judgment between caregivers and patients regarding donor site scars (DSS) after split-skin grafting. Furthermore, we investigated which scar characteristics best predict the patients’ overall satisfaction.

Methods

Patients with a DSS after split-skin grafting for any indication were included. Twelve weeks after complete wound healing, patients and their caregivers rated the DSS in vivo during outpatient visits using the validated Patient and Observer Scar Assessment Scale (POSAS), comprising seven wound characteristics. The caregivers’ assessment was not revealed before the patients completed their scores. Inter-observer agreement (IOA) was expressed as intra-class correlation coefficients (ICC). POSAS items that best predicted the patients’ overall satisfaction were calculated using multivariable regression analysis.

Results

A total of 106 patients with a DSS were included. Most of the DSSs were located on the thigh (n=102; 96%). Ten caregivers from four different medical centers judged the DSSs. IOA regarding the overall opinion of the DSS was ‘moderate’ at best (ICC 0.44; 95% confidence interval 0.27 to 0.58). IOAs regarding the other POSAS-items were ‘poor’. Itching and color best predicted the patients’ overall satisfaction. For caregivers, vascularity, pigmentation, relief, and pliability were most predictive for their overall judgment. 

Conclusion

Patients and caregivers show poor agreement in their appreciation of the donor site scar using the POSAS. This hampers shared decision-making, in which the patient's opinion is incorporated in treatment choice. Caregivers should realize their view may differ from their patients’ view, because treatment decisions should match the needs and preferences of the patient.

Keywords:
Patient satisfaction; Observer variation; Wound care
Repository Posting Date:
12-Sep-2012
Date of Publication:
12-Sep-2012
Conference Date:
2012
Conference Name:
23rd International Nursing Research Congress
Conference Host:
Sigma Theta Tau International, the Honor Society of Nursing
Conference Location:
Brisbane, Australia

Full metadata record

DC FieldValue Language
dc.type.categoryAbstracten_GB
dc.typePresentationen_GB
dc.titleAre Caregivers Able to Estimate How Patients Judge Their Scars?en_GB
dc.contributor.authorEskes, Anne M.en_GB
dc.contributor.authorBr�lmann, Fleur E.en_GB
dc.contributor.authorUbbink, Dirk T.en_GB
dc.contributor.authorVermeulen, Hesteren_GB
dc.author.detailsEskes, Anne M., MSc, RN, a.m.eskes@amc.nl; Br�lmann, Fleur E., MD; Ubbink, Dirk T., MD, PhD; Vermeulen, Hester, RN, PhD;en_GB
dc.identifier.urihttp://hdl.handle.net/10755/243389-
dc.description.abstract<b>Background</b><p>Nowadays, incorporating patient values and opinions in the decision-making process has become a standard in delivering high-quality care. However, caregivers tend to use their own opinion&nbsp;regarding the pros and cons of a treatment as a proxy for the patient&rsquo;s opinion. We investigated the agreement in judgment between caregivers and patients regarding donor site scars (DSS) after split-skin grafting. Furthermore, we investigated which scar characteristics best predict the patients&rsquo; overall satisfaction. <p><b>Methods</b><p>Patients with a DSS after split-skin grafting for any indication were included. Twelve weeks after complete wound healing, patients and their caregivers rated the DSS in vivo during outpatient visits using the validated Patient and Observer Scar Assessment Scale (POSAS), comprising seven wound characteristics. The caregivers&rsquo; assessment was not revealed before the patients completed their scores. Inter-observer agreement (IOA) was expressed as intra-class correlation coefficients (ICC). POSAS items that best predicted the patients&rsquo; overall satisfaction were calculated using multivariable regression analysis. <p><b>Results </b><p>A&nbsp;total of&nbsp;106 patients with a DSS were included. Most of the DSSs were located on the thigh (n=102; 96%). Ten caregivers from four different medical centers judged the DSSs. IOA regarding the overall opinion of the DSS was &lsquo;moderate&rsquo; at best (ICC 0.44; 95% confidence interval 0.27 to 0.58).&nbsp;IOAs regarding the other POSAS-items were &lsquo;poor&rsquo;. Itching and color best predicted the patients&rsquo; overall satisfaction. For caregivers, vascularity, pigmentation, relief, and pliability were most predictive for their overall judgment.&nbsp; <p><b>Conclusion</b><p>Patients and caregivers show poor agreement in their appreciation of the donor site scar using the POSAS. This hampers shared decision-making, in which the patient's opinion&nbsp;is incorporated in treatment choice. Caregivers should realize&nbsp;their view&nbsp;may differ from their patients&rsquo; view, because treatment decisions should match the needs and preferences of the patient.en_GB
dc.subjectPatient satisfactionen_GB
dc.subjectObserver variationen_GB
dc.subjectWound careen_GB
dc.date.available2012-09-12T09:21:34Z-
dc.date.issued2012-09-12-
dc.date.accessioned2012-09-12T09:21:34Z-
dc.conference.date2012en_GB
dc.conference.name23rd International Nursing Research Congressen_GB
dc.conference.hostSigma Theta Tau International, the Honor Society of Nursingen_GB
dc.conference.locationBrisbane, Australiaen_GB
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