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post-operatively

By Vernon Nelson,2014-12-25 01:45
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post-operatively

     Independent Interview and Assessment

     POST-OPERATIVE FOLLOW-UP FORM:

2/3mt / 6mt / 12mt / 3yr / 5yr / 10yr (circle as appropriate)

Extra Assessment: ......... / ........ / ..…….. (add date if applicable)

     ACTIVE Patient Trial No:

Patient‟s Initials: …………Patient‟s DoB: ......... / ........ / ..……..

    Name of Independent Assessor: ....................................................

Hospital: ..................................................

Date of Assessment: ......... / ........ / ..……..

Important information for the Independent Assessor

    After doing Section 1 and while you are writing a summary of the semi-structured interview please ask the patient to complete the questionnaire pack as rehearsed in your training session, see also, ”Guidance notes for Independent Assessors” on the ACTIVE

    website. This independent interview and assessment is designed to enable you to document trial patients‟ post-operative knee condition and knee-related quality of life. This assessment should be sufficiently comprehensive so that you can judge whether or not the patient has improved in comparison to his/her pre-operative state.

    Try to choose a quiet room where you and the patient can sit comfortably without being interrupted. Have the following equipment ready:

    Goniometer

    Stopwatch

    Tape measure/metre rule

    Tubi-grip (so patient can cover knees to maximise „blinding‟)

    You may also need access to steps/stairs, a skipping rope or the physiotherapy gym (if available) for testing the patient.

To maximise blinding, please follow this advice:

    Avoid carrying out the assessment in areas of the hospital where the patient‟s treatment might be discussed, e.g. the orthopaedic surgeon‟s outpatient clinic

    Ask the patient not to disclose what type of surgery they had (remind them of this several times).

    Avoid seeing the patient‟s scar - ask the patient in advance to wear trousers and for

    them to bring a pair of shorts ready to change into. For the physical assessment have some tubi-grip ready and ask the patient to put shorts on and cover both knees with the tubi-grip. Ensure you are not able to see the patient‟s knees when he/she is changing.

     INDEPENDENT INTERVIEW & ASSESSMENT Version 4 Oct 2004

    SECTION 1: SEMI-STRUCTURED INTERVIEW

    The semi-structured interview should address the same general questions for each patient whilst allowing you to use your own follow-up questions to gain further insights or explore unexpected responses. Immediately after the interview please use pages 3-4 to write a summary of the interview, documenting the patient‟s main problems, impact of main problems, current exercise,

    sports and activities, review of goals set, post-operative changes and impact of post-operative changes.

Starting the interview

    Begin with a bit of preamble, for example:

    “Hello my name is ________ we have spoken recently on the phone. It’s nice to see you again.

    As part of the ACTIVE research study I’d like to ask you some questions and assess you. It will probably take about 45-60 minutes, is that OK? Thank you.”

General questions post-operatively: impact on quality of life

Q1 Have you experienced any problems recently because of your knee?

Q2 Could you describe to me the main problems you are having?

Q3 How are these problems affecting your daily life and quality of life? (if necessary probe

    further to find out about the impact on general activities of daily living, work, leisure, life aspirations, social life, mental health)

    Q4 Apart from your knee, have you experienced any other health problems recently?

Q5 Has your knee condition changed since shortly before your treatment? (state how long ago

    this was)

Q6 Can you describe to me the main changes? (if changed)

    Q7 How would you say you feel now compared to how you felt just before your knee operation? (probe to find out whether patient’s quality of life has improved/deteriorated, whether pre-op

    goals are being achieved or have changed, find out current level of activity note any new goals,

    taking into account whether patient has adapted his/her goals over the course of time).

    Version 4 Oct 2004 2

     INDEPENDENT INTERVIEW & ASSESSMENT Version 4 Oct 2004

    ASSESSOR’S NOTES write a description below of the patient, summarising responses to the general questions and including any other relevant insights. It‟s helpful to include a few quotes from the patient. Remember your pre-operative notes provide a baseline from which you decide whether the patient has improved / deteriorated on subsequent assessments. Referring back to these notes will enable you to complete the “Cessation of Benefit form”.

Main problems/impact of main problems:

Current exercise and activity:

    Version 4 Oct 2004 3

     INDEPENDENT INTERVIEW & ASSESSMENT Version 4 Oct 2004

    Review of goals set: (refer to goals set pre-operatively - are they being achieved? Have they changed?)