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Patient selected goals and satisfaction after bilateral subthalamic nucleus deep brain stimulation in Parkinson's disease.
- Source :
-
Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia [J Clin Neurosci] 2020 Jun; Vol. 76, pp. 148-153. Date of Electronic Publication: 2020 Apr 17. - Publication Year :
- 2020
-
Abstract
- Assessing patient goals is crucial in understanding patient centered outcomes and satisfaction. However, patient goals may change throughout treatment. Our objective is to identify the changes in patient-selected goals of Parkinson's disease (PD) patients undergoing bilateral subthalamic nucleus deep brain stimulation (STN-DBS) and examine the relationship among patient-selected goal achievement, standard DBS outcome measures, and overall patient satisfaction. Seventy-five patients undergoing bilateral STN-DBS listed three patient-selected goals before surgery. After six months, patients were asked to restate the three goals and to rate the degree of goal achievement and the overall satisfaction of surgery. The three most frequently selected goals were "dyskinesia", "gait disorder", and "medication off duration". After six months, 80.0% of patients could not accurately recall their pre-DBS goals. "Dyskinesia" was the most consistently selected goal, more patients selected "tremor" and "less medication" at post-DBS compared to pre-DBS, and less patients selected "gait disorder" at post-DBS compared to pre-DBS. 74.7% of patients reported overall satisfaction by stating they were "very much" or "much better after surgery". Patient satisfaction significantly correlated with goal achievement (r = 0.640; p < 0.001). Interestingly, change in UPDRS motor scores did not correlate with patient satisfaction (r = 0.100; p = 0.395). Although recalled goals do not accurately represent the pre-surgical goals, the achievement score for recalled goals significantly correlated with patient satisfaction. Patient goals change due to many reasons. Therefore, follow-up patient counseling to discuss goals and outcomes is important in improving patient satisfaction after STN-DBS.<br /> (Copyright © 2020 Elsevier Ltd. All rights reserved.)
- Subjects :
- Adult
Aged
Dyskinesias prevention & control
Dyskinesias therapy
Female
Gait Disorders, Neurologic prevention & control
Gait Disorders, Neurologic therapy
Humans
Male
Middle Aged
Parkinson Disease psychology
Parkinson Disease surgery
Treatment Outcome
Tremor prevention & control
Tremor therapy
Deep Brain Stimulation psychology
Goals
Parkinson Disease therapy
Patient Satisfaction
Subthalamic Nucleus surgery
Subjects
Details
- Language :
- English
- ISSN :
- 1532-2653
- Volume :
- 76
- Database :
- MEDLINE
- Journal :
- Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia
- Publication Type :
- Academic Journal
- Accession number :
- 32312629
- Full Text :
- https://doi.org/10.1016/j.jocn.2020.04.005