Surgical Decision-Making Process, Providing Information on the Decision-Making Process, the Impact of Physical and Mental Health for Spinal Surgery Patients

Background: As the population ages, there are more and more patients suffering from the spinal lesions, and the severe cases will need to consider having a surgery. But the physical and psychological threats with surgery; always make the patients so hesitant that delay the timing of treatment. Objectives: First year we investigate the patient’s surgical decision-making processes and assess the physical and psychological health preoperatively, including anxiety, depression, pain and physical disability. In second year, is to determine the preoperative information providing’s effects upon reducing preoperative anxiety, postoperative depression, pain, and enhancing decision-making satisfaction. In third year, to follow the postoperative physical and emotional function and the factors that affect the recovery of postoperative physical and emotional function will be discussed. Methods: This study is a three-year longitude research design. First year we do depth interviews and descriptive survey research; second year is an experiment with pretest -posttest experimental group and control group; and keep following the survey research in the third year. The subjects are recruited from one regional teaching hospital and one medical center in Taipei. The first year we scheduled to interview 15 patients and have 64 questionnaire surveys; the second year, 78 patients will be recruited and each of experimental and control group will have 39 patients; cases we have in the second year will be followed-up in the third year. Instrument: Including physical function, pain scale, anxiety scale, depression scale, and semi-structured interview guide. Data collection procedure: The first year we ask patients to finish the questionnaire or have a recording interview after they complete the informed consent form. In the second year, the experimental group will receive surgery related information preoperatively. Then compare patients’ anxiety, depression, pain level and physical function with the control group. Experimental intervention for the experimental group is receiving surgery-related information and advisory preoperatively, the proposed manual and CD-ROM base on the relevant literature, the researchers clinical experience, and expert opinion to develop. In the third year, we follow-up patients’ physical function, depression, and pain level six weeks, three months, six months and one year after the surgery they receive. Data analysis consists descriptive statistics, t-test, paired t-test, one-way ANOVA, Pearson correlation, and multiple regressions. Interview recording is used to collect qualitative data. We will use qualitative data analysis (Miles & Huberman, 2002) to analysis and conclude the factors affect patient’s decision-making.