Client satisfaction of hand therapy intervention: An evaluation of the effectiveness of therapy for clients recovered from complex regional pain syndrome

Patient satisfaction with virtual evaluation, diagnosis, and treatment of CRPS

Background

The COVID-19 pandemic has led to an increased reliance on virtual care in the rehabilitation setting for patients with conditions such as complex regional pain syndrome (CRPS).

Aims

The aim of this study was to perform a quality improvement initiative to assess patient satisfaction and ensure that outcomes following virtual assessment, diagnosis, and treatment of CRPS with prednisone are safe and effective.

Methods

An online survey was distributed to 18 patients with CRPS who had been seen virtually between March and December 2020 through a rehabilitation clinic and treated with oral prednisone. Thirteen participants completed the survey, which was designed de novo by our team to evaluate participant perceptions and satisfaction regarding the virtual care experience. Also included in the survey was a CRPS-specific validated patient-report questionnaire (Hamilton Inventory for CRPS: PR-HI-CRPS), which allowed participants to describe their specific symptoms and associated functional and psychosocial impacts, both previously (pretreatment baseline) and at the time of survey (posttreatment).

Results

CRPS symptoms and related impacts were scored as significantly improved from baseline following treatment with prednisone. Likert scale results from survey responses related to patients' experiences and satisfaction with the virtual care process were analyzed; the majority of patients reported satisfaction with a virtual appointment for evaluation of CRPS, as well as with subsequent treatment decisions based on virtual assessment.

Conclusions

This quality improvement study suggests that virtual care is a potential option for a patient-accepted approach to overcoming challenges with in-person care imposed by the COVID-19 pandemic and could help inform future considerations in addressing geographic and patient-specific disparities in access to specialist care for CRPS.

Patient satisfaction of hand therapy services

STUDY DESIGN

This study utilized a cross-sectional cohort design that used survey techniques for data collection.

INTRODUCTION

Patient satisfaction is becoming increasingly important in the health care field; however, it is typically evaluated with the use a single question. Patient satisfaction encompasses numerous aspects that should be considered on evaluation.

PURPOSE OF THE STUDY

The purpose of this study was to determine if the Patient Satisfaction Questionnaire Short Form (PSQ-18) is an appropriate outcome measure to determine patient satisfaction for people receiving hand therapy services and to determine mean satisfaction scores of participants.

METHODS

Participants (n = 123) who received hand therapy services from an outpatient hand therapy center and a health care institute were obtained via a convenience sample. The PSQ-18, adapted for hand therapy, was used to assess patient satisfaction.

RESULTS

The mean satisfaction score was 1.81 (SD = 1.26). The following patient satisfaction subscales were also evaluated: general satisfaction, communication, technical quality, interpersonal manner, time spent with therapists, accessibility and convenience, and financial aspects.

DISCUSSION

Eighty percent of participants were satisfied with the therapy services they received. Patient satisfaction is complex, involving a multitude of components and thus must be evaluated in a manner that considers its multidimensional aspects.

CONCLUSION

The findings of this study suggest that the PSQ-18 adapted for hand therapy is an appropriate outcome measure to determine patient satisfaction for people receiving hand therapy as it evaluates multiple subscales of the phenomena.

Hand therapists report perceived differences in patient referrals from hand surgeons vs other referral sources: A survey study

STUDY DESIGN

Descriptive research.

INTRODUCTION/PURPOSE

Survey research was performed to determine if there is a perceived difference in outcomes of patients referred to hand therapy from specialized hand surgeons vs nonspecialized physicians.

METHODS

The survey was administered to members of the American Society of Hand Therapists through an electronic mailing.

RESULTS

A total of 744 American Society of Hand Therapists members responded to the survey. Therapists reported a difference in recovery time between patients referred by a hand surgeon vs a nonspecialized physician. Sixty-seven percent (n = 490) of the respondents answered yes and 12% (n = 84) answered no.

DISCUSSION

It is important to consider that not all hand patients receive treatment from a specialized hand surgeon and that a specialized hand therapist may be an integral team member for patients who have not received specialized care from their referral source.

CONCLUSION

Most hand therapists who responded to this survey believe that there is a difference in outcomes of patients referred to hand therapy from specialized hand surgeons vs nonspecialized physicians.

LEVEL OF EVIDENCE

Level 3.