PATIENTS PREFERENCES AND THEIR RELATIONSHIP WITH SATISFACTION FOLLOWING CARPAL-TUNNEL RELEASE

Patients' preferences for specific health outcomes in carpal tunnel sy ndrome (CTS) and their association with demographic factors and satisf action with the results of surgery after 6 months were evaluated. Two hundred fifty subjects with CTS and enrolled in a prospective communit y-based cohort study in Maine completed a preference questionnaire bef ore surgery. Patients were asked to specify the single most important reason they decided to undergo surgery and to rate the importance of i mprovement in 10 areas, including lessening of specific symptoms and i mprovement in specific functional states related to CTS. The single mo st important reason for CTS patients to have surgery was relief of nig ht pain (37%), followed by relief of numbness (21%) and relief of dayt ime pain (13%). When patients were asked to rate the importance of obt aining relief from specific symptoms and improvement in specific funct ional states, relief of numbness received the highest rating, with 94% of the patients answering that it was extremely or very important. Wo rkers' compensation recipients, patients with less than a college leve l of education, and patients with more severe symptoms and Functional impairment at baseline assigned higher importance to symptom relief an d functional improvement. Controlling for other predictors, higher pre ference for improved strength was associated with lower satisfaction w ith the results of the surgery at 6 months. Most CTS patients undergoi ng surgery have realistic preferences for health outcomes that are inf luenced by demographic and clinical characteristics; however, physicia ns should pay attention to unrealistic preferences that might influenc e patients' satisfaction with surgical results.